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Vitamin E

  • Includes tocopherol, tocotrienol.
  • Function
    • Antioxidant (protects RBCs and membranes from free radical damage).
  • Deficiency
    • No protection against oxidative injury (especially in long axons with large membrane surface area and erythrocytes with high oxygen exposure)
    • Hemolytic anemia, acanthocytosis
    • Muscle weakness, posterior column and spinocerebellar tract demyelination (loss of proprioception and vibratory sense)
    • Neurologic presentation may appear similar to vitamin B12 deficiency, but without megaloblastic anemia, hypersegmented neutrophils, or ↑ serum methylmalonic acid levels.
  • EXCESS
    • Risk of enterocolitis in infants.
    • High-dose supplementation may alter metabolism of vitamin K → enhanced anticoagulant effects of warfarin → hemorrhagic stroke in adults

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