Continued vitamin A deficiency in can lead to problems with vision and increased susceptibility to infections. An increased risk for vitamin A deficiency occurs in: People with medical conditions that affect the way food is absorbed in the intestines, such as celiac disease, Crohn’s disease, cystic fibrosis. Diseases affecting the liver or pancreas. People who live on a strict vegan diet. Prolonged excessive alcohol consumption or alcoholism.
What is vitamin A deficiency?
Vitamins are a group of substances that are needed by the body in small amounts to maintain good health. Vitamin A cannot be manufactured by the human body, making it an essential part of a healthy diet. Vitamin A is important for healthy eyes, good vision, healthy skin, and for fighting infections. Vitamin A is sometimes referred to as retinol. Foods that contain vitamin A include yogurt, milk, eggs, and fish liver oils. Another substance called beta-carotene, found in green lettuce and orange and yellow vegetables and fruits, can be converted to vitamin A by the body. Mild forms of vitamin A deficiency can usually be treated without long-term effects. Vitamin A deficiency is more common in developing countries, where it often leads to blindness and even death. The recommended daily amount of vitamin A for adults is 0.7 milligrams for men and 0.6 milligrams for women. A daily diet that includes some of the above foods is sufficient for healthy adults. Excess vitamin A is stored by the body. Therefore, you do not necessarily need the recommended amount of vitamin A every day. A very high intake of vitamin A can lead to problems such as rough skin, dry hair, and an enlarged liver. High amounts of vitamin A in pregnant women can also cause the unborn baby to develop birth defects. Therefore, women who are pregnant or become pregnant should not take vitamin A supplements. Women who are pregnant or become pregnant should also not consume liver or liver products such as liver pate and liver sausage.
Causes
Vitamin A deficiency can be caused by a prolonged inadequate intake of vitamin A. This is especially the case in cultures where rice is a major component of the diet because it does not contain carotene. Vitamin A deficiency can also occur when the body is unable to process vitamin A from the diet. This can occur in the context of a variety of diseases, including: celiac disease, Crohn’s disease, giardiasis (an infection of the intestines), cirrhosis of the liver, obstruction of bile flow from the liver and gallbladder into the intestines.
Symptoms, complaints and signs
Mild forms of vitamin A deficiency may cause fatigue. Both mild and severe forms of vitamin A deficiency may increase the risk for:
Infections, including throat and chest infections and gastroenteritis,
delayed growth and bone development in children and adolescents, infertility, miscarriage. Severe forms of vitamin A deficiency can also cause eye and vision problems, night blindness, thinning and ulceration of the cornea on the surface of the eyes, dryness of the conjunctiva and cornea on the surface of the eyes (xerophthalmia), oval or triangular or irregular foamy spots on the whites of the eyes (Bitot spots). Corneal perforations and severe visual impairment due to damage to the retina at the back of the eye may also accompany the condition. Dry skin, dry hair, and itching (pruritus) are also common symptoms of vitamin A deficiency.
Diagnosis and course of the disease
When a doctor suspects vitamin A deficiency, a blood test is ordered. First, confirmation of vitamin A deficiency is pending. Then, check to see if any symptoms, such as anemia, are present. Further investigations will include tests of vision, especially under nocturnal conditions. Serum retinol-binding protein testing is easier to perform and relatively inexpensive. Determination of zinc levels may also help, as zinc deficiency interferes with retinol-binding protein production. In children, x-rays of the long bones may be useful to evaluate bone growth, which may be delayed in vitamin A deficiency.Morbidity increases once blindness is advanced. Irreversible conditions include punctate keratopathy, keratomalacia, and corneal perforation.
Complications
Because vitamin A is involved in many metabolic reactions, vitamin A deficiency can lead to several complications. First, a marked deficiency of vitamin A manifests itself in the appearance of night blindness. If the deficiency is intense and persists for a longer period of time, it also leads to long-term destruction of the eyes through keratin formation in the conjunctiva and cornea. Increased vascularization and infiltration of leukocytes then takes place in the cornea. This leads to edema and dissolution of the collagen matrix. The eyes are irreversibly damaged. As a result, malnutrition and the associated reduced supply of vitamin A can lead to blindness. Skin and mucous membranes also become increasingly keratinized if vitamin A is lacking. This keratinization in turn increases the risk of cracks in the skin and mucous membranes. At the same time, these skin lesions greatly increase the risk of infection. The number of mucus-producing cells also decreases. This can lead to complicated infections, especially in the respiratory organs. These are often associated with extensive necrosis (death of cells). As a result, persistent pneumonia can develop, which is sometimes fatal. Frequent urinary tract infections increase the risk of developing bladder stones, among other things. Another complication that can occur with vitamin A deficiency is additional bone formation in the ear. This can also lead to deafness or blindness due to displacement of nerves.
