VITAMIN A: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

Overview

Vitamin A is a fat-soluble vitamin. Its different forms are often called "retinoids." They include retinol, retinal, retinoic acid, and retinyl ester.

Vitamin A is needed for the proper growth and functioning of many parts of the body, including the eyes, skin, and immune system. It can be found in many foods, including fruits, vegetables, and fish. Carotenoids are a group of chemicals found in plants. Some can be converted to vitamin A in the body.

People most commonly use vitamin A for treating vitamin A deficiency. It is also used for aging skin, acne, HIV/AIDS, cataracts, child development, infections, and many other conditions.

Uses & Effectiveness ?

Effective for

Vitamin A deficiency. Taking vitamin A by mouth is effective for preventing and treating vitamin A deficiency.

Possibly Effective for

Aging skin. Applying vitamin A (retinol) on the skin improves skin color, flexibility, and wrinkles in people with aging skin. It isn't clear whether non-prescription retinol works as well as prescription products such as tretinoin (Renova).
A lung disease that affects newborns (bronchopulmonary dysplasia). Giving vitamin A as a shot seems to reduce the risk of this lung disease in infants born with a low birth weight. Vitamin A shots can only be given by a healthcare provider. It isn't clear whether giving vitamin A by mouth is helpful.
Diarrhea. Giving vitamin A by mouth to young children who are at risk of vitamin A deficiency seems to prevent diarrhea. It isn't clear whether taking vitamin A while breastfeeding can help to prevent diarrhea in the nursing infant.
Measles. Taking vitamin A by mouth seems to reduce the risk of measles, its complications, and death in young children with vitamin A deficiency.
Ability to see in low-light conditions. Taking vitamin A by mouth during pregnancy seems to reduce night blindness by 37% in malnourished adults. Vitamin A might work better for this condition when taken with zinc.
White patches inside the mouth that are usually caused by smoking (oral leukoplakia). Taking high-dose vitamin A by mouth can help treat these lesions.
Death from any cause. Taking high-dose vitamin A by mouth reduces the risk of death in children under 5 years of age who are at risk for vitamin A deficiency. Taking vitamin A doesn't seem to reduce the risk of death in healthy adults.
Complications after childbirth. Taking vitamin A by mouth before, during, and after pregnancy reduces diarrhea and the risk of death after giving birth in malnourished adults.
An inherited eye condition that causes poor night vision and loss of side vision (retinitis pigmentosa). Taking vitamin A by mouth can slow the progression of an eye disease that causes damage to the retina.
A type of inflammatory bowel disease (ulcerative colitis). Taking vitamin A by mouth daily for 2 months can reduce symptoms in adults with ulcerative colitis.
Skin wrinkles from sun damage. Applying non-prescription vitamin A (retinol) serum to the skin improves skin smoothness and wrinkles in females with sun-damaged skin. It might work as well as the prescription products that are approved by the FDA for treating skin wrinkles, such as tretinoin (Renova).

Possibly Ineffective for

Prone to allergies and allergic reactions (atopic disease). Giving a single dose of vitamin A by mouth to infants does not seem to prevent atopy.
Death of an unborn or premature baby. Taking vitamin A by mouth before, during, or after pregnancy does not seem to prevent infant death during the first year of life. Also giving vitamin A by mouth directly to infants doesn't seem to prevent infant death.
Infection of the intestines by parasites. Giving a single dose of vitamin A by mouth to children taking medicine to treat intestinal parasites doesn't seem to prevent reinfection.
The most serious type of skin cancer (melanoma). Taking a high dose of vitamin A by mouth doesn't seem to improve survival in people with melanoma.
Miscarriage. Taking vitamin A by mouth, alone or in combination with other vitamins, before or during early pregnancy doesn't reduce the risk of miscarriage or stillbirth.
Blood infection (sepsis). Giving vitamin A to premature infants doesn't seem to prevent sepsis.
Tuberculosis. Taking vitamin A by mouth doesn't seem to improve symptoms or decrease the risk of death in people with this condition.

Likely InEffective for

Head and neck cancer. Taking vitamin A by mouth does not reduce the risk of developing new tumors or improve survival in people with head and neck cancer.
HIV transmission. Taking vitamin A by mouth does not lower the risk of passing HIV to the fetus during pregnancy, to newborns during delivery, or to infants during breastfeeding. Taking vitamin A supplements during pregnancy might actually increase the risk of passing HIV to babies through breast milk.
Infection of the lower airways. Taking vitamin A by mouth does not prevent or reduce symptoms of lower airway infections in children. Also, taking vitamin A while breast-feeding does not seem to prevent these infections in nursing infants.

