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Vitamin E Deficiency

By

Larry E. Johnson

, MD, PhD, University of Arkansas for Medical Sciences

Last full review/revision Nov 2020| Content last modified Nov 2020
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Topic Resources

Vitamin E deficiency caused by a diet low in vitamin E is common in developing countries. In developed countries, the cause is usually an absorption disorder. Some infants are born with vitamin E deficiency, which usually improves with supplements.

  • Vitamin E deficiency may cause impaired reflexes and coordination, difficulty walking, and weak muscles.

  • Premature infants with the deficiency may develop a serious form of anemia.

  • The diagnosis is based on symptoms and results of a physical examination.

  • Taking vitamin E supplements corrects the deficiency.

Vitamin E (tocopherol) is an antioxidant: It protects cells against damage by free radicals, which are by-products of normal cell activity and which participate in chemical reactions within cells. Some of these reactions can be harmful. (See also Overview of Vitamins.)

Vitamin E, like vitamins A, D, and K, is a fat-soluble vitamin, which dissolves in fat and is best absorbed when eaten with some fat. Good sources of vitamin E include vegetable oils, nuts, seeds, green leafy vegetables, and wheat germ.

Newborns have a relatively low reserve of vitamin E because only small amounts of vitamin E cross the placenta. Thus, newborns, particularly premature newborns, are at increased risk of vitamin E deficiency. However, with age, risk decreases because infants usually get enough vitamin E in breast milk or in commercial formulas. Adults can store large amounts of vitamin E in fat tissue, making the deficiency less likely.

Causes

A very low fat diet lacks vitamin E, because vegetable oils are the main source of this vitamin and because vitamin E is best absorbed when eaten with some fat. Disorders that impair fat absorption (such as certain liver disorders, gallbladder disorders, pancreatitis, and cystic fibrosis) can also reduce the absorption of vitamin E and increase the risk of vitamin E deficiency.

In the United States and other developed countries, vitamin E deficiency is rare among older children and adults and is usually due to

In developing countries, the most common cause of vitamin E deficiency is

  • Inadequate intake of vitamin E

Did You Know...

  • A very low fat diet may lead to deficiency of vitamins E, A, D, and K, because these vitamins must be eaten with some fat to be absorbed.

Symptoms

In children, symptoms may include slow reflexes, difficulty walking, loss of coordination, loss of position sense (knowing where the limbs are without looking at them), and muscle weakness.

In adults with vitamin E deficiency due to a malabsorption disorder, these symptoms rarely develop because adults store large amounts of vitamin E in fat (adipose) tissue.

Vitamin E deficiency can cause a form of anemia in which red blood cells rupture (hemolytic anemia). Premature infants who have a vitamin E deficiency are at risk of this serious disorder.

In premature infants, bleeding (hemorrhage) may occur within the brain, and blood vessels in the eyes may grow abnormally (a disorder called retinopathy of prematurity). Affected newborns also have weak muscles.

Diagnosis

  • Physical examination

  • Sometimes blood tests

The diagnosis of vitamin E deficiency is based on symptoms, the presence of conditions that increase risk, and results of a physical examination.

Blood tests to measure the level of vitamin E may be done to confirm the diagnosis.

Treatment

  • Vitamin E supplements

Treatment of vitamin E deficiency involves taking vitamin E supplements by mouth.

Premature newborns may be given supplements to prevent disorders from developing. Most full-term newborns do not need supplements, because they get enough vitamin E in breast milk or commercial formulas.

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