scholarly journals Risk of Birth Defects From Vitamin A “Acne Supplements” Sold Online

2021 ◽  
pp. 2021075
Author(s):  
Dina Zamil ◽  
Emily Burns ◽  
Ariadna Perez-Sanchez ◽  
Milbrey Parke ◽  
Rajani Katta
Keyword(s):  
Vitamin A ◽  
Dietary Supplements ◽  
Birth Defects ◽  
High Dose ◽  
Internet Search ◽  
Teratogenic Effects ◽  
Teratogenic Risk ◽  
Consumer Confusion ◽  
Nutritional Needs ◽  
Labeling Requirements

Background: Dietary supplements are popular among US consumers and claim to address a variety of conditions, including acne. Acne supplements containing vitamin A are of particular interest, due to the potentially teratogenic effects of vitamin A doses over 10,000 IU. Objective: This study examined dosage, pregnancy risks, and labeling of vitamin A-containing acne supplements available online. Methods: An Internet search of acne supplements sold online was conducted between March and May 2020. Supplement labels and websites were analyzed for vitamin A content and pregnancy warnings, and then divided into categories based on dosage and teratogenic risk. Results: A total of 49 acne supplements was found, and of these 26 (53%) contain vitamin A. Three supplements are likely teratogenic, 4 contain vitamin A doses exceeding the daily level of intake that meets the nutritional needs of most people, and  15 have an unknown teratogenic risk. Among the 6 supplements with over 10,000 IU vitamin A, 2 have no pregnancy warning at all, including the supplement with the highest vitamin A dose found in this study. Conclusions: Dietary supplements are not subject to the same stringent regulations as drugs, and as such, consumers may be unaware of pregnancy risks. Furthermore, FDA requirements on labeling of vitamin A supplements may lead to consumer confusion regarding dosage. As such, we encourage stricter labeling requirements for vitamin A-containing supplements, including pregnancy warnings for high-dose supplements and clearer dosage labeling.

Somite necrosis and developmental malformations induced by vitamin A in the golden hamster

Development ◽  
1965 ◽  
Vol 13 (1) ◽  
pp. 1-8
Author(s):  
Miguel Marin-Padilla ◽  
Vergil H. Ferm
Keyword(s):  
Spina Bifida ◽  
Vitamin A ◽  
Experimental Animal ◽  
Golden Hamster ◽  
High Dose ◽  
Pregnant Mother ◽  
Teratogenic Effects ◽  
Experimental Animals ◽  
Pregnant Mothers ◽  
Developmental Malformations

The primary teratogenic effects of vitamin A in young embryos, when the vitamin is administered to their pregnant mothers are unknown. The morphogenesis of experimental cranioschisis and sacral rachischisis, commonly induced by vitamin A, is also still unknown. A variety of methods is now available for the induction of anencephaly (cranioschisis) and sacral spina bifida (sacral rachischisis) in some experimental animals. A method frequently used is the administration of a high dose of vitamin A to the pregnant mother. This has been employed in the rat (Cohlan, 1953; Giroud & Martinet, 1955) and in mice (Kalter & Warkany, 1961). In the present experiments, the golden hamster was used as the experimental animal. This study is divided into two parts. The first part consists in the establishment of a method for the induction of developmental malformations in the golden hamster by vitamin A.

scholarly journals South African preschool children habitually consuming sheep liver and exposed to vitamin A supplementation and fortification have hypervitaminotic A liver stores: a cohort study

2019 ◽  
Vol 110 (1) ◽  
pp. 91-101 ◽  
Author(s):  
Martha E van Stuijvenberg ◽  
Muhammad A Dhansay ◽  
Jana Nel ◽  
Devika Suri ◽  
Michael Grahn ◽  
...  
Keyword(s):  
South Africa ◽  
Preschool Children ◽  
Vitamin A ◽  
Total Serum ◽  
High Dose ◽  
Serum Retinol ◽  
Hypervitaminosis A ◽  
Total Liver ◽  
Before And After ◽  
Retinyl Esters

