In my natural fertility practice, achieving optimal status in vitamin A, one of the most important compounds, is encouraged in every man and woman during the pre-conception period.
As vitamin D is nutrition du jour, I see many people taking high dose Vitamin D supplements without regard to balancing with other fat-soluble vitamins A, K2 and the critical minerals, such as magnesium and zinc. Naturally, the issue of the proper ratio of vitamin A to vitamin D has emerged as a concern. As these vitamins and minerals with fats all work in combination, it is essential it should be the right dosage in the right ratio. Increasing one vitamin increases the demand for the other, potentially inducing deficiency and excess/toxicity. I am wary of supplementing an individual nutrient as it does not work in isolation in arbitrary concentration in the biological system which is impossible to micromanage. Considering the complex ways in which the human body and nutrients interact, the optimal status of these important fat-soluble vitamins through eating traditional food that the human body has adapted to over millions years of evolutionary history is the rational way.
Vitamin A is a catalyst on which innumerable biochemical processes depend. It is particularly crucial in mammalian reproduction and embryonic development.
- It balances the normal cell cycle, so that proliferation is not too great or apoptsis (programmed cell death) too little. If tissues continually grow and do not die, tumours will form. This is particularly relevant for female health and disease. Menorrhagia, fibroids and endometriosis are all related to the loss of a normal cell cycle and it could be due to vitamin A deficiency, very common problem nowadays.
- Adequate vitamin A is required by both female and male reproductive cells for healthy reproduction. Both sperm and eggs require vitamin A. It helps make hormones like testosterone and oestrogen.
- To enable the maternal immune system to accept the foetus, a foreign graft, the aggressiveness of the immune system should be in check and tolerable immunity should be developed. The regulatory T cells (Tregs) modulate the immune system and develop tolerable immunity. Loss of this immune component can result in autoimmunity. Humans require retinol derivatives to develop immunological tolerance and a Vitamin A deficiency is possibly a factor in the development of autoimmunity and resulting negative consequences in reproduction.
- Vitamin A is essential for embryonic and foetal development. Vitamin A enables cell growth and specialization, the orderly formation of the organs and skeleton. Development of immune function and eye development and vision require vitamin A.
Regarding vitamin A, the nutritional expert, Dr Weston Price said,
“While essential throughout the lifespan for growth, immunity, epithelial tissue maintenance, lung and visual function, “[vitamin A’s] influence is particularly critical during periods when cells proliferate rapidly and differentiate, such as during pregnancy and early childhood.”
Sources of Vitamin A, plant/synthetic/animal?
Dr Weston Price observed in indigenous societies, pregnant women consumed special foods rich in vitamin A–such as liver, spring butter and fish eggs–in a conscious effort to produce healthy, well-formed children. Modern research completely validates these traditions. Weston A. Price Foundation is a treasure trove of information on nutrition. Sections on prenatal nutrition, pregnancy, the importance of fat-soluble vitamins are highly recommended to read.
Plants do not contain vitamin A, even Carrots!
Pre-formed vitamin A exists only in animal fats. Provitamin A carotenoids found in plants are not vitamin A and need to be converted into the active form of vitamin A, retinol that the human body requires. The vitamin A content of foods is measured in retinol activity equivalents (RAE).
The most commonly discussed carotenoid, beta carotene, which is found in all yellow, red, orange fruits and vegetables or dark green leaves is up to 28 times less potent than retinol and these are much less reliable sources of Vitamin A than liver and cod liver oil.
The conversion is not given
Many factors determine the efficacy of carotenoid absorption and its conversion to vitamin A and the ability varies about ten-fold between individuals. Children under the age of five and individuals with diabetes, thyroid or liver impairment cannot make this conversion at all. The use of medications, smoking, alcohol consumption, food processing, body composition and genetic variation contribute to poor conversion. Additionally, this conversion cannot take place without the presence of fat in the diet. Therefore, one should never rely solely on plant sources for this incredibly vital nutrient.
Synthetic Supplements: wrong form, potentially dangerous
I would not encourage women to rely on pre-natal vitamins for vitamin A. These tablets contain only precursors to vitamin A or a synthetic form of beta carotene. Many people cannot convert these precursors into usable vitamin A, so they remain vitamin A deficient during pregnancy and lead to the production of vitamin A-deficient breast milk after giving birth. Another danger is synthetic vitamin A’s link with birth defects.
Active vitamin A is stored in the liver and fat, making liver and fats the best sources. Beside these, foods that develop and sustain offspring such as milk and eggs are next best. Butter and cod liver oil are also good sources of Vitamin A. These natural foods provide the correct ratio of vitamin A and D and minerals.
Controversy regarding the consumption of liver
Unfortunately, official guidelines warn pregnant women to avoid foods like liver and cod liver oil, claiming that too much vitamin A from these foods can cause birth defects. Some of my clients who used to enjoy liver refrain from consuming it while pregnant following the guideline.
The study usually cited in support of these warnings was carried out in 1995 at the Boston University School of Medicine and published in the New England Journal of Medicine. Controversy over this has raged through the years, mostly because in the study, the linkage with birth defects was not between natural vitamin A from real food but between high-dose synthetic A from supplements and processed food like margarine.
As a result of the unfair stigmatization of Vitamin A, most pre-natal vitamin formulations do not contain active vitamin A and only contain carotenoids while pregnant women need extra vitamin A for supporting their increased metabolic needs and foetal growth. High amounts of synthetic vitamin A from supplements can be toxic, especially to those with impaired liver function and to those whose diets are otherwise poor. High levels of natural vitamin A have no toxic effects, regardless of the medical establishment’s dire warnings to the contrary.
The risks for vitamin A deficiency during pregnancy outweigh the risks of high doses of true vitamin A from animal foods. In fact, avoidance of liver is a known risk factor for inadequate vitamin A intake. Liver is incredibly rich in fat-soluble vitamins, including vitamins A, D, E, and K as well as other vitamins and minerals that are required for reproduction but difficult to obtain in other ways.
It is best to obtain vitamin A from natural high-fat sources like grass-fed butter, egg yolks, offal, fish, shellfish and cod liver oil.
My recommendations for ensuring vitamin A status are any of the following:
- Eat 4 ounces of beef liver once a week or eat a half ounce every day.
- Eat up to three whole eggs a day.
- Drink up to three servings of full-fat dairy per day.