From the Guidelines
Vitamin E deficiency should be treated with supplementation, typically 400-800 IU daily for adults with confirmed deficiency, as it is a rare condition that can lead to serious consequences such as hemolytic anemia, neuromuscular degeneration, and retinal and cognitive deficits 1.
Causes and Risk Factors
Vitamin E deficiency most commonly occurs in people with fat malabsorption disorders like cystic fibrosis, Crohn's disease, or liver disease, rather than from inadequate dietary intake 1.
- Fat malabsorption due to inflammatory diseases or cystic fibrosis increases the risk of inadequate supply of fat-soluble micronutrients, including vitamin E.
- Genetic causes, such as abetalipoproteinemia or the absence of the alpha-tocopherol transfer protein, can also lead to vitamin E deficiency.
Symptoms and Diagnosis
Symptoms of vitamin E deficiency include:
- Nerve and muscle damage
- Vision problems
- Weakened immune function
- Coordination difficulties
- Peripheral neuropathy
- Muscle weakness
- Ataxia Diagnosis is typically made through blood tests to measure vitamin E levels, and regular monitoring is important to ensure proper dosing and avoid potential toxicity from excessive supplementation 1.
Treatment and Prevention
Treatment involves vitamin E supplementation, and the supplement should be taken with food to enhance absorption since vitamin E is fat-soluble 1.
- For severe cases, higher doses of 800-1,600 IU daily may be needed initially, followed by maintenance doses.
- Children require lower doses based on age and weight.
- Dietary sources of vitamin E, such as nuts, seeds, vegetable oils, and leafy greens, should be incorporated into the diet when possible. It is essential to note that large vitamin E doses can result in over-replacement and exacerbate vitamin K deficiency, affecting blood coagulation, so care should be taken, especially in individuals taking anticoagulant drugs like warfarin or those who are vitamin K deficient 1.
From the Research
Vitamin E Deficiency Overview
- Vitamin E deficiency is a common issue, with over 90% of Americans not consuming sufficient dietary vitamin E to meet estimated average requirements 2.
- The main cause of vitamin E deficiency is inadequate dietary intake of α-tocopherol.
Health Consequences of Vitamin E Deficiency
- Plasma α-tocopherol concentrations <12 μmol/L are associated with increased infection, anemia, stunting of growth, and poor outcomes during pregnancy for both the infant and the mother 2.
- Inadequate vitamin E status can lead to increased damage to target tissues due to low dietary amounts of α-tocopherol 2.
- Abnormal lipoprotein metabolism can also affect vitamin E delivery to tissues, despite higher circulating α-tocopherol concentrations 2.