Is vitamin A safe during pregnancy?

What does the evidence say about vitamin A during pregnancy?

1. The safe daily ceiling for vitamin A in pregnancy is 3,000 mcg RAE, which works out to about 10,000 IU, and that ceiling applies only to preformed vitamin A from animal foods and supplements, not to the beta-carotene your body converts from plants. 1
2. A single 3-ounce serving of beef liver contains roughly 6,582 mcg RAE of vitamin A, more than double a full day's safe ceiling in one helping, which makes liver, pate, and liverwurst the easiest food-based way to go over. 1
3. Loading up on carrots, sweet potatoes, and leafy greens isn't a safety concern the way high-dose supplements are, since the beta-carotene in produce hasn't been linked to the birth-defect risk tied to excess preformed vitamin A. 2
4. In a study that followed nearly 23,000 pregnant women, taking more than 10,000 IU a day of supplemental vitamin A before seven weeks of pregnancy was tied to a meaningfully higher rate of birth defects than lower intakes. 3
5. Isotretinoin, a prescription acne medication chemically related to vitamin A, causes such a well-documented pattern of serious birth defects that it's the clearest reason any retinoid pill or prescription-strength cream needs your healthcare provider's okay before or during pregnancy. 4

Is vitamin A safe in each trimester?

• First trimester. The first trimester, especially the weeks before seven weeks, is the most sensitive window for vitamin A-related birth defects, so this is the moment to check your prenatal label and skip any separate high-dose vitamin A pill. If you were using a prescription retinoid like tretinoin or isotretinoin for acne, stop and tell your healthcare provider right away, since these are close chemical relatives of vitamin A.
• Second trimester. As nausea eases and more variety returns to your plate, take a look at how many foods you're eating that list added vitamin A, like certain fortified cereals and dairy products. Liver, liver pate, and liverwurst are worth having only occasionally, if at all, since one serving can supply several days' worth of vitamin A at once.
• Third trimester. There's no extra vitamin A target to chase in the third trimester, so keep doing what's already working: your prenatal vitamin plus a normal, varied diet. If you're considering any new supplement or skincare product this late in pregnancy, run the label past your healthcare provider before you start it.