This article is the third in an ongoing series on the fat-soluble vitamins,covering those that are integral to health and healing from chronic illness but often lacking in the modern diet. Check out Mickey’s previous articles on the importance of vitamin K and vitamin D, and my article on vitamin E.
We’ve all been told by our grandmas that we have to eat our carrots so we’ll have good eyes, but why? It’s due to the vitamin A in carrots, which is essential not only for good eyesight, but also for a whole host of other functions in our bodies. In this post we’re getting into the vitamin A nitty-gritty. And how did Grannie know that anyway?
What is vitamin A?
The term vitamin A is a little misleading, as it makes us think there’s just one nutrient involved. Vitamin A is actually a group of fat-soluble nutrients, the retinoids and the carotenoids. The retinoid forms of vitamin A, also called preformed vitamin A, are primarily found in animal food sources, while the carotenoid forms, also called provitamin A, are found in plant food sources. We need both forms of for the health of different systems in the body. Some people’s bodies are able to effectively convert the carotenoids (the most well-known being beta-carotene) into the retinoids. Others aren’t able to make the conversion for a wide variety of reasons, such as genetic issues, reduced digestive system functioning (as in the case of some autoimmune diseases, like Crohn’s and celiac, or due to things like low stomach acid, enzyme deficiency, etc.), alcohol abuse, a low-fat diet (since healthy fats are required for absorption of fat-soluble vitamins) or the use of certain medications.
What does vitamin A do in the body?
Vitamin A is important to eye, skin, and immune health. Additionally, it supports growth, reproduction, tissue healing, regulation of genetic processes, cancer prevention, and protection from pollution (this is called antioxidation). Looking more in-depth at vitamin A’s role in the standout areas of eye, skin, and immune health is worthwhile here.
A fact most of us are familiar with is that one of the most important roles vitamin A plays is in eyesight. This is through one of the retinoid forms, retinol, which is used in the synthesis of rhodopsin. Rhodopsin is a pigment that allows the rods in our retinas to detect very small amounts of light, allowing us to see at night. Vitamin A also helps protect the health of our corneas, the thin covering over our eyes.
Something many people are not as familiar with is how significant vitamin A is to skin health. It stimulates the growth of the base layer of skin cells, helps them progress from less to more mature skin cells, and provides the them with stability. Vitamin A plays this role both externally and for the internal mucous membranes, which means it is important for the health of the intestinal tract, lungs, bladder, and vagina, as well as the more obvious skin and eyes.
Finally, research shows that vitamin A plays a key role in antibody formation and the inflammatory response, both of which are important parts of the immune response. T and B cells cannot be correctly produced and immune responses cannot be correctly signaled without vitamin A. The body must also have a way to stop the inflammatory response, so our cells don’t become over-reactive. Vitamin A plays a part in applying the “brakes.” Food sensitivities or intolerances can be related to this kind of over-reaction, so optimal vitamin A levels may be important to lowering food sensitivity risks.
What does deficiency look like?
One of the very first signs of vitamin A deficiency is night blindness. The eyes may also be generally dry, red, and irritated. Many of us are already familiar with another sign of deficiency, that of keratosis pilaris, better known as “chicken skin.” This is the dry, bumpy, rough skin that most often develops on the backs of the arms. It is a dysfunction of the cells progressing from less to more mature and then shedding properly, which, as we noted earlier, vitamin A helps control. People are often told that there is nothing they can do about this condition or that they have to apply medications to the area, but the truth is that getting more vitamin A into the diet or troubleshooting digestion to make sure it is functioning well for proper absorption of vitamin A is the key.
Acne is also more common in the case of deficiency. Another sign of deficiency one might notice is that the internal mucous membranes are more dry than they should be, for instance a dry mouth or genitals. Finally, deficiency shows itself in immune function with things like repeat infections and poor recovery from infections.
How do you get vitamin A?
Getting vitamin A from our diets in no problem for those on the Autoimmune Protocol. Although most Americans get the retinoid forms of vitamin A from butter or eggs, they are even more abundant in organ meats, which are a cornerstone of the nutrient-dense foods we add on the AIP. The retinoids can also be found in shrimp and salmon. The carotenoid forms can be found in the orange and yellow vegetables and fruits, especially sweet potatoes and carrots, but are also found in many dark, leafy greens like spinach, kale, and even romaine lettuce.
If I need to take a vitamin A supplement, which kind should I choose?
The Autoimmune Protocol is a very nutrient-rich diet, but if you are still noticing stubborn signs of deficiency (like that chicken skin!), you might ask your doctor about supplementing. There are important cautions here though, as vitamin A toxicity is a very real possibility. Since fat-soluble vitamins are stored in the body and not excreted regularly like other vitamins or minerals, even small doses of can result in toxic overload. A big early giveaway for toxicity while supplementing is a pressure headache.
It is best to always use a food-source supplement when dealing with vitamin A, rather than a synthetic one. Cod liver oil is an excellent choice here. I like this brand. It’s also important to note that vitamin A must be in balance with other fat-soluble vitamins D and K2, which will help prevent toxicity. If you are going to supplement vitamin A be sure to get daily sunlight for some vitamin D and fermented foods for some vitamin K2. Additionally, keep in mind that vitamins and minerals often require co-factors to function well in the body. In the case of vitamin A, zinc is needed to help release it and vitamin C and another fat-soluble vitamin, vitamin E, can help prevent stores from being depleted too rapidly. One final issue to consider is that some synthetic retinoid prescription medicines, for example some psoriasis treatment drugs, when combined with vitamin A supplementation can substantially increase the risk of toxicity. To reiterate: it is best to supplement based on proper testing and follow-up with your doctor.
Staying Healthy with Nutrition by Elson M. Haas, M.D.