Vitamin E

(Tocopherol)

A nutritional vitamin E deficiency is common in developing countries; a deficiency in adults rarely occurs in developed countries, which usually attributed to a fat malabsorption. The main symptoms are hemolytic anemia and neurological disorders. The diagnosis is based on the ratio of plasma alpha-tocopherol to total plasma lipids; a lower quotient value suggests a vitamin E deficiency. For therapy, high-dose vitamin E is administered orally when neurologic deficits are present or if the defect is due to malabsorption.

Vitamin E is a group of blocks incl. Tocopherols and tocotrienols, which are biologically similar active. Alpha-tocopherol is the most active component, but is beta, gamma and delta tocopherols, tocotrienols and four stereoisomers some as an important biological activity. These components act as antioxidants that prevent lipid peroxidation of polyunsaturated fatty acids in cell membranes (see table: sources, functions and effects of vitamins).

(See also overview of vitamins.) Vitamin E is a group of blocks incl. Tocopherols and tocotrienols, which are biologically similar active. Alpha-tocopherol is the most active component, but is beta, gamma and delta tocopherols, tocotrienols and four stereoisomers some as an important biological activity. These components act as antioxidants that prevent lipid peroxidation of polyunsaturated fatty acids in cell membranes (see table: sources, functions and effects of vitamins). The Plasmatocopherolspiegel change with all plasma lipid levels. The normal plasma alpha Tocopherolspiegel is 5-20 mcg / ml (11.6 to 46.4 mcgmol / l). High doses of vitamin E does not protect against cardiovascular disease; whether supplements can protect against tardive dyskinesia or increase or decrease the risk of prostate cancer is controversial. There is no convincing evidence that doses up to 2000 I.E./Tag slow the progression of Alzheimer’s disease. Although the amount of vitamin E in IU contained in fortified foods and supplements stated, loud in the US, current recommendations to use the unit mg. Vitamin E deficiency A nutritional vitamin E deficiency is common in developing countries; a deficiency in adults rarely occurs in developed countries, which usually attributed to a fat malabsorption. The main symptoms are hemolytic anemia and neurological disorders. The diagnosis is based on the ratio of plasma alpha-tocopherol to total plasma lipids; a lower quotient value suggests a vitamin E deficiency. For therapy, high-dose vitamin E is administered orally when neurologic deficits are present or if the defect is due to malabsorption. A vitamin E deficiency leads to instability of red blood cells and degeneration of neurons, particularly peripheral axons and neurons of the posterior spinal cord. Etiology in developing countries is the most common cause of vitamin E deficiency an inadequate intake of vitamin E. In industrialized countries, the most common causes are diseases that cause fat malabsorption; this is in abetalipoproteinemia (Bassen-Kornzweig syndrome due to the genetically determined absence of apolipoprotein B), chronic cholestatic liver disease, pancreatitis, short bowel syndrome (short bowel syndrome) and cystic fibrosis the case. A rare genetic form of vitamin E deficiency without fat malabsorption clearly arises The main symptoms of vitamin E deficiency are as weakly developed hemolytic anemia and nonspecific neurological deficits during degraded Leberstoffwechsel.Symptome and discomfort. A Abetalipoproteinemia leads to the first two decades of life to progressive neuropathy and retinopathy. A vitamin E deficiency can in preterm infants to retinopathy of prematurity (retrolental fibroplasia) and intraventricular in newborns in some cases and carry subependymal hemorrhage. Affected premature babies after birth show muscle weakness. In childhood, a chronic cholestatic liver disease or cystic fibrosis cause neurological deficits spinozerebellar related ataxia and related loss of deep tendon reflexes, ataxia of the trunk and limbs, loss of vibration and position perception, ophthalmoplegia, muscle weakness, ptosis and dysarthria. Adults with malabsorption rarely suffer from spinocerebellar ataxia with vitamin E deficiency, as they in adipose tissue large vitamin E depots tragen.Diagnose Low Alpha Tocopherolspiegel or low plasma alpha-tocopherol / serum lipid ratio Without long-term inadequate intake or predisposing factors is a vitamin e deficiency unlikely. To confirm the diagnosis of vitamin levels must be controlled. Hemolysis of red blood cells by peroxides may indicate the lack, however, is non-specific. Hemolytic processes increase as the vitamin E deficiency destabilizes the red blood cells. A measurement of serum alpha-Tocopherolspiegels results in the most direct way to diagnose. In adults, there is a suspicion of vitamin E deficiency, if the alpha Tocopherolspiegel <5 mcg / ml (<11.6 mcmol / l). Because abnormal lipid levels can affect the vitamin E status in adults with hyperlipidemia a low ratio of serum alpha-tocopherol to lipids (<0.8 mg / g total lipid) is the most accurate indicator. In children and adults with Abetalipoproteinemia are serum alpha-Tocopherolspiegel not usually nachweisbar.Therapie Additional alpha-tocopherol or mixed tocopherols (alpha, beta, and gamma tocopherols) Causes malabsorption clinically demonstrated deficiency should 15-25 mg / kg / day of alpha-tocopherol are administered orally. It also könnenn mixed tocopherols (200-400 IU) to be administered. A larger dose alpha-tocopherol, which is injected, is required to treat a neuropathy at an early stage or at a Abetalipoproteinemia the disturbance of absorption and transport need to beseitigen.Prävention preterm infants possibly a vitamin E supplement, but for discharged newborns that enough in breast milk and contained in commercially available bottle food vitamin e aus.Wichtige points A vitamin e deficiency is caused in developing countries is usually due to inadequate dietary intake; in developed countries a disorder of fat absorption is the cause. The deficiency causes a weakly developed hemolytic anemia and non-specific neurological deficits. In patients with an inadequate intake or predisposing factors and corresponding findings of Tocopherolspiegel is measured to confirm the diagnosis. The treatment consists in the supplementary administration of tocopherol. Vitamin E intoxication Many adults take several months to several years of relatively large amounts of vitamin E to take (400-800 mg / day of alpha-tocopherol) one without apparent harm. Occasionally occur muscle weakness, fatigue, nausea or diarrhea. The most significant risk is bleeding. However, these only occur if the dose exceeds 1000 mg / day or the patient coumarin or warfarin occupies. Thus, the upper limit of intake for adults who are over 19 years old, for each form of alpha-tocopherol at 1000 mg / d. Analyzes of previous studies report that a high vitamin E intake can shorten life expectancy.

Health Life Media Team

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