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Vitamin E Deficiency: Causes, Symptoms, Complications, Diagnosis And Treatments

Vitamin E deficiency is characterised by an insufficient amount of vitamin E in the body. It is a nutrient-deficient condition in which the body has run out of vitamin E for some time due to the intake of less vitamin E rich foods or due to certain diseases or medicines.

Vitamin E is a fat-soluble vitamin that comes in various forms and has antioxidant properties. It is naturally found in many fruits, vegetables, cereals, nuts and oils such as wheat germ oil, almonds, avocados, sunflower seeds, salmon, mango, kiwi, spinach and capsicum.

Consumption of these foods helps in maintaining adequate levels of vitamin E in the body and prevent its deficiency.

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Vitamin E deficiency is rare and is unlikely to be caused by a low diet of vitamin E. If the deficiency occurs, it could possibly be due to irregularities in dietary fat absorption or metabolism, certain underlying conditions or due to certain medications that impair the absorption of vitamin E by the body. [1]

In this article, we will discuss the causes, symptoms, treatments and other details on vitamin E deficiency. Take a look.

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What Exactly Is Vitamin E?

Vitamin E is a major lipid-soluble or fat-soluble vitamin present in fat-containing foods. The fat-soluble property of this essential vitamin helps it to be stored within the fatty tissues of humans, so that it does not need to be consumed every day.

There is a total of eight naturally occurring forms of vitamin E, collectively termed tocochromanols (divided into tocopherols and tocotrienols). They are alpha-, beta-, gamma- and delta-tocopherols and alpha-, beta-, gamma- and delta-tocotrienols. [2]

Alpha-tocopherol is only among the eight compounds that are known to meet the recommended daily dietary needs of vitamin E. It is found in the red blood cells and serum in high concentration, along with some amount of gamma-tocopherol, while beta and delta tocopherols are found in small amounts in the plasma.

The liver metabolises only the alpha-tocopherol and excretes it through urine, while the remaining forms (beta-, gamma-and delta-tocopherols) are absorbed in the small intestine and excreted in the faeces.

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Why Does The Body Require Vitamin E?

Vitamin E, though required in small amounts, is essential for the body to maintain and regulate many body functions. Some of the benefits of vitamin E in the body include:

  • It has a potent antioxidant activity which is linked to the prevention of numerous diseases and conditions, especially chronic and inflammatory diseases.
  • May lower the chances of degenerative diseases like Alzheimer's. [3]
  • Promotes kidney functions.
  • Prevents the risk of heart diseases such as atherosclerosis and ischemic heart disease.
  • Helps prevent symptoms of premenstrual syndrome.
  • Maintains cognitive functions and prevents nerve damage.
  • Promotes good vision. [4]
  • Strengthens the muscles.
  • Improves fertility in men. [5]
  • Good for skin and hair.
  • Improves liver function.
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Causes Of Vitamin E Deficiency

1. Medical conditions

The deficiency is caused due to certain medical conditions that severely reduce the absorption of fats in the body, as fats are required to absorb vitamin E correctly. Some of these medical conditions include:

  • Chronic cholestatic hepatobiliary disease
  • Crohn's disease [6]
  • Exocrine pancreatic insufficiency
  • Patients with cystic fibrosis
  • Chronic renal disease
  • Inherited hemolytic anaemia
  • 2. Genetics

    Some of the cases of severe vitamin E deficiency in humans occur due to genetic defects in the alpha-tocopherol transfer protein, which is the vital source of vitamin E in the body. It includes diseases like congenital abetalipoproteinemia, spinocerebellar ataxia, along with other neurological disorders. [7]

    Another cause is genetic defects that lead to the malabsorption of fats in the body, thus leading to vitamin E deficiency. It includes diseases like cholestatic liver disease or cystic fibrosis. [8]

    Note: In developing and underdeveloped countries, intake of insufficient amounts of vitamin E is the main cause of its deficiency, while in developed countries, underlying conditions are the main cause of vitamin E deficiency.

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    Symptoms Of Vitamin E Deficiency

    Some of the vital signs and symptoms of vitamin E deficiency include:

    • Neurologic defects such as dysfunction of the brain, nerves, spinal cord and muscles. [9]
    • Muscle pain and weakness.
    • Muscle deterioration, including cardiomyopathy or disease of the heart muscles.
    • Low birth weights in newborns. [10]
    • Difficulty in moving the eyes up and down.
    • Hyporeflexia or decreased or absent reflex response of muscles.
    • Decreased night vision.
    • Loss or decreased sense of vibratory sense.
    • Feeling of numbness or tingling.
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Complications Of Vitamin E Deficiency

If left untreated, vitamin E deficiency can cause complications such as: [1]

  • Blindness or severe visual problems.
  • Cardiac arrhythmias
  • Dementia
  • Hemolytic anemia in infants with the deficiency.
  • Increase risk of bleeding.
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    Diagnosis Of Vitamin E Deficiency

    In most cases, the diagnosis of vitamin E is carried out by physical examinations. Other diagnostic methods include:

    • Blood tests: To find out low levels of alpha-tocopherol in the blood.
    • Neonatal screening: To screen for early signs of cystic fibrosis related to vitamin deficiency in a high-risk population. [11]
    • Differential diagnosis: This includes understanding the history of patients, along with detection of the exact underlying cause through various tests which are causing the deficiency.
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Treatments Of Vitamin E Deficiency

The primary treatment of vitamin E deficiency includes the intake of vitamin E supplements after consulting a medical expert, along with foods rich in vitamin E. In newborns or premature babies, vitamin E can lead to the development of anaemia. Therefore, vitamin E supplements are provided orally or intravenously. [12]

In full-term newborns, vitamin E deficiency is less detected as they get the vitamin through breast milk or commercial formulas.

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Children and adults with inherited vitamin E deficiency require a high amount of vitamin E supplements to prevent the risk of neurological conditions.

What Is The Daily Recommended Dose Of Vitamin E?

The daily recommended amount of alpha-tocopherol through supplements for people of various age groups are as follows: [1]

Age 0 to 6 months: 3 mg
Age 6 to 12 months: 4 mg
Age 1 to 3 years: 6 mg
Age 4 to 10 years: 7 mg
Adults and elderly patients: 10 mg

The RDA of vitamin E for healthy adults is 15mg/day.

Note: The dose of vitamin E supplements may vary according to your medical condition. Consult a medical expert before starting on the dose.

How To Prevent Vitamin E Deficiency?

  • Include vitamin E rich food in your diets such as sunflower oil, soybean oil, hazelnuts, peanuts, spinach, collard green, mango, broccoli and almonds.
  • Taking prescribed vitamin E supplements.
  • Avoid taking vitamin E supplements with certain medications like anticoagulants.
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    To Conclude

    Vitamin E deficiency is a not so common condition in individuals. However, when it occurs or when you notice its symptoms (mentioned above), it is good to consult a medical expert soon for its early diagnosis and treatments.

Story first published: Saturday, July 24, 2021, 8:30 [IST]