The effect of X-ray irradiation and retinoids on the fetus and pregnancy. Cosmetics for pregnant women: safe products and prohibited components Video: the benefits of group A vitamins

Girls take vitamins to improve the condition of their hair, skin and nails. And, at first glance, this is correct. But even useful substances sometimes turn into poison. For example, vitamin A can “work.” Many questions arise especially regarding taking medications with retinol when planning and during pregnancy. Excess of the substance can provoke pathologies of fetal development. And in some cases, women who have exceeded the permissible dosage are even recommended to terminate the pregnancy... How dangerous is vitamin A really during pregnancy?

To understand this issue, it is necessary to find out the dosages sufficient for the body to perform high-quality work, evaluate the properties of the vitamin and its effect on women's health during the period of bearing a baby.

But the first thing you need to understand is that vitamin A, which we get from food, and synthetic retinol in tablets are different substances and have different degrees of risk in case of overdose. To develop hypervitaminosis A as a result of an incorrect diet, you need to sit on fish oil alone for days. Agree, the diet is not structured in this way in any family. We usually eat foods rich in retinol several times a week, so the vitamin has time to be absorbed normally and not accumulate.

At the same time, if you intentionally “feed” the body daily, course after course, with retinol as part of a multivitamin complex, the whole set of overdose symptoms may very soon appear: poor appetite, nausea, vomiting. If a woman becomes pregnant during this period, the child may be born with deformities - retinol has a corresponding teratogenic effect.

Vitamin A - “calling card”

This vitamin was discovered first, so it is designated by the main letter of the alphabet.
Its discovery took place back in 1913, thanks to experimental mice that stopped growing and died without the required daily requirement of the vitamin.

Retinol is the active form of this substance that has been found in animal products, especially liver or whole milk.

Carotenoids exist in more than 500 types and can be converted into vitamin A. They can be found in plant foods. The most famous of them is beta-carotene. It is an antioxidant that protects cells from the destructive effects of free radicals. Moreover, in reasonable quantities it does not pose a particular danger to pregnant women. Vitamin A tends to accumulate inside the body and is used only when necessary.

Functions of retinol

Vitamin A has an effect on the immune system, protecting against colds, including influenza. Due to its positive effect on the mucous membranes, it is able to normalize lung function, restore soft fabrics for various skin diseases, stimulate collagen production.

Retinol forms and maintains a healthy state:

• skin;
• soft tissues;
• skeleton;
• teeth;
• mucous membranes.

Retinol is similar to the Latin word retina (which means “retina”) because it is involved in the formation of pigmentation in the retina. It promotes good vision in the dark.

Manifestations of vitamin A deficiency

When the body lacks a given substance, it expresses this in several ways.

• Eyes . Night blindness occurs when the lack of lighting becomes complete darkness for the eyes. A feeling of sand appears and myopia develops. The eyes water in the cold and get tired quickly. The eyelids suffer from redness.
• Leather The work of the sebaceous and sweat glands becomes unstable. The skin becomes rough and dries. As a result, wrinkles appear.
• Hair . The condition worsens, dandruff appears.
• Nails . Fragility increases. They become thinner, taking on an unhealthy appearance.
• Immunity. The overall level of immunity decreases, which leads to constant colds and the development of infections.

Natural retinol is really necessary during pregnancy, as it ensures the full development of the embryo and its nutrition. But it’s too early to breathe a sigh of relief; there is also a downside. Vitamin A is soluble in oils, but water does not have the same effect on it. It is deposited in the liver and in all tissues of the body, causing harm and toxicity when oversaturated.

Overdose of synthetic vitamin

If you just stick proper diet, then an overdose of this substance does not threaten. Only its synthetic form and retinol of animal origin are capable of negative effects.

Therefore, in almost all instructions medicines with vitamin A, pregnancy (especially the first trimester) and breastfeeding are indicated as periods when treatment with a specific drug is unacceptable.

The head physician of the Moscow reproduction clinic, Victoria Zaletova, does not recommend eating foods such as liver, fish oil and abuse food additives rich in retinol.

