People who limit their consumption of liver, dairy foods, and beta-carotene-containing vegetables can develop a vitamin A deficiency. Extremely low birth weight babies (2.2 pounds or less) are at high risk of being born with a deficiency, and vitamin A shots given to these infants have been reported in double-blind research to reduce the risk of lung disease. The earliest deficiency sign is poor night vision. Deficiency symptoms can also include dry skin, increased risk of infections, and metaplasia (a precancerous condition). Severe deficiencies causing blindness are extremely rare in Western societies.
Less severe deficiencies are more likely to occur with a variety of conditions causing malabsorption. A high incidence of vitamin A deficiency in people infected with HIV has also been reported. People with hypothyroidism have an impaired ability to convert beta-carotene to vitamin A. For this reason, some doctors suggest taking supplemental vitamin A (perhaps 5,000–10,000 IU per day) if they are not consuming adequate amounts in their diet.
Very old people with type 2 diabetes have shown a significant age-related decline in blood levels of vitamin A, irrespective of their dietary intake.