Vitamin E deficiency

Symptoms, at-risk groups, and clinical context for vitamin e deficiency. Sourced from NIH Office of Dietary Supplements and StatPearls.

Vitamin E deficiency is rare in healthy adults — almost all cases stem from fat malabsorption disorders or rare genetic conditions affecting vitamin E transport. Severe deficiency causes progressive neurological damage including ataxia and peripheral neuropathy. Premature infants are also vulnerable due to limited stores at birth.

Common symptoms

  • Loss of balance and coordination (ataxia)
  • Loss of position and vibration sense (proprioceptive loss)
  • Muscle weakness
  • Loss of deep tendon reflexes (areflexia)
  • Numbness or tingling in hands and feet (peripheral neuropathy)
  • Eye problems — limited upward gaze, retinal degeneration, reduced vision
  • Hemolytic anemia (red blood cells more susceptible to oxidative damage)
  • Difficulty walking, especially in the dark
  • Slurred speech (dysarthria) in advanced cases

At-risk groups

  • People with fat malabsorption disorders — cystic fibrosis, cholestatic liver disease, short-bowel syndrome
  • People with abetalipoproteinemia (rare genetic disorder of fat metabolism)
  • People with ataxia with vitamin E deficiency (AVED — TTPA gene mutation)
  • Premature or low birth weight infants
  • People who've had extensive intestinal surgery
  • People with chronic pancreatic insufficiency
  • Note: vitamin E deficiency from inadequate diet alone is essentially unheard of
When to see a doctor: Progressive ataxia (balance problems, clumsiness), loss of vibration sense, or muscle weakness — especially in a young person or someone with known fat malabsorption — warrants neurological evaluation including serum alpha-tocopherol testing. Early treatment with high-dose vitamin E can halt progression and partially reverse symptoms in genetic forms.
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Related deficiencies

Nutrients with overlapping symptoms — useful when investigating an unclear clinical picture.