Page 24 - summer2016

In fact, borderline deficiency. A short time period be- labels.” 50
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obstetricians tween pregnancies is a risk factor for a number “[Rothman and team] report findings con-
of adverse outcomes including prematurity, sistent with those of other studies suggesting
are often low birth weight and neural tube defects. The that the consumption of less than 10,000 IU of
the most leading hypothesis suggests that short intervals vitamin A per day from vitamin supplements is
clueless, may be a marker for a deficiency in nutritional safe.” Specifically addressing Rothman’s find-
reserves needed to support normal fetal develop-
ings that greater than 10,000 IU is teratogenic:
which is why ment. Maternal stores of critical micronutrients “[i]t would have been useful if Rothman . . . had
they often such as vitamins A, B , B , D , zinc and folate, presented more detailed data on the amounts
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recommend decline during pregnancy and may take many consumed by the women who took 10,000 IU or
more of vitamin A per day and on the birth de-
months to rebound.
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the fects in their infants. Without further knowledge
extremely THE ROTHMAN STUDY of this sort, [more detailed data on the women
The evidence points to the very real problem with the highest level of vitamin A consump-
poor quality of vitamin A insufficiency during pregnancy, an tion, very likely much more than 25,000 IU per
prenatal issue unlikely to be addressed by conventional day] we do not recommend using the dose–re-
vitamins that medical authorities in the near future. It was the sponse curve in the study by Rothman . . . for
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the drug Rothman study that sealed the stigmatization the purpose of advising pregnant women who
against vitamin A during pregnancy; this study have consumed more than the RDA of vitamin
companies has been critically examined by Masterjohn who A about the specific risk of malformation in
make. states that the preponderance of the evidence their offspring. We cannot make good estimates
supports intakes of vitamin A between 20,000 of the teratogenicity of this vitamin at higher
and 25,000 IU during pregnancy to reduce the consumption levels unless more data become
risk of birth defects. available.” 50
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From the CDC’s response to the Rothman How did we go from recommendations in
study: “Daily consumption of a single multi- 1995 to limit intake to 8,000-10,000 IU and
vitamin preparation containing folic acid and no prenatal vitamins routinely containing 8,000
more than the U.S. recommended daily allow- IU of retinol , to today where many prenatal
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ance (RDA) of vitamin A for pregnant women vitamins contain no preformed vitamin A (and
(8000 IU) is beneficial. . . In 1987 the Centers often little or no beta-carotene), compounded by
for Disease Control, the Teratology Society, and warnings against liver consumption? According
the Council for Responsible Nutrition indepen- to Dr. Dean Raffelock, “[the Rothman study]
dently published recommendations designed created a wave of fear in obstetricians and their
to reduce pregnant women’s exposure to high pregnant patients that continues to this day. . .
amounts of vitamin A from supplements.” In fact, obstetricians are often the most clue-
“These recommendations were made be- less, which is why they often recommend the
cause teratogenesis was assumed to occur at extremely poor quality prenatal vitamins that
some undetermined level above 8000 IU of the drug companies make.”
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vitamin A per day and because pregnant women In 2014, Pennsylvania State University
in the United States do not appear to benefit scientists stated: “[n]utrition experts know that
from additional vitamin A. The recommenda- vitamin A is necessary for prenatal growth and
tions included limiting vitamin A in prenatal development. . . but the role of vitamin A re-
multivitamin preparations to 5000 to 8000 IU mains unclear for the neonatal [newborn] period.
and the vitamin A content of all multivitamin Stores of vitamin A become depleted as the fetus
preparations to 10,000 IU; suggesting that reaches full term, to the point where newborns
women should not take 10,000 IU or more of are nearly depleted of vitamin A. Neonates born
vitamin A without consulting a physician; using in developing countries are likely to have even
beta-carotene rather than vitamin A in supple- lower amounts of vitamin A in their bodies.
ments; and specifying the amounts of retinol, [Newborns] are born with a low vitamin A level
retinyl esters, and beta carotene on supplement but a high demand for it.”
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24 Wise Traditions SUMMER 2016 Wise Traditions