Vitamin E deficiency: What you should consider

Vitamin E Mangel: Was du beachten solltest

Vitamin E is found in many dietary supplements and skin creams. A true vitamin E deficiency is not common. Vitamin E is important for the body cells. The organism cannot produce it itself. It must be supplied to the body through food. Vitamin E is usually very well tolerated.(1)

A number of positive properties are attributed to vitamin E. It is said to protect the body from aging, improve potency and alleviate menopausal symptoms. The statements on the effect on cancer diseases are the opposite.(10,11)

Sometimes there is talk of a protective character of vitamin E, then again of an increase in the disease rate. Therefore, risk groups in particular should consult a doctor in advance. This is especially true when vitamin E is taken in high doses and over the long term.

If the body lacks vitamin E, the muscles, brain, bones, immune system and digestion are affected. This shows the elementary importance of vitamin E for the body. In the following you will learn more about vitamin E deficiency, whether you belong to a risk group and what helps with vitamin E deficiency.

the essentials in brief

  • Vitamin E deficiency has physical or nutritional causes. Vitamin E deficiency is rare in Germany. However, an additional dose of vitamin E can have a positive effect on the body's cells.
  • Vitamin E deficiency leads to serious physical symptoms. For example, a vitamin E deficiency can cause severe brain damage.
  • A vitamin E deficiency is insidious. Although few people are affected by vitamin E deficiency, an existing deficiency is often noticed very late. The first signs are very general, such as tiredness.

Definition: What is vitamin E deficiency?

Vitamin E is an assault. Tocopherols and tocotrienols are the names of the chemical substances that belong to them. Tocopherols, which are equated with vitamin E in the following, are particularly common. Vitamin E is a fat-soluble vitamin. This means that the body can only absorb it if fats are consumed through food at the same time. Oils are often high in vitamin E.(2)

Vitamin E has an important cell protection function. There is usually a balance in the body. The body's cells store substances such as vitamin E in order to neutralize or reduce cell-damaging metabolic products. If vitamin E is missing, the cells have to use more energy to stabilize themselves. The cell membrane, i.e. the protective cover, can be damaged.(4,5,7)

Background: What you should know about vitamin E deficiency

Vitamin E is very important for the body. The body can store it. Therefore, a short-term undersupply of vitamin E does not necessarily result in a deficiency. We have summarized the most important information about vitamin E deficiency for you here in an understandable and neutral way.

What are the symptoms of vitamin E deficiency?

Milder symptoms of vitamin E deficiency include fatigue, irritability, and poor concentration. Muscle breakdown may occur. Since vitamin E also affects the nervous system, a deficiency can lead to gait disorders or tremors. Discomfort, such as numbness in the fingers, is common. Some nerve damage from vitamin E deficiency is irreversible, meaning it cannot be repaired.(4,6)

Vitamin E deficiency also leaves traces in the skin. Due to the limited protective function of the cells, the skin can become cracked or dry. The retina of the eye can also be damaged.(6,9)

How do I recognize vitamin E deficiency?

A vitamin E deficiency is usually determined by a blood level test by the doctor. Because the first symptoms are very non-specific, it can take a long time before a vitamin E deficiency is suspected. Values ​​of 12–46 μmol/l (0.5–2 mg/100 ml) in the plasma are considered normal values. Due to the storage capacity of the body, however, it is also important how much vitamin E is available to the organism as a whole. For this purpose, the body fat tissue can be analyzed.(6)

It is important to first check whether you belong to a risk group for vitamin E deficiency. This is particularly the case if you eat a very low-fat diet or if you have had your gallbladder removed or other fat-digesting disorders.

Gluten intolerance can also make it difficult to absorb vitamin E. Some thyroid diseases can lead to reduced nutrient absorption. In some cases, vitamin E deficiency is also genetic.(2,6)

How does vitamin E deficiency develop?

Vitamin E is found in all membranes of animal cells. However, it is mainly formed from plants. It is therefore important to get vitamin E through food.(4) Vitamin E deficiency is in rare cases a hereditary disease. The best-known form is Vitamin E Deficiency Ataxia (AVED).

Vitamin E deficiency also occurs in premature babies. Deficiency is not common in breast-fed infants. In adulthood, nutrition is particularly important. Bad habits like alcohol and tobacco use contribute to vitamin E deficiency.(6)

What happens with vitamin E deficiency?

