Can You Take Vitamin A With Vitamin D?

Quick answer

Neither vitamin's NIH fact sheet warns against the other, but both are stored in the body and both have adult limits that count food: 3,000 mcg a day of preformed vitamin A and 100 mcg (4,000 IU) of vitamin D. In one small study, a large vitamin A dose blunted active vitamin D's calcium effect.^1,2,3

Key facts

Adults need 700 to 900 mcg RAE of vitamin A and 15 to 20 mcg (600 to 800 IU) of vitamin D a day.^1,2
The vitamin A limit covers preformed vitamin A, such as retinol and retinyl palmitate. Beta-carotene does not count toward it.⁴
In 9 healthy adults, 15 mg of retinyl palmitate held the rise in blood calcium after active vitamin D to 1.4%, against 2.3% without it.³
The body keeps extra vitamin A mostly in the liver, and body fat holds on to vitamin D, so both can build up.^4,5

What happens when the two meet

Most research on how vitamin A and vitamin D act on each other has been done in cells and animals. One small human study tested it directly, and it is the main evidence for people.³

Nine healthy adults took, on separate nights, 15 mg of retinyl palmitate, 2 mcg of calcitriol, both, or a placebo. Calcitriol is the body's active hormone form of vitamin D, not the vitamin D3 sold in supplements. Calcitriol alone raised blood calcium by 2.3% the next day. Retinyl palmitate alone lowered it by 1.0%, and taken with calcitriol it held the rise to 1.4%. The authors put the vitamin A dose at about one serving of liver.^3,5

That was one dose, measured over one day, with far more vitamin A than people usually eat: average intakes are about 616 to 682 mcg RAE a day. No trial in our sources has tested what ordinary amounts of both do over months.⁴

Laboratory work points the same way. In human gut cells grown in a dish, vitamin A lowered the uptake of vitamin D, while vitamin D did not lower the uptake of vitamin A. These were not studies in people.⁶

What each one does

The two statements below are quoted from our ingredient pages, with their grades and the amounts behind them.

Contributes to the maintenance of normal vision*^1,4,7

Moderate evidence

A long-established role of the vitamin. NIH describes vitamin A as an essential part of rhodopsin, the light-sensitive protein in the retina, and as needed for the normal working of the cornea and the membranes that cover the eye. The EU list of permitted nutrient-function statements, based on reviews by the European Food Safety Authority (EFSA), includes this wording for foods that are at least a source of vitamin A. It describes what getting enough does; it is not a finding that extra vitamin A changes eyesight in people who already get enough.

Amount studied: The recommended intake: 900 mcg RAE a day for men and 700 mcg RAE for women, from food and supplements together

Contributes to normal muscle function*^5,8,9,10

Moderate evidence

Low vitamin D can cause muscle weakness, and 'contributes to the maintenance of normal muscle function' is a nutrient-function statement permitted in the EU. Extra vitamin D has not improved strength in trials: a pooled analysis of 54 placebo-controlled trials (8,747 people) found no benefit for muscle strength or physical performance, and a three-year trial of 2,000 IU a day in 2,157 adults aged 70 and over found no gain in physical performance. Read this as a reason not to run low, not as a strength aid.

Amount studied: The recommended daily intake; DO-HEALTH tested 2,000 IU a day for three years

Foods that carry both

Preformed vitamin A is found in beef liver and other organ meats, fish such as herring and salmon, eggs, and dairy products such as milk and cheese.^1,4

Fatty fish such as trout, salmon, tuna and mackerel, and fish liver oils, are among the best natural sources. Three ounces of cooked sockeye salmon has 14.2 mcg (570 IU), and a tablespoon of cod liver oil 34 mcg (1,360 IU).⁵

Fortified milk is the everyday overlap. A cup of skim milk with added vitamins A and D has 149 mcg RAE of vitamin A, and almost all US milk is fortified with about 3 mcg (120 IU) of vitamin D a cup.^2,4

Liver is where the two part ways. Three ounces of pan-fried beef liver has 6,582 mcg RAE of vitamin A, more than twice the adult limit, while liver has only small amounts of vitamin D.^4,5

