From the Guidelines
Vitamin E gamma tocopherol deficiency symptoms are not well-documented, but vitamin E deficiency in general manifests as neurological symptoms, including peripheral neuropathy, balance and coordination disorders, and muscle weakness, as seen in patients with fat malabsorption due to inflammatory diseases or cystic fibrosis 1. These symptoms are associated with long-standing fat malabsorption, such as in short bowel syndrome, and can be improved with vitamin E supplementation, typically 200 mg/day, after a few months of treatment 1. Some key points to consider:
- Deficiency is rare and usually appears in the context of severe malnutrition or genetic causes, such as abetalipoproteinemia or the absence of the alpha-tocopherol transfer protein (alpha-TTP) 1.
- Early vitamin E inadequacy in adults with fat malabsorption is generally asymptomatic, but neurological symptoms can develop over time 1.
- Gamma tocopherol has anti-inflammatory properties and helps protect against nitrogen-based free radicals, so deficiency might theoretically lead to increased inflammation and oxidative damage.
- Dietary sources of gamma tocopherol, such as nuts, seeds, and vegetable oils, are preferable to supplements, and supplementation should only occur under medical supervision due to the risk of excessive vitamin E interfering with blood clotting and medication effectiveness.
From the Research
Vitamin E Gamma Tocopherol Deficiency Symptoms
The symptoms of vitamin E gamma tocopherol deficiency are not directly addressed in the provided studies, as they primarily focus on alpha-tocopherol deficiency. However, the symptoms of vitamin E deficiency in general can be summarized as follows:
- Ataxia, which is a common and important neurological finding [(2,3,4,5,6)]
- Peripheral neuropathy resembling Friedreich's ataxia 2
- Impaired vision 5
- Pigment retinopathy 5
- Reflex changes 5
- Weakness 5
- Delayed central somatosensory conduction 5
- Amplitude reduction of the electroretinogram 5
- Organic mental syndrome 6
- Cognitive dysfunction 6
Disease Progression and Treatment
The disease progression and treatment of vitamin E deficiency can be summarized as follows:
- Vitamin E deficiency can occur with abetalipoproteinemia, cholestatic liver disease, or fat malabsorption 2
- Ataxia with isolated vitamin E deficiency (AVED) is an autosomal recessive genetic disorder with a mutation in the alpha-tocopherol transfer protein gene (TTPA) [(2,3,4,6)]
- High-dose vitamin E supplementation can stabilize neurological signs and lead to mild improvement of cerebellar ataxia, especially in early stages of the disease 4
- Treatment with alpha-tocopherol can improve cognitive function and neurologic recovery, although the latter may be slow and incomplete 6