What Happens When You Have a Vitamin E Deficiency?

November 25, 2025 •

4 min read

Vitamin E deficiency is extremely rare in healthy individuals, with the condition almost always linked to an underlying fat malabsorption disorder. However, when it does occur, a vitamin E deficiency can lead to significant nerve and muscle damage, affecting coordination, vision, and overall health.

Quick Summary

A deficiency can cause nerve and muscle damage, leading to loss of coordination, weakness, numbness, and vision problems, primarily stemming from fat absorption issues or genetic conditions.

Key Points

Nervous System Damage: A severe vitamin E deficiency primarily impacts the central and peripheral nervous systems, causing peripheral neuropathy, ataxia, and loss of reflexes.
Muscle Weakness: Oxidative stress from low vitamin E levels can lead to myopathy, resulting in significant muscle weakness and movement problems.
Vision Problems: Deficiency can weaken eye cells, causing vision deterioration, including potential blindness in severe, prolonged cases.
Rare Condition: The condition is not typically caused by a poor diet but by underlying medical issues affecting fat absorption, such as Crohn's or cystic fibrosis.
At-Risk Populations: Premature infants and individuals with fat malabsorption disorders or rare genetic conditions are at the highest risk.
Reversible Early On: Symptoms can often be improved or reversed with supplementation and by treating the root cause if detected in its early stages.
Hemolytic Anemia: In infants, a deficiency can cause this condition where red blood cells are destroyed prematurely.

The Critical Role of Vitamin E

Vitamin E is not a single compound but a group of fat-soluble compounds with potent antioxidant properties. Its primary function is to protect the body's cells from oxidative stress caused by free radicals, which are unstable molecules that can damage cell membranes. This protective role is particularly crucial for nerve cells, which have a high concentration of fatty acids. By neutralizing free radicals, vitamin E helps maintain the integrity of cell membranes and supports a healthy immune system. Beyond its antioxidant function, vitamin E also plays a role in widening blood vessels to prevent clotting and enabling cells to interact with each other.

The Mechanisms Behind Deficiency

In most developed nations, a vitamin E deficiency is not caused by poor diet but by an underlying medical condition. Since it is a fat-soluble vitamin, its absorption requires the presence of dietary fat. Therefore, any condition that interferes with the proper digestion and absorption of fat can lead to a deficiency.

Common causes include:

Fat Malabsorption Disorders: Conditions like cystic fibrosis, Crohn's disease, chronic pancreatitis, cholestatic liver disease, and celiac disease can all prevent the body from absorbing fat correctly.
Genetic Disorders: Rare inherited disorders such as abetalipoproteinemia and Ataxia with Vitamin E Deficiency (AVED) can impair the transport or metabolism of vitamin E, despite adequate intake.
Bariatric Surgery: Certain weight-loss surgeries, particularly malabsorptive procedures, can lead to chronic fat malabsorption and subsequent vitamin deficiencies.
Premature Infants: Preterm infants have very low vitamin E reserves at birth because the vitamin only crosses the placenta in small amounts during fetal development. Their immature digestive systems also make absorption difficult.
Very Low-Fat Diets: While uncommon in developed countries, an extremely low-fat diet can, over time, lead to inadequate vitamin E intake and absorption.

Serious Health Consequences of Deficiency

The consequences of prolonged vitamin E deficiency primarily affect the nervous system and can be severe if left untreated, potentially becoming irreversible. As the deficiency progresses, oxidative damage accrues, particularly in vulnerable neurons.

Neurological and Muscular Symptoms

Peripheral Neuropathy: Nerve damage, or peripheral neuropathy, is a key symptom, causing numbness, tingling, and a loss of sensation in the limbs.
Ataxia: A lack of control over body movements, or ataxia, can lead to coordination and walking difficulties as Purkinje neurons in the cerebellum break down.
Muscle Weakness: Oxidative stress can damage muscle fibers, resulting in generalized muscle weakness, known as myopathy.
Loss of Reflexes: Areflexia, or the loss of deep tendon reflexes, is often one of the first identifiable signs in progressive cases.