Manifestation of hypervitaminosis

The toxic effect is expressed in loss of appetite, which is accompanied by nausea. This causes weight loss and increased drowsiness. One of the signs of excess vitamin A in the body is a disturbance in normal gait. Internal changes affect the kidneys and central nervous system. The skin also reflects the impact, causing severe itching.

As for the effect on the fetus, it is also not easy for him: an overdose of retinol causes congenital deformities, injuries, disruption of the development of the nervous and reproductive systems, limbs and heart.

It is very important to consider that many pharmaceutical drugs contain retinol in their composition, so be sure to read the instructions when taking medications while planning and while already pregnant. In addition, doctors recommend avoiding vitamin A-based cosmetics while pregnant and breastfeeding a child.

How much vitamin A do you need during pregnancy?

Obstetrician-gynecologist and endocrinologist Elena Gevorkova answers the question of whether pregnant women can take vitamin A. She emphasizes that due to the risk of fetal development problems, it is necessary to carefully monitor the dosage. This does not mean that a slight excess of permissible norms will 100% lead to pathologies. A serious threat arises if more than 10,000 IU (3 mg/3000 mcg) per day enters the woman’s body for a long time.

The permissible daily dose of this vitamin depends on several indicators: the woman’s age, the amount of retinol in the body before pregnancy, at different stages of which the level of consumption also differs.

International organizations dealing with the issue of congenital deformities in children make the following recommendations:

• dosage for pregnant women - maximum 3 mg (3000 mcg) per day;
• dosage for nursing - maximum 1.2 mg (1200 mcg) per day.

According to doctors, multivitamins for pregnant women contain too much retinol. Therefore, they should not be taken uncontrolled and continuously. You should drink them only if there are medical indications for use. In this case, a doctor must prescribe the complex and dosage. Drinking retinol at your own discretion from the series “so that the child develops better” is unacceptable.

In general, if taking multivitamins is necessary, it is recommended to adhere to the following regimen: take two months before conception and another one and a half to two months of pregnancy. Then you need a break. And two to three months before giving birth, it is permissible to resume the course, adhering to it in the first months of lactation.

Retinol in food

To provide a pregnant woman’s body with all the necessary substances, it is not necessary to take pills. Nutrients from natural foods are the most beneficial and are best absorbed. At the same time, many dishes on our usual table are sources of vitamin A.

• Food of animal origin. These are eggs and dairy products, fish oil. It is especially worth highlighting whole milk. This also includes the kidneys and liver.
• Plant food. These are carrots, tomatoes, sweet peppers of orange and red colors, all types of cabbage, pumpkin. Various legumes also contain large amounts of beta-carotene. If we single out the leaders among fruits, they will be peaches, apples, and apricots. Seasonal fruits such as melon and watermelon also contain this vitamin. Sea buckthorn, rose hips, and cherries are also useful.
• Greens. If pregnancy occurs in the summer, then you can add “greens” to your diet. This includes sorrel, nettle, fennel, and horsetail. However, these products can only be used on the menu without fanaticism.

The table below analyzes in detail the quantitative content of retinol in popular food products and the percentage of coverage of a pregnant woman’s daily requirement for vitamin A. The calculation is based on the content of the substance in 100 g of a particular product.

Table - Foods high in vitamin A

If you don't have medical indications to take medications containing vitamins, then the question of how to take vitamin A during pregnancy is simply removed at the sight of this table. Thus, 100 g of broccoli easily covers half of a woman’s daily need for retinol, and 100 g of chicken liver is more than four times this need. Eat a balanced, healthy diet and there will be no talk of any retinol deficiency.

Remember that a contraindication is taking a synthetic form of retinol combined with vitamin diet. There is no doubt that vitamin A during pregnancy and ordinary life necessary for the body, like many other substances. But is it worth taking? chemicals when there are natural products that can meet the body's needs?

