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Hypervitaminosis A

Vitamin A toxicity

 

Hypervitaminosis A is having too much vitamin A in the body.

Causes

 

Vitamin A is a fat-soluble vitamin that is stored in the liver. Many foods contain vitamin A, including:

  • Meat, fish, and poultry
  • Dairy products
  • Some fruits and vegetables

Some dietary supplements also contain Vitamin A.

Too much vitamin A can make you sick. Large doses of vitamin A during pregnancy can cause birth defects.

  • Acute vitamin A poisoning occurs quickly, most often when an adult takes several hundred thousand international units (IUs) of vitamin A.
  • Chronic vitamin A poisoning may occur over time in adults who regularly take more than 25,000 IU a day.
  • Babies and children are more sensitive to vitamin A. They can become sick after taking smaller doses of vitamin A or if they swallow products that contain vitamin A, such as skin cream with retinol in it.

 

Symptoms

 

Symptoms may include:

  • Abnormal softening of the skull bone (in infants and children)
  • Blurred vision
  • Bone pain or swelling
  • Bulging of the soft spot in an infant's skull ( fontanelle )
  • Changes in alertness or consciousness
  • Decreased appetite
  • Dizziness
  • Double vision (in young children)
  • Drowsiness
  • Hair changes, such as hair loss and oily hair
  • Headache
  • Irritability
  • Liver damage
  • Nausea
  • Poor weight gain (in infants and children)
  • Skin changes, such as cracking at corners of the mouth, higher sensitivity to sunlight, oily skin, peeling, itching, and yellow color to the skin
  • Vision changes
  • Vomiting

 

Exams and Tests

 

These tests may be done if a high vitamin A level is suspected:

  • Bone x-rays
  • Blood calcium test
  • Cholesterol test
  • Liver function test
  • Blood test to check vitamin A level

 

Treatment

 

Treatment involves simply stopping supplements (or rarely, foods) that contain vitamin A.

 

Outlook (Prognosis)

 

Most people fully recover.

 

Possible Complications

 

Complications can include:

  • Excessively high calcium level
  • Failure to thrive (in infants)
  • Kidney damage due to high calcium
  • Liver damage

Taking too much vitamin A during pregnancy may cause abnormal development in the growing baby. Talk to your health care provider about eating a proper diet while you are pregnant.

 

When to Contact a Medical Professional

 

Call your provider if you think that you or your child may have taken too much vitamin A, or you have symptoms of excess vitamin A.

 

Prevention

 

How much vitamin A you need depends on your age and gender. Other factors, such as pregnancy and your overall health, are also important. Ask your provider what amount is best for you.

To avoid hypervitaminosis A, avoid taking more than the recommended daily allowance of this vitamin. Recent emphasis on vitamin A and beta carotene as anticancer vitamins may contribute to chronic hypervitaminosis A if people take more than is recommended.

 

 

References

Institute of Medicine, US Panel on Micronutrients. Dietary reference intakes for vitamin A, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. National Academies Press. Washington, DC, 2001. PMID: 25057538 www.ncbi.nlm.nih.gov/pubmed/25057538 .

Mason JB. Vitamins, trace minerals, and other micronutrients. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 218.

Ross AC, Tan L. Vitamin A deficiencies and excess. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 48.

 
  • Vitamin A source - illustration

    Like most vitamins, vitamin A may be obtained in the recommended amount with a well-balanced diet, including some enriched or fortified foods.

    Vitamin A source

    illustration

    • Vitamin A source - illustration

      Like most vitamins, vitamin A may be obtained in the recommended amount with a well-balanced diet, including some enriched or fortified foods.

      Vitamin A source

      illustration

    Tests for Hypervitaminosis A

     

       

      Review Date: 2/3/2016

      Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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