Vitamin A Deficiency and Clinical Disease

Vitamin A deficiency manifests itself in a plethora of different ways. People suffering from a vitamin A deficiency may have dry eyes, medically known as xerophthalmia, they may be prone to infection, and may even suffer from inhibited growth. Careful and close examination of the deficiency reveals epochs of origin in the 18th or 19th centuries. However, as of late, and with the aid of modern technology, medical science is learning more about how vitamin A deficiencies affect societies in lower income nationalities and how these impacts are affecting global health policies.

Exploration of vitamin A deficiency demands closer examination of xerophthalmia. It is a little known fact that xerophthalmia is an almost inevitable side effect of vitamin A deficiency. The order of events during the progression of xerophthalmia begins with dryness and leads to night blindness. Individuals suffering from vitamin A deficiency gradually lose the ability to see at night or in dark rooms. The revelation of xerophthalmia led to experimental treatments originated by the ancient Egyptians.

These experimental treatments included dripping the excretions of grilled lamb’s liver into the eyes of sufferers. The records of this practice led to speculations by George Wolff in 1971, which eventually gave birth to additional experimentation of vitamin A deficiencies. Historical records indicate an increase of “night blindness” throughout the 18th and 19th centuries. The instance of night blindness during this time was considered common and a variety of different cures were prescribed by physicians of the time.

During this timeframe, more severe forms of xerophthalmia began to manifest themselves in the form of corneal ulceration. During the first two decades of the 20th century, researchers finally began animal experimentation to test theories surrounding night blindness, inhibited growth and vitamin A deficiency. It soon also became evident that deficiencies in levels of vitamin A can lead to increased mortality. Mortality as related to vitamin A deficiency was revealed to be oft related to the location and ‘class’.

Individuals living in rural or underdeveloped areas are more at risk for vitamin A deficiency related mortality. As medical science learned more about the deficiency, so too was it developing crystallized vitamin A, which first came to fruition in 1937. As time passed, large scale laboratory testing became commonplace and it wasn’t until 1986 that the first large scale field study was published. This study, in turn, led to some shocking revelations concerning vitamin A deficiency and mortality, particularly among children from six months to 5 years of age living in rural, undeveloped locales.

This study revealed a dramatic reduction in mortality rates in direct correlation to vitamin A intake. “The greatest reduction in mortality was observed in an Indonesian study that employed monosodium glutamate fortification (thereby providing subjects with daily, small doses of vitamin A) and an Indian study in which the children received a small dose once a week (reductions in mortality of 45 and 54%, respectively)” (Sommer 2008)

Speculation then arose as to which forms of vitamin A were more beneficial, crystallized pill form or vitamin A as derived from food. This speculation prompted a new series of studies that examined the conversion levels of natural vitamin A in available foods. Ever since the 1974 WHO/USAID conference reignited global interest in the problem, there has been sharp disagreement about whether it can (and should) be solved solely through changes in the consumption of b-carotene–containing foods or requires some form of nondietary vitamin.

(Sommers 2008) Final supposition reveals that vitamin A in pill form works quickly and effectively in the healing process of mild to severe xeropthalmia by boosting levels of active retinol. This supposition also reveals that foods available in developing countries contain far less the conversion of b-carotene than needed, thereby revealing an increasing need for supplementation of the nutrient in these underdeveloped locations. Conclusively, Although vitamin A has finally taken its place as a major

health intervention, we still do not precisely know how it increases resistance to infection, although there is ample clinical and laboratory evidence that it does. Although vitamin Awas one of the first ‘‘accessory’’ factors to be identified by nutritional research, our understanding of its role in human health is still evolving. (Sommers 2008)


Sommers, A. (2008, June). Vitamin A Deficiency and Clinical Disease: A Historical Overview. Journal of Nutrition, 1835-1839.

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