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Vitamin A (retinol)

Essential fat-soluble nutrient with EFSA claims for vision, immune function, skin, and iron metabolism, narrow safe upper limit at therapeutic doses.

Why

Vitamin A is essential for vision (retinal pigment cycle), epithelial differentiation (skin, mucosa), immune function, and iron metabolism. EFSA has authorised health claims for all four of these. Two main dietary forms: preformed retinol (animal sources) and provitamin carotenoids (β-carotene from plants). Preformed retinol is teratogenic at high doses, pregnancy intake should not exceed 3,000 µg/day RAE. Smoker beta-carotene caution (ATBC, CARET trials) is well-established.

How it works

Retinaldehyde combines with opsin in retinal photoreceptors, basis of vision. Retinoic acid binds nuclear retinoic acid receptors regulating gene expression in epithelial differentiation. Modulates innate and adaptive immunity (cytokine production, T-cell maturation). Mobilises iron from hepatic stores.

Expected onset · Deficiency correction over weeks; preventive use ongoing

How to take

Dosage

RDI: 700–900 µg RAE/day. Supplement: 700–1,500 µg/day. Upper level (EFSA): 3,000 µg/day preformed retinol from supplements + diet.

Timing

With meals containing fat

On the label

'Retinol' or 'retinyl palmitate' (preformed). β-Carotene from food/algal source is the safer form for general supplementation in non-smokers. Stated µg RAE not just IU.

Ideal for

Adults with low dietary intake of yellow/orange vegetables and liver; vegetarians with restricted dietary sources; populations at risk of deficiency. Pregnant women: get from dietary sources only; supplement only under clinical guidance.

Safety

Teratogenic at high doses, pregnancy intake should not exceed 3,000 µg/day RAE; avoid liver during pregnancy (very high vit A content). Beta-carotene supplements increased lung cancer in current/former smokers (ATBC, CARET trials). Avoid in this group, prefer dietary carotenoid sources. Hepatotoxicity at chronic doses >7,500 µg/day. Caution with isotretinoin and other systemic retinoids (additive). Avoid in hypothyroidism without supervision.

Evidence

At a glance

EFSA-authorised claims for vision, immune function, skin/mucosa and iron metabolism, highest regulatory tier. ATBC 1994 NEJM RCT: β-carotene 20 mg/day increased lung cancer incidence by 18% in male smokers, defined the smoker-caution rule. Rothman 1995 NEJM established teratogenicity threshold around 3,000 µg retinol equivalents/day in early pregnancy.

Where to get it

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