What happens to your body when you don't get enough vitamin E?

While most healthy individuals get sufficient vitamin E from their diet, a deficiency can have severe, progressive effects on the body, particularly the nervous system. It is a rare condition most often caused by underlying disorders that impair fat absorption, which is critical for this fat-soluble vitamin.

Quick Summary

A lack of vitamin E can cause widespread issues, including nerve and muscle damage, impaired vision, and a weakened immune system, mainly due to oxidative stress.

Key Points

• Nervous system damage: Vitamin E deficiency leads to oxidative stress on nerve cells, resulting in muscle weakness, poor coordination (ataxia), and tingling sensations.

• Compromised vision: The eyes are particularly sensitive to a lack of vitamin E, which can cause retinal damage (retinopathy) and potential blindness in severe cases.

• Weakened immune response: With inadequate vitamin E, immune cells are less protected from damage, leading to a higher risk of infections.

• Fat malabsorption is the primary cause: In developed countries, deficiency is typically due to medical conditions like cystic fibrosis or Crohn's disease that prevent proper fat absorption.

• Serious in premature infants: Premature babies are at risk for hemolytic anemia due to low fat stores and an immature digestive system.

• Symptoms can be reversed with treatment: Early and consistent treatment with vitamin E supplements can stop the progression of neurological symptoms and, in some cases, reverse them.

The Critical Role of Vitamin E

Vitamin E is not a single compound but a group of eight fat-soluble antioxidants, with alpha-tocopherol being the only form known to meet human requirements. Its primary function is to protect cells throughout the body from oxidative stress and damage caused by unstable molecules called free radicals. Because it is a fat-soluble vitamin, adequate dietary fat is necessary for its proper absorption by the body. When levels are too low, this protective function is compromised, leading to a cascade of problems that affect multiple physiological systems over time.

The Serious Effects of Vitamin E Deficiency

A deficiency of vitamin E can trigger a variety of systemic issues. The nervous system is particularly vulnerable to the cellular damage that results from a lack of antioxidant protection. The symptoms often worsen progressively if left untreated.

Neurological Complications

• Muscle Weakness (Myopathy): A lack of vitamin E can cause oxidative damage to muscle cells, leading to significant and widespread muscle weakness. This can start subtly and worsen over time, making it difficult to perform daily tasks.
• Poor Coordination and Ataxia: Ataxia is a condition characterized by impaired balance and coordination. Vitamin E is crucial for the health of certain neurons, and without it, these cells can break down, hampering their ability to transmit signals properly and leading to difficulty walking or general clumsiness.
• Peripheral Neuropathy: Nerve damage can cause numbness and tingling sensations, often in the hands and feet. This is a result of damage to the nerve fibers that transmit signals from the brain and spinal cord to the rest of the body.
• Impaired Reflexes: Early signs of deficiency may include hyporeflexia, or diminished reflexes, which can progress as the condition worsens.

Vision Problems

Vitamin E is an essential component for the health of the eyes. The retina has a high concentration of fatty acids, which are particularly susceptible to oxidative damage without sufficient antioxidant protection.

• Retinopathy and Vision Loss: Damage to the retina, known as retinopathy, is a significant complication of vitamin E deficiency. Over time, this can cause progressive vision loss and, in severe, prolonged cases, complete blindness.
• Impaired Night Vision: Some individuals may experience poor vision in low-light conditions as an early symptom of eye damage.

Weakened Immune Function

Vitamin E helps support a robust immune system by protecting immune cells from oxidative stress and regulating various immune responses. A deficiency can lead to:

• Increased Susceptibility to Infections: With compromised immune cells, the body is less equipped to fight off infections from bacteria and viruses. This can lead to frequent illness and a longer recovery time.
• Poor Response to Illness: This effect is especially pronounced in older adults, who are already at a higher risk for impaired immune function.

Other Health Impacts

• Hemolytic Anemia: In cases of severe deficiency, particularly in premature infants, red blood cells can rupture. This condition is known as hemolytic anemia.
• Dry and Flaky Skin: The antioxidant properties of vitamin E help maintain skin moisture and protect it from damage. A deficiency can manifest as dry, rough, or flaky skin.
• Poor Wound Healing: The body's ability to regenerate and repair damaged skin cells is hindered without sufficient vitamin E, causing wounds to take longer to heal.
• Cardiomyopathy: In severe, long-term cases, heart muscle deterioration (cardiomyopathy) can occur.

Causes of Deficiency

While low dietary intake is a possible cause in regions with food insecurity, the primary reason for vitamin E deficiency in developed countries is a medical condition that impairs fat absorption.

• Fat Malabsorption Disorders: Conditions like cystic fibrosis, Crohn's disease, and certain liver or pancreatic diseases can prevent the body from properly absorbing dietary fat, and therefore, vitamin E.
• Genetic Disorders: Rare inherited conditions, such as Ataxia with Vitamin E Deficiency (AVED), result from a defective alpha-tocopherol transfer protein, which impairs the body's ability to distribute and utilize vitamin E.
• Premature Infants: Due to an immature digestive tract and low fat stores, preterm infants are at a higher risk of deficiency.

Treatment and Prevention

Treatment primarily focuses on addressing the underlying cause and supplementing vitamin E intake. In most cases, a healthcare professional will prescribe high-dose oral supplements. Regular monitoring of serum vitamin E levels is crucial to track progress and adjust the treatment plan. Prevention involves maintaining a balanced diet rich in vitamin E sources, especially for those with risk factors.

