This is in response to the posting over concern of a woman who had been
taking Vitamin A at the level of 10,000 IU daily, not knowing she was
pregnant, and her doctor warning her that such high doses are linked with
causing birth
defects.

She may be assured that she was still within the limits of the maximum safe
daily dosage as provided by the World Health Organization.  I refer to the
document:

Safe Vitamin A Dosage During Pregnancy and Lactation, Recommendations and
report of a consultation. Preliminary version.  Prepared by World Health
Organization, Micronutrient Initiative, and Family and Reproductive Health,
WHO Geneva 1997.

On the recommendations page, it is stated:

For fertile women, independent of their vitamin A status, 10,000 IU (3000
ug RE) is the maximum daily supplement to be recommended at any time during
pregnancy.

The mechanism of teratogenicity or birth defects to the child, is discussed
later in the paper. It is noted that this mechanism is mediated through the
influence of high concentrations of some retinoic acid metabolites on gene
function at critical periods of organogenesis and embryonic development,
this occurring during the first 6 weeks following conception.  It is noted
that there is little research available in this area.

There is some concern about countries where vitamin A intakes habitually
exceed the Recommended Daily Allowance, and a particular concern was
expressed about consumption of liver during pregnancy as liver is extremely
high in Vitamin A.  Here in the Federated States of Micronesia, it is now
recommended that antenatal women take a daily multivitamin which includes
4000 IU Vitamin A.  However, people here are normally consuming a very low
amount of Vitamin A rich foods in the diet such as milk, eggs, and liver,
and the carotene sources of orange and yellow fruits and vegetables, and
green leaves, so that the pregnant women here  are in much greater need of
a Vitamin A supplement.  Also, it may be noted that this country of FSM has
a serious problem of Vitamin A Deficiency, and a massive Vitamin A
supplementation program is presently planned for implementation, so that
the situation is quite different than that in the USA.

I hope this may be of help.


Lois Englberger, UNICEF Health and Nutrition Advisor,
Federated States of Micronesia
E-mail:       [log in to unmask]