Following her Facebook Live chat with Heather Richards via the Sano Life Facebook page, which you can catch up on at the link below, Angela clears up the confusion around whether vitamin A is safe during pregnancy.

Watch Heather Richards chatting to Angela Heap about fertility nutrition

Guest contributor, Angela Heap, is a BANT ( British Association of Nutritional Therapy) registered nutritionist, living in London. After nurturing a general interest in health for many years and experiencing issues with her own hormonal health, Angela trained at the College of Naturopathic Medicine (CNM). As a Nutritional Therapist Angela’s view and approach is to empower people towards optimum health and often works alongside conventional medicine practitioners in order to ensure the best outcome for the individual patient.

Angela has successfully supported many couples in their fertility journeys. Many of the men and women she has treated suffered from reproductive issues such as endometriosis, PCOS and issues with sperm health. She also supports couples with gene mutations such as MTHFR and Factor V Leiden. By supporting patients through a programme of good nutrition and a range of supplements Angela has many to bring their bodies back into balance to the extent that many went on to conceive naturally and others through Assisted Reproductive Technology (ART).

Vitamin A – Is it safe in pregnancy?

The new year has started off with a bang! Lots of clients who have been working with me for 3 months or more are now pregnant – Yay! As most are new mums, a few have gotten in touch about Midwives and Doctors’ misconceptions and concerns about vitamins and minerals. This is where the medical community starts to get involved. One of the main concerns is with Vitamin A and its ability to cause birth defects; so let me respond and shed some light on this.

I have looked into this issue myself quite thoroughly and the research links I have cited below mention that the research is over 30 years old in regards to the potential causes of birth defects. I will say that again: In this time frame, only 18 cases have been cited where this has caused deformities.

I’m sure you are aware that any adverse reaction to drugs needs to be reported.  All medicines are reported under the medical misuse category.

Drugs cause death and other health conditions by the hundreds of thousands annually. Vitamins don’t cause death (  We don’t have anything for supplements to report on this, but as always, if anything does show Teratogenicity ie potential for birth defects it has to be reported as such.

A basic look into drugs commonly used to help women conceive and to help those with sticky platelets, such as Aspirin have far more potential to cause birth defects, and not to mention fertility drugs that many use unwittingly without looking into the small print, that can also cause deformities and also death.

My point here is that many of my clients are getting wound up about this without looking into the issues more closely. Colleagues in the medical profession are making a point of issuing notice on Vitamin A without also mentioning that drugs, many of them used in fertility circles, have far more of a chance of producing birth defects – even taken at the correct dosage! Of the 18 reported cases over the last 30 years of babies with deformities all of the women in regards to Vitamin A took over 25,000IUs of Vitamin A. This exceeds the RDA on this by an exponential amount.

As always, the devil is in the detail. Most supplements will show two forms of Vitamin A – the one that can cause more damaging effects at high levels is Retinol only and not the mix of Retinol and beta-carotene, which is what most supplements have in them.

It is worth noting also in this instance that Natural Vitamin A (retinol) is also found in high doses in organ meat, such as liver. Which up until the 1970s was consumed abundantly and was readily available. Many children, like our parents who were born after the war, were given cod liver oil daily to ensure they didn’t develop deficiencies. This form of fish oil has a much higher form of Vitamin A.

One of the sources of this information is the NHS choices website. This website, which I find extremely unhelpful and very uninformed, states, ‘you should be able to get all the nutrients you need from your diet and don’t need any extra vitamin A’. Also, rather unhelpfully, in the article they give the measurement in Mgs, not IUs, which is the standard international unit used to measure Vitamin A, so right from the start shows a fundamental misunderstanding of Vitamin A.

In terms of its use in pregnancy, it is a vital and essential nutrient and the most important and well-known role of Vitamin A is in relation to eye function. Vitamin A is necessary to prevent drying of the eye (Xerophthalmia) and corneal changes. It is also used for retinal function. 500,000 people lose their sight each year due to Vitamin A deficiency. Vitamin A levels are also important in thyroid health as the vitamin is needed for the uptake of iodine and is required for thyroid hormone triiodothyroxine (T3) to bind to intracellular receptors.

Vitamin A is needed in pregnancy for growth, immunity, epithelial tissue maintenance and during cell proliferation, ie. foetal growth!

I work with many clients and look into a deeper analysis of fertility issues and pregnancy complications. One area I am fascinated with is Epigenetics. Many people who have polymorphisms in their BCMO1 gene have an issue converting beta-carotene into retinol. So I welcome the use of mixed Vitamin A for them in a retinol base, as they will have a problem converting beta-carotene in the body. Many of the studies on the populations in the human genome project also had the potential for poor eyesight so were really in need of vitamin A, should the gene express.

I ask questions about eyesight as part of my consultations and also look at this from a family health position as there is potential here to pass this on to offspring. One anecdotal thing I’m noticing much more than when I was a child is that there seems to be a huge number of kids with glasses at a young age. I only remember a few in my whole school growing up. So I’m wondering if reduced amounts of Vitamin A in pregnancy are a result of this.

WHO recommendations. More recent than 1995:

American Teratology Society information on Vitamin A

Further information on Vitamin A

On a personal note. I have used many American supplements for the last 8 years of working with women all of which have mixed vitamin A around 5000IUs and I have confidence with these levels of Vitamin A.  Having worked with hundreds of ladies and so far we’ve had no issues with this, with my recommendations!

I hope this helps you to make a more informed decision about vitamin A and its use in pregnancy and preconception.



2.Teratogenicity of high vitamin A intake. N Engl J Med. 1995 Nov 23 ;333(21):1369-73

Wiegand, et al.

3.Safety of vitamin A: recent results. Int J Vitam Nutr Res. 1998;68(6):411-6. Rothman, et al.

4.Teratogenicity of high vitamin A intake. NEJM. 1995 Nov 23;333(21)1369-73. 3. Miller, et al.

5.Preconceptional vitamin A use. Reprod Toxicol. 1998 Jan-Feb; 12(1)75-88

6.Tolerable levels of 10,000IUs

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