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Vitamin A Deficiency

  • Author :
  • TATA AIG Team
  • Published on :
  • 29/12/2023
  • 2 min read

Vitamin A is a fat-soluble vitamin. It has many essential roles in your body, such as helping with your eyesight, immune system, growth, reproduction, and skin health. There are two types of Vitamin A: preformed vitamin A and provitamin A carotenoid.

Preformed ones come from animal foods like liver, eggs, and dairy products. The second type of vitamin A comes from plant foods like dark green leafy vegetables, red palm oil, and yellow and orange fruits.

Your body changes provitamin A carotenoid into active vitamin A, but the conversion rate is low and varies depending on factors like your genes, diet, and health condition.

Vitamin A deficiency happens when your body has a low level of vitamin A or cannot use or store it well. It is a significant health issue affecting many people worldwide, notably in low- and middle-income nations.

Today, we will discuss some signs of vitamin A deficiency, as well as vitamin A deficiency diagnosis, treatment, and prevention tips.

Causes of Vitamin A Deficiency

Some of the most common deficiency in Vitamin A causes are:

Pregnancy and Breastfeeding

Pregnancy and lactation increase the vitamin A requirement, and if not met, it results in a deficiency.

Pregnant women need more vitamin A to support the growth and development of the fetus, especially the eyes, lungs, and immune system. Breastfeeding women need more vitamin A to provide adequate vitamin A to their infants through breast milk, as breast milk is the best source of vitamin A for infants up to six months of age.

A deficiency in Vitamin A during pregnancy and breastfeeding can pose serious risks for both the mother and the baby. These include a higher likelihood of maternal mortality, preterm birth, miscarriage, infant mortality, and low birth weight.

Increased Demand in Infants and Children

Infants and children have high vitamin A needs for their rapid growth and development, especially their vision, immunity, and cognitive function. They are also more susceptible to measles, diarrhoea, and respiratory infections, which can worsen their vitamin A status.

Vitamin A deficiency can lead to severe eye problems, such as xerophthalmia and blindness, as well as stunted growth, anaemia, and the threat of death from infectious diseases.

Certain Liver Disorders

The liver is the primary organ that stores and regulates vitamin A in your body. Suppose you have liver damage or disease, such as cirrhosis, hepatitis, or fatty liver disease.

In that case, your liver may not store or release vitamin A properly, resulting in vitamin A deficiency. Liver disorders can also affect bile production and secretion, which are essential for vitamin A absorption and metabolism.

Certain Digestive Disorders

Suppose you have a digestive disorder that affects your intestinal absorption or metabolism of vitamin A, such as celiac disease, Crohn’s disease, cystic fibrosis, or pancreatic insufficiency.

In that case, you may not efficiently absorb vitamin A from your diet or convert provitamin A carotenoid into active vitamin A.

Vitamin A Deficiency Diseases

Deficiency in vitamin A causes the following health problems.

Night Blindness

This is one of the earliest signs of vitamin A deficiency. It means you have difficulty seeing in dim light or darkness.

Night blindness occurs because vitamin A is essential for producing a pigment called rhodopsin, which is found in the rods of your retina and helps you see in low-light conditions.

Xerophthalmia

It is a term that describes the progressive stages of eye disease caused by vitamin A deficiency, ranging from mild dryness to irreversible blindness.

The following stages characterise Xerophthalmia:

Xerosis: This is the dryness and thickening of the conjunctiva and the cornea. It can cause blurred vision, photophobia (sensitivity to light), and discomfort.

Keratomalacia: This is the softening and ulceration of the cornea. It leads to severe pain, tearing, and pus. It also causes cornea perforation, which results in the eye collapsing and losing its shape and function.

Corneal scarring: This is the formation of opaque scars on the cornea, which can block the light from entering the eye and cause partial or complete blindness.

Increased Infections

Deficiency in Vitamin A causes immune system impairment. It makes you more susceptible to gastrointestinal, respiratory, and urinary tract infections.

Vitamin A has a role in producing and supporting white blood cells that fight diseases. It is also vital for the health and function of mucous membranes, the protective barriers in your nose, mouth, throat, lungs, stomach, intestines, and bladder, guarding against harmful invaders.

Infertility

Deficiency in Vitamin A causes can cause difficulty in conceiving or maintaining a pregnancy. Vitamin A is crucial for the growth and function of reproductive organs like testes, ovaries, uterus, and placenta.

Also, it plays a key role in producing and maintaining the quality of sex hormones such as testosterone, oestrogen, and progesterone.

Dry Skin and Hair

Dry skin and hair can cause cosmetic problems, such as wrinkles, cracks, and split ends, as well as health problems, such as infections, inflammation, and bleeding.

Vitamin A is vital for the growth and maintenance of the skin and hair and the production of sebum, the oil that moisturises and protects your skin and hair.

Bitot’s Spots

Bitot’s spots are white, foamy, or cheesy patches that appear on the conjunctiva of your eyes, usually on the outer part of the sclera (the white portion of your eye).

They are signs of severe vitamin A deficiency and mean your eyes are severely dry and inflamed. Bitot’s spots can impair your vision and increase your risk of eye infections.

