What are symptoms of lack of vitamin E?

October 4, 2025 •

4 min read

While severe vitamin E deficiency is uncommon, it can lead to significant health issues, especially concerning the nervous system. Recognizing what are symptoms of lack of vitamin E is vital for early diagnosis and prevention of potentially irreversible damage caused by oxidative stress.

Quick Summary

The main symptoms of a lack of vitamin E are neurological, such as muscle weakness, impaired coordination, and peripheral neuropathy. Other signs include vision problems, a weakened immune system, and hemolytic anemia, especially in infants. Deficiency is rare and typically stems from fat malabsorption disorders.

Key Points

Neurological Dysfunction: A lack of vitamin E often leads to progressive neurological damage, causing symptoms like muscle weakness, coordination difficulties (ataxia), and numbness.
Vision Problems: As the deficiency progresses, it can affect the eyes, weakening light receptors and potentially leading to significant vision deterioration or even blindness.
Impaired Immune Response: Vitamin E is crucial for immune function, and a deficiency can lead to a weakened immune system, increasing susceptibility to illness, particularly in older adults.
Underlying Malabsorption: Most deficiencies are not caused by diet alone but by disorders that impair the body's ability to absorb fat, such as cystic fibrosis, Crohn's disease, or liver conditions.
At-Risk Groups: Premature infants and individuals with specific genetic disorders or fat malabsorption conditions are the most vulnerable to developing a vitamin E deficiency.
Management and Prevention: Treatment involves addressing the underlying cause, taking supplements, and consuming foods rich in vitamin E like nuts, seeds, and leafy greens.

The Essential Role of Vitamin E

Vitamin E is a group of fat-soluble compounds with potent antioxidant properties that protect the body's cells from oxidative stress and damage caused by free radicals. It is crucial for maintaining the health of the central nervous system, supporting immune function, and protecting cell membranes throughout the body. A deficiency arises when the body does not have enough of this vital nutrient, leading to a breakdown in these protective functions over time. Since Vitamin E is a fat-soluble vitamin, its absorption relies on dietary fat and the body's ability to process it properly.

Neurological Symptoms of Vitamin E Deficiency

Because Vitamin E is critical for protecting the nervous system, its deficiency primarily manifests as progressive neurological damage. The symptoms often develop slowly over months or years, particularly in adults with malabsorption disorders.

Muscle weakness: A lack of vitamin E can result in generalized muscle weakness (myopathy). This is due to oxidative stress damaging nerve fibers and leading to the breakdown of muscle tissue.
Ataxia (Coordination and balance problems): Deficiency can cause the breakdown of specific neurons, known as Purkinje neurons, leading to difficulty with coordination, balance, and walking. This can present as a clumsy or unsteady gait.
Peripheral Neuropathy: This refers to damage to the peripheral nerve fibers, causing numbness, tingling, and a pins-and-needles sensation in the hands and feet.
Impaired Reflexes: A decrease or absence of deep tendon reflexes, such as in the knees and ankles, is an early sign of neurological involvement.
Loss of Proprioception: The loss of position sense is the inability to know where your limbs are in space without looking at them.

The Impact on Vision and Other Systems

Besides neurological issues, a lack of vitamin E can affect other critical bodily functions, including vision and immunity.

Vision deterioration: A deficiency can weaken light receptors in the retina and other eye cells over time, leading to gradual vision loss. In severe, prolonged cases, it can cause retinopathy, pigment changes in the retina, and eventually blindness.
Weakened Immune System: Adequate vitamin E is essential for proper immune function. A deficiency can suppress the immune system, making individuals, especially older adults, more susceptible to infections and illnesses.
Hemolytic Anemia: In severe cases, especially in premature or low-birth-weight infants, a lack of vitamin E can cause red blood cells to become fragile and rupture. This leads to a condition known as hemolytic anemia.
Cognitive Impairment: In advanced stages of deficiency, reduced cognition and even dementia have been reported.

Causes of Vitamin E Deficiency

Dietary deficiency of vitamin E is rare in healthy adults because the body stores it in fatty tissues. Therefore, a lack of vitamin E is typically caused by an underlying condition that affects fat absorption or metabolism.

