Monitoring of Vitamin E supplementation/treatment
Potentially detecting Vitamin E overdoses
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Alpha-tocopherol
Vitamin E, Serum
Serum
Ship specimen in amber vial to protect from light.
Patient Preparation: Patient should fast overnight (12-14 hours); infants should have specimen collected before next feeding.
Supplies: Amber Frosted Tube, 5 mL (T915)
Collection Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Submission Container/Tube: Amber vial
Specimen Volume: 0.5 mL
Collection Instructions: Centrifuge and aliquot serum into light protected plastic vial within 2 hours of collection.
If not ordering electronically, complete, print, and send a General Request (T239) with the specimen.
0.25 mL
Gross hemolysis | Reject |
Gross lipemia | Reject |
Gross icterus | OK |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 44 days | LIGHT PROTECTED |
Frozen | 44 days | LIGHT PROTECTED | |
Ambient | 7 days | LIGHT PROTECTED |
Monitoring of Vitamin E supplementation/treatment
Potentially detecting Vitamin E overdoses
Vitamin E is the generic term for two different groups of methylated phenol compounds with a chromane alcoholic core linked to poly-carbon chains (tocopherols and tocotrienols).
These vitamins are all free radical scavengers, with a-Tocopherol being the most potent one in humans, as most of the related compounds are not re-secreted by the liver, thus leading to much lower circulating concentrations.
Vitamin E deficiency is very rare and mostly seen in patients with extreme malabsorption of fat and in patients with abetalipoproteinemia, a rare inborn error of metabolism. Patients with these conditions may develop peripheral neuropathy, myopathy, retinopathy, and immune deficiency.
There is a large body of scientific studies that indicates positive effects on outcomes of various diseases if regular Vitamin E supplementation is provided; however, several trials have shown evidence of increasing bleeding risks at high Vitamin E doses. Therefore, tables of tolerable doses in children and adults have been established, which should not be exceeded.
0-17 years: 3.8-18.4 mg/L
> or =18 years: 5.5-17.0 mg/L
Vitamin E concentrations within the healthy reference population range usually indicate adequate Vitamin A stores.
The rare occurrence of low Vitamin A levels might correlate with potential deficiency and investigation of potential fat malabsorptions should be considered.
Conversely, Vitamin E concentrations significantly above the upper healthy reference population range might indicate that Vitamin E intake exceeds the tolerable upper daily intake level(s).
Testing of nonfasting specimens or the use of vitamin supplementation can result in elevated serum vitamin concentrations. Reference values were established using specimens from individuals who were fasting.
1. Ball GFM. Vitamins: Their role in the human body. Oxford, Blackwell Publishing. 2004:234-255
2. Traber MG. Vitamin E. In: Shils ME, Shike M, Ross AC, et al, eds. Modern Nutrition in Health and Disease.10th ed. Lippincott Williams and Wilkins; 2006:434-441
3. Roberts NB, Taylor A, Sodi R. Vitamins and trace elements. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:chap37
4. Sodi R. Vitamins and trace elements. In: Rifai N, Chiu RWK, Young I, Burnham C-AD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:417-417.e104
Deuterated vitamin E (d6-alpha-tocopherol) is added to serum as an internal standard. Vitamin E (alpha-tocopherol) and the deuterated internal standard are extracted from the specimens and analyzed by liquid chromatography-tandem mass spectrometry.(Unpublished Mayo method)
Sunday through Friday
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
84446
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
VITE | Vitamin E, S | 1823-4 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
2350 | A-Tocopherol, Vitamin E | 1823-4 |