Vitamin E
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Vitamin E is a fat-soluble vitamin that acts as an antioxidant and free-radical scavenger in lipophilic environments. Vitamin E requires bile for absorption, and 25% of it is absorbed orally. The vitamin is stored in adipose tissue, liver, and muscle.
The reference range of vitamin E in adults is 5.5-17 µg/mL. In children, it is 3-18.4 µg/mL. [1, 2, 3]
Conditions associated with vitamin E deficiency (< 3 µg/mL in adults; < 1.5 µg/mL in infants) include the following:
Motor and sensory neuropathy
Intestinal fat malabsorption (bowel disease, pancreatic disease, chronic cholestasis, celiac disease, cystic fibrosis, short-bowel syndrome, abetalipoproteinemia, intestinal lymphangiectasia)
Vitamin E toxicity (>40 µg/mL) may be associated with the following:
Increased all-cause mortality
Coagulopathy (easy bruising or bleeding; prolonged PT, aPTT; inhibition of platelet aggregation)
Impaired immunity
Constitutional and gastrointestinal symptoms (nausea, gastric distress, abdominal cramps, diarrhea; headache; fatigue; muscle weakness)
Specifics for collection and panels are as follows:
Specimen type: Blood serum
Container: Vacutainer, red top
Collection method: Venipuncture
Specimen volume: 0.5 mL
Other instructions: (1) fasting specimen (for infants, draw prior to next feeding) and (2) send specimen tube in light-protective container
Related tests: Vitamin A, beta carotene
Vitamin E is a fat-soluble vitamin that acts as an antioxidant and free-radical scavenger in lipophilic environments. Vitamin E requires bile for absorption, and 25% of it is absorbed orally. The vitamin is stored in adipose tissue, liver, and muscle.
Severe deficiency, as may occur in persons with abetalipoproteinemia or fat malabsorption, profoundly affects the central nervous system and can cause ataxia and a peripheral neuropathy resembling Friedreich ataxia.
While in most healthy adults, short-term supplementation with up to 1600 IU of vitamin E appears to be well tolerated and to have minimal side effects, long-term safety is questionable. Data suggest a possible increase in mortality and in the incidence of heart failure with long-term use of vitamin E (400 IU or more) in patients with chronic diseases. Therefore, an upper limit of 1000 mg/d may be too high.
Indications for testing of serum vitamin E include the following:
Evaluation of individuals with sensorimotor neuropathy
Evaluation of individuals with intestinal fat malabsorption
Burris CA, Ashwood ER, Burns DE. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 4th ed. St. Louis: Elsevier Saunders; 2006.
McPherson RA, Pincus MR. Henry’s Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia: Elsevier Saunders; 2011.
Wallach J. Interpretation of Diagnostic Tests. 6th ed. New York: Little, Brown; 1996.
Edward Charbek, MD Fellow in Pulmonary/Critical Care Medicine, St Louis University Hospital
Disclosure: Nothing to disclose.
Eric B Staros, MD Associate Professor of Pathology, St Louis University School of Medicine; Director of Clinical Laboratories, Director of Cytopathology, Department of Pathology, St Louis University Hospital
Eric B Staros, MD is a member of the following medical societies: American Medical Association, American Society for Clinical Pathology, College of American Pathologists, Association for Molecular Pathology
Disclosure: Nothing to disclose.
Judy Lin, MD
Disclosure: Nothing to disclose.
Vitamin E
Research & References of Vitamin E |A&C Accounting And Tax Services
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