Which vitamin A source suits you?

Overview of the common forms of vitamin A on the market. At Plenthera we currently stock cod liver oil, skate liver oil and freeze-dried liver.

What is vitamin A?

Vitamin A is a fat-soluble vitamin that the body needs for, among other things, vision, the skin, the mucous membranes and the immune system. You obtain it as retinol from animal products or as beta-carotene from vegetables and fruit.

Retinol is found mainly in liver, cod liver oil, egg yolk, full-fat dairy and butter. It is directly usable by the body and is stored in the liver. Precisely because of this, too much retinol can accumulate over time, which is why there is a safe upper limit.

Beta-carotene is found in, among other things, carrots, pumpkin, sweet potato, spinach and kale. The body converts some of it into vitamin A; exactly how much varies from person to person and depends on diet and vitamin A status. Beta-carotene from food carries no risk of excess vitamin A.

Vitamin A plays a key role in the eye: it is a building block of rhodopsin, the light-sensitive pigment in the rods of the retina that lets you see in low light. It is also involved in building and maintaining the skin and mucous membranes.

Vitamin A and EFSA – what is scientifically recognised?

The following health claims, among others, are authorised for vitamin A (Regulation (EU) 432/2012):

"Vitamin A contributes to the maintenance of normal vision."

"Vitamin A contributes to the maintenance of normal skin."

"Vitamin A contributes to the maintenance of normal mucous membranes."

"Vitamin A contributes to the normal function of the immune system."

"Vitamin A contributes to normal iron metabolism."

The claims apply to products that provide at least 15% of the reference intake per daily serving, i.e. at least 120 µg vitamin A. In our range, this applies to the liver capsules with a stated vitamin A content: Real Roots Runder Schildklier & Lever (700 µg per 2 capsules), Real Roots Runder Bijnier & Lever (272 µg per capsule) and Big Food Runderlever (150 µg per 6 capsules). For the cod liver oil products, the label does not state a vitamin A content.

Safety and pregnancy – choose consciously

Vitamin A is one of the vitamins where the dosage really matters. Because retinol is stored in the liver, too high an intake can build up over a longer period.

Adults: EFSA sets the safe upper limit (UL) at 3,000 µg retinol per day, from food and supplements combined. For post-menopausal women, EFSA advises limiting intake to 1,500 µg per day, because a high intake is associated with lower bone density. When using several products (for example cod liver oil plus a multivitamin), add up the amounts.

Pregnancy and trying to conceive: too high an intake of retinol can be harmful to the unborn child. In the Netherlands, pregnant women are therefore advised not to eat liver and not to use supplements with extra vitamin A (retinol). Cod liver oil, skate liver oil and liver capsules are therefore not suitable during pregnancy. If you are trying to conceive or are pregnant, consult your midwife or doctor.

Beta-carotene and smoking: high-dose beta-carotene supplements (20 mg per day and more) have been associated with adverse effects in smokers in large studies. Smokers are therefore better off not choosing high-dose beta-carotene supplements; beta-carotene from vegetables is not a problem.

Vitamin A at Plenthera and other forms on the market

Fermented cod liver oil and skate liver oil – at Plenthera

Green Pasture makes cod liver oil in the traditional way: the liver is fermented instead of heated, after which the oil is extracted. The range includes Fermented Cod Liver Oil (liquid 180 ml unflavoured or orange, 176 ml cinnamon, and 120 capsules), the combination with Concentrated Butter Oil (gel 188 ml unflavoured, chocolate or cinnamon, and 120 capsules) and Fermented Skate Liver Oil, oil from skate liver (120 capsules or 180 ml orange). There are also value packs of 3. The serving is 2 ml or ½ teaspoon, or 2 capsules. Green Pasture does not state a vitamin A or omega-3 content on the label: these are the natural amounts from the liver, which vary per batch.

Arctic cod liver oil – at Plenthera

The Arctic Cod Liver Oil from Nordic Naturals is purified cod liver oil from wild-caught Arctic cod, produced in Norway according to the European Pharmacopoeia. In liquid form (237 ml, unflavoured, orange or lemon), one teaspoon provides 1,060 mg omega-3, of which 340 mg EPA and 510 mg DHA; the softgels (180 pieces, lemon) provide 750 mg omega-3 per 3 softgels. EPA and DHA contribute to the normal function of the heart (with a daily intake of 250 mg EPA and DHA). Arctic-D (237 ml, lemon) additionally contains 25 µg vitamin D3 per teaspoon. A vitamin A content is not stated on these labels.

