Fat-Soluble Vitamins: A, D, E, and K

Fact Sheet No. 9.315 Food and Nutrition Series| Health

by L. Bellows and R. Moore*

What are Vitamins? Vitamin A: Retinol Quick Facts

Vitamins are essential micronutrients
• Small amounts of vitamin
your body needs in small amounts for various What is Vitamin A
A, vitamin D, vitamin E and
roles throughout the human body. Vitamins Vitamin A, also called retinol, has many
are divided into two groups: water-soluble vitamin K are needed to
functions in the body. In addition to helping
(B-complex vitamins and C vitamins) and maintain good health.
the eyes adjust to light changes, vitamin A
fat-soluble vitamins (A, D, E and K). Unlike plays an important role in bone growth, tooth • Fat-soluble vitamins will not
water-soluble vitamins that need regular development, reproduction, cell division, be lost when the foods that
replacement in the body, fat-soluble vitamins gene expression, and regulation of the contain them are cooked.
are stored in the liver and fatty tissues, and immune system. The skin, eyes, and mucous
are eliminated much more slowly than water- membranes of the mouth, nose, throat and • The body does not need
soluble vitamins. For more information on lungs depend on vitamin A to remain moist. these vitamins every day and
water-soluble vitamins, see fact sheet 9.312 Vitamin A is also an important antioxidant stores them in the liver and
Water-Soluble Vitamins: Vitamin B-Complex that may play a role in the prevention of adipose (fat) tissue when not
and Vitamin C. certain cancers. used.