Vitamin E is a component of the cell membrane. It keeps important proteins and fats in the body. In addition, the cells can be better supplied with blood. The term “antioxidants” is often used. Oxidation is the reaction with oxygen, eg from the air. Unsaturated fatty acids (“good fats”) are usually very sensitive to oxidation. Vitamin E counteracts this and improves absorption.(3,6)

Vitamin E capsule

Vitamin E is viscous at room temperature. The color is yellowish to reddish. Vitamin E is well tolerated by most people. (Image source: Michele Blackwell/Unsplash)

Vitamin E is ingested through food and absorbed in the small intestine. Then some of it enters the bloodstream and, most importantly, the liver. If there is too little vitamin E in the body, nerve cells (neurons) can regress.

It can also cause the red blood cell membrane, which carries oxygen in the blood, to become unstable. Vitamin E is also important for cell respiration, known as fluidity.(3,6)

How common is vitamin E deficiency?

Vitamin E deficiency is rather rare in industrialized countries with a very high-fat diet. Vitamin E deficiency is observed even more frequently in emerging and developing countries. An adult human needs about 5 mg of vitamin E per day to maintain basic cell functions. The average recommended daily dose is 12 to 15 mg.(12,13)

Falling below these reference values ​​can indicate an undersupply, since the body can store the vitamin for a long time, there does not have to be a deficiency. It is estimated that only 2.8% of the population in Germany are affected by vitamin E deficiency. AVED, the genetic form of vitamin E deficiency, affects only about 1 to 9 cases per 1,000,000 population.(12,14)

How do I fix vitamin E deficiency?

Vitamin E can be obtained either through food or through supplementation. So that the vitamin E can also be used by the body, oils and fats are particularly interesting.

If you suspect a vitamin E deficiency, consult your doctor. Caution is particularly important when vitamin E is taken in high doses and over a long period of time. This can lead to a higher tendency to bleed. The effect on cancer is also controversial.

On the one hand, the improved cell protection can have a preventive effect, on the other hand there are studies, especially in the case of lung and prostate carcinomas, that vitamin E even worsens the disease. Smokers should not self-medicate with vitamin E. Clarification is also necessary for interactions when taking medication.(8,10,11)

Which foods help with vitamin E deficiency?

Vitamin E is found in animal and plant foods. The following table gives you an overview (6,12,15):

Selected foods Vitamin E content (𝛼-tocopherol), measured in mg per 100 g
wheat germ oil 174
sunflower oil 62
olive oil 11.9
rapeseed oil 23
almonds 26
peanuts 9
Savoy cabbage freshly cooked 2.5
Salmon 2
raspberry 0.9
apples 0.5

How long does the therapy for vitamin E deficiency last?

If there is a vitamin E deficiency, it can take up to two years for the body to restore the storage reserves. In the case of chronic vitamin E deficiency diseases, a lifelong supplementation of vitamin E may be necessary.

Vitamin E deficiency: the most common symptoms and what you should be aware of

Depending on gender and age, both the risk of developing a vitamin E deficiency and the symptoms vary. Below you will find an overview of the most important life situations and the most common areas of application.

Vitamin E deficiency in infants and children

Vitamin E deficiency occurs mainly in premature babies. This is because the placenta secretes little vitamin E and premature babies have very little fatty tissue to store it. As a result, diseases of the retina of the eye up to blindness and severe damage to the central nervous system have been described.

For this reason, premature babies with a very low birth weight usually also receive vitamin E. If there is a hereditary variant of vitamin E deficiency in the family, it can be examined during pregnancy whether there is a genetic predisposition. Breast milk usually contains enough vitamin E and industrially produced baby food is fortified with vitamin E. (16)

For older children, the following are estimates of vitamin E needs, which are usually met through diet.(13)

Old Vitamin E requirement (tocopherol) per day (m=male, f=female)
1 to under 4 years 6mg (m), 5mg (f)
4 to under 7 years 8mg (m) 8mg (f)
7 to under 10 years 10mg (m) 9mg (f)
10 to under 13 years 13mg (m) 11mg (f)
13 to under 15 years 14mg (m) 12mg (f)

