Vitamin E deficiency: symptoms, causes, treatment

If you’re worried about vitamin E deficiency, you first need to understand what vitamin E is—and what it does.

Vitamin E is the shared name for a group of closely related antioxidant molecules. These molecules are “antioxidants” because they prevent the kind of oxidative stress that damages cells. This damage can lead to all sorts of diseases or dysfunctions—from cancer to reproductive disorders (Mohd Mutalip, 2018).

Your body relies on sufficient vitamin E intake to work properly. While vitamin E deficiencies are rare, there’s evidence that getting more vitamin E than you need to avoid a deficiency may improve your health (Lewis, 2018).

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Avoiding a vitamin E deficiency is important for a whole host of reasons. When your body has adequate amounts of vitamin E, it can:

• Help counteract the kind of damage that stress and inflammation cause due to its antioxidative properties (Mohd Mutalip, 2018)

• Influence how your cells work and their ability to helpfully perform important jobs inside your body (Azzi, 2019)

• Prevent some cellular or blood abnormalities that fuel heart disease or brain diseases, and support healthy blood pressure (Azzi, 2019; Emami, 2019)

• Strengthen the way your immune system works (Lewis, 2019)  

• Help people who have non-alcoholic fatty liver disease or other medical conditions (Vadarlis, 2020)

While this sounds great, scientists did much of the research in a lab environment and on cell cultures, so the results do not necessarily mean those molecules have the same effects on a living being.

The most common symptom of a vitamin-E deficiency is ataxia or muscle-related problems. Some examples of ataxia are problems walking, slurred speech, and poor coordination. A vitamin E deficiency may also make it hard for you to look upward, and it can cause poor muscle reflexes or responses (Kemnic, 2021). 

Other symptoms of a vitamin E deficiency include (Kemnic, 2021):

• Poor or decreased night vision

• Muscle weakness

• Blindness

• Heart arrhythmias

• Cognitive (thinking) issues 

Fortunately, the incidence of vitamin E deficiency in the U.S. is very low. 

Only about 0.1% of adults have low enough levels of vitamin E for healthcare providers to diagnose them with a deficiency. However, a large percentage of people—90% or more of adults in the U.S.—are not getting sufficient amounts of vitamin E intake from their diets (Traber, 2014; Kemnic, 2021). While this doesn’t necessarily lead to a deficiency, it may be associated with less-than-optimal health functioning (Lewis, 2019). 

All the different vitamin E molecules seem to offer some health benefits. But only one of these molecules—alpha-tocopherol—is “essential.” That means your body has to have it for normal and healthy functioning, just as it needs vitamin A, vitamin C, and other essential vitamins and minerals (Azzi, 2019). 

People who don’t have enough alpha-tocopherol may be vitamin E-deficient. Healthcare providers sometimes refer to this deficiency as ataxia with isolated vitamin E deficiency or AVED (Khadangi, 2019). 

Unless you have a medical condition that interferes with your body’s absorption of vitamin E, you don’t seem to be at much risk for a deficiency or poor vitamin E status. While it’s possible to develop a deficiency if you don’t get enough alpha-tocopherol in your diet, this is very uncommon in the U.S. and other developed countries (Kemnic, 2021).  

Some of the medical conditions that can cause a vitamin E deficiency include (Kemnic, 2021):

• GI disorders, such as Crohn’s disease, that interfere with proper nutrient absorption

• Cystic fibrosis

• Liver or pancreatic impairments or diseases

• Enzyme deficiencies

• Conditions related to fat absorption or fat malabsorption

Vitamin E deficiency also turns up among premature infants or low-birth-weight infants (Kemnic, 2021). 

Medical professionals typically diagnose a vitamin E deficiency using blood tests where they look for low blood levels of the vitamin, and treatment differs depending on the underlying cause. For example, if Crohn’s disease or another GI disorder is causing the deficiency, your healthcare provider will first attempt to treat that condition (Kemnic, 2021).

Vitamin E supplements and dietary changes are also common treatments. Along with a 200 IU dose of vitamin E, you may need to eat more seeds, vegetable oils, and other sources of vitamin E (Kemnic, 2021).  

People tend to get vitamin E from either foods or supplements. 

Vitamin E is a fat-soluble vitamin, meaning fats (a.k.a., lipids) help your body absorb and make use of it. Dietary sources of vitamin E include vegetable oils like sunflower and safflower oil, sunflower seeds, walnuts, spinach, broccoli, fatty fish, and fruits like bananas (Schmölz, 2016; Reboul, 2017; NIH-a, 2020).

Different foods contain differing amounts or concentrations of the eight types of vitamin E, so you must eat a variety of these foods (NIH-a, 2020). 

Supplements

You can also get vitamin E from multivitamins and other supplements. Some research has found that taking vitamin E may improve immune health, especially if you’re an older adult (Lewis, 2019). 

However, some of the research on vitamin E supplements has turned up inconsistent findings. Large-scale studies on people who take vitamin E supplements have mostly failed to show any significant health benefits, and one study found that healthy men who took a daily vitamin E supplement containing selenium and 400 IU of alpha-tocopherol experienced an increased risk of prostate cancer (Jiang, 2017; Niki, 2015). 

So, while vitamin E supplements may be helpful for people who have a diagnosed deficiency, it’s unclear whether other people benefit from taking them (Kemwel, 2021).

The important takeaway here is that true vitamin E deficiencies seem to be rare, but because vitamin E does all sorts of helpful things in your body, adding more vitamin E sources into your diet may be good for you and your immune system.

If you think you may have symptoms of a vitamin E deficiency, it may be a good idea to get medical advice from your healthcare provider before taking a supplement. 

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Current version

November 09, 2021

Written by

Health Guide Team

Fact checked by

Felix Gussone, MD

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About the medical reviewer

Felix Gussone, MD, Ro

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.