There is interest in using vitamin A for a number of other purposes, but there isn't enough reliable information to say whether it might be helpful.

Side Effects

When taken by mouth: Vitamin A is likely safe when taken in amounts less than 10,000 units (3,000 mcg) daily. Vitamin A is available in two forms: pre-formed vitamin A (retinol or retinyl ester) and provitamin A (carotenoids). The maximum daily dose relates to only pre-formed vitamin A.

Pre-formed vitamin A is possibly unsafe when taken in doses greater than 10,000 units (3,000 mcg) daily. Higher doses might increase the risk of side effects. Long-term use of large amounts might cause serious side effects including mental changes.

When applied to the skin: Vitamin A is possibly safe when used short-term. Retinol 0.5% serum has been used daily for up to 12 weeks without serious side effects.

Special Precautions and Warnings

Pregnancy and breast-feeding: Vitamin A is likely safe when taken in recommended amounts of less than 10,000 units (3,000 mcg) of pre-formed vitamin A daily. Larger amounts are possibly unsafe and can cause birth defects. Monitor vitamin A intake from all sources during the first three months of pregnancy. Forms of vitamin A are found in several foods including animal liver, some fortified breakfast cereals, and dietary supplements.

Children: Vitamin A is likely safe when taken in the recommended amounts. The maximum amounts of vitamin A that are safe for children are based on age. Vitamin A is possibly unsafe for children when taken by mouth in high doses. Taking high doses can cause side effects, including irritability, sleepiness, diarrhea, and other problems.

Excessive use of alcohol: Drinking alcohol might increase vitamin A's potentially harmful effects on the liver.

Disorders in which the body does not absorb fat properly: People with conditions that affect fat absorption are not able to absorb vitamin A properly. These conditions include celiac disease, short gut syndrome, jaundice, cystic fibrosis, pancreatic disease, and cirrhosis of the liver. If you have one of these conditions, take water-soluble forms of vitamin A, called carotenoids, instead.

Iron deficiency: Iron deficiency might affect the body's ability to use vitamin A.

Liver disease: Too much vitamin A might make liver disease worse. Do not take vitamin A supplements if you have liver disease.

Malnutrition: In people with severe protein malnutrition, taking vitamin A supplements might result in having too much vitamin A in the body.

Zinc deficiency: Zinc deficiency might cause symptoms of vitamin A deficiency. Taking a combination of vitamin A and zinc supplements might be necessary to improve this condition.

Interactions ?

Major Interaction

Do not take this combination

Medications for skin conditions (Retinoids) interacts with VITAMIN A
Some medications for skin conditions are made from vitamin A. Taking vitamin A and these medications together could cause toxic effects.

Moderate Interaction

Be cautious with this combination

Antibiotics (Tetracycline antibiotics) interacts with VITAMIN A
Taking very large amounts of vitamin A along with tetracyclines can increase the chance of a serious side effect called intracranial hypertension. But taking normal doses of vitamin A along with tetracyclines does not seem to cause this problem. Do not take large amounts of vitamin A if you are taking antibiotics.
Medications that can harm the liver (Hepatotoxic drugs) interacts with VITAMIN A
Taking large amounts of vitamin A might harm the liver. Some medications can also harm the liver. Taking high doses of vitamin A along with a medication that can harm the liver might increase the risk of liver damage.
Warfarin (Coumadin) interacts with VITAMIN A
Warfarin is used to slow blood clotting. Large amounts of vitamin A can also slow blood clotting. Taking vitamin A along with warfarin can increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your warfarin might need to be changed.

Dosing

Vitamin A is an important nutrient. It is found in many foods, including fruits, vegetables, eggs, whole milk, meat, and fish. The amount that should be consumed on a daily basis is called the recommended dietary allowance (RDA). The RDA is 900 mcg daily for males and 700 mcg daily for females. While pregnant, the RDA is 770 mcg daily. While breast-feeding, the RDA is 1300 mcg daily. In children, the RDA depends on age.

