Q. Are vitamin A and D supplements safe to take with fatty liver?

Answered by
Dr. Sagar Ramesh Makode
and medically reviewed by Dr. Hemalatha
This is a premium question & answer published on May 03, 2020 and last reviewed on: Mar 30, 2021

Hi doctor,

I am a 33-year-old female. I have low vitamin A and D levels. I have a fatty liver for few months. Is it safe to take vitamin A and D supplements with liver disease? What is the highest dose to be taken? I do not know whether it is a simple fatty liver or it has progressed to NASH and fibrosis. I have a smoking habit and acid reflux with low heart rates, and fat indigestion. I have a vitamin A of 0.9 umol/L and vitamin D of 37 nmol/L. Previously, I had an abdominal ultrasound and it showed a liver size of 14.6 centimeters in length. It gave rise to a moderately coarse dense echo pattern consistent with fatty infiltration. I have an ALT level of 58 U/L. Currently, I am taking N-acetyl cysteine.



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Your vitamin A level is in the marginal range. Having a range less than 0.7 umol/L or 0.5 umol/L is considered low and up to 1.05 umol/L is considered marginal. So, you need to take some supplements at a low dose. Taking up to 10,000 units daily is unlikely to cause any harmful effects in the body. So taking supplements of 7500 or even 10,000 units per day for a month or two is enough for you. I guess that you do not have any other symptoms of vitamin D deficiency like xerophthalmia or visual difficulties.

In this condition, you need to take high doses. For vitamin D, supplements like Calcirol sachet can be taken with a dose of 60,000 units once a week for eight weeks along with milk. Both these parameters are unlikely to interfere with liver issues regarding fatty liver and high ALT (alanine transaminase) levels. You have an unlikely cause to have progression to severe liver disease within this short period of time without symptoms.

Thank you doctor,

After taking supplements, my level comes back to normal. How long will it take to reach a lower range? I want to know whether fatty liver can cause low levels of fat-soluble vitamins in the body. Will fat digestive enzymes help in fat absorption?



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This time period varies and it depends upon the quantity of vitamins stored in the liver and body. Usually, it takes up to six to twelve months after stopping the supplements. As your vitamin A is low, increasing your intake of vitamin A-rich foods will help you. Regarding vitamin D, dietary intake is not the primary source of vitamin D but it is synthesized on the skin due to sunlight exposure. So increase your sunlight exposure especially in the morning. Otherwise, you can take vitamin D supplements intermittently. Digestive enzymes can increase absorption. Fatty liver occurs due to excessive calorie intake or impaired internal fat-handled by the liver rather than gut digestion. So increasing intake is a better option.

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