Signs of Vitamin A Deficiency: What to Watch For
Know about vitamin A deficiency, the influence of it on immunity, fertility, growth, skin, hair and nails. Learn about the reason for deficiency and how to prevent it and more.
Introduction
If your eyes struggle in dim light, your skin is unusually dry, or you seem to catch every cold going around, your body might be hinting at a vitamin problem—specifically, vitamin A deficiency. Vitamin A is essential for clear vision, strong immunity, healthy skin, and normal growth. When levels dip too low, the earliest signs can be subtle. Left unaddressed, though, a deficiency can threaten your sight and overall health.
In this guide, we’ll walk you through the most common signs of vitamin A deficiency, who’s most at risk, how doctors diagnose it, and the safest ways to restore healthy levels. Along the way, we’ll share expert-backed insights, practical cooking tips that improve absorption, and how to tell vitamin A deficiency apart from lookalike conditions. If symptoms persist beyond two weeks or your vision is worsening, consult a doctor online with Apollo 24|7 for timely evaluation and care.
Consult a Top General Practitioner for Personalised Advice
What Is Vitamin A and Why Does It Matter
Vitamin A is a fat-soluble nutrient that comes in two main forms: preformed vitamin A (retinol and retinyl esters) found in animal foods, and provitamin A carotenoids (like beta-carotene) found in colourful fruits and vegetables. Your body converts carotenoids into active vitamin A as needed. Retinol is stored mainly in the liver and transported by retinol-binding protein (RBP) to tissues that need it.
Why it matters:
- Vision: Vitamin A is a core component of rhodopsin, the light-sensitive pigment in the retina that enables night vision. Low levels can cause night blindness (nyctalopia), one of the earliest warning signs.
- Immunity: It maintains mucosal barriers (eyes, lungs, gut) and supports antibody and T-cell responses, reducing the severity of infections.
- Skin and cellular health: Vitamin A regulates cell growth and differentiation, helping keep skin supple and wounds healing well.
- Reproduction and development: It supports fetal organ development and fertility, which makes both deficiency and excess safety-critical during pregnancy.
Daily needs vary by age and life stage, measured as retinol activity equivalents (RAE). Most adults need about 700–900 mcg RAE per day from food. The tolerable upper intake level (UL) for adults is 3,000 mcg RAE (about 10,000 IU) of preformed vitamin A; carotenoids don’t have a UL because they are not linked to toxicity in typical diets [1]. Long-tail keyword used: recommended daily allowance vitamin A RAE.
How Vitamin A Deficiency Develops?
Vitamin A deficiency can arise from two broad pathways: not getting enough (intake problems) and not absorbing or using it properly (utilisation problems).
- Low intake: Diets very low in animal foods and poor in orange/yellow vegetables and leafy greens can lead to inadequate intake. Infants weaned early without fortified foods, and older adults with limited diets, are at higher risk.
- Fat malabsorption: Because vitamin A is fat-soluble, any condition that impairs fat absorption—celiac disease, cystic fibrosis, chronic pancreatitis, cholestatic liver disease, or post-bariatric surgery—can cause deficiency despite a seemingly adequate diet.
- Liver disease and alcohol: Vitamin A is stored in the liver; chronic liver disease and heavy alcohol use can deplete stores and impair mobilisation.
- Genetics: Some people have common BCMO1 variants that limit beta-carotene conversion, increasing reliance on preformed retinol from animal foods or fortified products.
- Increased needs: Pregnancy, lactation, measles, and frequent infections can raise requirements.
A pattern seen in clinics: people on very low-fat diets, extremely restrictive eating plans, or long-term use of fat-blocking medications sometimes report dry eyes and skin, frequent infections, and poor wound healing are classic deficiency signals.
Eye-Related Signs You Shouldn’t Ignore
Night blindness is often the first symptom of vitamin A deficiency. You may notice that driving at dusk or navigating dim rooms becomes challenging. That’s because the retina’s rod cells depend on vitamin A to regenerate rhodopsin for low-light vision
As deficiency progresses, the eye’s surface (conjunctiva and cornea) dries out, called xerophthalmia. Classic features include:
- Conjunctival dryness and a gritty sensation.
- Bitot spots: foamy, whitish patches on the conjunctiva caused by keratinised debris.
- Corneal involvement: xerosis (drying), followed by ulceration and softening (keratomalacia), which can lead to permanent vision loss if untreated [3,4].
These ocular signs are medical red flags. High-risk children with measles or malnutrition can progress quickly to corneal damage. Globally, vitamin A deficiency remains a preventable cause of blindness in children and increases the risk of severe illness and death from infections like measles and diarrhoea.
If you develop night blindness, visible eye surface changes, eye pain, or sudden vision loss, seek urgent in-person care. If symptoms are gradual or unclear, consult a doctor online with Apollo 24|7 within the week; worsening symptoms beyond two weeks warrant prompt evaluation. Early diagnosis and treatment can reverse many eye findings before permanent damage occurs.
Skin, Hair, and Nails: What Your Body Might Be Telling You
Because vitamin A regulates cell turnover, the skin often telegraphs a deficiency. Common changes include:
- Dry, rough, or scaly skin, especially on the arms and legs.