Food Sources for Vitamin A • Most people do not need

What are Fat-Soluble vitamin supplements.
Vitamins? Eating a wide variety of foods is the best
way to ensure that the body gets enough • Megadoses of vitamins A, D,
The fat-soluble vitamins, A, D, E, and vitamin A. The retinol, retinal, and retinoic E or K can be toxic and lead
K, are stored in the body for long periods acid forms of vitamin A are supplied to health problems.
of time and generally pose a greater risk primarily by foods of animal origin such as
for toxicity when consumed in excess than dairy products, fish and liver. Some foods of • Requirements for vitamins
water-soluble vitamins. Eating a normal, plant origin contain the antioxidant, beta- may be expressed in different
well-balanced diet will not lead to toxicity carotene, which the body converts to vitamin mathematical units. Close
in otherwise healthy individuals. However, A. Beta-carotene, comes from fruits and attention should be paid to
taking vitamin supplements that contain vegetables, especially those that are orange ensure that similar units are
megadoses of vitamins A, D, E and K may or dark green in color. Vitamin A sources being compared.
lead to toxicity. The body only needs small also include carrots, pumpkin, winter squash,
amounts of any vitamin. dark green leafy vegetables and apricots, all of
While diseases caused by a lack of fat- which are rich in beta-carotene.
soluble vitamins are rare in the United States,
symptoms of mild deficiency can develop How much Vitamin A
without adequate amounts of vitamins in
the diet. Additionally, some health problems The recommendation for vitamin A
may decrease the absorption of fat, and in intake is expressed as micrograms (mcg) of
turn, decrease the absorption of vitamins A, retinol activity equivalents (RAE). Retinol
D, E and K. Consult a medical professional activity equivalents account for the fact that
about any potential health problems that may the body converts only a portion of beta-
interfere with vitamin absorption. carotene to retinol. One RAE equals 1 mcg of
retinol or 12 mcg of beta-carotene
*
L. Bellows, Colorado State University Extension food and (Table 1). The Recommended Dietary © Colorado State University
nutrition specialist and assistant professor; and R. Moore, Allowance (RDA) for vitamin A is 900 mcg/ Extension. 3/02. Revised 11/12.
graduate student. 11/2012
day for adult males and 700 mcg/day for www.ext.colostate.edu
adult females.
 Compared to vitamin A, it takes twice to form and maintain bones. Vitamin to vitamin D deficiency. Since most foods
the amount of carotene rich foods to meet D benefits the body by playing a role in have very low vitamin D levels (unless they
the body’s vitamin A requirements, so immunity and controlling cell growth. are enriched) a deficiency may be more
one may need to increase consumption of Children especially need adequate amounts likely to develop without adequate exposure
carotene containing plant foods. of vitamin D to develop strong bones and to sunlight. Adding fortified foods to the
Recent studies indicate that vitamin healthy teeth. diet such as milk, and for adults including
A requirements may be increased due to a supplement, are effective at ensuring
hyperthyroidism, fever, infection, cold, and Food Sources for Vitamin D adequate vitamin D intake and preventing
exposure to excessive amounts of sunlight. The primary food sources of vitamin D low vitamin D levels.
Those that consume excess alcohol or have are milk and other dairy products fortified Vitamin D deficiency has been
renal disease should also increase intake of with vitamin D. Vitamin D is also found in associated with increased risk of
vitamin A. oily fish (e.g., herring, salmon and sardines) common cancers, autoimmune diseases,
as well as in cod liver oil. In addition hypertension, and infectious disease. In
Vitamin A Deficiency to the vitamin D provided by food, we the absence of adequate sun exposure, at
Vitamin A deficiency in the United obtain vitamin D through our skin which least 800 to 1,000 IU of vitamin D3 may
States is rare, but the disease that results produces vitamin D in response to sunlight. be needed to reach the circulating level
is known as xerophthalmia. It most required to maximize vitamin D’s benefits.
commonly occurs in developing nations How much Vitamin D Who is at Risk — These populations may
usually due to malnutrition. Since vitamin The Recommended Dietary require extra vitamin D in the form of
A is stored in the liver, it may take up to Allowance (RDA) for vitamin D appears supplements or fortified foods:
2 years for signs of deficiency to appear. as micrograms (mcg) of cholecalciferol • Exclusively breast-fed infants: Human
Night blindness and very dry, rough skin (vitamin D3) (Table 1). From 12 months milk only provides 25 IU of vitamin D
may indicate a lack of vitamin A. Other to age fifty, the RDA is set at 15 mcg. per liter. All breast-fed and partially
signs of possible vitamin A deficiency Twenty mcg of cholecalciferol equals breast-fed infants should be given a
include decreased resistance to infections, 800 International Units (IU), which is vitamin D supplement of 400 IU/day
faulty tooth development, and slower bone the recommendation for maintenance of
growth. healthy bone for adults over fifty. Table 1 • Dark Skin: Those with dark pigmented
lists additional recommendations for skin synthesize less vitamin D upon
Too much Vitamin A various life stages. exposure to sunlight compared to
In the United States, toxic or excess Exposure to ultraviolet light is necessary those with light pigmented skin.
levels of vitamin A are more of a concern for the body to produce the active form • Elderly: This population has a reduced
than deficiencies. The Tolerable Upper of vitamin D. Ten to fifteen minutes of ability to synthesize vitamin D upon
Intake Level (UL) for adults is 3,000 mcg sunlight without sunscreen on the hands, exposure to sunlight, and is also
RAE (Table 2). It would be difficult to arms and face, twice a week is sufficient to more likely to stay indoors and wear
reach this level consuming food alone, receive enough vitamin D. This can easily sunscreen which blocks vitamin D
but some multivitamin supplements be obtained in the time spent riding a bike synthesis.
contain high doses of vitamin A. If you to work or taking a short walk. In order to • Covered and protected skin: Those that
take a multivitamin, check the label to be reduce the risk for skin cancer one should cover all of their skin with clothing
sure the majority of vitamin A provided apply sunscreen with an SPF of 15 or more, while outside, and those that wear
is in the form of beta-carotene, which if time in the sun exceeds 10 to 15 minutes. sunscreen with an SPF factor of 8,
appears to be safe. Symptoms of vitamin A
block most of the synthesis of vitamin
toxicity include dry, itchy skin, headache, Vitamin D Deficiency D from sunlight.
nausea, and loss of appetite. Signs of severe Symptoms of vitamin D deficiency in
