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The Myth of Vitamin A & Pregnancy

I wrote this piece long ago for social media, but sadly I still hear weekly stories of women being told to avoid organ meat in pregnancy and GPs nearly falling off their chair when they learn she is taking liver capsules or Foraged for You in pregnancy. Please share this with everyone who continues to perpetuate this extremely concerning myth. 

Despite popular belief, organ meats are incredibly safe [and beneficial!] to consume during pregnancy.

The original fear surrounding vitamin A in pregnancy stems back to the famous acne medication, Accutane. Tragically, women who conceived while taking this drug miscarried or gave birth to deformed babies. Due to the now well-known consequences it can only be taken if a known contraceptive is also being used. Accutane is a form of vitamin A known as isotretinoin, which differs from retinol found in food.

Vitamin A is actually one of the most important vitamins for both fertility and pregnancy. It’s crucial for not only healthy eye development, but the development of the brain, kidney, heart and lungs. In addition, fetal development of nervous, circulatory, and respiratory systems all depend on vitamin A.

While the evidence is still conflicting, to err on the side of caution we avoid synthetic vitamin A in doses >10,000 IU/day during preconception and pregnancy. Sadly, most natal supplement manufacturers have removed all vitamin A from their products, due to the misguided fear that all vitamin A is harmful, and now deficiencies are all-too-common. This is especially true in the plant-based community as retinol is only available from animal products. While fruit and vegetable sources contain precursors known as carotenoids, only 10-50% are converted to vitamin A. This conversion depends on factors including genetics and your current vitamin A status.

To learn more about retinol and preventing iron deficiency, please read: The Anaemia of Vitamin A Deficiency.

When it comes to retinol in food, there are no documented reports of teratogenicity. Even if we did need to be mindful of 10,000 IU,  you’d need to be consuming 60g liver/day or ~400g liver/week to get even close, remembering that the intense flavour of liver most often makes it a self-limiting food. 

Note:  

  • 1 serve of The Mother’s Blend = 2098 IU
  • 1 serve or 6 capsules of Cell Squared liver capsules = 3200 IU
  • 1T Nordic Naturals Cod Liver Oil = 400 IU
  • So, you would need to be taking all of the above + eating pâté EVERY DAY for any question mark to be raised. I haven’t met a preconception or pregnant women to eat pâté alone every day, not to mention volunteer to do so when they have found one supplement that works for them, that doesn’t come with the taste that so many prefer to avoid [for the record, I love pâté]. 

So, eat the pâté please. And if you are plant-based, supplement wisely with the help of a trained practitioner.

Have you been told to avoid organ meats / vitamin A?

References

Azaïs-Braesco V, Pascal G. Vitamin A in pregnancy: requirements and safety limits. Am J Clin Nutr. 2000;71(5 Suppl):1325S-33S. doi:10.1093/ajcn/71.5.1325s

Clagett-Dame M, Knutson D. Vitamin A in reproduction and development. Nutrients. 2011;3(4):385-428. doi:10.3390/nu3040385

McCauley ME, van den Broek N, Dou L, Othman M. Vitamin A supplementation during pregnancy for maternal and newborn outcomes. Cochrane Database Syst Rev. 2015;2015(10):CD008666. Published 2015 Oct 27. doi:10.1002/14651858.CD008666.pub3

Thorne-Lyman AL, Fawzi WW. Vitamin A and carotenoids during pregnancy and maternal, neonatal and infant health outcomes: a systematic review and meta-analysis. Paediatr Perinat Epidemiol. 2012;26 Suppl 1(0 1):36-54. doi:10.1111/j.1365-3016.2012.01284.x

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