- Follicular hyperkeratosis—small, rough bumps that can resemble “chicken skin.”
- Cracking at the corners of the mouth, dry lips, and delayed wound healing.
Hair may become dry and brittle; nails may develop ridges or break easily. These changes are nonspecific; they overlap with other issues like low essential fatty acids, zinc deficiency, hypothyroidism, excessive handwashing, or harsh soaps. But when combined with eye symptoms or frequent infections, they strengthen the suspicion of vitamin A deficiency.
If your skin is very dry despite adequate moisturisers and you follow a low-fat diet or have digestive issues, consider whether your meals consistently include both provitamin A sources (carrots, sweet potato, leafy greens) and a little healthy fat (olive oil, nuts, yoghurt) to aid absorption.
When it’s not vitamin A: Eczema, psoriasis, and keratosis pilaris can mimic follicular roughness. Zinc deficiency can also cause poor wound healing and periorificial dermatitis-like rashes. A clinician can help sort this out, and a basic nutrient panel (including zinc and vitamin A) can be coordinated via Apollo 24|7 home collection if needed.
Immunity and Infections: The Hidden Impact
Vitamin A supports the integrity of mucosal surfaces and the function of immune cells. When levels are low, people may report:
- Frequent colds or respiratory infections
- More severe or prolonged diarrhoea
- Slower recovery from common illnesses.
In children, deficiency is strongly linked with worse outcomes from infections, particularly measles. Supplementation in deficient populations reduces measles-related complications and mortality, largely by stabilising mucosal barriers and moderating immune responses. In adults with chronic gut conditions, low vitamin A may contribute to altered gut immunity and recurring infections.
Growth, Fertility, and Pregnancy
- Children with vitamin A deficiency can experience stunted growth and increased infection risks. Adolescents might show delayed growth spurts or poor skin healing coupled with a higher infection burden.
- In adults, vitamin A is essential for reproduction and early embryonic development. Deficiency has been linked to subfertility, while excess preformed vitamin A can be teratogenic (harmful to a developing fetus). This dual reality underscores the need for balanced intake in pregnancy:
- Deficiency risks: night blindness in pregnancy, increased maternal anaemia and infection risk in deficient regions.
- Safety: Avoid high-dose preformed vitamin A supplements during pregnancy unless specifically prescribed. Rely on prenatal vitamins within recommended ranges and food sources (with caution on liver, which is very high in preformed vitamin A) [1].
Getting Diagnosed the Right Way
Diagnosis usually starts with a dietary and symptom history plus targeted lab tests:
- Serum retinol: A level below 0.70 micromoles/L (20 mcg/dL) suggests deficiency, but values can be influenced by recent intake and infection/inflammation.
- Retinol-binding protein (RBP): Can approximate retinol status; useful when sophisticated assays aren’t available.
- Inflammation caveat: C-reactive protein (CRP) and other inflammation markers help interpret retinol levels, because inflammation can lower serum retinol independent of liver stores.
- Specialised tests: Retinol isotope dilution is a research-level method to estimate total body stores; rarely needed clinically.
Food-First Prevention: What to Eat and How to Cook It
Top animal sources (preformed vitamin A, retinol):
- Liver (very high; use sparingly), egg yolks, full-fat dairy, fortified milk/yoghurt, butter, and fish (e.g., salmon).
- Top plant sources (provitamin A carotenoids):
- Carrots, sweet potatoes, pumpkin, butternut squash
- Dark leafy greens (spinach, kale), broccoli
- Mango, papaya, apricot, and red palm oil (where commonly used) [1,2]
Absorption tips:
- Include some healthy fat (1–2 teaspoons oil, nuts, seeds, dairy) with plant sources to improve carotenoid absorption.
- Chop, puree, and cook vegetables lightly; heat and blending help release carotenoids from plant cell walls.
- Pair greens with oil (e.g., spinach sautéed in olive oil) and orange vegetables with yoghurt or tahini.
Treatment and Supplementation: Do’s and Don’ts
When deficiency is confirmed or strongly suspected—especially with eye signs supplementation is often needed, alongside dietary measures:
- Adults: Clinical references suggest high-dose retinol for a brief period, for example, 100,000 IU orally daily for 3 days, then 50,000 IU daily for 2 weeks, followed by maintenance and diet correction; dosing varies by clinician and context [3]. Intramuscular dosing may be used if malabsorption is severe.
- Children: WHO-recommended regimens are used in deficient settings and for xerophthalmia; dosing depends on age (e.g., 200,000 IU for children >12 months, with specific schedules) [2,3]. This is medical care and should not be self-administered.
Safety:
- Avoid exceeding the adult UL of 3,000 mcg RAE/day (about 10,000 IU preformed vitamin A) chronically, unless supervised.
- Signs of toxicity include headache, nausea, dizziness, liver enzyme elevations, and, in pregnancy, risk of birth defects. Beta-carotene is generally safe but can cause harmless yellowing of the skin (carotenodermia) at high intakes.. Interactions: Orlistat (fat-blocker) reduces absorption; isotretinoin/retinoid therapies can interact—always disclose meds to your doctor.
