Drugs Q & A

What Happens If You Accidentally Took Vitamin A During Pregnancy?

Almost every pregnant person will face a decision about taking medicines before and during pregnancy. Many people need to take medicine to stay healthy during pregnancy.  However, not all medicines are safe to take during pregnancy.

Some medicines may cause birth defects, pregnancy loss, prematurity, infant death, or developmental disabilities. Treating for Two is an initiative that aims to improve the health of people and their babies by identifying the safest treatment options for common conditions before, during, and after pregnancy.

What is Vitamin A?

Vitamin A, along with other vitamins, minerals, and other compounds, is an essential micronutrient. This means that our bodies cannot manufacture it and therefore it has to be included in our diet.

Vitamin A from food is stored in the liver until required by the body and is bound to protein before being transported to where it is needed.

Vitamin A is essential for many physiological processes, including maintaining the integrity and function of all surface tissues (epithelia): for example, the skin, the lining of the respiratory tract, the gut, the bladder, the inner ear and the eye. Vitamin A supports the daily replacement of skin cells and ensures that tissues such as the conjunctiva are able to produce mucous and provide a barrier to infection. Vitamin A is also essential for vision under conditions of poor lighting, for maintaining a healthy immune system, for growth and development and for reproduction. Vitamin A supports many systems in the body. For this reason, vitamin A deficiency is now referred to as vitamin A deficiency disorders (VAD).

One of the main consequences of VAD is an increased risk of severe infection. Infection increases the body’s demand for vitamin A and so the deficiency gets worse. Children can therefore become involved in a vicious cycle of deficiency and infection, which is why vitamin A deficiency is such an important cause of child mortality.

Vitamin A is currently listed on the Nutrition Facts label measured in international units (IU). However, the Institute of Medicine lists the Recommended Dietary Allowances (RDA) of vitamin A in micrograms (mcg) of retinol activity equivalents (RAE) to account for different absorption rates of preformed vitamin A and provitamin A carotenoids. Under the Food and Drug Administration’s (FDA) new food and dietary supplement labeling regulations, as of July 2018 large companies will no longer list vitamin A as IU but as “mcg RAE.”

•        RDA:  The Recommended Dietary Allowance for adults 19 years and older is 900 mcg RAE for men (equivalent to 3,000 IU) and 700 mcg RAE for women (equivalent to 2,333 IU).

•        UL:  The Tolerable Upper Intake Level is the maximum daily intake unlikely to cause harmful effects on health. The UL for vitamin A from retinol is 3,000 micrograms of preformed vitamin A.

Can a pregnant woman take vitamin A?

Yes, vitamin A is an essential pregnancy nutrient for a pregnant woman and her unborn child. Taking vitamin A during pregnancy will support several physiological processes in the body which include helping the body maintain homeostasis, prevention of anemia, supporting metabolism during pregnancy, tissue maintenance, and fetal development, especially of the bones, teeth, skin, and vision

However, due to the teratogenic effects of excessive vitamin A intake, the World Health Organization recommends a maximum dose of up to 10,000 IU daily or 25,000 IU weekly after the first 60 days of gestation.

Women who consume excessive amounts of vitamin A during the early months of pregnancy can cause serious birth defects in their unborn children, a large new study has shown. The babies of women who consumed more than 10,000 international units of vitamin A daily — nearly four times the recommended amount — from supplements or food or both were more likely to be born with malformations of the head, heart, brain, and spinal cord.

The amounts that place babies at risk are currently found in a single pill in some vitamin preparations and can be readily obtained if more than one vitamin supplement is taken daily.

What happens if you accidentally take high-dose vitamin A during pregnancy?

If you accidentally take a high dose of Vitamin A during pregnancy talk to your doctor or healthcare provider immediately. Acute vitamin A poisoning occurs quickly and symptoms may include drowsiness, irritability, abdominal pain, nausea, vomiting, severe headache, blurred vision, nausea, dizziness, muscle aches, and problems with coordination. In severe cases, getting too much-preformed vitamin A can even lead to coma and death.

Generally, signs and symptoms will resolve on their own within 1 to 4 weeks, depending on their severity. Birth defects caused by vitamin A toxicity during pregnancy are irreversible.

Supplements considered safe during pregnancy

According to Healthline, your doctor should approve and supervise all micronutrient and supplements to ensure that they’re necessary and taken in safe amounts.

Always purchase vitamins from a reputable brand that has their products evaluated by third-party organizations like the United States Pharmacopeia (USP).

Beyond vitamin A, the following supplements are considered safe during pregancy:

Prenatal vitamins: Prenatal vitamins are multivitamins that are specially formulated to meet the increased demand for micronutrients during pregnancy.

They’re intended to be taken before conception and during pregnancy and breastfeeding.

Observational studies have shown that supplementing with prenatal vitamins reduces the risk of preterm birth and preeclampsia. Preeclampsia is a potentially dangerous complication characterized by high blood pressure and possibly protein in the urine.

While prenatal vitamins aren’t meant to replace your healthy eating plan, they may help prevent nutritional gaps by providing extra micronutrients that are in high demand during pregnancy.

Since prenatal vitamins contain the vitamins and minerals that you’ll need, taking additional vitamin or mineral supplements may not be necessary unless suggested by your doctor.

Prenatal vitamins are often prescribed by doctors and available over the counter.

Folate: Folate is a B vitamin that plays an integral role in DNA synthesis, red blood cell production, and fetal growth and development. Folic acid is the synthetic form of folate found in many supplements. It gets converted into the active form of folate — L-methylfolate — in the body.

It’s recommended to take at least 600 micrograms (mcg) of folate or folic acid per day to reduce the risk of neural tube defects and congenital abnormalities like cleft palate and heart defects.

Iron: The need for iron increases significantly during pregnancy, as maternal blood volume increases by about 45 percent Iron is critical for oxygen transport and healthy growth and development of your baby and the placenta.

In the United States, the prevalence of iron deficiency in pregnant women is around 18 percent, and 5 percent of these women have anemia. Anemia during pregnancy has been associated with preterm delivery, maternal depression, and infant anemia.

Vitamin D: This fat-soluble vitamin is important for immune function, bone health, and cell division. Vitamin D deficiency during pregnancy has been linked to an increased risk of cesarean section, preeclampsia, preterm birth, and gestational diabetes.

The current recommended intake of vitamin D during pregnancy is 600 IU or 15 mcg per day. However, some experts suggest that vitamin D needs during pregnancy are much higher. Check-in with your doctor regarding screening for vitamin D deficiency and proper supplementation.

Magnesium: Magnesium is a mineral involved in hundreds of chemical reactions in your body. It plays critical roles in immune, muscle, and nerve function. Deficiency in this mineral during pregnancy may increase the risk of chronic hypertension and premature labor.

Some studies suggest that supplementing with magnesium may reduce the risk of complications like fetal growth restriction and preterm birth.


Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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