Want to hear about retinol? (and retinoic acid). Here, many experts recommend Differin and its other analogues to everyone... Without mentioning a word that this is very dangerous for women of childbearing age, it is fetal toxic. I use 1/2 times a week a very simple serum containing 1% retinol (retinol palmitate) and have noticed a dramatic result in smoothing out the skin, as well as against comedones. This is certainly not as powerful a remedy as pharmaceutical ointments against acne, but is there still a danger in using retinol-containing creams for women planning to become pregnant someday? Or does this only apply to a specific form of retinol? I read that you definitely can’t take it orally; it also accumulates in the body in fatty tissues over time. Does this also apply to carotenoids? For example, spirulina is useful for pregnant women... But it contains elephantine doses of beta-carotene.... B general question about the dangers of retinol for pregnant / non-pregnant women in cosmetics? I googled this topic and found only contradictory incompetent guesses, along the lines of “it’s better not to take risks, but what if it happens”

Doctors' answers

There is a teratogenic effect of retinol. This is not a synonym for the word toxic. The toxic effect of the drug means that when it enters the body it can negatively affect the health of the person who uses it. Teratogenic effect is a damaging effect on the fetus in the body of a pregnant woman. taking the drug. It means the possibility of malformations of the organs of the embryo or fetus. The fact that retinol has this effect has been known for a long time. It is not for nothing that the use of retinoids is recommended after receiving negative test for pregnancy on the first day of the next menstruation, that is, when the absence of pregnancy is confirmed. When retinol is taken orally, we recommend not planning a pregnancy for at least 1-2 months. When applied externally, the concentration of retinol in the body is less predictable. But this does not mean that retinol that enters the body through the skin is less dangerous for the fetus. There are no studies that have clearly reliably established the route of retinol entering the skin. I recommend avoiding its use for girls who are not protecting themselves from pregnancy and are planning one.

Alice, I think I need to make a small correction. There is enough large group medications called retinoids. This group includes retinol and its synthetic analogues transretinoic acid, 13 cis transretinoic acid (you may be familiar with them from drugs such as tretinoin, isotretinoin, also known as roaccutane). The group of retinoids includes aromatic analogues tigazone and neotigazone. So, in terms of the magnitude of the teratogenic effect, the most dangerous are synthetic analogues of vitamin A (tretinoin, roaccutane and especially its aromatic analogues. The latter are excreted within 2 years and are extremely toxic and, in fact, are very dangerous for the fetus. If they are taken, pregnancy is prohibited for about 2-3 years. As for retinoic acid (and this is the well-known roaccutane), when taken orally, a period of 2 weeks is required for its complete elimination. However, given the danger of the effect on the fetus and given the insufficient knowledge of this group of drugs, many manuals give a period of six months. retinol itself, then small amounts of up to 5-6 thousand IU are acceptable for taking during pregnancy (this is usually covered by eating sour cream butter) Large doses of retinol during pregnancy are unacceptable (content in Vit A is up to 50 thousand IU) As for creams, it is necessary to clarify the amount Vit A Since it is possible to calculate it in every cream, but it is quite troublesome, it is easier to avoid using cosmetics with retinol during pregnancy.

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The Pharmacovigilance Agency of the European Medicines Agency (PRAC) introduces new recommendations on the use of retinoids.

Retinoids are often used in oral, cream, and gel forms to treat acne, psoriasis, and some cancers.

• In July 2016, PRAC launched an investigation into the safety of retinoids due to the increased risk of neuropsychiatric diseases. The analysis showed that the use of oral retinoids during pregnancy is fraught with negative consequences for the fetus. In this regard, the use of acitretin, alitretinoin and isotretinoin should be prohibited in women of childbearing age.

• As for tropical retinoids, the amount of substance absorbed is very small and is unlikely to harm the development of the fetus. However, repeated use of drugs in a large dose may increase absorption, so the use of topical forms is also not recommended during pregnancy or in women planning.

Risk of developing neuropsychiatric diseases

Although warnings about the possible development of depression and mood changes are already included in the instructions for oral retinoids, a review of the available data shows that the scale side effects underrated.

• Of course, it cannot be ignored that patients with severe skin diseases themselves have an increased risk of depression and anxiety. However, European pharmacovigilance insists on the need for more detailed indication of symptoms and signs of changes in mood and behavior in the instructions for drugs. This will help patients and their relatives be more attentive to the changes taking place.

