A Family Doctor's Tale - VITAMIN A DEFICIENCY

DOC I HAVE VITAMIN A DEFICIENCY

Vitamin A Deficiency is a medical condition caused by the deficiency of the human body of Vitamin A as a result of inadequate dietary intake or impaired absorption.

Vitamin A (retinol) is found primarily in
1.animal sources - fish liver oil, liver , dairy products and meat.
2.vegetable sources: Vitamin A precursor (carotene) is found in green and yellow vegetables and fruits such as tomatoes, carrots. papaya, etc.
However only one third of the carotene is converted to Vitamin A.

Optimal requirements of Vitamin A are:
1.adults and children above puberty: 5000IU daily
2.Infants and children before puberty: 1500-2500 IU daily

Functions of Vitamin A:
1.Vitamin A together with protein opsin form the light-sensitive
pigments in the cones and rods of the retina and is thus important for clear vision.

2.Vitamin A also acts to maintain the integrity of epithelial tissues and mucous membranes by preventing metaplasia of the squamous type. It is therefore important for good skin function.

3.Vitamin A is also peripheral antagonist to estrogen.
It is therefore useful in the treatment of people with overly high
estrogens.

Causes of Vitamin A Deficiency:
Vitamin A Deficiency occurs
1.when there is vitamin A deficiencies due to
a.diet - insufficienct vitamin C in diet
b.malabsorption as in celiac syndrome, sprue or hepatitic cirrhosis
c.Failure to convert carotene to Vitamin A
d.rapid loss of Vitamin A from the body

2.Severity of Vitamin A deficiency is inversely related to age.
It is more common in elderly people.

Symptoms of Vitamin A Deficiency:
1.Vitamin A Deficiency is a silent disease.
People with Vitamin A Deficiency often do not know that they have the condition.

2.Vision-Initial manifestation of inadequate Vitamin A may be night blindness with progression to xeropthalmia and keratomalacia.
Corneal perforation may occur followed by blindness.

Bitot's spots which are superficial patches exposed bulbar conjunctiva are a pathognomic changes of Vitamin A deficiciency in the eye.

3.Skin- hyperkeratosis and metaplasia of mucous membrane may occur and lead to increased susceptibilty to infection.

Reversal of corticosteroid induced impairment of wound healing has been reported after topical application of Vitamin A.

4.Growth-growth retardation, loss of appetite and anemia is common in cildren with Vitamin A deficiciency

5.Mental-Brain dysfunction may occur in children with Vitamin A deficiciency.

Diagnosis of Vitamin A Deficiency:
1.Blood Vitamin A levels are low

Treatment of Vitamin A Deficiency:
The goal of Vitamin A Deficiency treatment is the prevention of vision defects and skin problems.

Therefore, prevention of Vitamin A Deficiency is as important as treatment. Vitamin A Deficiency treatment and prevention measures are:

Medications:
Vitamin A supplements
Vitamin A is given at 25.000 to 50,000 IU per day orally until the response is adequate.

Side effects are:
1.painful and tender swellings of the bones

2.dry rough skin

3.headache

4.weakness

5.liver and spleen enlargement

6.Massive overdosage of Vitamin A may lead cerebral edema, liver failure, convulsions and death

Prognosis of Vitamin A Deficiency:
1.good response to treatment in vitamin A deficiciency.

2.treat underlying cause such as malabsorption to get a good response in the treatment of Vitamin A Deficiency.

3.eye damage may not be reversible

4.Overdosage symptoms usually disappear within 1-4 weeks after stopping high vitamin A dosage.