Vitamin E Deficiency vs. Sufficiency

Aspect	Vitamin E Deficiency	Vitamin E Sufficiency
Antioxidant Protection	Weakened defense against oxidative stress and free radical damage.	Strong antioxidant protection, shielding cells from damage.
Nervous System	Increased risk of nerve damage, muscle weakness, and poor coordination.	Normal nerve function, strong muscles, and balanced coordination.
Vision	Progressive retinal damage, potential for vision loss and blindness.	Supports healthy vision and protects light receptors in the eyes.
Immune Response	Compromised immune function, leading to frequent infections.	A robust immune system capable of fighting off illnesses effectively.
Skin Health	Dry, flaky skin and slow healing of wounds.	Healthy, moisturized skin with proper healing capabilities.

Conclusion

Vitamin E deficiency is a serious condition that can lead to irreversible damage if not addressed. While rare in healthy adults, it is a significant risk for those with underlying health issues affecting fat absorption. The wide-ranging effects on the nervous system, eyes, and immune function underscore the vital importance of this powerful antioxidant. If you or a loved one experience any symptoms suggestive of a deficiency, seeking prompt medical evaluation is essential. Early diagnosis and treatment, often involving high-dose supplementation under a doctor's supervision, can help prevent the progression of symptoms and lead to a good prognosis.

For more information on the genetic aspect of this condition, you can refer to MedlinePlus's entry on Ataxia with vitamin E deficiency.

Rich Sources of Vitamin E

Here is a list of foods high in vitamin E to help support your intake:

• Vegetable Oils: Wheat germ, sunflower, and safflower oil are excellent sources.
• Seeds and Nuts: Sunflower seeds, almonds, hazelnuts, and peanuts are packed with vitamin E.
• Leafy Greens: Spinach, turnip greens, and Swiss chard provide good amounts of the vitamin.
• Other Vegetables and Fruits: Avocado, sweet potato, and mango are also good sources.
• Fortified Cereals: Some breakfast cereals are fortified with additional vitamin E.

What happens to your body when you don't get enough vitamin E? - FAQ

What are the main symptoms of a vitamin E deficiency?

Symptoms often include neurological issues like muscle weakness, coordination problems (ataxia), impaired reflexes, numbness, and tingling. Vision problems and a weakened immune system are also common effects.

Is vitamin E deficiency common?

No, it is quite rare in healthy individuals because vitamin E is widely available in many foods. When it does occur, it is usually linked to an underlying medical condition, like a fat malabsorption disorder.

What causes vitamin E deficiency in adults?

The most frequent cause is a disorder that impairs the body's ability to absorb fat, which is necessary for vitamin E absorption. This can include conditions like cystic fibrosis, Crohn's disease, chronic liver disease, and rare genetic disorders.

How does a vitamin E deficiency affect the nervous system?

Vitamin E protects nerve cells from oxidative damage. Without sufficient levels, these cells are damaged, which can lead to peripheral neuropathy (numbness/tingling) and ataxia (coordination and balance issues).

Can a vitamin E deficiency cause vision problems?

Yes, it can lead to vision issues, including retinopathy, which is damage to the retina. In severe, untreated cases, this can result in progressive vision loss and even blindness.

How is vitamin E deficiency treated?

Treatment depends on the cause but typically involves high-dose vitamin E supplements taken orally. Addressing the underlying medical condition is also a crucial part of the management plan.

What foods should I eat to get more vitamin E?

Excellent dietary sources include nuts (almonds, hazelnuts), seeds (sunflower), vegetable oils (wheat germ oil, sunflower oil), leafy green vegetables (spinach), avocados, and fortified cereals.

Frequently Asked Questions

How common is vitamin E deficiency?

Vitamin E deficiency is very rare in healthy individuals. It is most often linked to underlying medical conditions that affect the body's ability to absorb fat rather than a simple lack of dietary intake.

What are the main neurological symptoms of vitamin E deficiency?

The primary neurological symptoms include muscle weakness, difficulty with balance and coordination (ataxia), decreased reflexes, and peripheral neuropathy, which causes numbness and tingling.

Can vitamin E deficiency affect my vision?

Yes, vitamin E deficiency can cause vision problems. It can lead to damage of the retina (retinopathy) and progressive vision loss, which can become permanent if left untreated for long periods.

Does a vitamin E deficiency affect the immune system?

Yes, it can weaken the immune system. Vitamin E is a crucial antioxidant that protects immune cells from damage. Without enough, the body's ability to fight off infections is reduced.

What medical conditions cause vitamin E deficiency?

Conditions that cause fat malabsorption are the main culprits, including cystic fibrosis, Crohn's disease, celiac disease, and certain liver or pancreatic disorders. Some rare genetic diseases can also cause it.

What are good food sources of vitamin E?

Rich sources include nuts (almonds, hazelnuts), seeds (sunflower seeds), vegetable oils (wheat germ, sunflower), avocados, and leafy green vegetables (spinach).

Can vitamin E deficiency symptoms be reversed?

If caught early, many symptoms can be reversed or halted with treatment. However, if the deficiency is prolonged and severe, some neurological damage and vision loss may become irreversible.

Who is most at risk for vitamin E deficiency?

Premature infants are at higher risk due to low fat stores. Additionally, individuals with fat malabsorption disorders or rare genetic conditions are most susceptible.