In supplements, vitamin A is available in two forms: pre-formed vitamin A (retinol or retinyl ester) and provitamin A (carotenoids). For products that contain both, only count the amount of pre-formed vitamin A to determine what is safe. Vitamin A is also available in many topical products, including creams, serums, and lotions. Speak with a healthcare provider to find out what type of product and dose might be best for a specific condition.

View References

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Mathew, J. L., Patwari, A. K., Gupta, P., Shah, D., Gera, T., Gogia, S., Mohan, P., Panda, R., and Menon, S. Acute respiratory infection and pneumonia in India: a systematic review of literature for advocacy and action: UNICEF-PHFI series on newborn and child health, India. Indian Pediatr. 2011;48(3):191-218. View abstract.

Mathew, J. L., Shah, D., Gera, T., Gogia, S., Mohan, P., Panda, R., Menon, S., and Gupta, P. UNICEF-PHFI Series on newborn and child health, India: methodology for systematic reviews on child health priorities for advocacy and action. Indian Pediatr. 2011;48(3):183-189. View abstract.

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Matsunami, E., Takashima, A., Mizuno, N., Jinno, T., and Ito, H. Topical PUVA, etretinate, and combined PUVA and etretinate for palmoplantar pustulosis: comparison of therapeutic efficacy and the influences of tonsillar and dental focal infections. J Dermatol. 1990;17(2):92-96. View abstract.

Matthay, K. K., Villablanca, J. G., Seeger, R. C., Stram, D. O., Harris, R. E., Ramsay, N. K., Swift, P., Shimada, H., Black, C. T., Brodeur, G. M., Gerbing, R. B., and Reynolds, C. P. Treatment of high-risk neuroblastoma with intensive chemotherapy, radiotherapy, autologous bone marrow transplantation, and 13-cis-retinoic acid. Children's Cancer Group. N.Engl.J Med. 10-14-1999;341(16):1165-1173. View abstract.

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Menendez, C., Kahigwa, E., Hirt, R., Vounatsou, P., Aponte, J. J., Font, F., Acosta, C. J., Schellenberg, D. M., Galindo, C. M., Kimario, J., Urassa, H., Brabin, B., Smith, T. A., Kitua, A. Y., Tanner, M., and Alonso, P. L. Randomised placebo-controlled trial of iron supplementation and malaria chemoprophylaxis for prevention of severe anaemia and malaria in Tanzanian infants. Lancet 9-20-1997;350(9081):844-850. View abstract.

Mermin, J., Lule, J., Ekwaru, J. P., Malamba, S., Downing, R., Ransom, R., Kaharuza, F., Culver, D., Kizito, F., Bunnell, R., Kigozi, A., Nakanjako, D., Wafula, W., and Quick, R. Effect of co-trimoxazole prophylaxis on morbidity, mortality, CD4-cell count, and viral load in HIV infection in rural Uganda. Lancet 10-16-2004;364(9443):1428-1434. View abstract.

Meyskens, F. L., Jr., Kopecky, K. J., Appelbaum, F. R., Balcerzak, S. P., Samlowski, W., and Hynes, H. Effects of vitamin A on survival in patients with chronic myelogenous leukemia: a SWOG randomized trial. Leuk.Res 1995;19(9):605-612. View abstract.

Meyskens, F. L., Jr., Liu, P. Y., Tuthill, R. J., Sondak, V. K., Fletcher, W. S., Jewell, W. R., Samlowski, W., Balcerzak, S. P., Rector, D. J., Noyes, R. D., and . Randomized trial of vitamin A versus observation as adjuvant therapy in high-risk primary malignant melanoma: a Southwest Oncology Group study. J Clin Oncol. 1994;12(10):2060-2065. View abstract.

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Mignone, L. I., Giovannucci, E., Newcomb, P. A., Titus-Ernstoff, L., Trentham-Dietz, A., Hampton, J. M., Willett, W. C., and Egan, K. M. Dietary carotenoids and the risk of invasive breast cancer. Int.J.Cancer 6-15-2009;124(12):2929-2937. View abstract.

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Miller, P. E. and Snyder, D. C. Phytochemicals and cancer risk: a review of the epidemiological evidence. Nutr.Clin.Pract. 2012;27(5):599-612. View abstract.

Millikan, L. E. Pivotal clinical trials of adapalene in the treatment of acne. J Eur Acad Dermatol Venereol. 2001;15 Suppl 3:19-22. View abstract.

