Vitamin E deficiency Domina Petric MD Vitamin E

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Vitamin E deficiency Domina Petric, MD

Vitamin E deficiency Domina Petric, MD

Vitamin E deficiency • Vitamin E deficiency can result from insufficient dietary intake or

Vitamin E deficiency • Vitamin E deficiency can result from insufficient dietary intake or impaired absorption of the vitamin. Two most important dietary factors that affect the need for vitamin E are: • Selenium • PUFAs (polyunsaturated fatty acids) 1/10/2022 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 2

Vitamin E deficiency Selenium spares the need for vitamin E. The dietary intake of

Vitamin E deficiency Selenium spares the need for vitamin E. The dietary intake of PUFAs increases the need for vitamin E. 1/10/2022 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 3

Vitamin E deficiency Other factors that can be expected to increase vitamin E needs

Vitamin E deficiency Other factors that can be expected to increase vitamin E needs are deficiencies of: • sulfur containing amino acids • copper • zinc • manganese • riboflavin Vitamin E can be replaced by several lipidsoluble synthetic antioxidants and vitamin C. 1/10/2022 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 4

Vitamin E deficiency Conditions involving the malabsorption of lipids can also lead to vitamin

Vitamin E deficiency Conditions involving the malabsorption of lipids can also lead to vitamin E deficiency: • loss of pancreatic exocrine function (pancreatitis, pancreatic tumor, nutritional pancreatic atrophy in severe selenium deficiency) • lumenal deficiency of bile (biliary stasis due to mycotoxicosis, biliary atresia) • defects in lipoprotein metabolism (abetalipoproteinemia) 1/10/2022 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 5

Vitamin E deficiency • Premature infants, who are typically impaired in their ability to

Vitamin E deficiency • Premature infants, who are typically impaired in their ability to utilize dietary fats, are also at risk of vitamin E deficiency. Mutations in the α-TTP gene can produce tissue level vitamin E deficiency due to impaired uptake and transport of α-tocopherol: • low circulating tocopherol levels • progressive peripheral neuropathy-pathology of the large axons of sensory neurons and ataxia 1/10/2022 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 6

Vitamin E deficiency • The targets of vitamin E deficiency are the neuromuscular, vascular

Vitamin E deficiency • The targets of vitamin E deficiency are the neuromuscular, vascular and reproductive system. • The various signs of vitamin E deficiency are manifestations of membrane dysfunction resulting from the oxidative degradation of polyunsaturated membrane phospholipids and/or the disruption of other critical cellular processes. 1/10/2022 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 7

Pharmacologic use High levels of vitamin E may be appropriate in cases of oxidative

Pharmacologic use High levels of vitamin E may be appropriate in cases of oxidative stress. Daily doses of 100 -150 IU/kg body weight prevent neurological abnormalities in cases of abetalipoproteinemia or chronic cholestasis. Intakes of 400 -1200 IU/day are needed by individuals with familial isolated vitamin E deficiency. Supplements of 400 IU/day have been shown to support normal plasma tocopherol concentrations in patients with cystic fibrosis. 1/10/2022 Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 8

Literature • Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc.

Literature • Combs GF. The Vitamins. Fundamental Aspects in Nutrition and Health. Elsevier Inc. 2008. 1/10/2022 9

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