Vision Problems

Vitamin E deficiency can weaken the light receptors and other cells in the eye, potentially leading to retinopathy, which impairs vision over time. In severe and prolonged cases, vision loss or even blindness can occur.

Weakened Immune System

Vitamin E is vital for supporting immune cell function. Its deficiency can impair the immune response, making individuals, particularly older adults, more susceptible to illnesses.

Hemolytic Anemia

This blood disorder occurs when red blood cells rupture prematurely. Vitamin E protects red blood cell membranes from oxidative damage, and without it, their stability is compromised. Hemolytic anemia is a particular risk for premature infants with the deficiency.

Comparison of Deficiency in Adults vs. Infants


Symptom	Adults with Malabsorption	Premature Infants
Neurological Issues	Develop slowly, may be delayed due to fat stores.	Develop quickly due to low reserves.
Muscle Weakness	Appears over time.	Often present at birth or shortly after.
Ataxia & Coordination	Manifests gradually, over years.	Can be part of the initial clinical picture.
Immune System	Weakened response; potential for increased illness.	Immune function may be impaired.
Hemolytic Anemia	Rare, as adults have large vitamin E stores.	High risk, as red blood cells are more susceptible to damage.
Retinopathy	Can occur in prolonged cases.	Potential for retinopathy of prematurity.

Diagnosis and Treatment

Diagnosis typically involves a physical examination, a review of the patient's medical history (looking for underlying conditions), and blood tests to measure the serum alpha-tocopherol level. For adults, a low ratio of serum alpha-tocopherol to lipids is the most accurate indicator.

Treatment primarily involves addressing the underlying cause of malabsorption and administering vitamin E supplementation, often in high doses, to restore normal levels. Dietary modifications are also recommended, focusing on foods rich in vitamin E, such as nuts, seeds, vegetable oils, and leafy greens. Early detection and treatment are crucial, as many symptoms can be reversed before they cause permanent damage.

Conclusion: Prevention Is Key

Although rare in healthy people, the consequences of a vitamin E deficiency are serious and impact the nervous system, muscles, and vision. Prevention is key, especially for at-risk individuals. A balanced diet, rich in vitamin E sources, is important for overall health. However, for those with conditions affecting fat absorption, regular medical monitoring and supplementation are vital to prevent progressive damage. If you suspect a deficiency due to an existing condition or experiencing any related symptoms, consulting a healthcare provider is the best course of action. More information on dietary requirements and the functions of Vitamin E can be found on the NIH Office of Dietary Supplements website(https://ods.od.nih.gov/factsheets/VitaminE-Consumer/).

Frequently Asked Questions

No, vitamin E deficiency is very rare in healthy people in developed countries. It is almost always caused by an underlying medical condition that prevents proper absorption of fat, and therefore, the fat-soluble vitamin E.

The initial signs of a deficiency can be subtle and develop slowly over years. The first identifiable sign is often the loss of deep tendon reflexes, or hyporeflexia.

Doctors diagnose the condition through a combination of a physical exam, a review of medical history, and blood tests to measure the level of serum alpha-tocopherol. A specific test involves comparing the alpha-tocopherol level to total lipids in the blood.

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

Good dietary sources of vitamin E include nuts (almonds, hazelnuts), seeds (sunflower seeds), vegetable oils (sunflower, olive), leafy green vegetables (spinach), and fortified cereals.

If caught and treated in the early stages, the symptoms of vitamin E deficiency can often be reversed with supplementation. However, without treatment, the symptoms can worsen and become very difficult or impossible to reverse.

People with fat malabsorption disorders (like cystic fibrosis, Crohn's disease, or liver disease), individuals who have undergone bariatric surgery, those with certain genetic disorders, and premature infants are at the highest risk.