Fatigue

Poor vitamin A levels make you feel tired, weak, and lazy. Fatigue can disturb your physical and mental performance, as well as your mood and motivation. Fatigue may arise due to vitamin A's role in producing red blood cells, which carry oxygen to your organs.

Vitamin A deficiency can also affect the absorption and metabolism of other nutrients, such as zinc and iron. Zinc is an enzyme cofactor. They convert provitamin A carotenoid into active vitamin A. Iron is a protein component that transports vitamin A in your blood.

Therefore, your vitamin A status may be compromised if you have zinc or iron deficiency. Conversely, if you have vitamin A deficiency, your zinc and iron status may be impaired, as vitamin A regulates zinc and iron homeostasis.

Diagnosis of Vitamin A Deficiency

Some methods to diagnose vitamin A deficiency are:

Clinical Signs

During a medical examination, your doctor may assess your eyes, skin, hair, and nails to identify potential signs of a vitamin A deficiency. They might inquire about your medical history, symptoms, and factors that could contribute to vitamin A deficiency, including your diet, lifestyle, existing health conditions, and medications.

Laboratory Tests

You may need to go through blood tests to measure your vitamin A, zinc, iron, and RBP levels. The most common blood test for vitamin A is the serum retinol test, which measures the amount of vitamin A in your blood. Your doctor may also recommend a modified relative dose response (MRDR) test or the conjunctival impression cytology (CIC) test.

Dietary Assessment

Your doctor may ask you to keep a food diary or fill out a food frequency questionnaire to estimate your dietary intake of vitamin A and provitamin A carotenoid. They may also use food composition tables or databases to calculate your vitamin A intake from different food sources.

Treatment and Prevention of Vitamin A Deficiency

Vitamin A deficiency treatment can be done through one or a combination of the following methods.

Intramuscular Supplements

Depending on your age, weight, and clinical status, your doctor may prescribe you vitamin A supplement in capsules, tablets, syrups, or injections. They can help restore vitamin A levels and improve your symptoms and complications.

However, these supplements can also cause side effects and toxicity if taken in excess or without medical supervision. Some of the potential side effects of vitamin A overdose are nausea, vomiting, headache, dizziness, blurred vision, liver damage, bone loss, and congenital disabilities.

Fortified foods

These foods have added vitamin A or provitamin A carotenoids to increase their nutritional value and prevent deficiency. Common fortified foods include cereals, bread, milk, margarine, oil, sugar, and condiments.

However, these foods may not provide enough vitamin A to treat severe cases of vitamin A deficiency and may have variable quality and availability. Always inspect the labels and expiration dates on these food items.

Dietary Diversification

Dietary diversification means increasing the variety and quality of your diet to include more vitamin A-rich foods and other nutrients that affect your vitamin A status, such as fat, protein, zinc, and iron.

Diversification can help prevent and treat vitamin A deficiency in the long term and improve your overall health and well-being. It can also help you enjoy different foods' taste, texture, and colour.

Foods Rich in Vitamin A

Here are some vitamin A-rich foods with the vitamin A content per 100 grams.

Food Vitamin A (mcg)
Carrot 835
Sweet Potato 709
Spinach 469
Mango 445
Pumpkin 426
Tomato 328
Papaya 276
Fenugreek Leaves 189
Lettuce 166
Butter 95

Conclusion

Vitamin A deficiency can have severe and sometimes irreversible consequences for your health and well-being. The scenario becomes much worse if left untreated.

Therefore, it is essential to recognise the symptoms and complications of vitamin A deficiency and seek medical attention as soon as possible.

If the vitamin A deficiency results in severe illness and requires immediate hospitalisation, be ready to exhaust a significant chunk of your savings if you do not have a health insurance plan.

Medical insurance covers many ailments and the costs involved in treating them. For example, if you are admitted to ICU or visit very often to your doctor and pay consultancy charges, the insurer will cover these expenses. There is also a provision in the policy that covers pre and post-hospitalisation expenses.

Always compare health insurance plans, look into their settlement ratio, network hospitals, and claim procedure, and then decide on the ideal plan.

FAQS

What are the 3 signs of vitamin A deficiency?

Some signs of vitamin A deficiency are:

Night blindness, which means difficulty seeing in dim light or darkness.

Dry eyes, which means reduced tear production and eye lubrication.

Bitot’s spots, which are white, foamy, or cheesy patches on the conjunctiva of the eyes

What are the diseases caused by vitamin A deficiency?

Vitamin A deficiency diseases include:

Eye diseases, including night blindness, dry eyes, xerophthalmia, and blindness

Infections like measles, diarrhoea, and malaria due to impaired immunity

Skin issues, such as dryness, cracking, and infection

Infertility due to reduced reproductive function

Anaemia and fatigue due to reduced red blood cell production

What foods should you eat for a vitamin A deficiency?

To avoid or improve vitamin A deficiency, include these in your diet:

Animal foods like liver, eggs, milk, and fish.

Plant foods like leafy greens, orange and yellow fruits and veggies, and red palm oil.

Which food is highest in vitamin A?

The liver contains the highest amount of vitamin A, followed by fish oils and some types of cheese.

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