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Are You Consuming Too Much Vitamin A?

Vitamin A is a fat-soluble vitamin required for vision, growth, reproduction,

cell growth and differentiation, and a healthy immune system. It's a common

ingredient in multivitamins. Recent studies, however, suggest that excessive

vitamin A intake is associated with an increased risk of fracture.

A study published in the New England Journal of Medicine followed 2322 men in

Sweden for 30 years. Researchers found that the fracture risk was greatest in

men with the highest blood levels of retinol, one of the most active forms of

vitamin A.

Another study found similar results. The Nurses Health Study looked at 72,337

postmenopausal women over an 18 year period and found that women who consumed

at least 3000 mcg a day as retinol equivalents were 48% more likely to have a

hip fracture compared to women whose daily intake was less than 1250 mcg (4125

IU) per day.

Retinol may interfere with the activity of vitamin D, a vitamin that

facilitates the absorption of calcium.

The Centers for Disease Control and Prevention (CDC), however, reviewed data

from the 5,800 people in the third National Health and Nutrition Examination

Survey (1988-94) to determine whether there was an association between bone

mineral density and blood levels of vitamin A (in the form of retinyl esters).

They didn't find an association.

Retinol is the form of vitamin A found in most multivitamins and in cod liver

oil, liver, fortified foods, and whole milk products. Beta carotene, which is

converted to vitamin A in the body (and another common multivitamin

ingredient), was not associated with an increased risk of fracture. Beta

carotene is found in carrots, tomatoes, cantaloupe, spinach and other fruits

and vegetables.

The recommended dietary allowance (RDA) of vitamin A for men over 18 is 900 mcg

(3000 IU) and for women it's 700 mcg (2,310 IU). This calculation should

include all sources of retinol, including foods such as liver, dietary

supplements such as multivitamins, cod liver oil, and vitamin A supplements,

and fortified foods such as cereal. The upper limit for retinol is 3000 mcg

(10000) IU per day.

Until we know more, it would be wise to check your supplements (especially your

multivitamin), and consult your healthcare provider before taking vitamin A

supplements to avoid possible adverse effects.

Sources

Ballew C, Galuska D, Gillespie C. High serum retinyl esters are not associated

with reduced bone mineral density in the third National Health and Nutrition

Examination Survey, 1988-94. J Bone Miner Res 2001;16:2306-12.

Feskanich D, Singh V, Willett WC, Colditz GA.Vitamin A intake and hip fractures

among postmenopausal women.JAMA 2002 Jan 2;287(1):47-54.

Michaelsson K, Lithell H, Vessby B, Melhus H. Serum retinol levels and the risk

of fracture. New England Journal of Medicine. 2003;348:387-94.

Johansson S, Lind PM, HAKansson H, Oxlund H, rberg J, Melhus H. Subclinical

hypervitaminosis A causes fragile bones in rats. Bone. 2002;31:685-9.

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Posted: 2009209@447.51

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POINTS

- A study published in the New England Journal of Medicine followed 2322 men in

Sweden for 30 years. Researchers found that the fracture risk was greatest in

men with the highest blood levels of retinol, one of the most active forms of

vitamin A.

- Retinol may interfere with the activity of vitamin D, a vitamin that

facilitates the absorption of calcium.

- Retinol is the form of vitamin A found in most multivitamins and in cod liver

oil, liver, fortified foods, and whole milk products. Beta carotene, which is

converted to vitamin A in the body (and another common multivitamin

ingredient), was not associated with an increased risk of fracture. Beta

carotene is found in carrots, tomatoes, cantaloupe, spinach and other fruits

and vegetables.