Source: EMA. PRAC recommends updating measures for pregnancy prevention during retinoid use. 9 February 2018.

X-ray exposure during pregnancy. All radiographic procedures should be performed with minimal exposure. Each radiology department should have a protocol for examining women of reproductive age.

To minimize unintended fetal exposure, any woman undergoing diagnostic radiation to areas near the uterus should be asked whether she is pregnant or might become pregnant the day before the procedure. Any answer other than a categorically negative one should be considered positive.

Areas distant from the fetus can be examined radiographically at any stage of pregnancy with the consent of an informed radiologist. X-ray exposure of tissue near the uterus in a woman of childbearing age is dangerous during pregnancy, including immediately or several weeks after the examination. More detailed recommendations on this issue are contained in the work of Popat et al.

Vitamin A is not produced in the body, although it is so necessary for the normal functioning of vital systems. Coming with food and accumulating in the liver, this substance participates in metabolism and regeneration processes, strengthens the immune system. During pregnancy, along with other useful micro- and macroelements, it is responsible for correct formation and development of embryonic organs. Both a lack and an excess of vitamin A can negatively affect the well-being of the expectant mother and the health of the baby.

Forms of vitamin A and their effect on the body

The term “vitamin A” is used to refer to two types (or forms) of nutrients:

• carotenoids (including beta-carotene) are provitamins that, when they enter the body, are oxidized, broken down and transformed into fat-soluble vitamin A;
• retinoids - in this form, vitamins of group A enter the systemic bloodstream and are delivered to organs and cells.

With an excess of retinol (hypervitaminosis A), disturbances in the processes of fetal formation and development are possible. Beta-carotene, on the contrary, is absorbed in the amount required by the body.

During pregnancy, vitamin A is recommended to be consumed with food or as part of the supplement. vitamin complexes, created specifically for expectant mothers: there it is presented with beta-carotene or a combination of carotenoid and retinoid to avoid overdose.

Video: benefits of vitamins A

The effect of vitamin A on the fetus during pregnancy

Vitamin A is involved in many processes occurring in the body:

• strengthening immunity;
• protection against bacterial infections of the digestive tract, respiratory tract, and genitourinary system;
• absorption and distribution of fats;
• liberation of the body from toxins;
• neutralization of free radicals;
• slowing down the aging process;
• preventing the development of malignant tumors;
• improvement of condition skin;
• prevention of occurrence age spots and stretch marks;
• maintaining the function of light and color perception by the retina;
• moisturizing the mucous membrane of the eyes;
• formation and good nutrition placenta;
• growth of bones, teeth, new cells (in mother and baby);
• regulation of protein synthesis;
• the formation and full development of the cardiovascular, circulatory, immune, respiratory, central, and nervous systems of the embryo;
• healthy functioning of the heart and lungs;
• redox and metabolic processes.

On early stages During pregnancy, vitamin A is important for the formation and growth of the embryo, and in late pregnancy - for the nutrition of the baby and the development of its immune system.

Retinoids and carotenoids are usually supplied to the body in sufficient quantities through food. But there are also cases of hypovitaminosis (deficiency), the signs of which are:

• deterioration of visual acuity (including when yellow and blue colors become difficult to distinguish);
• thickening and dryness of the mucous membrane of the eyes, irritation, burning sensation and itching of the organs of vision;
• frequent conjunctivitis;
• a sharp weakening of the immune system;
• loss of appetite and rapid weight loss;
• hair loss and dandruff;
• slow healing of wounds and scratches;
• increased sensitivity of tooth enamel;
• deterioration of the skin condition (it looks faded, aged, dry).

The causes of retinol hypovitaminosis can be different: impaired absorption in the intestines, consumption of fatty foods, chronic infectious diseases, pathologies of the digestive system and urinary system, anemia, celiac disease and others.

One of the signs of vitamin A deficiency is hair loss.

The optimal daily content of retinol in the blood is 800–1000 mcg (or 0.14–0.26 mcg/ml). In case of severe deviations from the norm, appropriate treatment is prescribed; in case of minor deviations, it is enough to adjust the diet. The effectiveness of the therapy is determined using a blood test for vitamins and microelements.

