DS Pregnancy Vitamin A Issue

I am 20 months post op and had a early miscarriage in Dec and getting ready to try again soon.  I am working with a RE and just started with a new high risk OB last month.  My OB is concerned because I am taking such a high dose of Vit A.  I take 100,000 units a day and this keeps my levels in the low normal range.  When I was taking 75,000 units a day my bariatric surgeon increased the dosage because I wasn't in range and it has helped tremendously.  I have worked so diligently to get my levels in range for a healthy pregnancy, and now I am worried that they are going to advise I don't get pregnant because of the possibility of birth defects or decrease my Vit A which could end up hurting me and the baby so there seems to be no good answers. 

I am scheduled to see a maternal fetal specialist next week at the request of my OB so I am hoping that goes well and I am also getting my blood drawn for my most recent levels on 2/23/12.

I am wondering if there are DSer's that have experienced this Vit A issue during pregnancy and how it was handled by your physician(s).  I would love to hear if anyone supplemented with high doses of Vit A and how the pregnancy and fetus were affected.

Thanks so much and hoping some of you have good things to share.

I think your OB needs to use his/her common sense for a second - if you're not ABSORBING the vit A, then how can it cause harm? Vit A supplements are harmful in high dosages to the fetus because they do cross into the fetus; however, NOT IF YOU'RE NOT ABSORBING IT!

Personally, I did ditch my vit A supplement because my A was high-normal near the very top of the range (98, I believe), but if it had been hanging out in the low end, I would have continued supplementing.

Initially, my OB said it should be alright since the baby is only absorbing what I get through my bloodstream, but then he called me back about 3 weeks later with concern.   He said that he had done additional research and the Vitamin A is also stored in my fat cells so I am guessing that could be potentially toxic for a fetus.  My Vit A level is currently 47 (it was only 38 on 75,000 units/day) so I would sure hate to mess up all the progress I have made!  I guess I will just have to see what the maternal fetal specialist has to say.  

LOTS of things are stored in fat cells, including various toxins. I don't understand what that has to do with anything unless you plan on losing lots of additional weight DURING your pregnancy.

I agree with you, and I am afraid it may be hard to get a "definitive" answer from a physician either way.  I have lost all my weight and have been stable for several months.

 Wow! I was completely unaware about dangers of Vit A. My OB who is uninterested in learning about my DS or my vitamins has never mentioned anything. For that matter neither did my surgeon. I am 34 weeks and have been taking 100k iu of vit A a day... Now my lab levels are right with in normal range but I am in sheer panic mode over this! I can not find anything on line about WHAT types of birth defects. Just that too much A could cause them. So now I sit here in utter fear over me being ignorant to dangers of Vit A what harm could I have caused???

Please don't panic as I really think that my doctor is just being super cautious because he doesn't know much about our surgery.  It may be that your OB believes that the baby will not experience any toxic affects because it absorbs the Vit A directly from your bloodstream, which seems to be what the consensus is.  I really appreciate hearing from another person who is also supplementing with 100K a day so please keep me posted.  I don't really even know what kind of birth defects are possible with Vit A toxicity but I am sure if you have been getting your ultrasounds and bloodwork then everything is ok.  Sorry to panic you over this!  I felt very scared initally but not so much now as I have been reading more online.  I meet with the maternal fetal specialist next week and will let you know what she says.   

If your labs are within normal range, I really don't think there is cause for concern. Obviously, studies on vit A supplementation during pregnancy have been on NORMAL women, not those of us who don't absorb all that vit A.

The types of birth defects caused are physical, with the most common being cleft lip and cleft palate (both of which are usually "fixable" nowadays). Even in the studies, I believe it was only 20-30% of the babies born to the mothers with high vit A supplementation that had defects at birth.