Special Situations to Know
The special situations include:
- Children: In areas where deficiency is common, WHO supports periodic high-dose vitamin A supplements in children aged 6–59 months to reduce morbidity and mortality. For an individual child with signs like night blindness or Bitot spots, urgent evaluation is essential.
- Measles: Vitamin A given during measles illness in deficient children reduces complications and death. Adults with poor status may also benefit under medical guidance.
- Older adults: Reduced appetite, dental issues, and low-fat or highly restrictive diets can predispose to deficiency. Routine screening may be considered if symptoms arise.
- Strict vegan or plant-based diets: These can provide ample provitamin A if diverse and paired with adequate dietary fat. Those with BCMO1 variants or malabsorption may still need fortified foods or medical guidance.
- Post-bariatric surgery: Lifelong micronutrient monitoring is standard; vitamin A deficiency can develop months to years after surgery without supplementation. Apollo24|7 can coordinate periodic labs via home collection and follow-up counselling.
When It Isn’t Vitamin A Deficiency
Several conditions mimic its signs:
- Night blindness: Retinitis pigmentosa and other retinal dystrophies can cause similar symptoms; an eye exam helps differentiate.
- Dry eyes: Sjögren’s syndrome, prolonged screen time with reduced blinking, environmental dryness, or contact lens issues can overlap with xerophthalmia.
- Skin and hair changes: Hypothyroidism, zinc deficiency, atopic dermatitis, and essential fatty acid deficiency can look similar.
A combined deficit is common zinc deficiency impairs mobilisation of vitamin A from liver stores, compounding symptoms. A clinician may test multiple nutrients simultaneously to avoid missing a mixed cause.
If you’ve tried diet adjustments and symptoms don’t improve after two weeks, book a physical visit to a doctor with Apollo 24|7 for a comprehensive evaluation.
Conclusion
Vitamin A sits at the crossroads of clear vision, strong immunity, healthy skin, and normal development. Deficiency often begins quietly: struggling to see in dim light, unusually dry eyes or skin, and catching colds more often than usual. Left unchecked, it can threaten vision and overall health. The good news is that it’s both preventable and treatable. Start by looking at your plate. Combine carotenoid-rich plants carrots, sweet potatoes, leafy greens with a touch of healthy fat, and include reliable sources of preformed vitamin A like eggs, dairy, and fortified foods. If symptoms worsen or don’t improve within two weeks, consult a doctor online with Apollo 24|7 for guidance. They can help you choose safe, effective supplementation, investigate underlying causes, and arrange home collection for labs if needed.
Consult a Top General Practitioner for Personalised Advice
Consult a Top General Practitioner for Personalised Advice
Dr. Anand Ravi
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr Syed Mateen Pasha
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr. Syed Ismail Ali
General Practitioner
7 Years • MBBS
Hyderabad
Apollo 24|7 Clinic, Hyderabad
Dr. Johnson. S
General Practitioner
7 Years • MBBS MD(Preventive and social Medicine)
Pune
Apollo Clinic, Nigdi, Pune
Dr. Madhuri Sai Sreepada
General Practitioner
9 Years • MBBS
Hyderabad
BRIGHT SMILES MEDICARE & DENTAL CARE, Hyderabad
Consult a Top General Practitioner for Personalised Advice
Dr. Anand Ravi
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr Syed Mateen Pasha
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr. Syed Ismail Ali
General Practitioner
7 Years • MBBS
Hyderabad
Apollo 24|7 Clinic, Hyderabad
Dr. Johnson. S
General Practitioner
7 Years • MBBS MD(Preventive and social Medicine)
Pune
Apollo Clinic, Nigdi, Pune
Dr. Madhuri Sai Sreepada
General Practitioner
9 Years • MBBS
Hyderabad
BRIGHT SMILES MEDICARE & DENTAL CARE, Hyderabad
Frequently Asked Questions
What are the earliest signs of vitamin A deficiency?
Night blindness (poor vision in dim light) and dry, irritated eyes are early clues. Dry, rough skin and more frequent infections can also appear.
How is vitamin A deficiency diagnosed?
Doctors use blood tests like serum retinol (with CRP to account for inflammation) and sometimes retinol-binding protein. Eye exam findings, such as Bitot spots, are strongly suggestive.
Can I fix vitamin A deficiency with food alone?
Mild cases may improve with diet: eggs, dairy, fish, and carotenoid-rich plants plus healthy fats. Moderate to severe deficiency, or eye involvement, usually requires short-term supplements under medical supervision.
Is liver safe to eat for vitamin A?
Liver is extremely rich in preformed vitamin A. Occasional small portions can help some people, but pregnant individuals should avoid it due to toxicity risk. Don’t consume liver frequently unless advised by your clinician.
How long before I feel better after treatment?
Eye symptoms can improve within days to weeks once levels are restored; skin and immune changes may take longer. If your condition does not improve after trying these methods, book a physical visit to a doctor with Apollo24|7.