Foods and Toxins To Avoid /

Vitamin A in Liver, Pate and Supplements

01 In Brief

Vitamin A is a fat-soluble vitamin and daily requirements are easily derived from a balanced diet. In pregnancy there is no need for any extra supplements. Studies of pregnant women who have used oral synthetic Vitamin A to treat acne during pregnancy have shown an increase in the incidence of serious abnormalities of the baby's face, brain and heart. For that reason it is advised that pregnant women do not take additional Vitamin A during pregnancy. This includes multi vitamins that are not labeled for use in pregnancy.

02 What Do I Need To Know?

  • Vitamin A is a fat soluble vitamin also known as retinol and is essential for the normal functioning of the retina in the eye, and the growth and development in the fetus of skin, hair, nails and mucous membranes and normal immunity.
  • It has 2 main forms: 
    • Retinoid: a preformed Vitamin A from animal tissue e.g. meats and fish oils;
    • Retinol: betacarotene derived from foods such as carrots, meats and dark green leafy vegetables is converted in the body to the retinol form of Vitamin A. With increasing amounts ingested in the diet the amount converted to retinol is significantly decreased. Hence increased intake from is not considered to cause adverse effects in the fetus.
  • Studies of Isotretinoin, (a prescription medication with Vitamin A activity used to treat severe cystic acne) in women who were pregnant, have shown an increased risk of miscarriage and a 20 per cent incidence of  major malformations. These malformations include cleft palate and other facial abnormalities, and abnormalities of the eye, ear, heart and brain, including hydrocephalus, microcephaly and intellectual disability. Similar effects have been seen in animal studies.
  • The effect of Isotretinoin can be seen even in the early weeks before a woman may not be aware she is pregnant.
  • In pregnancy it is advised that women obtain Vitamin A predominantly from beta carotene in their diet and fortified foods. 
  • The effects on the fetus appear to be dose-related. The National Health and Medical Research Council has published guidelines for intake of vitamin A for life stage and gender.
  • Data from the US currently recommends not to exceed an upper limit of 5000 IU/day for preformed Vitamin A or retinoid and 8000IU /day for betacarotene. 
  • Liver and cod liver oil is a rich source of Vitamin A and in pregnancy it is advised to limit the amount of  liver and liver products such as pate because of the increased amount of Vitamin A. It should also be avoided because of the risk of listeria.

03 What Others Say

  • A recent  summary from the Illinois Teratogen Information Service

Vitamin A and Pregnancy

04 I Want To Know More

  • National Institutes of Health

Dietary Supplement  Fact Sheet : Vitamin A and Carotenoids

05 Clinicians Tools and Resources

  • Australian Prescriber

Oral Isotretinoin

  • National Health and Medical Research Council 

Nutrient reference values Vitamin A


The information published here has been reviewed by Flourish Paediatrics and represents the available published literature at the time of review.
The information is not intended to take the place of medical advice.
Please seek advice from a qualified healthcare professional.
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Last updated: 13/07/2011 by Dr Elizabeth Hallam*/Claire Galea