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VITAMIN A AS FAT-SOLUBLE VITAMIN: TOXICITY AND CLINICAL PROBLEMS
Toxicity
Toxic effects of vitamin A have been observed in children and adults when supplements of 25,000 to 50,000 I.U. have been taken daily for several months. The symptoms include nausea, vomiting, abdominal pain, failure to grow in children or weight loss in adults, drying and scaling of the skin, thinning of the hair, swelling and tenderness of the long bones, joint pains, and enlargement of the liver and spleen. The condition is corrected when the individual stops taking the supplement, although recovery may require weeks.
Clinical problems
Some estimates of dietary intakes indicate that one diet in every four may not provide the recommended allowances for vitamin A. However, in the United States vitamin A deficiency symptoms are not widely prevalent. When they do occur they are generally mild. In diseases of malabsorption such as pancreatitis, celiac disease, or cystic fibrosis the absorption is often sufficiently impaired to produce some signs of deficiency. When diets are low in fat, or when there is inadequate bile production, the absorption of vitamin A may be significantly reduced.
Night blindness (nyctalopia) is a form of vitamin A deficiency sometimes seen in the United States. It is experienced when the visual purple is slowly reduced in the eye because of lack of vitamin A. The affected person has difficulty in adjusting to the glare of automobile headlights or in trying to find a seat in a darkened theater, for example.
Skin changes and infections caused by lack of vitamin A are rarely seen in the United States, but are fairly prevalent in the Far East. With the lack of the vitamin the skin becomes keratinized {dry and scaly). Soft, moist epithelium normally offers protection against bacteria, but when it becomes dry and hard, infections of the respiratory tract, the mouth, the eye, and the genitourinary tract occur easily. Additional vitamin A does not provide further protection against infection to individuals who are well nourished, but it would be indicated for those persons whose vitamin A store has become depleted. Xerophthalmia is the severe eye disease caused by changes in the epithelium of the eye and is the cause of some blindness in the Orient.
*64/234/5*