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Mittal, R., Malhotra, S., Pandhi, P., Kaur, I., and Dogra, S. Efficacy and safety of combination Acitretin and Pioglitazone therapy in patients with moderate to severe chronic plaque-type psoriasis: a randomized, double-blind, placebo-controlled clinical trial. Arch.Dermatol. 2009;145(4):387-393. View abstract.

Mockenhaupt, F. P., Reither, K., Zanger, P., Roepcke, F., Danquah, I., Saad, E., Ziniel, P., Dzisi, S. Y., Frempong, M., Agana-Nsiire, P., Amoo-Sakyi, F., Otchwemah, R., Cramer, J. P., Anemana, S. D., Dietz, E., and Bienzle, U. Intermittent preventive treatment in infants as a means of malaria control: a randomized, double-blind, placebo-controlled trial in northern Ghana. Antimicrob.Agents Chemother. 2007;51(9):3273-3281. View abstract.

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Moon, T. E., Levine, N., Cartmel, B., Bangert, J. L., Rodney, S., Dong, Q., Peng, Y. M., and Alberts, D. S. Effect of retinol in preventing squamous cell skin cancer in moderate-risk subjects: a randomized, double-blind, controlled trial. Southwest Skin Cancer Prevention Study Group. Cancer Epidemiol Biomarkers Prev. 1997;6(11):949-956. View abstract.

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MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet 7-6-2002;360(9326):7-22. View abstract.

Muhilal, Permeisih, D., Idjradinata, Y. R., Muherdiyantiningsih, and Karyadi, D. Vitamin A-fortified monosodium glutamate and health, growth, and survival of children: a controlled field trial. Am J Clin Nutr 1988;48(5):1271-1276. View abstract.

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Munoz, N., Wahrendorf, J., Bang, L. J., Crespi, M., Thurnham, D. I., Day, N. E., Ji, Z. H., Grassi, A., Yan, L. W., Lin, L. G., and . No effect of riboflavine, retinol, and zinc on prevalence of precancerous lesions of oesophagus. Randomised double-blind intervention study in high-risk population of China. Lancet 7-20-1985;2(8447):111-114. View abstract.

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Murray, H. E., Anhalt, A. W., Lessard, R., Schacter, R. K., Ross, J. B., Stewart, W. D., and Geiger, J. M. A 12-month treatment of severe psoriasis with acitretin: results of a Canadian open multicenter study. J Am Acad.Dermatol. 1991;24(4):598-602. View abstract.

Muslimatun, S., Schmidt, M. K., Schultink, W., West, C. E., Hautvast, J. A., Gross, R., and Muhilal. Weekly supplementation with iron and vitamin A during pregnancy increases hemoglobin concentration but decreases serum ferritin concentration in Indonesian pregnant women. J Nutr 2001;131(1):85-90. View abstract.

Mwanri, L., Worsley, A., Ryan, P., and Masika, J. Supplemental vitamin A improves anemia and growth in anemic school children in Tanzania. J Nutr 2000;130(11):2691-2696. View abstract.

Nacul, L. C., Kirkwood, B. R., Arthur, P., Morris, S. S., Magalhaes, M., and Fink, M. C. Randomised, double blind, placebo controlled clinical trial of efficacy of vitamin A treatment in non-measles childhood pneumonia. BMJ 8-30-1997;315(7107):505-510. View abstract.

Nduati, R., John, G., Mbori-Ngacha, D., Richardson, B., Overbaugh, J., Mwatha, A., Ndinya-Achola, J., Bwayo, J., Onyango, F. E., Hughes, J., and Kreiss, J. Effect of breastfeeding and formula feeding on transmission of HIV-1: a randomized clinical trial. JAMA 3-1-2000;283(9):1167-1174. View abstract.

Negri, E., La, Vecchia C., Franceschi, S., D'Avanzo, B., Talamini, R., Parpinel, M., Ferraroni, M., Filiberti, R., Montella, M., Falcini, F., Conti, E., and Decarli, A. Intake of selected micronutrients and the risk of breast cancer. Int J Cancer 1-17-1996;65(2):140-144. View abstract.

NEI statement: Update on vitamin A as a treatment for retinitis pigmentosa. Optom.Vis.Sci 2008;85(9):E790-E791. View abstract.