Freeze-dried liver – at Plenthera

Liver is naturally the richest food source of retinol. Real Roots combines freeze-dried beef liver with organ tissue: Runder Schildklier & Lever (700 µg vitamin A per 2 capsules) and Runder Bijnier & Lever (272 µg per capsule), both 90 capsules. The organic, grass-fed Runderlever from Big Food (180 capsules) provides 150 µg vitamin A per daily dose of 6 capsules, alongside 11.9 µg vitamin B12 and 0.9 mg copper. You will find more organ products in the category Organ.

Other forms on the market

Individual retinol (retinyl palmitate or acetate) in capsules or drops gives an exact dosage per serving. Beta-carotene is the plant-based, vegan route and is converted by the body as needed. Carotenoid blends combine beta-carotene with, among other things, lutein and zeaxanthin. We do not currently stock these. Vitamin A is also found in many multivitamins.

How do you use vitamin A?

1. Choose your source: cod liver oil as a traditional combination of fat-soluble vitamins and fish fatty acids, liver capsules for vitamin A with a stated content.
2. Stick to the dosage on the label.
3. Take cod liver oil and liver capsules with a meal; vitamin A is fat-soluble.
4. Add up vitamin A from several products and stay below the safe upper limit of 3,000 µg per day.
5. Do not use cod liver oil or liver products if you are pregnant or trying to become pregnant.
6. Do you use medicines based on retinoids (for example for acne) or blood thinners? Then consult your doctor first.

Myths and misconceptions about vitamin A

Myth 1: "Eating carrots gives you super vision in the dark."

Half true. A vitamin A deficiency leads to poorer vision in low light, and supplementation restores it. With a normal vitamin A status, extra vitamin A does not improve your vision. The story was popularised in the Second World War by the British Royal Air Force – whether it was a deliberate cover for radar is disputed among historians.

Myth 2: "The more vitamin A, the more beautiful the skin."

Incorrect. Vitamin A contributes to the maintenance of normal skin, but more than you need does not make the skin better. A structurally too high intake can actually cause complaints, such as headaches and dry, flaky skin.

Myth 3: "Cod liver oil is just fish oil."

Not quite. Fish oil comes from the fish flesh, cod liver oil from the liver. Cod liver oil therefore also naturally contains fat-soluble vitamins such as A and D. If you only want omega-3, have a look at fish oil.

Combining vitamin A with other supplements

• Vitamin D: the other fat-soluble vitamin from cod liver oil; vitamin D contributes to the normal function of the immune system.
• Vitamin E: fat-soluble; vitamin E contributes to the protection of cells from oxidative stress.
• Zinc: involved in the transport of vitamin A from the liver; zinc contributes to the maintenance of normal vision.
• Fish Oil and omega 3: for those looking for EPA and DHA without vitamin A from liver.
• Multivitamin: make sure you add up the vitamin A from cod liver oil or liver and from the multivitamin.

Frequently asked questions

What is the difference between retinol and beta-carotene?

Retinol is the ready-made form of vitamin A from animal sources such as liver and cod liver oil. Beta-carotene is a plant-based provitamin that the body partly converts into vitamin A; this conversion varies from person to person.

How much vitamin A do I need per day?

The reference intake (RI) on labels is 800 µg per day. EFSA's safe upper limit for adults is 3,000 µg retinol per day from food and supplements combined.

Can I use cod liver oil or liver capsules if I am pregnant?

In the Netherlands, pregnant women are advised not to eat liver and not to use supplements with extra vitamin A (retinol). Cod liver oil, skate liver oil and liver capsules are therefore not suitable during pregnancy. Consult your midwife or doctor.

How much vitamin A is in cod liver oil?

Cod liver oil naturally contains vitamin A, but the amount varies by fish, season and purification process. For the cod liver oil products from Green Pasture and Nordic Naturals, the label does not state a vitamin A content. The liver capsules from Real Roots and Big Food do state the content.

Does vegan vitamin A exist?

Ready-made vitamin A (retinol) comes only from animal sources. The plant-based option is beta-carotene, from vegetables such as carrots, pumpkin and spinach or as a supplement. We do not currently stock beta-carotene supplements.

When is the best time to take vitamin A?

Vitamin A is fat-soluble. Preferably take cod liver oil and liver capsules with a meal, at the dosage stated on the label.

Sources

• Regulation (EU) 432/2012 – list of permitted health claims.
• EFSA (2006) – Tolerable Upper Intake Levels for Vitamins and Minerals (vitamin A).
• EFSA NDA Panel (2015) – Scientific Opinion on Dietary Reference Values for vitamin A. EFSA Journal 13(3):4028.
• Voedingscentrum (Netherlands Nutrition Centre) – Vitamin A.
• Penniston KL & Tanumihardjo SA (2006). The acute and chronic toxic effects of vitamin A. Am J Clin Nutr 83(2):191–201.
• Tanumihardjo SA (2011). Vitamin A: biomarkers of nutrition for development. Am J Clin Nutr 94(2):658S–665S.