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Vitamin E is a fat-soluble vitamin that exists in eight different forms. Each form has its own biological activity, which is the measure of potency or functional use in the body . Alpha-tocopherol (α-tocopherol) is the name of the most active form of vitamin E in humans. It is also a powerful biological antioxidant . Vitamin E in supplements is usually sold as alpha-tocopheryl acetate, a form of alpha-tocopherol that protects its ability to function as an antioxidant. The synthetic form is labeled "D, L" while the natural form is labeled "D". The synthetic form is only half as active as the natural form.
Vegetable oils, nuts, green leafy vegetables, and fortified cereals are common food sources of vitamin E in the United States (U.S.). Table 1, Selected Food Sources of Vitamin E, suggests many food sources of vitamin E . Food values are listed in the alpha-tocopherol form of vitamin E.
Who is at risk for vitamin E deficiency?
Vitamin E deficiency is rare in humans. There are three specific situations when a vitamin E deficiency is likely to occur.- persons who cannot absorb dietary fat due to an inability to secrete bile or with rare disorders of fat metabolism are at risk of vitamin E deficiency ;
- individuals with rare genetic abnormalities in the alpha-tocopherol transfer protein are at risk of vitamin E deficiency; and
- premature, very low birth weight infants (birth weights less than 1500 grams, or 3 pounds, 4 ounces) are at risk of vitamin E deficiency .
Who may need extra vitamin E to prevent a deficiency?
Individuals who cannot absorb fat require a vitamin E supplement because some dietary fat is needed for the absorption of vitamin E from the gastrointestinal tract. Intestinal disorders that often result in malabsorption of vitamin E and may require vitamin E supplementation include :- Crohn's Disease is an inflammatory bowel disease that affects the small intestines. People with Crohn's disease often experience diarrhea and nutrient malabsorption.
- Cystic Fibrosis is an inherited disease that affects the lungs, gastrointestinal tract, pancreas, and liver. Cystic fibrosis can interfere with normal digestion and absorption of nutrients, especially of fat soluble vitamins including vitamin E.
Abetalipoproteinemia is a rare inherited disorder of fat metabolism that results in poor absorption of dietary fat and vitamin E. The vitamin E deficiency associated with this disease causes problems such as poor transmission of nerve impulses, muscle weakness, and degeneration of the retina that can cause blindness. Individuals with abetalipoproteinemia may be prescribed special vitamin E supplements by a physician to treat this disorder.
Ataxia and vitamin E deficiency (AVED) is also a rare inherited disorder. It is caused by a genetic defect in a liver protein that is responsible for maintaining normal alpha-tocopherol concentrations in the blood. These individuals have such severe vitamin E deficiency that without supplements they are unable to walk (ataxia).
Very low birth weight infants may be deficient in vitamin E. Necrotizing enterocolitits, a condition sometimes seen in very low birth weight infants that is characterized by inflammation of the lining of the intestines, may lead to a vitamin E deficiency. These infants are usually under the care of a neonatologist, a pediatrician specializing in the care of newborns who evaluates and treats the exact nutritional needs of premature infants.
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Here is a link to more information about the genetics of Ataxia with Vitamin E Deficiency that was prepared by our genetic counselor and which has links to some useful resource for those dealing with this condition: http://www.accessdna.com/condition/Ataxia_with_Vitamin_E_Deficiency/46. There is also a number listed for anyone who wants to speak to a genetic counselor by phone. I hope it helps. Thanks, AccessDNA
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