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Nevill, C. G., Some, E. S., Mung'ala, V. O., Mutemi, W., New, L., Marsh, K., Lengeler, C., and Snow, R. W. Insecticide-treated bednets reduce mortality and severe morbidity from malaria among children on the Kenyan coast. Trop.Med Int Health 1996;1(2):139-146. View abstract.

Newton, S., Cousens, S., Owusu-Agyei, S., Filteau, S., Stanley, C., Linsell, L., and Kirkwood, B. Vitamin a supplementation does not affect infants' immune responses to polio and tetanus vaccines. J Nutr 2005;135(11):2669-2673. View abstract.

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Nighland, M. and Grossman, R. Tretinoin microsphere gel in facial acne vulgaris: a meta-analysis. J Drugs Dermatol 2008;7(8 Suppl):s2-s8. View abstract.

Nissen, S. B., Tjonneland, A., Stripp, C., Olsen, A., Christensen, J., Overvad, K., Dragsted, L. O., and Thomsen, B. Intake of vitamins A, C, and E from diet and supplements and breast cancer in postmenopausal women. Cancer Causes Control 2003;14(8):695-704. View abstract.

Niu, C., Yan, H., Yu, T., Sun, H. P., Liu, J. X., Li, X. S., Wu, W., Zhang, F. Q., Chen, Y., Zhou, L., Li, J. M., Zeng, X. Y., Yang, R. R., Yuan, M. M., Ren, M. Y., Gu, F. Y., Cao, Q., Gu, B. W., Su, X. Y., Chen, G. Q., Xiong, S. M., Zhang, T. D., Waxman, S., Wang, Z. Y., Chen, Z., Hu, J., Shen, Z. X., and Chen, S. J. Studies on treatment of acute promyelocytic leukemia with arsenic trioxide: remission induction, follow-up, and molecular monitoring in 11 newly diagnosed and 47 relapsed acute promyelocytic leukemia patients. Blood 11-15-1999;94(10):3315-3324. View abstract.

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No author. The alpha-tocopherol, beta-carotene lung cancer prevention study: design, methods, participant characteristics, and compliance. The ATBC Cancer Prevention Study Group. Ann.Epidemiol. 1994;4(1):1-10. View abstract.

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Nosten, F., Luxemburger, C., Kyle, D. E., Ballou, W. R., Wittes, J., Wah, E., Chongsuphajaisiddhi, T., Gordon, D. M., White, N. J., Sadoff, J. C., and Heppner, D. G. Randomised double-blind placebo-controlled trial of SPf66 malaria vaccine in children in northwestern Thailand. Shoklo SPf66 Malaria Vaccine Trial Group. Lancet 9-14-1996;348(9029):701-707. View abstract.

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Nursyam, E. W., Amin, Z., and Rumende, C. M. The effect of vitamin D as supplementary treatment in patients with moderately advanced pulmonary tuberculous lesion. Acta Med Indones. 2006;38(1):3-5. View abstract.

Nyirady, J., Bergfeld, W., Ellis, C., Levine, N., Savin, R., Shavin, J., Voorhees, J. J., Weiss, J., and Grossman, R. Tretinoin cream 0.02% for the treatment of photodamaged facial skin: a review of 2 double-blind clinical studies. Cutis 2001;68(2):135-142. View abstract.

O'Neil, C., Shevill, E., and Chang, A. B. Vitamin A supplementation for cystic fibrosis. Cochrane.Database.Syst.Rev. 2008;(1):CD006751. View abstract.

Ogaro, F. O., Orinda, V. A., Onyango, F. E., and Black, R. E. Effect of vitamin A on diarrhoeal and respiratory complications of measles. Trop.Geogr.Med 1993;45(6):283-286. View abstract.

Okada N, Nomura M Morimoto S et al. Bone mineral density of the lumbar spine in psoriatic patients with long term etretinate therapy. J Dermatol. 1994;21:308-311.

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Olsen, E. A., Katz, H. I., Levine, N., Nigra, T. P., Pochi, P. E., Savin, R. C., Shupack, J., Weinstein, G. D., Lufrano, L., and Perry, B. H. Tretinoin emollient cream for photodamaged skin: results of 48-week, multicenter, double-blind studies. J Am Acad Dermatol 1997;37(2 Pt 1):217-226. View abstract.

