Deficiency is uncommon and typically the result of an underlying condition. Some premature infants also have low levels.
Vitamin E occurs in eight chemical forms. With a blood test, a doctor can learn how much of one form, alpha-tocopherol, a person has. Using this information, they can determine whether a person's overall level of vitamin E.
A normal level is usually with the range of 5.5–17 milligrams per liter (mg/L). The normal range may be different for premature infants and children under 17. Normal ranges can also vary slightly among labs.
When an adult has less than 4 mg/L of vitamin E in their blood, they usually require supplementation.
Signs and symptoms of deficiency
Vitamin E deficiency may cause disorientation and vision problems.
Low levels of vitamin E can lead to:
- Muscle weakness: Vitamin E is essential to the central nervous system. It is among the body's main antioxidants, and a deficiency results in oxidative stress, which can lead to muscle weakness.
- Coordination and walking difficulties: A deficiency can cause certain neurons, called the Purkinje neurons, to break down, harming their ability to transmit signals.
- Numbness and tingling: Damage to nerve fibers can prevent the nerves from transmitting signals correctly, resulting in these sensations, which are also called peripheral neuropathy.
- Vision deterioration: A vitamin E deficiency can weaken light receptors in the retina and other cells in the eye. This can lead to loss of vision over time.
- Immune system problems: Some research suggests that a lack of vitamin E can inhibit the immune cells. Older adults may be particularly at risk.
Muscle weakness and difficulties with coordination are neurological symptoms that indicate damage to the central and peripheral nervous systems.
The peripheral system is the network of nerves located beyond the brain and spinal cord. These neurons pass messages throughout the body.
The central nervous system communicates between the brain and the spinal cord.
The sheaths of neurons are mostly composed of fats. When the body has too little vitamin E, it contains fewer antioxidants that protect these fats, and the function of the nervous system breaks down.
Causes of vitamin E deficiency
Vitamin E deficiency often runs in families.
Learning about family history can make diagnosing certain rare, inherited diseases easier. Two of these diseases, congenital abetalipoproteinemia and familial isolated vitamin E deficiency, are chronic and result in extremely low vitamin E levels.
Vitamin E deficiency can also result from diseases that severely reduce the absorption of fat. This is because the body requires fat to absorb vitamin E correctly.
Some of these diseases include:
Deficiency is also common in newborns and babies born prematurely who have lower birth weights and less fat.
Premature infants are at particular risk because an immature digestive tract can interfere with fat and vitamin E absorption.
Vitamin E deficiencies in these infants can also lead to hemolytic anemia, which destroys red blood cells.
When to see a doctor
When a person has no history of genetic disease but experiences any symptoms of a vitamin E deficiency, they should contact a doctor.
An extremely low level of vitamin E in the blood can indicate an underlying health issue. Further testing will help to determine the cause and treatment options.
What are the treatment options?
Newborns and premature babies may be given a vitamin E supplement via a tube in the stomach.
Vitamin E supplementation is often effective.
Newborns and premature babies
Current practice involves providing vitamin E supplementation through a tube in the stomach. When necessary, it can also be administered intravenously.
While one dose can sufficiently raise blood levels of vitamin E, multiple doses may be required.
Children and adults
Children and adults with deficiencies caused by inherited conditions require supplementation with high doses of vitamin E.
Supplementation can stop the progression of the disease. When the deficiency is detected early, it may prevent neurological symptoms.
Vitamin E in the diet
It is highly unlikely that a person has low levels of vitamin E unless they have an underlying chronic disease, a genetic condition, or a diet extremely low in fat. For others, supplementation is usually not necessary.
Vitamin E is plentiful in a wide variety of foods. The body cannot produce it, so it must be obtained from the diet or a supplement.
Foods that contain vitamin E include:
- vegetable oils, such as wheat-germ oil, peanut oil, and olive oil
- nuts, seeds
- whole grains
- most vegetables, including spinach, Swiss chard, red peppers, and avocados
Taking too many fat-soluble supplements can be dangerous.
A person should not take too many supplements of fat-soluble vitamins, including vitamins A, D, E, and K.
Too much vitamin E can also interact with blood thinners, such as warfarin, and chemotherapy medications.
A person should inform the doctor of all supplements and vitamins they take regularly. Do not exceed the recommended dosage of supplements unless instructed to by a physician.
When an adult has a vitamin E deficiency, a chronic illness or genetic condition is likely responsible.
A person should seek treatment from a specialist and a qualified dietitian who has experience with the illness.
When a diet extremely low in fat is responsible for the deficiency, it can be remedied by adding fats to the diet.
Ongoing vitamin E supplementation will be necessary to halt the progression of illness and prevent complications. When a person is diagnosed early and receives continuous treatment, their outlook is usually good.
Research continues on vitamin E supplementation, toxicity, and safe limits.