Fish liver oils need a label check. A tablespoon of cod liver oil has 34 mcg (1,360 IU) of vitamin D, about a third of the adult limit, so count it before adding a multivitamin, and read its label for vitamin A too.⁵

Adding up the amounts

Vitamin A and vitamin D for adults^1,2,4,5
Per day, adults	Vitamin A	Vitamin D
Recommended amount	900 mcg RAE for men, 700 mcg RAE for women	15 mcg (600 IU), or 20 mcg (800 IU) from age 71
Upper limit	3,000 mcg of preformed vitamin A	100 mcg (4,000 IU)
What the limit counts	Preformed vitamin A from food, drinks and supplements, not beta-carotene	Vitamin D from every source
Where the body keeps it	Mostly in the liver	Partly in body fat

Many multivitamins combine preformed vitamin A and beta-carotene. Only the preformed share counts toward the upper limit: NIH's example is a 3,000 mcg RAE product with 60% from beta-carotene, which supplies 1,200 mcg RAE of preformed vitamin A.⁴

What’s in ours

Men's Multi: Vitamin A, 600 mcg RAE per serving, from the label

What’s in ours

Vitamin D3: Vitamin D-3, 50 mcg (2,000 IU) per serving, from the label
Men's Multi: Vitamin D, 10 mcg per serving, from the label
Ashwagandha Complex: Vitamin D3, 20 mcg per serving, from the label
Immune Support: Vitamin D3, 40 mcg per serving, from the label

Men's Multi is our only product with vitamin A. Its label gives the vitamin A as beta-carotene, which does not count toward the limit for preformed vitamin A.⁴

Cautions

In pooled observational studies, the highest intakes of vitamin A and of retinol were linked to more hip fractures, while beta-carotene intake was not, and both very low and very high blood retinol were linked to more hip fractures. Studies of this kind cannot show cause.¹¹

That bone finding is one reason to keep an eye on retinol when vitamin D is taken for bone. The studies were observational and cannot show cause, but they point the same way as the calcium study: keep preformed vitamin A within its limit.^3,11

Ask your pharmacist how far apart to take them

Orlistat, a weight-loss medicine, reduces the absorption of fat-soluble vitamins, including vitamin D. Its label advises a daily multivitamin with vitamins A, D, E and K taken at a separate time from orlistat, and in its trials low vitamin D levels were more common on orlistat than on placebo.^2,12,13

On the medicine's label

Ask first if you are pregnant, could become pregnant or are breastfeeding. Too much preformed vitamin A can cause birth defects, and supplements giving more than 3,000 mcg RAE (10,000 IU) of it a day are to be avoided.⁴
Do not add vitamin A if you take isotretinoin. Its label says to avoid supplements that contain vitamin A.¹⁴
Ask first if you smoke or used to smoke. NIH advises smokers, and possibly former smokers, to avoid multivitamins with large amounts of beta-carotene or vitamin A.¹⁵
Ask first if you take a thiazide water pill, a statin, steroid tablets or a bile acid sequestrant, which affect vitamin D.²
Ask first if you have a liver condition, high blood calcium, kidney disease or kidney stones.
Ask first if the supplements are for a child. Children's limits for both vitamins are much lower than adults'.^2,4

Questions people ask

Should vitamin A and vitamin D be taken at different times?

No study in our sources tested spacing them apart. The one human study of the interaction gave a large single dose of vitamin A with active vitamin D, which is not the same as taking ordinary amounts of both with a meal.³

Does vitamin A cancel out vitamin D?

The evidence does not show that. One small study found that a large dose of vitamin A trimmed a short-term calcium response to active vitamin D, and no trial has tested ordinary amounts of both over months.³

Can you take vitamin A and D in pregnancy?

Ask your doctor or midwife first. Vitamin D needs stay at 15 mcg a day in pregnancy, but too much preformed vitamin A can cause birth defects, and prenatal supplements generally contain no vitamin A as retinol.^2,4,15

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See the Full Measure line Men's Multi Ashwagandha Complex Immune Support

Sources

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

This page is information, not medical advice. Talk to your doctor or pharmacist about your own situation.