Olsen, E. A., Katz, H. I., Levine, N., Shupack, J., Billys, M. M., Prawer, S., Gold, J., Stiller, M., Lufrano, L., and Thorne, E. G. Tretinoin emollient cream: a new therapy for photodamaged skin. J Am Acad Dermatol 1992;26(2 Pt 1):215-224. View abstract.

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Ortega, J. J., Madero, L., Martin, G., Verdeguer, A., Garcia, P., Parody, R., Fuster, J., Molines, A., Novo, A., Deben, G., Rodriguez, A., Conde, E., de la Serna, J., Allegue, M. J., Capote, F. J., Gonzalez, J. D., Bolufer, P., Gonzalez, M., and Sanz, M. A. Treatment with all-trans retinoic acid and anthracycline monochemotherapy for children with acute promyelocytic leukemia: a multicenter study by the PETHEMA Group. J Clin.Oncol. 10-20-2005;23(30):7632-7640. View abstract.

Ozdemir, M., Engin, B., Baysal, I., and Mevlitoglu, I. A randomized comparison of acitretin-narrow-band TL-01 phototherapy and acitretin-psoralen plus ultraviolet A for psoriasis. Acta Derm.Venereol. 2008;88(6):589-593. View abstract.

Pakasi, T. A., Karyadi, E., Suratih, N. M., Salean, M., Darmawidjaja, N., Bor, H., van, der, V, Dolmans, W. M., and van der Meer, J. W. Zinc and vitamin A supplementation fails to reduce sputum conversion time in severely malnourished pulmonary tuberculosis patients in Indonesia. Nutr J 2010;9:41. View abstract.

Pangaribuan, R., Erhardt, J. G., Scherbaum, V., and Biesalski, H. K. Vitamin A capsule distribution to control vitamin A deficiency in Indonesia: effect of supplementation in pre-school children and compliance with the programme. Public Health Nutr 2003;6(2):209-216. View abstract.

Pant, C. R., Pokharel, G. P., Curtale, F., Pokhrel, R. P., Grosse, R. N., Lepkowski, J., Muhilal, Bannister, M., Gorstein, J., Pak-Gorstein, S., Atmarita, and Tilden, R. L. Impact of nutrition education and mega-dose vitamin A supplementation on the health of children in Nepal. Bull World Health Organ 1996;74(5):533-545. View abstract.

Panth, M., Shatrugna, V., Yasodhara, P., and Sivakumar, B. Effect of vitamin A supplementation on haemoglobin and vitamin A levels during pregnancy. Br J Nutr 1990;64(2):351-358. View abstract.

Papagaroufalis, C., Megreli, C., Hagjigeorgi, C., and Xanthou, M. A trial of vitamin A supplementation for the prevention of intraventricular hemorrhage in very low birth weight neonates. J Perinat.Med 1991;19 Suppl 1:382-387. View abstract.

Papaioannou, D., Cooper, K. L., Carroll, C., Hind, D., Squires, H., Tappenden, P., and Logan, R. F. Antioxidants in the chemoprevention of colorectal cancer and colorectal adenomas in the general population: a systematic review and meta-analysis. Colorectal Dis. 2011;13(10):1085-1099. View abstract.

Parker, S., Coburn, P., Lawrence, C., Marks, J., and Shuster, S. A randomized double-blind comparison of PUVA-etretinate and PUVA-placebo in the treatment of chronic plaque psoriasis. Br.J Dermatol. 1984;110(2):215-220. View abstract.

Paton, N. I., Chua, Y. K., Earnest, A., and Chee, C. B. Randomized controlled trial of nutritional supplementation in patients with newly diagnosed tuberculosis and wasting. Am J Clin Nutr 2004;80(2):460-465. View abstract.

Paul, C. and Ortonne, J. P. Use of conventional systemic treatments in psoriasis: systematic review and expert opinion of a panel of dermatologists. J Eur.Acad.Dermatol.Venereol. 2011;25 Suppl 2:1. View abstract.

Pearson, E., Bose, C., Snidow, T., Ransom, L., Young, T., Bose, G., and Stiles, A. Trial of vitamin A supplementation in very low birth weight infants at risk for bronchopulmonary dysplasia. J Pediatr 1992;121(3):420-427. View abstract.

Penn, N. D., Purkins, L., Kelleher, J., Heatley, R. V., Mascie-Taylor, B. H., and Belfield, P. W. The effect of dietary supplementation with vitamins A, C and E on cell-mediated immune function in elderly long-stay patients: a randomized controlled trial. Age Ageing 1991;20(3):169-174. View abstract.