A deficiency or excess of retinol in the body can be determined through laboratory tests of blood, hair or nail samples.

Indications for prescribing vitamin A during pregnancy

Additionally, you can take vitamin A only as prescribed by your doctor. For preventive purposes, carotenoids are recommended for pregnant women, and for the treatment of hypovitaminosis, the use of retinoids is acceptable.

Research by American doctors has confirmed that there is a relationship between taking high doses of vitamin A in early pregnancy and the occurrence of fetal development pathologies such as impaired formation of limbs and organs, liver and kidney damage.

Additional vitamin intake may be prescribed in the following cases:

• diseases of the mucous membranes and skin (candidiasis, eczema, dermatitis of allergic origin);
• eye pathologies (conjunctivitis, keratitis, decreased ability to adapt to darkness);
• extensive wounds, burns, fractures (to improve and accelerate healing processes);
• acute and chronic pneumonia;
• anemia.

The iron content in the blood depends on the concentration of retinol in the blood.

Contraindications and precautions

In order to avoid side effects when taking vitamin A, you need to know about the contraindications for its use:

• allergy, bronchial asthma- such conditions in some cases can significantly increase the level of the substance in the blood serum;
• hypothyroidism - the body is not able to convert vitamin A into retinol, which means there is a risk of overdose;
• liver pathologies - since the transformation of the vitamin occurs in this organ, additional load can lead to exacerbation of chronic diseases.

Caution should be exercised when taking prenatal vitamin complexes that already contain retinol or beta-carotene, as well as when using cosmetics, which includes vitamin A (it enters the body through the pores).

Vitamin A is involved in the production of sex hormones. Its deficiency or excess can affect the hormonal levels of the expectant mother and provoke pregnancy complications.

Why is an overdose of vitamin A dangerous during pregnancy?

In the first trimester of pregnancy, an overdose of the vitamin is dangerous because it can negatively affect the formation of the embryo (heart defects, kidney defects, congenital deformity, paralysis). In the second and third trimesters, retinol in large doses gives additional load on the pancreas and liver of the mother and fetus, which leads to the development of pathologies of these organs (enlarged liver, impaired bile outflow).

Signs of hypervitaminosis

Excess retinol in the body can be characterized by the following symptoms:

• loss of appetite;
• nausea, vomiting;
• pain in the abdomen, joints;
• disruptions in the digestive system;
• enlarged liver and spleen;
• renal dysfunction;
• uncontrolled release of hormones (as evidenced by sweating, chills, frequent change mood, depression, insomnia or drowsiness);
• brittleness and splitting of nails;
• hair loss;
• dryness and flaking of the skin;
• small cracks on the lips (usually in the corners of the mouth);
• appearance of pigment spots

There is a fairly large group of medications called retinoids. This group includes retinol and its synthetic and aromatic analogs.<…>The latter are excreted within 2 years, are extremely toxic and in fact are very dangerous for the fetus. If taken, pregnancy is prohibited for about 2–3 years. As for retinoic acid, when taken orally, a period of 2 weeks is required for its complete elimination. However, given the danger of action on the fetus and the insufficient knowledge of this group of drugs, many guidelines give a period of six months. As for retinol itself, small amounts of it, up to 5–6 thousand IU, are acceptable for use during pregnancy (this is usually covered by eating butter and sour cream). Large doses of retinol during pregnancy are unacceptable (vitamin A content is up to 50 thousand IU). As for creams, it is necessary to clarify the amount of vitamin A. Since it is possible to calculate it in each cream, but this is quite troublesome, it is better to avoid using cosmetics with retinol during pregnancy.

Montes Rosel Ksenia Vasilievna, cosmetologist

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The amount of vitamin A needed by the expectant mother primarily depends on age:

• up to 19 years - 750 mcg (or 2500 IU);
• from 20 - 770 mcg (or 2565 IU).

In different sources, the intake rates of retinol for pregnant women differ markedly. Doctors, based on research by American scientists, believe that it is better to stick to minimum dosages.

