Getting Your Vitamin A During Pregnancy and Beyond

It is important to have an adequate intake of vitamin A in all stages of life, including pregnancy and while breastfeeding. A vegan diet is sufficient for meeting those needs and it eliminates the risk of a dangerously high vitamin A intake!

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What is vitamin A and why do I need it?

Vitamin A is generally known to be important for vision but it also plays a key role in the immune system, reproduction, and in the proper function of lungs, kidneys, and the heart. It is a fat-soluble vitamin that is is also considered to be an antioxidant, which means it helps to protect cells from damage. Vitamin A comes in two forms: preformed vitamin A (known as retinoids) is found in animals and provitamin A (known as carotenoids) is found in plants.

During pregnancy, vitamin A is critical in supporting the baby’s growth. While most people in the US get enough vitamin A, there can be negative birth outcomes for babies born to mothers with a vitamin A deficiency, which is still common in developing nations. 

How much vitamin A do I need?

The National Academy of Medicine (NAM) provides recommended daily intakes of vitamin A in micrograms of retinol activity equivalents (RAE) [1]. The following apply for women over the age of 19:

• All Women: 700 mcg RAE
• During Pregnancy: 770 mcg RAE
• During Lactation: 1,300 mcg RAE

If you look at a food label or supplement, vitamin A will likely be listed in international units (IU) and the conversion to RAEs is not straightforward. Because of this confusion, the FDA has revised guidelines that will go into effect by the year 2021, when all companies will have to list the vitamin A content in mcg RAE instead of IU [2]. 

In the meantime, you should be aware that the bioavailability of vitamin A is highly varied depending on the exact type (such as beta-carotene or alpha-carotene) and delivery method (food versus supplement). For example, the 21,000 IU of beta-carotene in 1 cup of carrots provides roughly 1,050 mcg RAE. Luckily, you don’t need to do any conversions if you get your needs met through a plant-based diet. 

Can too much vitamin A be harmful?

I often see warnings around vitamin A, citing that too much can be dangerous. This turns out to be true, but only for intakes of very large doses from the animal-derived form of vitamin A.

Pregnant women should be careful in getting too much preformed vitamin A can, as it can cause birth defects [3]. And if you are not pregnant, excess can still be harmful, potentially causing nausea, liver damage, and toxicity [1]. But remember, this is the form of vitamin A that comes from animals. For this reason, the upper intake level (UL) is only set for preformed vitamin A (10,000 IU for all adults over 19 years old).

What are the dangers of getting too much of the provitamin A that’s found in plants? There is a possibility that your skin turns yellow, which is harmless. In fact, there are no known negative effects from too much vitamin A from plants.

Can I get enough vitamin A from food?

Yes! Your daily vitamin A needs are easily met with a varied plant-based diet. Some of the highest levels of vitamin A are found in [4]:

• Orange and yellow vegetables: sweet potatoes, carrots, squash, pumpkin
• Dark leafy vegetables: spinach, kale, collards
• Orange and yellow fruits: cantaloupe, apricots, mangos
• Fortified foods such as breakfast cereals

You don’t need to count how much vitamin A you’re taking in on a plant-based diet, you’re likely getting plenty. Just 1 cup of carrots or sweet potatoes or spinach meets your daily needs. And there are no known risks of getting too much, so don’t limit yourself.

Should I supplement with vitamin A?

Probably not. Most prenatals and multivitamins contain vitamin A, despite the fact that the majority of us get enough from our diets. Generally, supplementing with vitamin A is not recommended. This is one more reason why I chose the Gentle Prenatal from Dr. Fuhrman and would also recommend the Essential Prenatal from Ritual – they are careful to include what you need, and skip what you don’t.

Summary

1. Vitamin A needs increase during pregnancy and breastfeeding, but you can still meet those needs through diet alone.
2. Eat a varied diet with vitamin A rich foods such as sweet potatoes, spinach, and carrots.
3. You do not need to supplement with vitamin A or include it in your multivitamin.