Most people know they need to keep an eye on their vitamin and mineral intake to make sure they stay healthy. Many will add an extra glass of orange juice to breakfast to boost their vitamin C or eat spinach and kale to up their iron and calcium levels.

But one vitamin tends to hide in the background despite carrying the risk of serious health problems if it falls too low. Vitamin E is a nutrient that supports a healthy immune system - too little and your body will not function properly.

As most people can get all they need from a healthy diet, it is rarely in the spotlight. However, people with some conditions which mean their body is less able to absorb fat, can find they are failing to get the nutrients from their diet.

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According to the Cleveland Clinic Vitamin E is an antioxidant which protects your cells from free radicals. It explains: "Free radicals are chemical reactions that can damage your cells.

"Your body needs plenty of vitamin E to fight free radicals. If you lack vitamin E, your immune system may have trouble protecting you against illnesses and infections."

It says the vitamin has a number of uses. It is also important because it:

• Supports healthy skin


• Promotes good vision


• Prevents blood clots


• Reduces inflammation

The Cleveland Clinic says: "Vitamin E deficiency symptoms mostly affect your nervous system. These may include muscle weakness, vision issues and problems controlling your body movements.

"Other symptoms include numbness and fatigue. Severe cases can lead to blindness." Other symptoms of vitamin E deficiency can include:

• Bleeding within the brain


• Abnormal growth of blood vessels in the eyes


• A blood disorder called Haemolytic anaemia
  


• Slow reflexes


• Trouble walking


• Weakened immune system

"Fat absorption disorders and certain genetic disorders usually cause vitamin E deficiency," advises the Cleveland Clinic. "Less commonly, low vitamin E intake causes the condition. Vitamin E is found in many foods. So people who are healthy rarely have the deficiency."

Fat absorption disorders

In countries such as the UK and USA where there is plenty of food for most people, deficiency of vitamin E is uncommon. If you do have vitamin E deficiency, it’s often due to a disorder that prevents your body from absorbing fat. These diseases include:

• Liver disease


• Pancreatitis


• Cystic fibrosis


• Crohn’s disease


• Celiac disease

Certain rare genetic diseases can also lead to the condition. These include abetalipoproteinemia and ataxia with vitamin E deficiency.

Low intake of vitamin E

In countries with high rates of food insecurity, the most common cause of vitamin E deficiency is a lack of vitamin E in the foods you eat. A very low-fat diet doesn’t contain a lot of vitamin E. And your body needs some fat to digest and absorb it.

"Newborns — particularly premature infants — have a higher risk of being deficient in vitamin E. That’s because very little vitamin E crosses the placenta during fetal development. So, when they’re born, they don’t have a lot of the vitamin stocked up," says the Clinic.

"With age, their risk goes down. Babies can usually get the vitamin E they need through breast milk or formula.

"Your risk of developing vitamin E deficiency goes up if you don’t eat foods with any fat in them. Your body needs fat to digest and absorb certain vitamins."

If you have any of these symptoms, the Cleveland Clinic recommends you contact your healthcare provider