Perez-Guzman, C., Vargas, M. H., Quinonez, F., Bazavilvazo, N., and Aguilar, A. A cholesterol-rich diet accelerates bacteriologic sterilization in pulmonary tuberculosis. Chest 2005;127(2):643-651. View abstract.

Petersson I, Majberger E, Palm S, and Larsen A. Treatment of rheumatoid arthritis with selenium and vitamin E. Scand J Rheumatol 1991;20:218.

Phillips-Howard, P. A., Nahlen, B. L., Wannemuehler, K. A., Kolczak, M. S., ter Kuile, F. O., Gimnig, J. E., Olson, K., Alaii, J. A., Odhacha, A., Vulule, J. M., and Hawley, W. A. Impact of permethrin-treated bed nets on the incidence of sick child visits to peripheral health facilities. Am J Trop.Med Hyg. 2003;68(4 Suppl):38-43. View abstract.

Piattelli, A., Carinci, F., Iezzi, G., Perrotti, V., Goteri, G., Fioroni, M., and Rubini, C. Oral lichen planus treated with 13-cis-retinoic acid (isotretinoin): effects on the apoptotic process. Clin.Oral Investig. 2007;11(3):283-288. View abstract.

Piattelli, A., Fioroni, M., Santinelli, A., and Rubini, C. bcl-2 expression and apoptotic bodies in 13-cis-retinoic acid (isotretinoin)-topically treated oral leukoplakia: a pilot study. Oral Oncol. 1999;35(3):314-320. View abstract.

Pike, J. and Chandra, R. K. Effect of vitamin and trace element supplementation on immune indices in healthy elderly. Int J Vitam Nutr Res 1995;65(2):117-121. View abstract.

Piraccini, B. M., Tosti, A., Iorizzo, M., and Misciali, C. Pustular psoriasis of the nails: treatment and long-term follow-up of 46 patients. Br.J Dermatol. 2001;144(5):1000-1005. View abstract.

Potential interventions for the prevention of childhood pneumonia in developing countries: a meta-analysis of data from field trials to assess the impact of vitamin A supplementation on pneumonia morbidity and mortality. The Vitamin A and Pneumonia Working Group. Bull World Health Organ 1995;73(5):609-619. View abstract.

Potischman, N., Herrero, R., Brinton, L. A., Reeves, W. C., Stacewicz-Sapuntzakis, M., Jones, C. J., Brenes, M. M., Tenorio, F., de Britton, R. C., and Gaitan, E. A case-control study of nutrient status and invasive cervical cancer. II. Serologic indicators. Am J Epidemiol. 12-1-1991;134(11):1347-1355. View abstract.

Potischman, N., McCulloch, C. E., Byers, T., Nemoto, T., Stubbe, N., Milch, R., Parker, R., Rasmussen, K. M., Root, M., Graham, S., and . Breast cancer and dietary and plasma concentrations of carotenoids and vitamin A. Am J Clin Nutr 1990;52(5):909-915. View abstract.

Potischman, N., Swanson, C. A., Coates, R. J., Gammon, M. D., Brogan, D. R., Curtin, J., and Brinton, L. A. Intake of food groups and associated micronutrients in relation to risk of early-stage breast cancer. Int J Cancer 7-30-1999;82(3):315-321. View abstract.

PrayGod, G., Range, N., Faurholt-Jepsen, D., Jeremiah, K., Faurholt-Jepsen, M., Aabye, M. G., Jensen, L., Jensen, A. V., Grewal, H. M., Magnussen, P., Changalucha, J., Andersen, A. B., and Friis, H. Daily multi-micronutrient supplementation during tuberculosis treatment increases weight and grip strength among HIV-uninfected but not HIV-infected patients in Mwanza, Tanzania. J Nutr 4-1-2011;141(4):685-691. View abstract.

Prince, M. I., Mitchison, H. C., Ashley, D., Burke, D. A., Edwards, N., Bramble, M. G., James, O. F., and Jones, D. E. Oral antioxidant supplementation for fatigue associated with primary biliary cirrhosis: results of a multicentre, randomized, placebo-controlled, cross-over trial. Aliment.Pharmacol.Ther. 2003;17(1):137-143. View abstract.

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