Vitamin A

1. What is Vitamin A?

Vitamin A is a fat soluble vitamin that is essential for several bodily functions such
as; vision, reproduction, growth and maintenance of epithelial tissues. Vitamin A
can be classified into Retiniods and Carotenoids.

 Retinoids (aka retinol) are the bioavailable forms of vitamin A found in

animal foods.
 Carotenoids or previtamin A are found in plant foods.

2. Structures of Vitamin A

 Retinol: A primary alcohol containing a β-Ionone ring with an

unsaturated side chain. It’s commonly found in animal tissue as a
retinyl ester with long chain fatty acid.

 Retinal: this is the aldehyde derived formed from the oxidation of

retinol.

 Retinoic Acid: This is derived from the oxidation of retinal. Retinoic

acid cannot be reduced in the body and can’t be converted back into
retinal or retinol.

 β-Carotene: Plants produce this form of vitamin A which is oxidized

in the intestines to form two molecules of retinol.

3. Absorption of Vitamin A

 Retinoid: - Retinyl Ester present in our diet is hydrolyzed in the

intestinal mucosa by bile, digestive enzymes, releasing retinol and
free fatty acid. After being absorbed retinyl ester reform in the
 intestine cell to be further converted and transported to the liver. 90%
of the retinoids can be absorbed into the cell.

 Carotenoids: - Carotenes is absorbed across the intestinal mucosa as

intact molecules. The intestinal cells then converts the carotene to
retinoids, which is re-esterifid to long chain fatty acids in the intestinal
mucosa and is secreted as a component of chylomicrons into the
lymphatic system. Approximately 80% of carotene is absorbed.

 Poor absorption occurs in cases of diarrhea, jaundice and abdominal

disorder.

 Absorption increases with fat intake.

 Vitamin A which is not absorbed is excreted within 1-2 days.

4. Storage and Transport of Vitamin A

 Storage: - The live has an enormous capacity to store vitamin A in the

form of retinolpalmitate. Under normal conditions a person has
sufficient vitamin a reserves to meet their needs for 6-9 months.

 Transport: - Retinol is transported from the intestinal cells as retinyl

ester to the blood stream as chylomicron and is then taken up by the
liver as chylomicron remnants.

 When needed retinol is released from the liver and transported to

extrahepatic tissues by the plasma retinol binding protein (RBP). The
retinol-RBP complex attaches to specific receptors on the cell surface
of peripheral tissues allowing retinol to enter. Cellular retinol- RBP
carries it to the nucleus where the vitamin A acts as a steroid
hormone.

5. Functions of Vitamin A
 Vitamin A plays several roles in our bodies: Vision, Regulation of
Gene Expression, Skin and Bodily lining, Immune defenses,
Reproduction and Growth.

 Vision: - Vitamin A two roles in eye sight: Light perception at the

retina and Maintenance of the cornea.

 Vitamin A is a component of the visual pigment of the rods and cone

cells of the retina. Retinol is transported to the retina of the eye where
it is oxidized to retinal.

 When needed retinal is transported to the rods and bind to the protein
called opsin to form Rhodospin. When rhodopsin is exposed to the
light a series of photochemical isomerization occurs resulting in the
bleaching of the visual pigment releasing the retinal and the opsin.
This triggers a nerve impulse that is transmitted by the optic nerve to
the brain. The vitamin then reunites with the pigment, but a little
vitamin A is destroyed each time this reaction takes place, and fresh
vitamin A must replenish the supply.

 Regulation of Gene Expression: - Vitamin A is the form of retinoic

acid plays an important regulatory role in gene expression. Retinol is
taken up and oxidized by the cells to retinal and further oxidized to
retinoic acid. Retinoic acid ca binds to different nuclear receptors to
initiate or inhibit gene expression. It plays a major role in cellular
differentiation and specialization for physiological roles.

 Skin and Bodily lining: - Vitamin A in the form of retinoic acid

influences the production, structure and function of epithelial cells and
mucus forming cells within the body. Our body requires vitamin A for
proper differentiation and maintenance of these cells.

 Immune system: - The body depends on an adequate supply of

vitamin A for normal functioning of the immune system. Genes
 involved in immune responses are regulated by Vitamin A, which
means it is essential for fighting serious conditions like cancer and
autoimmune diseases, but also illnesses like the flu or common colds.
Beta-carotene is also a powerful antioxidant that can help boost the
immune system and prevent a variety of chronic illnesses. Vitamin A
can especially help the immunity of children.

