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Test ID VITE Vitamin E, Serum

Useful For

Monitoring of Vitamin E supplementation/treatment

 

Potentially detecting Vitamin E overdoses

Method Name

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)

Reporting Name

Vitamin E, S

Specimen Type

Serum


Shipping Instructions


Ship specimen in amber vial to protect from light.



Specimen Required


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.


Specimen Minimum Volume

0.25 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 44 days LIGHT PROTECTED
  Frozen  44 days LIGHT PROTECTED
  Ambient  7 days LIGHT PROTECTED

Reject Due To

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus OK

Clinical Information

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.

Reference Values

0-17 years: 3.8-18.4 mg/L

≥18 years: 5.5-17.0 mg/L

Interpretation

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).

Cautions

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.

Clinical Reference

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

Method Description

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)

Day(s) Performed

Sunday through Friday

Report Available

3 to 5 days

Test Classification

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.

CPT Code Information

84446

NY State Approved

Yes

Forms

If not ordering electronically, complete, print, and send a General Request (T239) with the specimen.