How do you tell if you need more vitamin E?

November 15, 2025 •

3 min read

While severe vitamin E deficiency is rare in healthy adults, it is most often linked to underlying medical conditions that affect nutrient absorption. So, how do you tell if you need more vitamin E, and what specific signs should you be aware of?

Quick Summary

Vitamin E deficiency symptoms, which are uncommon in healthy people, include muscle weakness, coordination problems, and vision issues, often caused by malabsorption disorders.

Key Points

Neurological Signs: Persistent muscle weakness, coordination problems, and difficulty walking are key indicators of a potential vitamin E deficiency.
Vision Problems: A deficiency can weaken eye receptors, leading to vision deterioration over time.
Immune Compromise: A weakened immune system, potentially resulting in more frequent infections, can be a sign of low vitamin E levels.
Underlying Causes: In healthy adults, a deficiency is almost always linked to fat malabsorption disorders rather than diet alone.
At-Risk Groups: Premature infants, individuals with cystic fibrosis, and those with genetic disorders are most susceptible to a deficiency.
Dietary Solution: Most people can meet their vitamin E needs by eating foods like sunflower seeds, almonds, and leafy greens.

What are the Signs and Symptoms of a Vitamin E Deficiency?

Vitamin E serves as a potent antioxidant, protecting cells from damage. A deficiency compromises this protection, particularly affecting the nervous system. Symptoms are typically gradual, and untreated severe deficiency can cause significant health problems.

Neurological Symptoms

Neurological issues are the most common signs of low vitamin E, resulting from oxidative damage to nerve cells.

Muscle Weakness: Oxidative stress can damage the central nervous system, causing generalized muscle weakness.
Coordination and Walking Difficulties: Damage to specific neurons can impair signal transmission, leading to balance issues and poor muscle control (ataxia).
Numbness and Tingling: Nerve damage can result in peripheral neuropathy, causing loss of feeling or tingling in the limbs.
Slowed Reflexes: A reduced or absent deep tendon reflex can be an early indicator.

Other Physical Indicators

Beyond neurological signs, vitamin E deficiency can impact other bodily functions.

Vision Deterioration: Low levels can damage retinal cells, potentially causing vision loss over time. In premature infants, it may cause abnormal eye blood vessel growth.
Weakened Immune System: Vitamin E supports immune function, and a deficiency can make the body more prone to illness.
Hemolytic Anemia: Severe deficiency, particularly in premature babies, can lead to a type of anemia where red blood cells are destroyed.

What Causes a Vitamin E Deficiency?

Vitamin E absorption depends on dietary fat. Deficiencies are usually caused by conditions affecting absorption rather than insufficient dietary intake.

Key causes include:

Fat Malabsorption Disorders: Conditions hindering fat absorption are the most frequent cause in developed nations. These include cystic fibrosis, Crohn's disease, chronic pancreatitis, and liver/gallbladder disorders.
Genetic Disorders: Rare hereditary conditions like abetalipoproteinemia and ataxia with vitamin E deficiency (AVED) can disrupt vitamin E metabolism.
Extremely Low-Fat Diets: Severely restricted fat intake can impair the absorption of fat-soluble vitamins.
Low Intake: In areas with food insecurity, insufficient vitamin E in the diet is a more common factor.

Who is at High Risk for a Vitamin E Deficiency?

Certain groups are more susceptible to vitamin E deficiency.

Premature Infants: These infants have low vitamin E stores at birth, increasing their risk of complications like hemolytic anemia.
People with Malabsorption Conditions: Individuals with conditions like cystic fibrosis or liver disease face a higher risk due to poor fat absorption.
Individuals with Genetic Disorders: Those with rare conditions like abetalipoproteinemia and AVED require specific management and supplementation.
Individuals with Poor Diet: While less common in well-nourished populations, those on very-low-fat diets or experiencing severe malnutrition are at increased risk.

Comparison of Risk Factors for Deficiency


Risk Factor	Cause of Deficiency	Symptoms Manifestation	Typical Age Group
Fat Malabsorption Disorders	Impaired absorption of dietary fat	Develops over time; neurological symptoms appear later in life	Adults, children
Premature Birth	Low vitamin E stores at birth	Present early in life; can be severe, including anemia	Infants
Genetic Disorders	Defective metabolism or transport of vitamin E	Progressive neurological issues from childhood	Children, adults
Very Low-Fat Diet	Inadequate fat for absorption	Subtle, can worsen over time if diet is not corrected	Adults

How to Increase Your Vitamin E Intake

For most healthy people, maintaining adequate vitamin E levels is achieved through a balanced diet.

Best Dietary Sources

Key sources include vegetable oils (wheat germ, sunflower, safflower), nuts and seeds (almonds, sunflower seeds, hazelnuts), leafy green vegetables (spinach, broccoli), and fruits like mango and avocado. Fortified foods can also contribute.

When to Consider Supplements

Supplements should be taken only under medical supervision, especially for individuals with malabsorption or diagnosed deficiencies. High doses can pose risks. Always inform your doctor about any supplements you are using. For further information, the NIH Office of Dietary Supplements is a valuable resource.

Conclusion: Seeking Professional Guidance is Key

Recognizing a vitamin E deficiency involves identifying a range of often subtle and slowly progressing symptoms, particularly neurological ones. While dietary deficiency is rare in healthy adults, those with malabsorption, genetic disorders, or premature infants face a higher risk. Persistent muscle weakness, coordination issues, or vision changes warrant consultation with a healthcare provider. Diagnosis is confirmed by a blood test, and treatment involves supplementation and addressing the underlying cause. Timely intervention to correct the deficiency can prevent symptom progression and restore normal function.

Frequently Asked Questions

Yes, a deficiency can damage nerve fibers, which may cause numbness and tingling sensations, a condition known as peripheral neuropathy.

A vitamin E deficiency is extremely rare in healthy adults who eat a balanced diet. When it does occur, it is usually due to a disorder that impairs the body's ability to absorb fat, such as Crohn's disease or cystic fibrosis.

Doctors diagnose vitamin E deficiency based on symptoms, a physical examination, and medical history. They will often confirm the diagnosis with a blood test to measure the level of alpha-tocopherol in the blood.

Good sources of vitamin E include vegetable oils like wheat germ and sunflower oil, nuts such as almonds and hazelnuts, seeds like sunflower seeds, and green vegetables like spinach and broccoli.

For most healthy individuals, supplementation is not necessary as a balanced diet can provide enough. However, supplements may be required for those with malabsorption disorders or diagnosed deficiencies, under the supervision of a healthcare provider.

If left untreated, a severe deficiency can be very dangerous. The progressive nerve and muscle damage can lead to a worsening quality of life, and in infants, it can cause severe anemia and other complications.

Vitamin E is a powerful antioxidant that helps protect cells from damage caused by free radicals. It also supports immune function, widens blood vessels, and prevents blood from clotting.