 Vitamin A plays a central role in the development and differentiation

of white blood cells such as lymphocytes, which play critical roles in
immune response.

 Reproduction: - Retinol and retinal forms of vitamin A are essential

for normal reproduction. They support spermatogenesis in males and
prevent fetal resorption in females.

 It is also essential for embryonic development. During fetal

development, it functions in limb development and formation of the
heart, eyes, and ears.

 Growth: - Vitamin A is essential for normal growth and development

especially in young children. Vitamin A aids bone renewal by creating
osteoclasts bone cells that break down bone tissue. This ensures bone
repairs in the case of fractions and balances blood calcium levels.

 Vitamin A is required for normal development of precursor cells

(stem cells) into red blood cells. Vitamin A facilitates the mobilization
of iron from storage sites to the developing red blood cell for
incorporation into hemoglobin.

6. Sources of Vitamin A

7. Recommended Daily Intake of Vitamin A:-

 How much of each vitamin you need depends on your age and gender. Other
factors, such as pregnancy and your health, are also important.
Infants (average intake)

0 to 6 months: 400 micrograms per day (mcg/day)

7 to 12 months: 500 mcg/day

Children:

1-3 years old: 300 mcg/day

4-8 years old: 400 mcg/day

9-13 years old: 600 mcg/day

Adult Females:

14 years old and up: 700 mcg/day

When pregnant: 750-770 mcg/day

When breastfeeding: 1,200-1,300 mcg/day

Adult Males:

14 years old and up: 900 mcg/day

8. Vitamin A Deficiency
 Vitamin A is essential for normal vision, as well as proper bone growth,
healthy skin, and protection of the mucous membranes of the digestive,
respiratory, and urinary tracts against infection. People with long-term
malabsorption of fats are very susceptible to developing a Vitamin A
deficiency.
 This can be a serious problem for children because the lack of vitamin A
causes severe visual impairment and blindness; it also increases the risk of
severe illness, and even death, significantly.

 Poor eye sight: - A Vitamin A deficiency can lead to a thickening of the

cornea and eventually even to blindness. This results in Nyctalopia,
Xerophthalmia, Bitot’s spot and Keratomalacia.

 Nyctalopia (Night Blindness/ tunnel vision): Patients cannot see in low light
or near darkness conditions. Nyctalopia occurs as a result of inadequate
pigment in the retina. Night blindness is also found in pregnant women in
some instances, especially during the last trimester of pregnancy when the
vitamin A needs are increased.

 Xerophthalmia: - this is dryness of the conjunctiva and cornea. Instead of

looking smooth shiny it appears muddy &wrinkled.

 Bitot’s Spot: - These are foamy and whitish cheese-like tissue spots that
develop around the eye ball, causing severe dryness in the eyes. These spots
do not affect eye sight in the day light.

 Keratomalacia: - a condition that comes from severe deficiency of vitamin A

and is a bilateral condition. Early symptoms of Keratomalacia may include
night blindness and extreme dryness of the eyes. This may lead to infected
corneas, a rupture, or degenerative tissue changes, all can cause blindness.

 Skin Damage: - Vitamin A deficiency will lead to the drying, scaling, and
follicular thickening of the skin. Keratinization of the skin occurs when the
epithelial cells lose their moisture and become hard and dry, can occur in the
mucous membranes of the respiratory, gastrointestinal tract, and urinary
tract.

 Respiratory Infections: - Respiratory infections can occur because the body’s

immunity is impaired by the lack of vitamin A. The younger the person, the
 more severe the effects can be. Growth retardation and infections are
common among children, and the mortality rate can reportedly exceed 50%
in children with severe vitamin A deficiency.

 Pregnancy Risks: - For pregnant women, the vitamin A demand is the

highest during the last trimester. A pregnant woman can suffer from night
blindness if her vitamin A intake is not sufficient

9. Toxicity of Vitamin A:-excessive intake of vitamin A produces a toxic

syndrome call hypervitaminosis A. if the amount exceeds 7.5mg/day of
vitamin A should be avoided.

 Early signs of chronic hypervitaminosis A are reflected in the skin which

becomes dry and pruritic due to a decrease in keratin synthesis. The liver
becomes enlarged and can become cirrhotic. In the nervous system there is a
rise in intracranial pressure.

 Pregnant women should not ingest excessive vitamin A because of its

potential for causing congenital malformation in the developing fetus.