Vitamin A has been discussed numerous times and many believe we should not be supplementing it due to studies showing toxic/adverse effects. However, looking through some studies on pubmed it seems that many of those used Vitamin A alone, which could likely compromise the results. There's been further research that shows Vitamin A and D antagonize each other, one depleting the other and vice versa; in other words both prevent each others toxicity.Therefore what concerns me is that I see many taking 5,000 - 10,000 IU of D a day without supplementing A. If D in fact reduces A, would getting A from diet alone be enough with such high D dosages?
In a study I found on Pubmed on Vitamin A and bone fractures (in 74,000+ women) it was observed that A intake was many times higher than D and A seemed to cause no adverse effects. I'll post a few sections of the paper. I would like to hear your thoughts on the study and what you would consider a safe Vitamin A and D ratio.
Vitamin A and retinol intakes and the risk of fractures among participants of the Women's Health Initiative Observational Study.
Am J Clin Nutr. 2009 Jan;89(1):323-30. Epub 2008 Dec 3
Caire-Juvera G, Ritenbaugh C, Wactawski-Wende J, Snetselaar LG, Chen Z.
Nutrition Department, Centro de Investigación en Alimentación y Desarrollo, Hermosillo, Sonora, Mexico. gcaire@ciad.mx
Abstract
Background: Excessive intakes of vitamin A have been shown to have adverse skeletal effects in animals. High vitamin A intake may lead to an increased risk of fracture in humans.
Objective: The objective was to evaluate the relation between total vitamin A and retinol intakes and the risk of incident total and hip fracture in postmenopausal women.
Design: A total of 75,747 women from the Women's Health Initiative Observational Study participated. The risk of hip and total fractures was determined using Cox proportional hazards models according to different intakes of vitamin A and retinol.
Results: In the analysis adjusted for some covariates (age; protein, vitamin D, vitamin K, calcium, caffeine, and alcohol intakes; body mass index; hormone therapy use; smoking; metabolic equivalents hours per week; ethnicity; and region of clinical center), the association between vitamin A intake and the risk of fracture was not statistically significant. Analyses for retinol showed similar trends. When the interaction term was analyzed as categorical, the highest intake of retinol with vitamin D was significant (P = 0.033). Women with lower vitamin D intake (11 µg/d) in the highest quintile of intake of both vitamin A (hazard ratio: 1.19; 95% CI: 1.04, 1.37; P for trend: 0.022) and retinol (hazard ratio: 1.15; 95% CI: 1.03, 1.29; P for trend: 0.056) had a modest increased risk of total fracture.
Conclusions: No association between vitamin A or retinol intake and the risk of hip or total fractures was observed in postmenopausal women. Only a modest increase in total fracture risk with high vitamin A and retinol intakes was observed in the low vitamin D–intake group.
Discussion excerpt
Supplements contribute significantly to vitamin A intake in the United States. The mean intake of vitamin A from supplements in a sample of adult women in the Third National Health and Nutritional Examination Survey was 1338 µg/d. In our sample, the mean intake of vitamin A from supplements was 1075 µg/d at baseline and 1149 µg/d at year 3 follow-up. Many oily and supplemented foods contain vitamins A and D. The Recommended Dietary Allowance for vitamin A is 700–900 µg/d for men and women, with a tolerable upper intake of 3000 µg/d (41). The mean intake of total vitamin A in this study was 6400 µg/d, which is greater than the upper intake recommended. The issue is whether the effect of vitamin A on bone health occurs at the usual levels of retinol and vitamin D intakes experienced by most persons.
In the United States, milk and ready-to-eat cereals serve as the predominant food sources of vitamin D. Milk, however, is not uniformly consumed in the United States, and the amount of vitamin D added to milk may not be adequate to increase circulating 25-hydroxyvitamin D concentrations. In addition, only a few eligible milk products are fortified with vitamin D, such as a few brands of yogurt (42). Furthermore, the racial-ethnic groups at greatest risk of vitamin D insufficiency consume less milk and ready-to-eat cereals than do their white counterparts (43).
The mean intake of vitamin D in this study was 11 µg/d, which is a little higher than the current US recommendation for women aged 51–70 y (400 IU, equivalent to 10 µg/d) and lower than the recommendation for women aged 70 y (600 IU, equivalent to 15 µg/d) (44). The calcium requirement in older women is 1200 mg/d, which is similar to the mean intake of calcium found in our study (1236 mg/d). The findings in this study could therefore have implications for reducing the risk of osteoporotic fracture and for optimizing nonskeletal tissue function on the basis of dietary and supplemental intakes of vitamin A, vitamin D, and calcium.