overuse over a short period of time include • Disease: Fat malabsorption syndromes,
growing children include rickets (long, soft
dizziness, blurred vision and slowed inflammatory bowel disease (IBD),
bowed legs) and flattening of the back of
growth. Vitamin A toxicity also can cause and obesity are all known to result in a
the skull. Vitamin D deficiency in adults
severe birth defects and may increase the decreased ability to absorb and/or use
may result in osteomalacia (muscle and
risk for hip fractures. vitamin D in fat stores.
bone weakness), and osteoporosis (loss of
bone mass).
Too much Vitamin D
Vitamin D Recently published data introduces a
concern that some adults and children may The Tolerable Upper Intake Level (UL)
be more prone to developing vitamin D for vitamin D is set at 100 mcg for people 9
What is Vitamin D deficiency due to an increase in sunscreen years of age and older (Table 2). High doses
Vitamin D plays a critical role in the use. In addition, those that live in inner of vitamin D supplements coupled with
body’s use of calcium and phosphorous. It cities, wear clothing that covers most of large amounts of fortified foods may cause
works by increasing the amount of calcium the skin, or live in northern climates where accumulations in the liver and produce
absorbed from the small intestine, helping little sun is seen in the winter are also prone signs of poisoning. Signs of vitamin D
toxicity include excess calcium in the vitamin E in excess of the RDA does not or in people who take anticoagulants, such
blood, slowed mental and physical growth, result in any added benefits. as Coumadin (warfarin), or antibiotic
decreased appetite, nausea and vomiting. drugs. Newborn babies lack the intestinal
It is especially important that infants Vitamin E Deficiency bacteria to produce vitamin K and need
and young children do not consume excess Vitamin E deficiency is rare. Cases of a supplement for the first week. Those
amounts of vitamin D regularly, due to vitamin E deficiency usually only occur on anticoagulant drugs (blood thinners)
their small body size. in premature infants and in those unable may become vitamin K deficient, but
to absorb fats. Since vegetable oils are should not change their vitamin K intake
good sources of vitamin E, people who without consulting a physician. People
Vitamin E: Tocopherol taking antibiotics may lack vitamin K
excessively reduce their total dietary fat
may not get enough vitamin E. temporarily because intestinal bacteria are
What is Vitamin E sometimes killed as a result of long-term
Vitamin E benefits the body by acting Too much Vitamin E use of antibiotics. Also, people with chronic
as an antioxidant, and protecting vitamins diarrhea may have problems absorbing
The Tolerable Upper Intake Level
A and C, red blood cells, and essential sufficient amounts of vitamin K through
(UL) for vitamin E is shown in Table 2.
fatty acids from destruction. Research the intestine and should consult their
Vitamin E obtained from food usually does
from decades ago suggested that taking physician to determine if supplementation
not pose a risk for toxicity. Supplemental
antioxidant supplements, vitamin E in is necessary.
vitamin E is not recommended due to lack
particular, might help prevent heart disease of evidence supporting any added health
and cancer. However, newer findings Too much Vitamin K
benefits. Megadoses of supplemental
indicate that people who take antioxidant vitamin E may pose a hazard to people Although no Tolerable Upper Intake
and vitamin E supplements are not better taking blood-thinning medications such as Level (UL) has been established for
protected against heart disease and cancer Coumadin (also known as warfarin) and vitamin K, excessive amounts can cause
than non-supplement users. Many studies those on statin drugs. the breakdown of red blood cells and liver
show a link between regularly eating an damage. People taking blood-thinning
antioxidant rich diet full of fruits and drugs or anticoagulants should moderate
vegetables, and a lower risk for heart Vitamin K their intake of foods with vitamin K,
disease, cancer, and several other diseases. because excess vitamin K can alter blood
Essentially, recent research indicates that What is Vitamin K clotting times. Large doses of vitamin K are
to receive the full benefits of antioxidants not advised.
Vitamin K is naturally produced by
and phytonutrients in the diet, one should
the bacteria in the intestines, and plays
consume these compounds in the form of
an essential role in normal blood clotting, Summary
fruits and vegetables, not as supplements.
promoting bone health, and helping to
• Fat-soluble vitamins: A, D, E, and
produce proteins for blood, bones, and
Food Sources for Vitamin E K — are stored in the body for long
kidneys.
About 60 percent of vitamin E in the periods of time, and pose a greater
diet comes from vegetable oil (soybean, risk for toxicity than water-soluble
Food Sources for Vitamin K
corn, cottonseed, and safflower). This also vitamins. Fat-soluble vitamins are
Good food sources of vitamin K are only needed in small amounts.
includes products made with vegetable oil
green, leafy-vegetables such as turnip • Beta carotene is an important
(margarine and salad dressing). Vitamin E
greens, spinach, cauliflower, cabbage antioxidant that the body converts
sources also include fruits and vegetables,
and broccoli, and certain vegetables oils to Vitamin A, and it is found in a
grains, nuts (almonds and hazelnuts), seeds
including soybean oil, cottonseed oil, variety of fruits and vegetables.
(sunflower) and fortified cereals.
canola oil and olive oil. Animal foods, • Inadequate dietary consumption
in general, contain limited amounts of of vitamin D, along with limited
How much Vitamin E
vitamin K. sun exposure, makes vitamin D
The Recommended Dietary Allowance
deficiency a growing public health
(RDA) for vitamin E is based on the How much Vitamin K concern.
most active and usable form called alpha-
To help ensure people receive sufficient • Vitamin E benefits the body by
tocopherol (Table 1). Food and supplement
amounts of vitamin K, an Adequate Intake acting as an antioxidant, and
labels list alpha-tocopherol as the unit
(AI) has been established for each age research indicates that it may
International units (IU) not in milligrams
group (Table 1). offer a protective effect if obtained
(mg). One milligram of alpha-tocopherol
through a diet rich in fruits
equals to 1.5 International Units (IU). RDA
Vitamin K Deficiency and vegetables, as opposed to a
guidelines state that males and females
Without sufficient amounts of supplement or multivitamin.
over the age of 14 should receive 15 mcg
vitamin K, hemorrhaging can occur. • The bacteria in our gut produce
of alpha-tocopherol per day. Consuming
Vitamin K deficiency may appear in infants vitamin K, and it is also found in
green leafy vegetables.
Table 1. Recommended Dietary Intake (RDA) and Adequate Intake (AI) for Fat-Soluble Vitamins