Accidental one-time use too large quantity vitamin A is unlikely to harm the baby. But prolonged exposure to the body of increased doses of retinol can cause a teratogenic effect, which causes the appearance of abnormalities in the development of the child. Vitamin A is consumed by the body slowly, and it tends to accumulate in the liver and adipose tissue.

Excess beta-carotene can cause yellowing of the skin, but is not dangerous for the body. With retinol the situation is different: its overdose is fraught with serious consequences for both the mother and the fetus. The maximum allowable amount of retinol per day during pregnancy is 6000–10000 IU. Dosages above 18,000 IU are considered teratogenic.

Features of use depending on the timing of pregnancy

Considering the ability of vitamin A to accumulate in the body and influence metabolic processes even after the end of its intake, pregnant women are recommended to take it in minimal dosages and according to a certain schedule for preventive purposes.

Table: vitamin A regimen for expectant mothers

Rules for taking and products high in retinol and beta-carotene

In order for retinol to be absorbed into required quantity, the presence of fats, proteins, vitamin E is required. If expectant mother lacks any of these components, the breakdown and absorption of vitamin A is significantly reduced.

Before entering the bloodstream, retinol must combine with bile. If a dish contains insufficient fat, too little fat is produced. This means that it combines with a smaller amount of vitamin (at the same time, its absorption is reduced to 90%).

The following foods are rich in retinol:

• liver (beef, cod);
• fish oil, caviar, herring fillet;
• sour cream, cream, butter, whole milk, cottage cheese, cheese;
• eggs (yolks).

A lot of retinol is found in the liver, but it is dangerous to use during pregnancy: 90 grams of beef liver contains 12 times more vitamin A than the daily dose.

Photo gallery: animal products high in retinol

Retinol content per 100 grams - 380 mcg Retinol content per 100 grams - 15000 mcg Retinol content in one egg - 260 mcg Retinol content per 100 grams - 110 mcg Retinol content per 100 grams - 1000 mcg Retinol content per 100 grams - 500 mcg Retinol content per 100 grams - 270 mcg Retinol content per 100 grams - 4000 mcg Retinol content per 100 grams - 120 mcg Retinol content per 100 grams - 700 mcg

• carrots, zucchini, tomatoes, pumpkin, white cabbage and broccoli, bell pepper;
• spinach, sorrel, parsley, green onions, peppermint, fennel, lemongrass;
• apples, grapes, apricots, peaches, watermelons, melons, plums, cherries, persimmons;
• rosehip, rowan, sea buckthorn;
• oat, buckwheat, wheat, millet cereals.

When processing foods (cooking, grating, chopping, squeezing juice), carotenoids are broken down much more easily and converted into fat-soluble vitamin A more quickly.

Photo gallery: plant products containing carotenoids

Beta-carotene content per 100 grams - 3500 mcg Beta-carotene content per 100 grams - 850 mcg Beta-carotene content per 100 grams - 5600 mcg Beta-carotene content per 100 grams - 10,000 mcg Beta-carotene content per 100 grams - 700 mcg Beta-carotene content in 1 medium fruit - 3600 mcg Beta-carotene content per 100 grams - 630 mcg Beta-carotene content per 100 grams - 15,000 mcg Beta-carotene content per 100 grams - 10,000 mcg Beta-carotene content per 100 grams - 2332 mcg

Table: Sources of Retinol and Beta Carotene

The conversion factor for the breakdown of carotenoids into retinol is 6:1 (1 mcg of retinol is equal to 6 mcg of beta-carotene). Thus, to get 1 part processed fat-soluble vitamin A, you need to eat 6 parts beta-carotene.

Vitamin A in capsules, tablets, dragees, etc.

The forms of release of vitamins of group A can be different:

• dragees and tablets containing retinol acetate or retinol palmitate;
• oil solution;
• natural cod oil.

The substance is often included in multivitamin complexes, including those intended for pregnant women.

When prescribing a vitamin to expectant mothers, preference is usually given to beta-carotene or a combination of beta-carotene plus retinol of natural origin (cod oil). Synthetic analogues are not recommended due to the risk of side effects.