What Happens If You Don't Get Enough of Vitamin E?

January 4, 2026 •

4 min read

According to the National Institutes of Health, a vitamin E deficiency is extremely rare in healthy individuals and typically results from underlying medical conditions. However, for those affected, not getting enough of vitamin E can lead to severe and progressive health issues, primarily impacting the nervous system, eyes, and immune function.

Quick Summary

The consequences of vitamin E deficiency include nerve and muscle damage, vision impairment, and a weakened immune system. It is most commonly caused by fat malabsorption disorders or genetic conditions, not a typical diet.

Key Points

Neurological Damage: Severe vitamin E deficiency can cause nerve and muscle damage, leading to symptoms like poor coordination (ataxia), weak muscles, and loss of reflexes.
Vision Impairment: Inadequate vitamin E levels can damage retinal cells, causing vision problems that may progress to blindness in severe, prolonged cases.
Weakened Immunity: A deficient immune response can result from not getting enough of this vital antioxidant, increasing susceptibility to infections.
Rare Condition: True vitamin E deficiency caused by poor diet is extremely uncommon; it is almost always linked to an underlying medical condition affecting fat absorption.
Risk Factors: High-risk groups include premature infants and individuals with fat malabsorption disorders such as cystic fibrosis, Crohn's disease, or chronic liver disease.
Treatment is Effective: With early diagnosis, supplementation can often correct the deficiency and prevent further progression of symptoms.

What is Vitamin E and Why Do We Need It?

Vitamin E is a group of fat-soluble compounds that function as powerful antioxidants in the body. Its primary role is to protect the body's cells from oxidative stress, a process that can cause cell damage and contribute to the development of various chronic diseases. This essential nutrient supports immune function, cell signaling, and eye health. Because it is fat-soluble, its absorption requires dietary fat, a critical factor when considering the root causes of a deficiency.

Major Health Consequences of Vitamin E Deficiency

When the body does not have enough vitamin E, the lack of antioxidant protection can lead to severe complications, mainly affecting the nervous and muscular systems. The onset of symptoms is typically slow and progressive, often taking years to become noticeable.

Neurological and Muscular Impairments

One of the most profound effects of a prolonged deficiency is damage to nerve and muscle fibers. This can manifest in several ways:

Ataxia: A loss of control over body movements, leading to poor coordination and difficulty walking.
Muscle Weakness: Profound weakness in the muscles can develop over time.
Peripheral Neuropathy: Damage to the nerves outside the brain and spinal cord, causing numbness, tingling, and a loss of sensation.
Impaired Reflexes: The loss of deep tendon reflexes, such as the patellar reflex, is often one of the first identifiable signs.

Vision Problems

Retinopathy, or damage to the retina, is a significant risk. The lack of antioxidant protection can lead to the destruction of retinal cells, causing vision problems that can progress to complete blindness in severe, untreated cases. Limited upward gaze is another specific ophthalmologic symptom associated with the deficiency.

Weakened Immune Function

Vitamin E plays a critical role in supporting the immune system. A deficiency can compromise this function, leaving the body more vulnerable to infections. A weakened immune response can also lead to poor wound healing.

Other Severe Complications

In addition to neurological issues, other serious health risks can arise, particularly in specific populations:

Hemolytic Anemia: In premature infants with very low birth weights, a vitamin E deficiency can cause red blood cells to rupture, leading to a serious form of anemia.
Cognitive Impairment: Severe and long-term deficiency can lead to cognitive decline and dementia.
Cardiac Arrhythmias: In advanced stages, heart-related issues, such as irregular heartbeats, may occur.

What Causes a Vitamin E Deficiency?

It is crucial to understand that a dietary lack of vitamin E is an extremely rare cause of deficiency in developed nations. The primary drivers are conditions that hinder the absorption or metabolism of fat.

A Comparison of Deficiency Causes


Cause Type	Examples	Key Characteristic
Malabsorption Disorders	Cystic fibrosis, Crohn's disease, Chronic liver disease, Chronic pancreatitis	These conditions impair the body's ability to absorb fats, and therefore, the fat-soluble vitamin E.
Genetic Disorders	Abetalipoproteinemia, Ataxia with Isolated Vitamin E Deficiency (AVED)	Faulty genes impair the body's ability to produce or transport vitamin E, leading to a profound deficiency despite adequate dietary intake.
Premature Birth	Very low birth weight infants	Infants are born with very low vitamin E stores due to limited placental transfer during fetal development.
Extremely Low-Fat Diet	Very rare in developed nations	As vitamin E is fat-soluble, a diet with virtually no fat makes absorption from food impossible, though this is uncommon.

How to Prevent and Treat Vitamin E Deficiency

Prevention is key, especially for individuals with malabsorption issues. For healthy people, a balanced diet is usually sufficient.

Top Dietary Sources of Vitamin E

Consuming a variety of foods rich in vitamin E can ensure adequate intake for most people. Some of the best sources include:

Vegetable Oils: Wheat germ oil, sunflower oil, and safflower oil are particularly rich sources.
Nuts and Seeds: Sunflower seeds, almonds, hazelnuts, and peanuts are excellent choices.
Leafy Green Vegetables: Spinach, turnip greens, and broccoli contribute to daily intake.
Fortified Foods: Many cereals and some juices are fortified with vitamin E.

Supplementation and Medical Treatment

For individuals with a diagnosed deficiency, often due to an underlying condition, oral supplementation is the standard treatment. The dosage will be determined by a healthcare provider. It's important to note that high-dose supplementation is not recommended for healthy individuals, as it can increase the risk of bleeding. An authoritative source for further information on supplement safety and recommendations is the NIH Office of Dietary Supplements.

Conclusion: Early Recognition is Crucial

While vitamin E deficiency is uncommon, its consequences can be severe and long-lasting if left untreated. Symptoms like muscle weakness, vision changes, and poor coordination should prompt a visit to a healthcare provider, especially for individuals with risk factors like fat malabsorption disorders. Early diagnosis and treatment, often involving targeted supplementation, can effectively correct the deficiency and halt the progression of symptoms before permanent damage occurs. For most people, a diet rich in nuts, seeds, and oils is more than enough to maintain healthy vitamin E levels and reap the benefits of this vital antioxidant.

Frequently Asked Questions

The most common signs of a vitamin E deficiency are neurological symptoms such as muscle weakness, difficulty with body movements and coordination (ataxia), loss of reflexes, and vision problems.

While theoretically possible, a dietary-based deficiency is extremely rare in developed countries because vitamin E is found in many common foods. The most common causes are medical conditions that prevent proper fat absorption.

Conditions that cause poor fat absorption can lead to a deficiency. These include cystic fibrosis, Crohn's disease, chronic liver disease, chronic pancreatitis, and certain rare genetic disorders like abetalipoproteinemia.

A doctor diagnoses a vitamin E deficiency through a physical exam, a review of symptoms, and blood tests to measure the level of vitamin E in the blood.

In its early stages, a vitamin E deficiency is often reversible with treatment. However, if left to progress for an extended period, the damage, especially neurological, can become permanent and difficult to reverse.

For those with a diagnosed malabsorption issue, supplements are often a necessary part of treatment. For most healthy people, obtaining vitamin E from food sources is sufficient and often better absorbed.

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

The highest risk groups include individuals with fat malabsorption conditions, those with specific genetic disorders, and premature infants who are born with very low reserves of the vitamin.