ABSTRACT Background In some regions, multiple vitamin A (VA) interventions occur in the same target groups, which may lead to excessive stores. Retinol isotope dilution (RID) is a more sensitive technique than serum retinol to measure VA status. Objective We evaluated VA status before and after a high-dose supplement in preschool children living in a region in South Africa with habitual liver consumption and exposed to VA supplementation and fortification. Methods After baseline blood samples, subjects (46.7 ± 8.4 mo; n = 94) were administered 1.0 μmol [14,15]-13C2-retinyl acetate to estimate total liver retinol reserves by RID with a follow-up 14-d blood sample. Liver intake was assessed with a frequency questionnaire. In line with current practice, a routine 200,000 IU VA capsule was administered after the RID test. RID was repeated 1 mo later. Serum retinyl esters were evaluated using ultra-performance liquid chromatography. Results At baseline, 63.6% of these children had hypervitaminosis A defined as total liver retinol reserves ≥1.0 μmol/g liver, which increased to 71.6% after supplementation (1.13 ± 0.43 to 1.29 ± 0.46 μmol/g; P < 0.001). Total serum VA as retinyl esters was elevated in 4.8% and 6.1% of children before and after supplementation. The odds of having hypervitaminosis A at baseline were higher in children consuming liver ≥1/mo (ratio 3.70 [95% CI: 1.08, 12.6]) and in children receiving 2 (4.28 [1.03, 17.9]) or 3 (6.45 [0.64, 65.41]) supplements in the past 12 mo. Total body stores decreased after the supplement in children in the highest quartile at baseline compared with children with lower stores, who showed an increase (P = 0.007). Conclusions In children, such as this cohort in South Africa, with adequate VA intake through diet, and overlapping VA fortification and supplementation, preschool VA capsule distribution should be re-evaluated. This trial was registered at https://clinicaltrials.gov/ct2/show/NCT02915731 as NCT02915731.

Amounts and types of fatty acids in meals affect the pattern of retinoids secreted in human chylomicrons after a high-dose preformed vitamin A intake

Metabolism ◽  
2003 ◽  
Vol 52 (4) ◽  
pp. 514-519 ◽  
Author(s):  
Patrick Sauvant ◽  
Nadia Mekki ◽  
Monique Charbonnier ◽  
Henri Portugal ◽  
Denis Lairon ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Vitamin A ◽  
High Dose

scholarly journals The effects of maternal and infant vitamin A supplementation on vitamin A status: a randomised trial in Kenya

2007 ◽  
Vol 98 (2) ◽  
pp. 422-430 ◽  
Author(s):  
R. A. Ayah ◽  
D. L. Mwaniki ◽  
P. Magnussen ◽  
A. E. Tedstone ◽  
T. Marshall ◽  
...  
Keyword(s):  
Vitamin A ◽  
Controlled Trial ◽  
Randomised Trial ◽  
Maternal Serum ◽  
High Dose ◽  
Serum Retinol ◽  
Double Blind ◽  
Vitamin A Supplementation ◽  
Factors Affecting ◽  
Vitamin A Status

Postpartum vitamin A supplementation of mothers and infants is recommended, but the efficacy has been questioned. In this double-blind, placebo-controlled trial, Kenyan mother–infant pairs were randomised to maternal vitamin A (400 000 IU) or placebo < 24 h postpartum, and infant vitamin A (100 000 IU) or placebo at 14 weeks. Milk retinol was determined at weeks 4, 14 and 26, and maternal and infant serum retinol at weeks 14 and 26. Infant retinol stores were assessed at week 26, using a modified relative dose response (MRDR) test. Among 564 women, serum retinol at 36 weeks gestation was 0·81 (sd 0·21) μmol/l, and 33·3 % were < 0·7 μmol/l. Maternal serum retinol was not different between groups, but milk retinol was higher in the vitamin A group: (0·67 v. 0·60 μmol/l; 0·52 v. 0·44 μmol/l; 0·50 v. 0·44 μmol/l at 4, 14 and 26 weeks, respectively). When expressed per gram fat, milk retinol was higher in the vitamin A group only at 4 weeks. Infant serum retinol was not different between groups. However, although most infants had deficient vitamin A stores (MRDR>0·06 %) at 26 weeks, vitamin A to infants, but not mothers, resulted in a lower proportion of infants with deficient vitamin A stores (69 v. 78 %). High-dose postpartum vitamin A supplementation failed to increase serum retinol and infant stores, despite modest effects on milk retinol. Infant supplementation, however, increased stores. There is a need for a better understanding of factors affecting absorption and metabolism of vitamin A.