When should you see a doctor?
The affected person should always see a medical professional for vitamin A deficiency. There can be no independent cure for this disease in most cases, so treatment by a doctor is always necessary. The sooner the affected person consults a doctor, the better the further course is usually, so that the patient should consult a doctor at the first signs of the deficiency. A doctor should be consulted for vitamin A deficiency if the affected person suffers very frequently from various infections. There are also frequent bone fractures and further also delayed growth in children. The affected person also very often shows infertility or increased miscarriages. Vitamin A deficiency in the eyes can lead to vision problems or even night blindness, so that a doctor should also be consulted in these cases. Furthermore, very dry skin and severe itching on the skin also indicate this deficiency. In the case of these complaints, a general practitioner or a pediatrician can be consulted in the first instance. The further treatment then depends strongly on the cause of the vitamin A deficiency, so that no general prediction about the further course can be made in this case.
Treatment and therapy
Treatment of mild forms of vitamin A deficiency involves eating foods rich in vitamin A – for example, liver, beef, chicken, eggs, milk, carrots, mangoes, sweet potatoes, and green leafy vegetables. If vitamin A deficiency is already causing more severe symptoms, treatment also includes taking daily oral vitamin A supplements. Severe forms of vitamin A deficiency can cause permanent vision loss if treatment with vitamin A supplements is not given early. If mild eye problems occur early, treatment may result in full recovery without any permanent loss of vision.
Prevention
A regular intake of vitamin A-rich foods will usually prevent vitamin A deficiency from occurring in the first place, as long as there is no chronic condition preventing the body from getting the vitamin A it needs from the diet. It is recommended to eat at least five servings of fruits and vegetables per day. Vitamin A is often added to various foods such as breakfast cereals, pastries, bread, cookies and fitness bars. For people at generally increased risk, especially children, vitamin A supplements may be an adequate addition to a regular diet.
Follow-up
Vitamin A deficiency does not require extensive follow-up care. If the deficiency is corrected early, no subsequent symptoms or health complications will occur.Only in the case of severe deficiency symptoms, which may have already caused secondary symptoms, is further follow-up care advisable. For example, deterioration in vision or inflammation of the mucous membranes must be clarified by a doctor. As part of the follow-up care, the specialist can examine the affected body regions, take blood samples and, if necessary, also arrange for a CT scan. The aim is to fully capture the symptom picture. Subsequently, the symptoms can be alleviated by targeted measures. The intensity and duration of therapy depend on how severe the deficiency symptoms are. In the case of fatigue or concentration disorders, a clarifying discussion with the doctor is usually sufficient. Under certain circumstances, mild medication can be prescribed. A discussion with a nutritionist can also be part of the aftercare. During follow-up care, it must be ensured that the patient does not develop a vitamin A deficiency again. Comprehensive advice from a nutritionist and, if necessary, other specialists will ensure this. Follow-up care is provided by the patient’s family doctor or the relevant specialist if severe symptoms occur. Since susceptibility to infection increases with vitamin A deficiency, people with pre-existing conditions may need to consult their doctor again.
What you can do yourself
A vitamin A deficiency can be compensated for by those affected themselves. In most cases, a change in diet is sufficient. The diet must contain many animal foods, especially dairy products, fish, liver and lean meat. Foods rich in vitamin A should be kept dark and sealed in the refrigerator, as the substance is sensitive to light and oxygen. In case of noticeable deficiency symptoms, dietary supplements with vitamin A or beta-carotene are recommended. The intake of supplements should be discussed with the doctor in order to avoid an overdose. Pregnant women are particularly at risk and should talk to their gynecologist or general practitioner if they are deficient. Symptoms must be cured to accompany the causative treatment. Decreased vision can be temporarily reduced by a visual aid or the use of eye drops. In the case of fatigue and weakness, rest and relaxation are recommended. If muscle discomfort occurs, massages and hot baths will help. Dry skin can be treated with a suitable care product from the drugstore or homeopathy cabinet. For respiratory problems, a walk in the fresh air will help. Signs of anemia require medical clarification. The same applies to persistent exhaustion, lack of concentration or inflammation of the mucous membrane and skin.
