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Vitamin E
Vitamin
Report in 120Hrs
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Fasting Required
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Measures vitamin levels.
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Vitamin E Test Information Guide
- Why is it done?
- Measures serum levels of vitamin E (tocopherol), a fat-soluble antioxidant essential for protecting cells from oxidative damage
- Diagnose vitamin E deficiency, which may cause neurological symptoms, muscle weakness, and vision problems
- Evaluate patients with malabsorption disorders such as cystic fibrosis, celiac disease, Crohn's disease, or cholestasis
- Assess patients with neurological disorders, including ataxia, peripheral neuropathy, or cognitive decline
- Monitor vitamin E status in patients on long-term total parenteral nutrition (TPN) or with chronic liver disease
- Investigate patients with genetic conditions affecting fat absorption, such as abetalipoproteinemia
- Evaluate hemolytic anemia and retinopathy in premature infants
- Typically performed during annual physical examinations, when malabsorption is suspected, or when patients report neurological symptoms
- Normal Range
- Normal range: 5.5 to 17.0 μmol/L (or approximately 2.4 to 7.3 mg/mL)
- Reference ranges may vary slightly between laboratories and testing methods
- Units of measurement: Micromoles per liter (μmol/L) or milligrams per liter (mg/mL)
- Low values (below 5.5 μmol/L): Indicate vitamin E deficiency with potential for clinical manifestations
- High values (above 17.0 μmol/L): May occur from excessive supplementation but generally well-tolerated; normal with dietary sources
- Results should be interpreted in clinical context, considering patient symptoms and risk factors for deficiency
- Interpretation
- Low Vitamin E Levels (< 5.5 μmol/L): Indicates deficiency requiring clinical attention and potential supplementation; may manifest as neurological symptoms, muscle weakness, or vision problems; commonly seen in malabsorption disorders
- Normal Vitamin E Levels (5.5-17.0 μmol/L): Indicates adequate vitamin E status and sufficient antioxidant protection; no supplementation typically needed unless risk factors present
- High Vitamin E Levels (> 17.0 μmol/L): Usually benign and may result from supplementation; excessive intake from supplements may increase bleeding risk in patients on anticoagulants; generally not toxic but may warrant review of supplement intake
- Borderline Low Values (5.5-8.0 μmol/L): May warrant monitoring and dietary assessment; consider supplementation if patient has risk factors or symptoms; repeat testing recommended if clinical suspicion high
- Factors Affecting Results:
- Dietary intake varies with consumption of nuts, seeds, vegetable oils, and fortified foods; fat malabsorption significantly impacts levels; cholestasis and liver disease reduce absorption and storage; genetic mutations affecting lipid transport; medications affecting fat absorption
- Clinical Significance:
- Deficiency can cause spinocerebellar ataxia, peripheral neuropathy, myopathy, and retinopathy; in infants, may cause hemolytic anemia and retinopathy of prematurity; chronic deficiency increases oxidative stress and risk of neurodegeneration; correction of deficiency can halt progression of neurological symptoms
- Associated Organs
- Primary Organ Systems:
- Nervous system: Central and peripheral nervous system most vulnerable to vitamin E deficiency; neurological manifestations include ataxia, neuropathy, and cognitive decline
- Liver: Primary organ for vitamin E metabolism and storage; impaired function affects levels
- Gastrointestinal tract: Site of absorption; fat malabsorption directly impacts vitamin E uptake
- Eyes: Vitamin E protects against oxidative damage; deficiency can cause retinopathy
- Associated Medical Conditions:
- Cystic fibrosis: Pancreatic insufficiency and fat malabsorption lead to deficiency
- Celiac disease and inflammatory bowel disease: Mucosal damage impairs absorption
- Cholestatic liver disease: Reduced bile production affects fat-soluble vitamin absorption
- Abetalipoproteinemia: Genetic disorder preventing fat transport; severe deficiency common
- Chronic pancreatitis: Pancreatic dysfunction impairs fat digestion and absorption
- Premature infants: Underdeveloped absorption systems increase risk of deficiency
- Complications Associated with Deficiency:
- Progressive neurological deterioration if untreated; permanent motor neuron damage; vision loss from retinopathy
- Hemolytic anemia in infants; increased infection risk; accelerated aging of cells from oxidative stress
- Follow-up Tests
- If Deficiency Identified:
- Serum lipid panel: Assess total cholesterol and triglycerides; vitamin E transport depends on lipoproteins
- Liver function tests: Evaluate hepatic metabolism and storage capacity for vitamin E
- Fat-soluble vitamin panel: Assess for deficiencies of vitamins A, D, and K; co-deficiencies common in malabsorption
- Immunoglobulin A (IgA) and tissue transglutaminase (tTG): Screen for celiac disease if not previously diagnosed
- Genetic testing: Consider if abetalipoproteinemia or other genetic lipid disorders suspected
- If Malabsorption Identified:
- 72-hour fecal fat test: Quantifies steatorrhea and confirms fat malabsorption
- Fecal chymotrypsin or elastase: Assesses pancreatic function
- Upper endoscopy with small bowel biopsy: If inflammatory bowel disease or celiac disease suspected
- For Neurological Symptoms:
- Nerve conduction studies (NCS) and electromyography (EMG): Evaluate peripheral neuropathy
- MRI of brain and spinal cord: Assess for structural changes related to ataxia or neurological deficits
- Ophthalmologic examination: Screen for retinopathy or vision problems
- Monitoring During Treatment:
- Repeat vitamin E testing: After 2-3 months of supplementation to assess treatment response; then annually to monitor adequacy
- Regular clinical assessment: Monitor for resolution of neurological symptoms and prevention of progression
- Monitoring frequency: Every 6-12 months for patients on long-term supplementation or with chronic malabsorption
- Fasting Required?
- Fasting Status: No, fasting is not required for the vitamin E test
- Sample Collection:
- Blood sample collected by venipuncture into a standard serum separator tube or gold-top tube
- Specimen should be kept at room temperature until processing; protected from light exposure
- Medication Considerations:
- No specific medications need to be discontinued before testing
- Vitamin E supplements should be continued unless specifically instructed otherwise; inform provider of supplement use
- If assessing baseline status, it may be beneficial to wait at least 2-3 weeks after discontinuing supplements for accurate deficiency assessment
- Other Patient Preparation:
- No special restrictions on food or beverage intake before testing
- Arrive adequately hydrated for easier blood draw
- Inform healthcare provider of current dietary intake, supplements, and any gastrointestinal or absorption issues
- Report any medications that affect fat absorption (such as cholesterol-lowering drugs or pancreatic enzymes)
- Testing can typically be done at any time of day without special timing requirements
How our test process works!