Vitamin E deficiency in adults

Vitamin E deficiency in men

Men are particularly interested in vitamin E because it is said to improve potency. Basically there is a connection here. Since vitamin E has an influence on the blood transport in the body, a good supply of vitamin E also allows the blood to flow better in the erectile tissue. Before taking vitamin E to increase potency, however, it is advisable to consult a doctor.(17)

It is important to know that men over the age of 55 in particular should take vitamin E with caution. The Federal Institute for Risk Assessment suggests not to exceed 30 mg of daily vitamin E intake from food supplements. Since vitamin E is suspected of increasing the risk of prostate cancer, it is a precautionary measure.(10)

Vitamin E deficiency in women

Vitamin E supplementation is particularly recommended for women who are pregnant, menstruating or going through the menopause. But are these recommendations tenable? Basically, there can be a weaker supply of vitamin E during pregnancy. This is further enhanced by the addition of iron supplements .

The consequences can be high pressure during pregnancy or a small birth size. On the other hand, the processes in the body of pregnant women are very complex and have not yet been sufficiently studied. There are indications of premature rupture of membranes due to the additional intake of vitamin E. Due to this unclear situation, a doctor should be consulted if a vitamin E deficiency is suspected. (7.18)

Vitamin E can relieve menopausal symptoms.

The period is triggered by prostaglandins, which are pain transmitters. Since vitamin E acts on the central nervous system, it can in principle relieve the symptoms. The promises of vitamin E during the menopause (menopause) are manifold.

Hot flashes should be alleviated, osteoporosis (a common bone disease that affects older women in particular) and arteriosclerosis (thickening of blood vessels due to fat deposits) should be prevented. Since vitamin E also works through the skin, remedies for vaginal dryness are often enriched with vitamin E.

These effects are attributed to the cell-protecting mechanism of vitamin E. There are scientific studies that support these effects in principle. However, it is not possible to make precise statements about the extent of the actual effect. (7.19)

Vitamin E deficiency in animals

Vitamin deficiency also occurs in the animal kingdom. There is particular interest in administering vitamin E to pets and farm animals. In farm animals such as pigs, chicks, cows and goats, the addition of vitamin E is aimed at two effects.

On the one hand, diseases caused by vitamin E deficiency should be prevented, on the other hand, the aim is to increase the vitamin E content of animal products such as eggs, milk and meat. For example, alpine milk has a higher vitamin E content than that of stable cows.(20)

As in humans, there can also be disorders of the lipid metabolism in animals and, as a result, vitamin E deficiency. The symptoms, such as fatigue, are initially non-specific. Changes in gait can be easily observed in horses. Dogs and cats can also be affected.

Consequences of vitamin E deficiency

Vitamin E deficiency: joint pain and muscle pain

A vitamin E deficiency can cause pain. If circulatory disorders occur in the legs, this is noticeable through muscle pain . Joint pain occurs when bone cells are damaged and cell growth is disturbed.(7,21)

Vitamin E counteracts the pain. On the one hand, it protects against diseases that cause pain through its cellular function, on the other hand, vitamin E itself has a slightly reducing pain effect.(7)

Vitamin E deficiency: nutrition, digestion, obesity

Vitamin E is present in many foods. Especially when the digestion is disturbed, this has an influence on the absorption of vitamin E in the body. It should be noted that vitamin E is fat-soluble.

It is interesting that vitamin E is also useful in obesity. One might think that with high fat reserves in the body, there is also a lot of vitamin E. But vitamin E especially helps to utilize the good fats. In the case of fatty liver caused by obesity, the addition of vitamin E can have a positive effect on the cells.(22)

Vitamin E deficiency and psyche: stress, tiredness, nervousness

In particular, tiredness and nervousness are among the first noticeable symptoms of a vitamin E deficiency. Since vitamin E works through the nerve cells in the brain, a vitamin E deficiency can cause neurological and mental disorders.

Vitamin E particularly helps with oxidative stress, which does not mean the well-known stress caused by overload, but rather a stressful situation in the body's cells. However, there is a connection here, when the body cells are under stress, they increasingly release aggressive molecules, and vitamin E helps to restore the balance in the body.(7)

Vitamin E deficiency and dermatology: skin, hair, nails

Vitamin E deficiency is clearly shown by cracked skin and brittle hair. However, it is also found in countless skin creams, lotions and shampoos for healthy people. It is mainly advertised that vitamin E prevents skin aging and promotes hair growth. Nails should be strengthened.

