Vitamin E includes a group of eight fat-soluble nutrients – four tocopherols and four tocotrienols – that occur naturally in many plant foods and are added to some fortified foods. While all the nutrients are biologically active, the human body largely utilizes and retains the alpha-tocopherol version of vitamin E.
Vitamin E features prominently in the arsenal of vitamins your body counts on to stay healthy. This wonder vitamin has a critical role to play in nerve, muscle, and immune function. It also has antioxidant properties that help protect the body from damage caused by free radicals. To ply your body with enough vitamin E, most adults require 15 mg of vitamin E daily as per the recommended daily allowances (RDA) suggested by the Food and Nutrition Board (FNB). Nursing mothers need around 19 mg a day.1 And considering the vital role vitamin E plays, a deficiency of this vitamin can indeed throw the body out of whack.
Severe vitamin E deficiency is usually rare, especially in developed nations, but may happen as a result of malnutrition. Vitamin E also requires some amount of fat for efficient absorption and transportation, so a diet with minimal fat intake can also be a trigger. Non-dietary deficiency is usually connected with health conditions that hamper digestion and absorption of fat. Conditions like liver or gallbladder disorders, pancreatitis, and cystic fibrosis can, for instance, lead to fat malabsorption.2 Newborn babies, especially premature babies, may also be prone to vitamin E deficiency since only small quantities of vitamin E can cross the placenta. The risk slowly decreases as babies start getting enough vitamin E from milk. Growing children (even the picky eaters) and adults, on the other hand, are rarely vulnerable to vitamin E deficiency since they can store large quantities in fat tissue. Even with a deficiency because of fat malabsorption problems, the effects are more pronounced among infants than in adults.3 But if your body is deprived of vitamin E, it can translate to many health problems, some quite critical. Here’s what you need to watch out for.
1. Weakened Immunity
Get your fill of vitamin E every day! Some of the best sources of vitamin E are oils such as sunflower, safflower, canola, and wheat germ; nuts such as almonds, peanuts, and hazelnuts; and seeds such as sunflower seeds. Green vegetables such as broccoli, collard greens, and spinach are good sources too. Some foods such as fruit juices, breakfast cereals, spreads, and margarine are often vitamin E fortified.4 5
Your immune system needs a healthy dose of vitamin E to function efficiently. It is present in cellular membranes and body tissues of all cells. A deficiency, in turn, results in a weakened immune system, leading to frequent infections and illnesses. From colds and cough to other respiratory illnesses and urinary infections, this can manifest in different ways. A vitamin E-rich diet and vitamin E supplementation are known to improve disease resistance and also address the problem of decreased immunity observed in vulnerable groups like the aged or whose immunity is impaired, for instance, those with AIDS.6 7
2. Gastrointestinal Issues
Although individuals with Crohn’s disease are known to have low amounts of vitamin E, there is no established direct connection between vitamin E deficiency and Crohn’s disease. The condition is most likely linked to fat malabsorption seen in people with Crohn’s.8
When linked to poor fat absorption, severe vitamin E deficiency can often cause gastrointestinal problems like diarrhea, vomiting, swollen abdomen, and bulky foul-smelling stools. Infants are especially prone and may, consequently, not gain weight or grow as expected.9 10
3. Muscle Wasting
Animal studies show that vitamin E deficiency can also affect skin health, leading to problems with collagen metabolism and wound healing and causing skin ulceration. Human studies are needed to confirm this link and the exact cause for it, though.11
Muscle wasting is another repercussion of severe vitamin E deficiency. Studies show that without vitamin E, a torn cell membrane cannot heal properly. And since muscle cell membranes can tear just from normal use, not healing can be a problem. Muscle cells that are not repaired for long periods of time can lead to muscle wasting. Physical trauma of any kind, muscular dystrophy, or muscle weakness because of diabetes are conditions that cause muscle cell damage. Vitamin E deficiency is also evident in the frailty syndrome seen in the elderly, making them weak and unsteady on their feet.12
4. Eye Problems
Vitamin E protects the eyes from free radicals that damage healthy eye tissue. Unmitigated free radical damage can increase your risk of age-related macular degeneration and cataract formation. Which is what happens if you suffer from vitamin E deficiency. A deficiency can also weaken eye muscles and lead to involuntary eye movements.13
5. Hemolytic Anemia
Vitamin E is essential for the development of the nervous system and any deficiency can have adverse effects on it, especially among babies and children. Among children with low levels of vitamin E at birth, irreversible neurologic symptoms are not uncommon.14 Coordination issues and impaired reflexes are two common repercussions of vitamin E deficiency.
Premature babies who are deficient in vitamin E often grapple with hemolytic anemia, which is a disorder that causes red blood cells to be destroyed faster than they can be produced. The bone marrow unsuccessfully tries to replace the lost cells, leading to a lot of immature red blood cells. Studies show that infants treated with supplemental vitamin E can overcome some degree of anemia and also bring down the immature red blood cell count.15 16
6. Peripheral Neuropathy
Vitamin E deficiency can cause damage to muscles and nerves, leading to loss of feeling in the arms and legs and sensations such as burning, numbness, or tingling. Studies confirm that low amounts of nerve tocopherol can cause nerve injury. Timely introduction of vitamin E therapy may help reverse or at least arrest the neuropathy.17 18 19
7. Spinocerebellar Ataxia
Prolonged and severe deficiency of vitamin E can lead to spinocerebellar ataxia or spinocerebellar degeneration of structures in the brain. The spinal cord and the cerebellum degenerate if you have this condition. Since the cerebellum controls voluntary movements, any degeneration causes loss of muscle coordination.20
Such complications show up anytime between 2 and 20 years of age and affect coordination and control of voluntary movements. Other symptoms of ataxia are muscle weakness, tremors and tics, speaking difficulties, and slower reflexes. In some cases, there are physical and mental developmental delays too. Early vitamin E therapy has been found to delay, and sometimes even prevent, the development of some of these neurological problems.2122 23
Abetalipoproteinemia or Bassen-Kornzweig syndrome is a rare genetic disorder that hampers fat absorption by the intestine and fat transportation by the liver. This leads to the deficiency of essential vitamins and lipids, vitamin E deficiency being one. The signs and symptoms of ABL mirror those of vitamin E deficiency. They include progressive neurological deterioration, hemolytic anemia, muscle weakness, and sometimes degeneration of the retina of the eyes. This is a strange cycle. While ABL is one of the causes of vitamin E deficiency, it is also one of the results of vitamin E deficiency.
