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Test Code VITE Vitamin E, Serum


Specimen Required


Patient Preparation: Fasting overnight (12-14 hours) (infants-draw prior to next feeding).

Supplies: Amber Frosted Tube, 5 mL (T192)

Collection Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Submission Container/Tube: Amber vial (T192)

Specimen Volume: 0.5 mL

Collection Instructions: Send specimen in amber vial to protect from light within 24 hours.


Forms

If not ordering electronically, complete, print, and send a General Request form (T239) with the specimen (https://www.mayomedicallaboratories.com/it-mmfiles/general-request-form.pdf).

Useful For

Evaluation of individuals with motor and sensory neuropathies

 

Monitoring vitamin E status of premature infants requiring oxygenation

 

Evaluation of persons with intestinal malabsorption of lipids

Method Name

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

Reporting Name

Vitamin E, S

Specimen Type

Serum

Specimen Minimum Volume

0.25 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 14 days
  Frozen  14 days

Reject Due To

Hemolysis

Mild reject; Gross reject

Lipemia

Mild OK; Gross reject

Icterus

Mild OK; Gross OK

Other

NA

Clinical Information

Vitamin E (alpha-tocopherol) contributes to the normal maintenance of biomembranes, the vascular system, and the nervous system, and provides antioxidant protection for vitamin A. The level of vitamin E in the plasma or serum after a 12- to 14-hour fast reflects the individual's reserve status.

 

The current understanding of the specific actions of vitamin E is very incomplete. The tocopherols (vitamin E and related fat-soluble compounds) function as antioxidants and free-radical scavengers, protecting the integrity of unsaturated lipids in the biomembranes of all cells and preserving retinol from oxidative destruction. Vitamin E is known to promote the formation of prostacyclin in endothelial cells and to inhibit the formation of thromboxanes in thrombocytes, thereby minimizing the aggregation of thrombocytes at the surface of the endothelium. Those influences on thrombocyte aggregation may be of significance in relation to risks for coronary atherosclerosis and thrombosis.

 

Deficiency of vitamin E in children leads to reversible motor and sensory neuropathies; this problem also has been suspected in adults. Premature infants who require an oxygen-enriched atmosphere are at increased risk for bronchopulmonary dysplasia and retrolental fibroplasia; supplementation with vitamin E has been shown to lessen the severity of, and may even prevent, those problems.

 

Deficiencies of vitamin E may arise from poor nutrition or from intestinal malabsorption. At-risk persons, especially children, include those with bowel disease, pancreatic disease, chronic cholestasis, celiac disease, cystic fibrosis, and intestinal lymphangiectasia. Infantile cholangiopathies that may lead to malabsorption of vitamin E include intrahepatic and extrahepatic biliary atresia, paucity of intrahepatic bile ducts, arteriohepatic dysplasia, and rubella-related embryopathy. In addition, low blood levels of vitamin E may be associated with abetalipoproteinemia, presumably as a result of a lack of the ability to form very low-density lipoproteins and chylomicrons in the intestinal absorptive cells of affected persons.

 

Vitamin E toxicity has not been established clearly. Chronically excessive ingestion has been implicated as a cause of thrombophlebitis, although this has not been definitively verified.

Reference Values

0-17 years: 3.8-18.4 mg/L

≥18 years: 5.5-17.0 mg/L

Significant deficiency: <3.0 mg/L

Significant excess: >40 mg/L

Interpretation

Values that indicate a need for supplementation:

-Premature: <2.0 mg/L

-Neonate: <2.0 mg/L

-Child (3 months): <3.0 mg/L

-Child (2 years): <4.0 mg/L

-Adult: <4.0 mg/L

 

Values that indicate significant excess:

-Adult: >40.0 mg/L

Cautions

Testing of nonfasting specimens or the use of vitamin supplementation can result in elevated plasma vitamin concentrations. Reference values were established in patients who were fasting.

Clinical Reference

1. Ball GFM: Vitamins: their role in the human body. Oxford, Blackwell Publishing, 2004, pp 234-255

2. Traber MG: Vitamin E. In Modern Nutrition in Health and Disease.10th edition. Edited by ME Shils, M Shike, AC Ross, et al. Philadelphia, Lippincott Williams and Wilkins, 2006, pp 434-441

Method Description

Deuterated vitamin E (d[6]-alpha-tocopherol) is added to serum as an internal standard. Vitamin E (alpha-tocopherol) and the deuterated internal standard are extracted from the specimens using online turbulent flow HPLC and analyzed by liquid chromatography-tandem mass spectrometry using multiple reaction monitoring in positive mode.(Unpublished Mayo method)

Day(s) and Time(s) Performed

Monday through Friday; 12:01 a.m.

Analytic Time

2 days

Specimen Retention Time

14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

84446

LOINC Code Information

Test ID Test Order Name Order LOINC Value
VITE Vitamin E, S 1823-4

 

Result ID Test Result Name Result LOINC Value
2350 A-Tocopherol, Vitamin E 1823-4

NY State Approved

Yes