Is vitamin A (retinol) associated with toxicity?

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Last updated: April 28, 2025View editorial policy

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From the Guidelines

Vitamin A can be toxic when consumed in excessive amounts, with acute toxicity developing after ingesting quantities above 300,000 IU in adults or > 60,000 IU in children within a few hours or days, as reported in the 2022 espen micronutrient guideline 1. The symptoms of vitamin A toxicity include increased intracranial pressure, nausea, headaches, pain in joints and bones, and can also cause hepatotoxic effects with prolonged intake of high doses.

  • Key points to consider:
    • Chronic toxicity results from the ingestion of daily amounts of >25,000 IU for more than 6 years or >100,000 IU for more than 6 months, with a high inter-individual variability 1.
    • The IOM has set the UL for vitamin A at 3000 mg/d (10,000 IU) for women of childbearing age, highlighting the need for caution in this population 1.
    • Vitamin A toxicity can be severe, and it is essential to be aware of the risks, especially for pregnant women, as excessive vitamin A can cause birth defects.
    • A balanced diet can provide adequate vitamin A, and supplementation should be approached with caution, considering the potential for toxicity.
  • Important considerations for supplementation:
    • If supplements are needed, it is crucial to follow the recommended daily intake and be aware of the potential for toxicity, especially with prolonged use or high doses.
    • The body's ability to store vitamin A, due to its fat-soluble nature, allows it to accumulate to harmful levels over time, emphasizing the need for careful supplementation practices.

From the Research

Vitamin A Toxicity Studies

  • There are several studies that show vitamin A can be toxic in certain circumstances, including:
    • A study published in The American journal of clinical nutrition in 2006, which found that high intakes of preformed vitamin A can lead to osteoporosis and hip fracture, even at levels only twice the recommended dietary allowance (RDA) 2.
    • A case study published in Liver transplantation in 2006, which reported a case of vitamin A toxicity causing severe liver disease and liver failure in a 60-year-old male who had been taking large doses of vitamin A 3.
    • A study published in Annals of neurology in 2002, which found that vitamin A levels were higher in the cerebrospinal fluid of patients with idiopathic intracranial hypertension, suggesting that vitamin A toxicity may play a role in the pathogenesis of this condition 4.
    • A case study published in JGH open in 2020, which reported a case of liver toxicity caused by vitamin A in a 27-year-old female who had been taking high doses of vitamin A for over 18 months 5.
    • A review published in Anais da Academia Brasileira de Ciencias in 2015, which discussed the neurotoxic effects of vitamin A and retinoids, including bioenergetics state dysfunction, redox impairment, and cell death or proliferation 6.

Key Findings

  • High intakes of preformed vitamin A can lead to toxicity, even at levels only twice the RDA.
  • Vitamin A toxicity can cause severe liver disease and liver failure.
  • Vitamin A toxicity may play a role in the pathogenesis of idiopathic intracranial hypertension.
  • High doses of vitamin A can cause liver toxicity.
  • Vitamin A and retinoids can have neurotoxic effects, including bioenergetics state dysfunction and cell death or proliferation.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The acute and chronic toxic effects of vitamin A.

The American journal of clinical nutrition, 2006

Research

Vitamin A toxicity: when one a day doesn't keep the doctor away.

Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2006

Research

Liver toxicity from vitamin A.

JGH open : an open access journal of gastroenterology and hepatology, 2020

Research

The neurotoxic effects of vitamin A and retinoids.

Anais da Academia Brasileira de Ciencias, 2015

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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