ABL often begins in infancy. The chances of recovery from ABL, are more often than not, rather poor. Treatment involves high doses of vitamin E supplemented by dietary fat and other fat-soluble vitamins.24 25
9. Skeletal Abnormalities
While not directly linked to a vitamin E deficiency, in health conditions like cystic fibrosis, chronic cholestasis, and Peyronie’s disease, supplementation with vitamin E has been seen to bring relief to patients. On the other hand, the connection between vitamin E and conditions like heart disease or Alzheimer’s disease, though speculated widely, is at best tenuous.
Tests have shown that patients with ataxia, liver problems like ABL, and low vitamin E levels may develop skeletal abnormalities. Muscle imbalances during bone development may cause skeletal abnormalities such as clubfoot, backward or sideways curvature of the spine, or a highly arched foot. All of these can cause problems with walking or even standing.26 27
The bottom line? Get your vitamin E from a wide variety of food sources and you should be fine. If you suspect a deficiency, talk to a doctor about appropriate supplementation. It is possible to have side effects, some severe, from excessive doses so steer clear of self-medicating.
|↑1||Vitamin E. Office of Dietary Supplements.|
|↑2||What happens if I don’t get enough vitamin E? NIH.|
|↑3||Vitamin E. MSD Manuals.|
|↑4||Vitamin E. National Institutes of Health (NIH).|
|↑5||Vitamin E. Linus Pauling Institute.|
|↑6||Moriguchi, Satoru, and Mikako Muraga. “Vitamin E and immunity.” Vitamins and hormones 59 (2000): 305-336.|
|↑7||Tengerdy, Robert P. “Vitamin E, immune response, and disease resistance.” Annals of the New York Academy of Sciences 570, no. 1 (1989): 335-344.|
|↑8||Kuroki, Fumitoshi, Mitsuo Iida, Masaya Tominaga, Takayuki Matsumoto, Kohki Kanamoto, and Masatoshi Fujishima. “Is vitamin E depleted in Crohn’s disease at initial diagnosis?.” Digestive Diseases 12, no. 4 (1994): 248-254.|
|↑9, ↑21, ↑24, ↑26||Abetalipoproteinemia. National Organization for Rare Disorders (NORD).|
|↑10||Vitamin E. Linus Pauling Institute.|
|↑11||Vitamin E and Skin Health. Linus Pauling Institute.|
|↑12||Labazi, Mohamed, Anna K. McNeil, Timothy Kurtz, Taylor C. Lee, Ronald B. Pegg, José Pedro Friedmann Angeli, Marcus Conrad, and Paul L. McNeil. “The antioxidant requirement for plasma membrane repair in skeletal muscle.” Free Radical Biology and Medicine 84 (2015): 246-253.|
|↑13||Vitamin E. American Optometric Association.|
|↑14||Vitamin E. Linus Pauling Institute.|
|↑15||OSKI, FRANK A., and LEWIS A. BARNESS. “Hemolytic anemia in vitamin E deficiency.” The American journal of clinical nutrition 21, no. 1 (1968): 45-50.|
|↑16||Hemolytic Anemia in Children. STANFORD CHILDREN’S HEALTH.|
|↑17||What happens if I don’t get enough vitamin E?. NIH.|
|↑18, ↑22||Muller, D. P. R., JuneK Lloyd, and O. H. Wolff. “Vitamin E and neurological function.” The Lancet 321, no. 8318 (1983): 225-228.|
|↑19||Traber, Maret G., Ronald J. Sokol, Steven P. Ringel, Hans E. Neville, Cheryl A. Thellman, and Herbert J. Kayden. “Lack of tocopherol in peripheral nerves of vitamin E-deficient patients with peripheral neuropathy.” New England Journal of Medicine 317, no. 5 (1987): 262-265.|
|↑20||Spinocerebellar ataxia. National Center for Biotechnology Information (US). Genes and Disease [Internet]. Bethesda (MD): National Center for Biotechnology Information (US); 1998-.|
|↑23||Harding, A. E., S. Matthews, S. Jones, C. J. K. Ellis, I. W. Booth, and D. P. R. Muller. “Spinocerebellar degeneration associated with a selective defect of vitamin E absorption.” New England Journal of Medicine 313, no. 1 (1985): 32-35.|
|↑25||Abetalipoproteinemia. Genetics Home Reference.|
|↑27||Neville, Hans E., Steven P. Ringel, Mary Anne Guggenheim, Carol A. Wehling, and Jill M. Starcevich. “Ultrastructural and histochemical abnormalities of skeletal muscle in patients with chronic vitamin E deficiency.” Neurology 33, no. 4 (1983): 483-483.|