Treatment of Vitamin A Deficiency

How Is Vitamin A Deficiency Treated?

Treatment approaches for vitamin A deficiency depend on the severity of the condition:

Mild Deficiency

In mild cases, treatment primarily involves increasing the intake of vitamin A-rich foods.

Severe Deficiency

Severe deficiency can cause noticeable symptoms and requires supplementation. The standard treatment includes a daily dose of 60,000 IU of Vitamin A Palmitate in Oil for two days, followed by 4,500 IU once daily. If there are issues like vomiting, malabsorption, or signs of xerophthalmia, the following dosages are recommended:

• Infants under 6 months: 50,000 IU
• Infants 6–12 months: 100,000 IU
• Children over 1 year: 200,000 IU

Adults typically require the same treatment over two days, with a third dose administered at least two weeks later. These same dosages are recommended for children suffering from acute measles.

Children with Severe Measles

Vitamin A deficiency is a risk factor for severe measles. Supplementation helps reduce the duration, severity, and mortality risk associated with the disease.

Infants Born to HIV-Positive Mothers

These infants should receive 50,000 IU of vitamin A within the first 48 hours of life. However, prolonged use of high doses—especially in infants—should be avoided to prevent toxicity.

Pregnant or Breastfeeding Women

Supplementation should not exceed 10,000 IU to avoid potential harm to the fetus or infant. This limit also applies to preventive doses.

Overview of Vitamin A Deficiency

Vitamin A deficiency often results from prolonged dietary insufficiency and is most common in low-income regions such as Africa and Southeast Asia. It can also be caused by malabsorption conditions like celiac disease, cystic fibrosis, or pancreatic insufficiency, given that vitamin A is fat-soluble. Liver disorders that impair storage, as well as severe protein-calorie malnutrition, can also lead to deficiency.

The condition primarily affects young children and pregnant women, and it is a leading cause of preventable blindness. It also increases susceptibility to severe infections and raises mortality risks. According to the WHO, approximately 250 million preschool-aged children are vitamin A deficient, and 250,000 to 500,000 of them lose their vision annually—half of whom die within 12 months. Many pregnant women in low-income areas also suffer from this deficiency, leading to night blindness and higher mortality risks, especially during the third trimester.

It’s important to note that high vitamin A intake during pregnancy can cause birth defects, so women are advised to avoid excess intake while pregnant or trying to conceive.

Symptoms of Vitamin A Deficiency

Vitamin A deficiency may cause fatigue, increased susceptibility to infections, and impaired wound healing. Below are common symptoms:

Dry Eyes and Vision Problems

Ocular issues are a hallmark of vitamin A deficiency. In advanced cases, it may lead to full blindness or corneal damage characterized by Bitot’s spots—foamy, whitish spots on the eyes. Early signs include dry eyes and reduced tear production. A 1995 study in Nepal showed vitamin A supplementation significantly reduced cases of xerophthalmia in children.

Night Blindness and Corneal Damage

Other vision-related issues include poor night vision, keratomalacia (corneal softening), corneal ulcers, and retinal damage resulting in severe visual impairment.

Dry Skin and Skin Conditions

Vitamin A is essential for skin health. Its deficiency can lead to conditions like eczema, causing dryness, itchiness, and inflammation. However, skin issues can have multiple causes and require proper diagnosis.

Delayed Growth in Children

Children with insufficient vitamin A intake may experience stunted growth. A 2004 review suggested that vitamin A, when taken with other supplements, has a more significant effect on child development than when taken alone.

Frequent Respiratory Infections

Recurring throat and chest infections may signal a deficiency. While some studies found that high beta-carotene levels reduce respiratory infection risk, others—such as a 2008 Cochrane review—found no significant benefit unless the individual suffers from severe or chronic malnutrition.

Recommended Daily Intake of Vitamin A

Benefits of Vitamin A

Vitamin A is crucial for immune function, reproduction, and the proper functioning of the heart, lungs, kidneys, and other organs. It supports healthy vision—especially in low-light conditions—through its role in producing retinal pigments. Vitamin A also promotes skin health, fetal development, and lactation.

Sources of Vitamin A

Animal-Based Sources (Preformed Vitamin A)

These are absorbed efficiently and include:

• Beef and chicken liver (consume in moderation, especially during pregnancy)
• Fatty fish like salmon
• Milk and dairy products
• Cheddar cheese
• Egg yolks
• Butter

Plant-Based Sources (Provitamin A Carotenoids)

Found in colorful fruits and vegetables, though absorption varies depending on genetics, diet, and health:

• Orange and red vegetables like carrots, sweet potatoes, and red bell peppers
• Leafy greens such as spinach, kale, parsley, and dandelion greens
• Yellow fruits like mangoes, papayas, apricots, and pumpkin

Vitamin A Supplements

Supplements come in various forms, often providing up to 5,000 IU in multivitamins. However, the FDA's reference values are based on outdated guidelines from 1968. While multivitamins usually meet 100% of daily needs, there's little evidence supporting vitamin A supplementation unless a deficiency is present. Australian health guidelines recommend against routine use of vitamin A supplements, highlighting cost and potential toxicity risks.