Vitamin E Deficiency

ByLarry E. Johnson, MD, PhD, University of Arkansas for Medical Sciences
Reviewed/Revised Aug 2024
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Vitamin E deficiency caused by a diet low in vitamin E is common in countries with high rates of food insecurity. In countries with low rates of food insecurity, 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.

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

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

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

Newborns have a relatively low reserve of vitamin E because only small amounts of vitamin E cross the placenta. Thus, newborns, particularly preterm 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.

Vitamin E supplements do not protect against cancer or heart and blood vessel disorders. There is no convincing evidence that vitamin E

Causes of Vitamin E Deficiency

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 countries with low rates of food insecurity, vitamin E deficiency is rare among older children and adults and is usually due to

In countries with high rates of food insecurity, 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 of Vitamin E Deficiency

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). Preterm infants who have a vitamin E deficiency are at risk of this serious disorder.

In preterm 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 of Vitamin E Deficiency

  • 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 of Vitamin E Deficiency

Treatment of vitamin E

Preterm 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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