Common Causes:

Fat Malabsorption Disorders: Conditions that prevent the body from properly absorbing fat can lead to a deficiency. This includes cystic fibrosis, Crohn’s disease, liver disease (like cholestasis), chronic pancreatitis, and celiac disease.
Genetic Disorders: Rare genetic conditions can impair the transport or metabolism of vitamin E. These include Abetalipoproteinemia and Ataxia with isolated vitamin E deficiency (AVED), which affect the liver’s ability to distribute the vitamin.
Very Low-Fat Diets: While less common, an extremely low-fat diet can inhibit the absorption of fat-soluble vitamins, including vitamin E.
Premature Infants: Premature, low-birth-weight infants are at a higher risk of deficiency because they have low reserves at birth and limited placental transfer of the vitamin.

Comparison of Deficiency Symptoms in Different Groups


Feature	Adults with Malabsorption	Premature Infants	Individuals with AVED (Genetic)
Onset of Symptoms	Slow, often years after onset of malabsorption	Rapidly, shortly after birth	Progressive, typically starting between ages 5 and 15
Primary Symptoms	Peripheral neuropathy, ataxia, muscle weakness, vision problems	Hemolytic anemia, retinopathy of prematurity, bleeding	Ataxia, hyporeflexia, sensory loss, pigmentary retinopathy
Underlying Cause	Fat malabsorption from conditions like Cystic Fibrosis or Crohn's	Limited placental transfer; low bodily stores	Genetic mutation in the alpha-tocopherol transfer protein
Treatment Response	Symptoms often stabilize or improve with supplementation	Supplements can prevent or correct issues	High-dose supplements can halt progression

Treatment and Prevention

Management of a vitamin E deficiency focuses on two key aspects: addressing the underlying cause and restoring adequate vitamin E levels.

Treating the Underlying Cause: For individuals with fat malabsorption, managing the primary condition (e.g., cystic fibrosis, liver disease) is the first step. This may involve addressing dietary issues or other specific therapies.
Oral Supplementation: Oral vitamin E supplements are the standard treatment and can be given in varying doses depending on the severity and cause of the deficiency. High doses may be required to overcome malabsorption issues or in genetic cases.
Dietary Adjustments: A diet rich in foods containing vitamin E can help manage levels. Important sources include nuts (almonds, hazelnuts), seeds (sunflower seeds), vegetable oils (wheat germ, sunflower oil), leafy green vegetables (spinach), and fortified cereals.

Here are some foods high in vitamin E:

Oils: Wheat germ oil, sunflower oil, safflower oil.
Nuts and Seeds: Almonds, sunflower seeds, hazelnuts, peanuts.
Vegetables: Spinach, broccoli, red bell peppers, turnip greens.
Fruits: Avocado, mango, kiwi.
Seafood: Salmon, trout, abalone.

Conclusion: Seeking Medical Advice is Key

While a dietary lack of vitamin E is uncommon, the potential for serious, irreversible neurological damage from an underlying malabsorption disorder makes it a critical health issue to address. The various symptoms, from muscle weakness and impaired reflexes to vision problems and a weakened immune system, serve as warning signs. If you experience these symptoms, especially if you have a known fat malabsorption condition, it is vital to consult a healthcare provider for proper diagnosis and a personalized treatment plan. With timely intervention, the progression of symptoms can often be halted or even reversed, significantly improving quality of life.

For more detailed health information, you can visit a reliable source like the Cleveland Clinic.

Frequently Asked Questions

Vitamin E deficiency is a condition where the body lacks sufficient levels of this fat-soluble vitamin. It is most commonly caused by an underlying disorder that affects the body's ability to absorb fat, as vitamin E requires fat for absorption.

Yes, a lack of vitamin E can cause muscle weakness (myopathy) because the deficiency leads to oxidative stress, which damages nerve fibers and muscle tissue over time.

A deficiency can cause vision problems by damaging light receptors in the retina and other cells in the eye. Over time, this can lead to impaired vision, retinopathy, and in severe cases, blindness.

Those at highest risk include premature, low-birth-weight infants, individuals with chronic fat malabsorption disorders like cystic fibrosis or liver disease, and people with rare genetic disorders affecting vitamin E metabolism.

Treatment involves addressing the root cause, which is often a malabsorption issue, and then administering oral vitamin E supplements. Dietary changes to include more vitamin E-rich foods are also recommended.

With timely treatment, the progression of neurological symptoms can often be halted and, in some cases, reversed. However, if the deficiency is left untreated for a long period, the nerve damage may become permanent.

Excellent food sources of vitamin E include seeds (sunflower), nuts (almonds, hazelnuts), vegetable oils (wheat germ, sunflower), and leafy green vegetables (spinach).

A healthy vegan diet can provide sufficient vitamin E from plant-based sources. However, an extremely low-fat diet, regardless of other factors, can hinder the absorption of vitamin E since it is a fat-soluble vitamin.