Vitamin E Deficiency

Key Features

• Most commonly results from

  • Severe malabsorption (eg, cystic fibrosis)

  • Abetalipoproteinemia (genetic disorder)

  • Chronic cholestatic liver disease (including biliary atresia)

Clinical Findings

• Areflexia

• Disturbances of gait

• Decreased vibration and proprioception

• Ophthalmoplegia

Diagnosis

• Plasma vitamin E level below normal range of 0.5–0.7 mg/dL

Treatment

• Vitamin E supplementation, although optimum therapeutic dose has not been clearly defined

• Large doses, often administered parenterally, can be used to improve the neurologic complications seen in abetalipoproteinemia and cholestatic liver disease

• Several trials of supplemental vitamin E have shown slower cognitive decline in patients with Alzheimer disease

• Vitamin E supplementation may also provide benefit in patients with nonalcoholic fatty liver disease

• Supplemental vitamin E has no benefit in preventing cardiovascular disease or cancer