Life Stage Group Vitamin A Vitamin D Vitamin E Vitamin K

(mcg1/RAE) (mcg2) (mcg a-TE3) (mcg)
Infants4
0 - 6mo 400* 10* 4* 2.0*
6mo - 12mo 500* 10* 5* 2.5*
Children
1 - 3y 300 15 6 30*
4 - 8y 400 15 7 55*
Males
9 - 13y 600 15 11 60*
14 - 18y 900 15 15 75*
19 - 30y 900 15 15 120*
31 - 50y 900 15 15 120*
51 - 70y 900 15 15 120*
>70y 900 20 15 120*
Females
9 - 13y 600 15 11 60*
14 - 18y 700 15 15 75*
19 - 30y 700 15 15 90*
31 - 50y 700 15 15 90*
51 - 70y 700 15 15 90*
>70y 700 20 15 90*
Pregnant
14 - 18y 750 15 15 75
19 - 30y 770 15 15 90
31 - 50y 770 15 15 90
Lactation
14 - 18y 1200 15 19 75
19 - 30y 1300 15 19 90
31 - 50y 1300 15 19 90

As retinol activity equivalents (RAEs). 1 RAE = 1mcg retinol or 12 mcg beta-carotene.

1

As cholecalciferol (vitamin D3). 10 mcg cholecalciferol = 400 IU of Vitamin D.

2

As alpha-tocopherol equivalents. 1 mg of alpha-tocopherol = 1.5 IU of Vitamin E=22IU of d-alpha-tocopherol=33 IU of dl-alpha- tocopherol

3

4
At 6 months of age, infants may be introduced to solid foods while remaining on formula or breast milk. There may be some overlap in specific
nutrient requirements.

*Indicates an Adequate Intake (AI). All other values are Recommended Dietary Allowance (RDA).
Table 2. Tolerable Upper Intake Levels (UL) for Fat-Soluble Vitamins

Life Stage Group Vitamin A Vitamin D Vitamin E Vitamin K*

(mcg/d) (mcg/d) (mg a-TE)
Infants1
0 - 6mo 600 25 ND2 ND
6mo - 12mo 600 38 ND ND
Children
1 - 3y 600 63 200 ND
4 - 8y 900 75 300 ND
Males/Females
9 - 13y 1700 100 600 ND
14 - 18y 2800 100 800 ND
19 - 70y 3000 100 1000 ND
>70y 3000 100 1000 ND
Pregnant and Lactating
<18 2800 100 800 ND
19 - 50y 3000 100 1000 ND

1
At 6 months of age, infants may be introduced to solid foods while remaining on formula or breast milk. There may be some overlap in specific
nutrient requirements.

ND = not determinable due to insufficient data

2

*An UL for vitamin K was not established.

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Colorado State University, U.S. Department of
WhatYouNeedToKnow.aspx Agriculture and Colorado counties cooperating.
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