Vitamin E deficiency

Vitamin E deficiency, pharmacologic use

1. Domina Petric, MD
Vitamin E deficiency

2. Vitamin E deficiency
•Vitamin E deficiency can result from
insufficientdietary 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)
4/11/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
2

3. Vitamin E deficiency
Selenium spares the need for
vitamin E.
The dietary intake of PUFAs
increasesthe need for vitamin E.
4/11/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
3

4. Vitamin E deficiency
Other factors that can be expected toincrease vitamin E
needs are deficiencies of:
•sulfurcontaining amino acids
•copper
•zinc
•manganese
•riboflavin
VitaminE can be replaced by severallipid-
soluble synthetic antioxidantsandvitamin C.
4/11/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
4

5. 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)
4/11/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
5

6. Vitamin E deficiency
•Premature infants, who are typically impaired in
theirability to utilize dietary fats, are also at risk of
vitaminE deficiency.
Mutations in the α-TTP gene can produce tissuelevel
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 andataxia
4/11/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
6

7. Vitamin E deficiency
•The targets of vitamin E deficiency are the
neuromuscular, vascularand
reproductive system.
•Thevarious 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.
4/11/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
7

8. 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 areneeded by individuals
with familial isolated vitaminE deficiency.
Supplements of 400 IU/day have beenshown to
support normal plasma tocopherol concentrations in
patients with cystic fibrosis.
4/11/2018
Combs GF. The Vitamins. Fundamental Aspects
in Nutrition and Health. Elsevier Inc. 2008.
8

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