Vitamin E Deficiency

Vitamin E Deficiency - General Information

Vitamins are an essential part for the proper functioning of the bodies and their deficiency can cause diseases which can at times cripple life. They are organic substances that are taken in small amounts. Thirteen vitamins (vitamin A, vitamin C, D, E, K, and the group of B vitamins) are known.

Vitamin E is a group of compounds (fat soluble) known as tocopherols/tocotrienols with composition of alpha-tocopherol (25%) and gamma-tocopherol (75%). It is an essential fat-soluble vitamin; absorbed via bile salts and stored in the fats of the body. Their importance and functioning are: a major antioxidant (prevents tissue injury); prevents clotting of blood, carries oxygen to blood and nourishment to cells; slows down aging of cells; maintains the immune system, eyes and skin; and helps in the reproductive system of animals. It prevents a number of diseases in the heart, brain, liver, skin, eye, skin and cell cataract. Besides these, it is also used as a preservative for packaged foods.

The recommended daily allowance of Vitamin E as per the RDA (Recommended Dietary Allowance) is 15 mg/22.5 IU for adults (up to 1,000 mg/1,500 IU). The allowance for children below 3 years is 6 mg/9 IU and for those 4-8 yrs is 7 mg/10.5 IU. To be more specific, males (10 mg/15 IU) require more than females (8 mg/12 IU). Moreover, pregnant women (10 mg/15 IU) and lactating women (12 mg/18 IU) need more than normal doses.

Vitamin E is found in a variety of foods in small quantities and hence a proper diet is a must. Foods like vegetable oils (corn, soya, and sunflower oil etc.), muscle meats, liver, fish, chicken, almonds, cereals, fruits, vegetables, milk, hazelnuts, bread, eggs and others.

Vitamin E Deficiency - Symptoms

Vitamin deficiency can be a primary deficiency (insufficient vitamins in the food you are eating) or a secondary one (disorder of the body does not allow sufficient absorption of the vitamin due to lifestyle factors-smoking/drinking etc. or medicines). Therefore, having a proper diet eliminates the chances of a deficiency occurring. Vitamins need to be consumed regularly as they are not stored in the human body. Vitamin E deficiency can be checked by checking the content of the alpha-tocopherol in the blood plasma, via the method high-pressure liquid chromatography. Therefore, if the content of alpha-tocopherol is below 5.0 mg/l, it indicates a deficiency.

Situations wherein a vitamin E deficiency is likely to occur are: (1) persons unable to absorb dietary fats/fat-soluble nutrients; (2) premature/ under-weight infants (weighing below 1500 grams/3.5 pounds) as less vitamin E moves via the placenta cord and (3) people with genetic abnormalities of the transfer protein (lipoproteins) or fat metabolism.

Vitamin E deficiency causes damage to nerves and is very rare as it is stored in body fat. It leads to nerve disfunctioning and lack of co-ordination in the skeleton and muscles. Moreover, older children and adults rarely get it. A vitamin E deficiency mainly affects the nervous system like Ataxia etc, which results in lack of co-ordination slow reflexes, loss of co-ordination, positional sense and cognitive functioning; and changes in the muscles and skeleton. Others symptoms are difficulty in concentration and walking, fatigue, depression and irritability, low immunity and thyroid, anemia (red blood cells get destroyed), eye problems, diarrhea. It also causes muscle and nerve weakness, and even hemorrhage (internal bleeding in brain).

People suffering from diseases like liver, pancreas, kidney, Cystic fibrosis, Crohns’ disease, Celiac disease, cholestasis, pancreatitis and colorectal cancer etc. are at higher risk as either the medications interfere with the absorption of the Vitamin E or the genetics prevents its absorption. Moreover, a low-fat diet (means less vitamin E) can also cause it. Thus, Vitamin E supplements are required to offset the above deficiency.

Vitamin E Deficiency - Treatment

Vitamin treatment is done for the following reasons (1) primary when the deficiency is found; (2) next is to prevent a deficiency from developing and (3) when unable to detect a vitamin deficiency and to prevent diseases that might occur due to this. The treatment is very important especially during diseases which interfere in the vitamins’ normal functioning and require higher doses than normal.

The treatment can be as (1) having a proper diet providing the recommended allowance of the vitamin E; (2) through oral vitamin E supplements for those who are unable to/will not take vitamin E-rich foods and (3) through injections which are generally recommended for those having problems in absorption of fat-soluble vitamins. Treatment can continue from a few weeks in infants to months in patients having severe diseases/genetic disorders. Although, blood tests that check out the deficiency are not routine, supplements are the most popular form of treatment. Moreover, to detect vitamin E deficiency early, introduction of neonatal screening is also encouraged.

People having genetic problems (like biotinidase deficiency, Pernicious anemia, and homocystinuria) that impair the absorption of the vitamins require large doses-megadoses (10-1,000 more than the RDA) of vitamin E. Vitamin supplements are easily available, whether effective or not. Therefore, to be on the safer side, it is always advisable to consult a doctor before taking any supplements on your own. However, you should keep in mind that a balanced diet is the best method to keep the vitamin E levels intact.

Vitamin E supplements (for oral intake) are found in various forms like capsules, pills, liquids, and powders for people having an improper diet or running a risk of a deficiency. Moreover, for external usage, it is available as lotions, oils, gels, ointments and creams. Some examples include “Aquasol E®” (brand name); Vitamin E skin cream, ointment, or gel; Vitamin E oral solution; Vitamin E tablets or capsules. Moreover, it is also used as a part of multi-vitamin formula. There are a number of commercial supplements which can be classified as (1) the most common and inexpensive one is the Fully Synthetic Vitamin E, "d, l-alpha-tocopherol", sold as the acetate ester; (2) the Semi-Synthetic "natural source" vitamin E esters, used in tablets and multiple vitamins like the highly fractionated natural d-alpha tocopherol and (3) high gamma-tocopherol fraction supplements and the Less fractionated "natural mixed tocopherols".

Besides the above, supplements are also available as natural (vitamin E food sources like vegetable oil) or synthetic (from petroleum oils) formulations. If the name as a “d”-prefix, then it is a natural one (for example, d-alpha-tocopherol is a natural one). If above (oral/external) is taken in proper dosage, no side-effects occur, while if taken in overdose, symptoms such as blurred vision, diarrhea, nausea, vomiting, dizziness, headache, unusual bleeding and fatigue, stomach cramps, severe burning, itching, rash, mild stinging, cancer and skin allergies (contact dermatitis) can occur.