What Happens If I Don't Have Vitamin E? The Health Risks Explained

January 10, 2026 •

4 min read

While vitamin E deficiency is rare in healthy adults, it can lead to serious health problems, primarily affecting the nervous system. It's crucial to understand what happens if I don't have vitamin E and the signs to watch for, which include muscle weakness and coordination issues.

Quick Summary

A vitamin E deficiency can lead to nerve and muscle damage, resulting in impaired coordination, muscle weakness, and vision problems. Severe, untreated deficiency can cause permanent neurological damage and a compromised immune system. Certain medical conditions affecting fat absorption increase risk.

Key Points

Neurological Damage: A lack of vitamin E can cause nerve and muscle damage, leading to symptoms like muscle weakness, poor coordination (ataxia), and peripheral neuropathy (numbness and tingling).
Impaired Immune Function: Vitamin E is a powerful antioxidant that supports the immune system, and a deficiency can weaken the body's ability to fight off infections.
Vision Problems: Oxidative damage to retinal cells can cause vision deterioration, including reduced night vision and, in severe cases, blindness.
Increased Bleeding Risk: Excessive vitamin E supplements can increase the risk of bleeding by interfering with blood clotting, especially for those on blood thinners.
Rare in Healthy Adults: A dietary deficiency is uncommon; risk is higher in individuals with certain malabsorption disorders like Crohn's disease or cystic fibrosis.
Hemolytic Anemia: In specific cases, particularly with premature infants, a deficiency can lead to the premature destruction of red blood cells.
Fat Absorption is Key: As a fat-soluble vitamin, proper absorption of vitamin E relies on the body's ability to absorb fats. Underlying conditions can disrupt this process.

The Critical Role of Vitamin E

Vitamin E is a fat-soluble nutrient that functions primarily as a powerful antioxidant, protecting your body's cells from oxidative stress. Oxidative stress is caused by harmful compounds called free radicals, which form naturally when your body converts food to energy. Without sufficient vitamin E, this cellular damage goes unchecked, leading to a cascade of health issues. The body relies on vitamin E to maintain a robust immune system, support neurological function, and ensure proper blood vessel health.

Neurological Complications from Deficiency

A deficiency in vitamin E most significantly impacts the nervous system. The protective sheaths of nerve cells are rich in fats, which are especially vulnerable to oxidative damage when vitamin E is scarce. This damage can severely disrupt the nervous system's ability to transmit signals, leading to a variety of neurological symptoms. The effects can be gradual, making them difficult to notice in the early stages.

Common Neurological Symptoms:

Peripheral Neuropathy: Nerve damage can cause numbness and tingling sensations, especially in the hands and feet.
Ataxia: This condition is characterized by a loss of control over body movements, leading to coordination and walking difficulties.
Muscle Weakness (Myopathy): The muscles can weaken and atrophy over time, causing fatigue and a decline in physical strength.
Speech and Vision Issues: Deficiency can cause slurred speech and vision deterioration due to damage to the retina and other eye cells.

Weakened Immune System

Vitamin E is a vital component of the immune system. It helps immune cells, such as T-cells, function effectively to fight off invading bacteria and viruses. A deficiency can impair this function, leaving the body more susceptible to infections. This is particularly concerning for older adults, who may already have a less robust immune response. A compromised immune system can also result in slow wound healing.

Impact on Vision

The retina and other cells in the eyes contain high levels of unsaturated fatty acids, making them highly susceptible to oxidative damage. Vitamin E protects these crucial cells. A deficiency can weaken the light receptors in the eyes, leading to retinopathy and progressive vision loss. In severe, prolonged cases, untreated deficiency can even lead to blindness.

Red Blood Cell Damage (Hemolytic Anemia)

Vitamin E protects red blood cell membranes from oxidative destruction. A lack of this nutrient can lead to the premature rupture of red blood cells, a condition known as hemolytic anemia. This is particularly risky for premature infants, who are born with limited vitamin E stores and are more vulnerable to this serious blood disorder.

Who Is at Risk for Vitamin E Deficiency?

Dietary deficiency of vitamin E is very rare in healthy individuals in developed countries, as many foods are fortified or naturally contain sufficient amounts. The most common causes are underlying medical conditions that interfere with fat absorption. Since vitamin E is a fat-soluble vitamin, adequate fat is necessary for its absorption in the gut.

Risk factors include:

Malabsorption Disorders: Conditions like cystic fibrosis, Crohn's disease, chronic pancreatitis, and celiac disease can impair the body's ability to absorb dietary fats and, consequently, vitamin E.
Genetic Disorders: Rare inherited conditions, such as ataxia with vitamin E deficiency (AVED) and congenital abetalipoproteinemia, directly impact vitamin E transport and absorption.
Premature Infants: Due to low vitamin E placental transfer during gestation, premature infants are born with low reserves.
Extremely Low-Fat Diets: While uncommon, a very low-fat diet can inhibit the absorption of vitamin E.