Multiple Congenital Malformations Associated with Maternal Isotretinoin Therapy

PEDIATRICS ◽  
1984 ◽  
Vol 74 (3) ◽  
pp. 428-430
Author(s):  
ELIZABETH DE LA CRUZ ◽  
SHYAN SUN ◽  
KAMTORN VANGVANICHYAKORN ◽  
FRANKIN DESPOSITO
Keyword(s):  
Vitamin A ◽  
Congenital Malformations ◽  
Cardiac Anomaly ◽  
Teratogenic Effects ◽  
Experimental Animals ◽  
Synthetic Vitamin ◽  
Extensive Information ◽  
Few Data ◽  
Vitamin A Derivative ◽  
Isotretinoin Therapy

Isotretinoin (Accutane), an oral synthetic vitamin A derivative, introduced in September 1982 by Roche Laboratories has been widely used in the treatment of recalcitrant cystic acne. Although there is extensive information regarding the teratogenic effects of excessive vitamin A in experimental animals,1 there are few data available on its possible effects in humans. We report a case of a preterm infant with microcephaly, microphthalmia, rudimentary pinnae, cardiac anomaly, and hepatocellular derangement born to a mother on isotretinoin therapy. This constellation of abnormalities mimicks the type of malformations seen in the animal models and is strongly suggestive of the teratogenicity of this drug to the human fetus.

scholarly journals Combatting Vitamin A deficiency

2017 ◽  
Vol 8 (2) ◽  
pp. 151 ◽  
Author(s):  
Ted H Greiner
Keyword(s):  
Vitamin A ◽  
Vitamin A Deficiency ◽  
Economic Benefits ◽  
Point Of View ◽  
Preschool Age ◽  
High Dose ◽  
Sample Sizes ◽  
Sweet Potatoes ◽  
Target Groups ◽  
Wide Range

Food-based approaches to combat vitamin A deficiency (VAD) continue to be largely ignored by governments and donor agencies. This review deals with common misperceptions as well as constraints that may lay behind this reality. First, high-dose vitamin A capsules provided to preschool age children are no solution for VAD. Second, researchers may assume that it is not possible to standardize foods adequately to study their efficacy in controlled trials. This review summarizes the results of 57 such trials, providing an overview that may assist researchers in making decisions on target groups to study, types of food supplements to provide, quantities, supplementation periods, impacts that are realistic to expect, and sample sizes. Even more complex is to design efficacy trials or impact evaluations of interventions. Again, the paper reviews 40 such trials, providing summary information on approaches, target groups, sample sizes, periods of intervention, and impacts measured using a variety of indicators. There are a number of barriers or constraints that must be planned for and overcome if food-based approaches are to work. This paper reviews several of the most important ones, briefly touching on many of the most effective ways that have been found to overcome them. Food-based approaches can reach all members of the community, are safe for pregnant women, tend to be at least partially sustainable, and confer a wide range of nutritional and other benefits in addition to improving vitamin A status. Food-based approaches are sometimes described as expensive, but this is based on a narrow view. For example, biofortification and dissemination of sweet potatoes cost $9 to $30 per disability-life-year (DALY) gained, while that from VAS was estimated at the estimated cost effectiveness of VAS is $73 per DALY gained. From the community point of view, the economic benefits of food based approaches are likely to subsidize or outweigh their costs.

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