Immunoglobulin and serum protein electrophoresis requesting is changing on 8 July 2026. Clinicians can now request immunoglobulins only or immunoglobulins and electrophoresis. This change will enable doctors to more effectively request the tests that are clinically indicated and streamline laboratory testing, delivering improved turnaround times for these tests. This change will apply to Epsom & St Helier Hospitals and their associated GPs initially, and will then be rolled out to all service users in south west London.
Vitamin E
| Category | Biochemistry |
|---|---|
| Turnaround time | 2 weeks |
Additional information
Background
Vitamin E, also known as α-tocopherol, is a fat-soluble vitamin obtained from dietary intake from vegetables, seed oils, nuts and polyunsaturated fatty acids, particularly vegetable oils. Vitamin E has physiological roles as an antioxidant, in the modulation of gene transcription, the inhibition of platelet aggregation and cell signalling.
Vitamin E measurement is used to diagnose suspected vitamin E deficiency. Common indications for investigating vitamin E deficiency include malnutrition, for patients on long term nutritional support such as total parental nutrition and conditions associated with fat malabsorption including Cystic Fibrosis, pancreatic insufficiency and obstructive liver disease. Vitamin A is commonly requested alongside Vitamin E in these patients. Another indication for vitamin E requesting is for patients with abetalipoproteinaemia, as these patients lack ApoB needed for transport of vitamin E from the enterocytes to plasma. Signs/symptoms of deficiency may include limb ataxia, sensory impairment, absent deep tendon reflexes, depigmentation of retina and haemolytic anaemia. Toxicity is rare but high intakes can antagonise vitamin K leading to increased bleeding risk, particularly in patients on anticoagulants.
The best indicator of vitamin E status is the vitamin E to cholesterol ratio. This is because the main circulating form of vitamin E (α-tocopherol) is bound to lipoproteins. In the acute phase, both α tocopherol and cholesterol concentration fall together so the α tocopherol to cholesterol ratio is not affected in the acute phase response/inflammation.
Sample requirements
Serum sample, centrifuged, separated and frozen within 24 hours of venepuncture.
Light protection not required
Minimum volume 0.5mL separated serum.
Haemolysed samples are not suitable for analysis.
Reference ranges
| Reference range µmol/L | |
| Age | Vitamin E |
| All | 11.6 – 46.4 |
Storage and transport
Once centrifuged and separated, serum should be stored frozen at -20°C until dispatch.
Transport 1st class post ambient temperature
Delivery address
Central Pathology Reception
Clinical Blood Sciences
South West London Pathology
St Georges University Hospital Foundation NHS Trust
Ground Floor
Jenner Wing
Blackshaw Road
London
SW17 0QT
Contacts
Tony Dedman, Technical Lead for Specialist Biochemistry, Tony.dedman@stgeorges.nhs.uk
Clinical advice and result interpretation is available by contacting the duty biochemist at stgh-tr.DutyBiochemist@nhs.net
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