How to Address a Deficiency

Treatment for a vitamin E deficiency depends on its underlying cause. For those with malabsorption disorders or genetic conditions, lifelong high-dose supplementation may be necessary under medical supervision. For cases linked to insufficient dietary intake, increasing the consumption of vitamin E-rich foods is the best strategy. Foods high in vitamin E include vegetable oils (like sunflower and olive oil), nuts, seeds, leafy green vegetables, and fortified cereals. A balanced diet is generally sufficient for most people.

Comparison of Vitamin E Deficiency Severity


Symptom	Mild Deficiency	Moderate Deficiency	Severe, Untreated Deficiency
Neurological Function	Subtle muscle weakness, mild coordination issues, reduced reflexes.	Ataxia (coordination problems), muscle weakness, loss of feeling (peripheral neuropathy).	Permanent nerve damage, profound muscle weakness, ataxia, severe visual issues, cognitive impairment, and potential dementia.
Immune Response	Mildly compromised immune function, potentially leading to more frequent infections.	Weakened immune system, making the body more vulnerable to bacterial and viral infections.	Chronically weakened immune response, increasing risk of serious illnesses and hindering recovery from wounds or surgery.
Vision	Potential for mild vision deterioration over time due to retinal damage.	Noticeable vision problems, including retinopathy and reduced night vision.	Progressive vision loss and potential for complete blindness.
Other Effects	Fatigue, general malaise.	Hemolytic anemia (in specific cases), slow wound healing.	Cardiomyopathy (disease of the heart muscle), poor pregnancy outcomes.

Conclusion

While a dietary-induced vitamin E deficiency is uncommon in healthy individuals, its consequences can be severe for those with malabsorption issues or genetic conditions. From causing nerve and muscle damage to impairing vision and weakening the immune system, the effects of a vitamin E deficiency underscore the nutrient's importance. Timely diagnosis and appropriate treatment—often involving high-dose supplementation—are crucial to prevent irreversible damage. For the average person, maintaining a balanced diet rich in nuts, seeds, and leafy greens is the best way to ensure adequate intake and avoid a deficiency. It's always best to consult a healthcare provider if you suspect a deficiency to determine the underlying cause and the correct course of action.

What Happens Without Vitamin E: A Summary

Without enough vitamin E, the body's cells, particularly nerve and muscle cells, are damaged by oxidative stress, leading to neurological problems like ataxia and peripheral neuropathy. The immune system weakens, and vision can deteriorate, with severe, long-term deficiency causing permanent damage, including blindness and heart complications. The primary cause of deficiency is not a poor diet but rather malabsorption disorders or genetic conditions.

Visit the NIH Office of Dietary Supplements for more authoritative information on Vitamin E.

Frequently Asked Questions

The initial signs of vitamin E deficiency can be subtle, but often involve neurological symptoms like mild muscle weakness, general fatigue, coordination issues, and a weakened immune response. These symptoms can easily be mistaken for other issues, so medical consultation is important for a proper diagnosis.

Yes, a deficiency can significantly affect vision. Vitamin E protects the light receptors in the eyes from oxidative damage. Insufficient levels can lead to retinopathy, causing vision problems, including night blindness and progressive vision loss over time.

While most healthy individuals get enough vitamin E from their diet, you are at a higher risk if you have an underlying condition that affects fat absorption, such as Crohn's disease, cystic fibrosis, or chronic pancreatitis. Genetic disorders that impact vitamin E transport also increase risk.

Treatment depends on the cause. For deficiencies due to malabsorption disorders, high-dose vitamin E supplements are typically necessary, administered under a doctor's supervision. For dietary insufficiency, a diet rich in vitamin E foods like nuts, seeds, and leafy greens is recommended.

Yes, low vitamin E can cause nerve damage, a condition known as peripheral neuropathy. This happens because the deficiency causes oxidative stress that damages the fatty sheaths of nerve cells, disrupting nerve signal transmission and leading to numbness, tingling, and muscle weakness.

To prevent deficiency, eat foods rich in vitamin E such as almonds, sunflower seeds, wheat germ oil, sunflower oil, spinach, broccoli, and avocados. Because vitamin E is fat-soluble, consuming these with a source of healthy fat aids in absorption.

Taking vitamin E through food is very safe. However, high-dose supplements can be risky and may increase the risk of bleeding, especially for people taking blood-thinning medication. It's crucial to consult a healthcare provider before starting high-dose vitamin E supplements.