Who is Susceptible to Vitamin E Deficiency?

November 13, 2025 •

3 min read

Vitamin E deficiency is extremely rare in healthy individuals, occurring mostly in people with underlying conditions that affect fat absorption. This means that while most people get enough of this essential nutrient from their diet, specific populations are at a much higher risk.

Quick Summary

This article outlines the primary risk groups for vitamin E deficiency, including those with fat malabsorption disorders, premature infants, and individuals with specific genetic conditions. It details how certain health issues and lifestyle choices impact the body's ability to absorb and utilize this vital nutrient.

Key Points

Fat Malabsorption: Chronic conditions affecting fat digestion, such as cystic fibrosis, Crohn's disease, and liver disorders, are the most common cause of deficiency in developed nations.
Genetic Disorders: Rare hereditary diseases like abetalipoproteinemia and Ataxia with Vitamin E Deficiency (AVED) directly disrupt the body's ability to transport or use vitamin E.
Premature Infants: Born with low vitamin E stores and immature digestive systems, pre-term infants are highly susceptible to deficiency.
Neurological Symptoms: Progressive nerve damage due to oxidative stress is a hallmark of the deficiency, leading to muscle weakness, coordination issues, and vision problems.
Treatment Focus: Managing the underlying condition and providing appropriate vitamin E supplementation are the main strategies for treatment.
Symptoms Can Be Reversed: When addressed early, many neurological symptoms associated with vitamin E deficiency can be improved or halted through supplementation.

Understanding Vitamin E Deficiency

Vitamin E is a fat-soluble antioxidant crucial for protecting cells from damage caused by free radicals. It supports immune function, vision, and skin health. Because it is a fat-soluble vitamin, its absorption is heavily dependent on the body's ability to digest and absorb dietary fat. In the developed world, vitamin E deficiency is seldom caused by a diet low in the vitamin alone; instead, it is most often the result of an underlying medical condition. Recognizing these risk factors is key to prevention and early treatment.

Populations at Risk Due to Fat Malabsorption

The most common reason for vitamin E deficiency in developed countries is a disorder that impairs the absorption of dietary fat. Without sufficient fat intake and the proper functioning of the digestive system, the body cannot absorb enough vitamin E, leading to low levels over time. Several conditions fall into this category:

Cystic Fibrosis: This genetic disorder causes severe damage to the lungs and digestive system, affecting the body's ability to break down and absorb fats.
Crohn's Disease and Celiac Disease: These inflammatory bowel diseases cause damage to the intestinal lining, impairing nutrient absorption, including fat-soluble vitamins.
Chronic Pancreatitis: Inflammation of the pancreas affects its ability to produce the enzymes needed to digest fat.
Liver and Gallbladder Disorders: Conditions like chronic cholestasis or primary biliary cirrhosis affect bile production or flow, which is necessary for fat absorption.
Bariatric Surgery: Certain weight-loss surgeries, particularly malabsorptive procedures, can significantly reduce the body's ability to absorb nutrients, increasing the risk of vitamin E deficiency.

Inherited Genetic Disorders

Some individuals are genetically predisposed to vitamin E deficiency, even with a normal diet and healthy digestive system. These rare inherited disorders affect how the body processes or transports vitamin E. Key examples include:

Abetalipoproteinemia: This rare genetic disorder of fat metabolism results in extremely poor absorption of dietary fat and vitamin E. Without treatment, it can lead to severe neurological problems and blindness.
Ataxia with Vitamin E Deficiency (AVED): This autosomal recessive disorder is caused by a mutation in the gene for the alpha-tocopherol transfer protein (TTPA). The body is unable to properly transport vitamin E, leading to severe deficiency and progressive nerve damage.

Vulnerable Newborns

Premature and low-birth-weight infants are at a higher risk of vitamin E deficiency. This is because only small amounts of the vitamin cross the placenta during fetal development, leaving them with low stores at birth. Additionally, their gastrointestinal systems are not yet mature enough to efficiently absorb fat and fat-soluble vitamins. Without proper intervention, this can lead to complications such as hemolytic anemia.

Symptoms of Vitamin E Deficiency

While the underlying cause varies, the symptoms of vitamin E deficiency are often similar and primarily neurological in nature due to damage from oxidative stress. These signs progress slowly over time and include:

Muscle weakness
Loss of coordination (ataxia)
Numbness or tingling (peripheral neuropathy)
Impaired reflexes
Vision problems

Comparison Table: Causes of Vitamin E Deficiency


Feature	Fat Malabsorption Disorders	Genetic Disorders (e.g., AVED)	Premature Infants
Cause	Impaired absorption due to digestive system issues	Defective transport or metabolism of vitamin E	Low vitamin stores at birth and immature GI system
Onset	Varies, often associated with disease progression	Typically in childhood (ages 5–15 for AVED)	At or shortly after birth
Primary Problem	Body cannot absorb fat, which is needed for vitamin E absorption	Liver and cells cannot retain and distribute vitamin E	Insufficient stores of vitamin E from fetal development
Symptoms	Neurological deficits, muscle weakness, vision problems	Progressive neurological issues like ataxia and neuropathy	Hemolytic anemia, muscle weakness, eye issues
Treatment	Addressing underlying condition + supplementation	High-dose, lifelong vitamin E supplementation	Supplements provided by medical staff

Conclusion

Vitamin E deficiency is not a widespread issue resulting from a poor diet in the general population, but rather a specific concern for those with underlying health conditions. The most vulnerable groups include individuals with fat malabsorption disorders such as cystic fibrosis and Crohn's disease, people with rare genetic mutations like AVED, and premature infants with underdeveloped digestive systems. Early diagnosis and management, which often involve targeted vitamin E supplementation and treatment of the root cause, are essential for preventing the progression of neurological symptoms. If you have any risk factors or experience potential symptoms, consulting a healthcare provider is critical for proper evaluation and care.

Information on vitamin E can be further explored through the Office of Dietary Supplements, a part of the National Institutes of Health.

Frequently Asked Questions

In developed countries, the primary cause is usually an underlying disorder that impairs the absorption of dietary fat, not simply a low intake from food.

Conditions that cause fat malabsorption include cystic fibrosis, Crohn's disease, chronic pancreatitis, liver disease, and celiac disease.

Premature infants are at risk because they have low reserves of vitamin E at birth and their digestive systems are not fully developed to absorb the vitamin efficiently.

Yes, a very low-fat diet can lead to vitamin E deficiency over time, as some dietary fat is necessary for the proper absorption of this fat-soluble vitamin.

Neurological symptoms include muscle weakness, difficulty with coordination and walking (ataxia), numbness and tingling (peripheral neuropathy), and vision deterioration.

Yes, vitamin E deficiency is treatable. Treatment involves addressing the underlying cause and taking vitamin E supplements, often at high doses.

With early diagnosis and treatment, many symptoms of vitamin E deficiency can be resolved or halted. However, advanced neurological damage may be more difficult to reverse completely.