There are studies that confirm a hair and skin smoothing effect and protection against UV radiation. However, the effect depends heavily on the amount of vitamin E contained and the carrier substance of the product.

By the way: hair and nails do not grow faster with shampoos and creams, the growth is genetically determined. However, conditioning products can contribute to healthy hair and nails.(23)


Vitamin E deficiency has serious consequences in humans. This is due to the important importance of the vitamin for the body, especially for its cells. But even if there is no deficiency, many people take additional vitamin E. This tends to have a positive effect on many areas of the body. However, the exact effects depend heavily on the amount of supplements and the absorption of the vitamin in the body.

If you feel weak and exhausted, there does not have to be a vitamin E deficiency. But caution is advised here. Check your eating habits and your individual risk. If in doubt, consult your doctor. Men should follow the consumption recommendations of the Federal Office for Risk Assessment.


  1. German pharmacist journal: Vitamin E - more than an antioxidant. DAZ 2004, No. 43, p. 109, October 17, 2004. Source
  2. Tocopherol. Julia Schmidt, 05/03/2021. Source
  3. Frank, J. Impact of dietary polyphenols on vitamin E status: studies in models of increasing complexity - from physicochemical experiment to human study. Nutrition Review 54 (2007) Issue 2, Page 52-59. Source
  4. Aue, K. Basic knowledge of nutrition (eps. 7): Vitamin E – as an antioxidant in food. DAZ 2006, No. 44, p. 68, October 29, 2006. Source
  5. Schwedt, G. Vitamin E – the tocopherols. DAZ 2007, No. 12, p. 101, March 21, 2007. Source
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  7. Federal Institute for Risk Assessment. Ed.: Domke, A., Groflklaus,R., Niemann, B., Przyrembel, H., Richter K., Schmidt, E., Weiflenborn, A., Wörner,B., Ziegenhagen, R. Use of vitamins in Food: Toxicological and nutritional aspects, Part 1. BfR-Wissenschaft 03/2004. ISBN 3-931675-87-4. Source
  8. Vitamin E deficiency, Larry E. Johnson LE, as of 08/2019 Source
  9. Berke, A. Vitamins and the eye. Optometrie 4/2001 p. 28-p.38 Source
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  11. ain-red. Too much vitamin E can accelerate the spread of lung cancer. 09/11/2019. Source
  12. E. Source
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  14. Anheim, M. Ataxia with vitamin E deficiency. orphanet. February 2013 source
  15. Vitamin E (tocopherols).05.02.2021 Source
  16. S3 guideline of the German Society for Nutritional Medicine (DGEM): Parenteral nutrition in pediatric and adolescent medicine. Current nutritional medicine 2014; 39: e99-e147 sources
  17. National Cancer Institute (NCI): Pentoxifylline, atorvastatin and vitamin E in the treatment of patients with erectile dysfunction after radiation therapy for prostate cancer. 05/01/2020. Source
  18. Dietary supplementation of vitamin E during pregnancy. Cochrane Switzerland, translation by Noack, I. Source
  19. Menopause today and tomorrow: The natural menopause: The ABC of medicinal herbs, nutrients and hormones - Part II. J GYNÄKOL ENDOKRINOL 2007; 10 (1)0 . Official organ of the Austrian Menopause Society. Source
  20. Leiber, F., Kunz, C., Wettstein HC., Kreuzer, M. Vitamin E content of cow's milk as a function of grass feeding in valleys and on alpine pastures. Publication series Institute for Livestock Sciences, ETH Zurich, Volume 24 (M. Kreuzer, C. Wenk & T. Lanzini, eds.) 2003 Source
  21. Vitamin E for intermitens claudication. Source
  22. Sanyal A, Naga Chalasani MD, Kowdley K et al. Pioglitazone, Vitamin E, or Placebo for Nonalcoholic Steatohepatitis. May 6, 2010. N Engl J Med 2010; 362:1675-1685. DOI: 10.1056/NEJMoa0907929. Source
  23. Pavicic, T., Kreksen, J., Proksch, E., Liekfeld, P. Guideline of the GD Gesellschaft für Dermopharmazie e. V. "Dermocosmetics against skin aging" GD - Society for Dermopharmacy eV,13. March 2017. Source
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