Vitamin E deficiency can present as a predominantly neuromuscular picture, in which slowly progressive peripheral neuropathy (often large‑fiber, length‑dependent, and sensory‑predominant) coexists with proximal muscle weakness and myopathy due to ongoing oxidative damage to peripheral nerves and muscle cell membranes. In reported series, patients have developed areflexia, gait instability, distal numbness, and reduced vibration sense along with elevated creatine kinase or myopathic changes on EMG, sometimes after years of unrecognized low vitamin E status rather than an obvious malabsorption syndrome. When deficiency is documented and α‑tocopherol is repleted with an adequately absorbed preparation, some individuals show meaningful improvements in strength, sensory symptoms, and electrophysiologic measures, highlighting that peripheral neuropathy and myopathy attributed to “idiopathic” or purely degenerative causes may in fact be partially reversible when vitamin E deficiency is identified and treated. This medication is commonly used for High Cholesterol.
Puri, V., Chaudhry, N., Tatke, M. and Prakash, V. (2005), Isolated vitamin E deficiency with demyelinating neuropathy. Muscle Nerve, 32: 230-235. Martinello F, Fardin P, Ottina M, Ricchieri GL, Koenig M, Cavalier L, Trevisan CP. Supplemental therapy in isolated vitamin E deficiency improves the peripheral neuropathy and prevents the progression of ataxia. J Neurol Sci. 1998 Apr 1;156(2):177-9. Hegele RA, Angel A. Arrest of neuropathy and myopathy in abetalipoproteinemia with high-dose vitamin E therapy. Can Med Assoc J. 1985 Jan 1;132(1):41-4. Sokol RJ, Butler-Simon N, Heubi JE, Iannaccone ST, McClung HJ, Accurso F, Hammond K, Heyman M, Sinatra F, Riely C, et al. Vitamin E deficiency neuropathy in children with fat malabsorption. Studies in cystic fibrosis and chronic cholestasis. Ann N Y Acad Sci. 1989;570:156-69.
Some side effects may be linked to nutrient depletion caused by this medication.
Research demonstrates that fibrates, particularly fenofibrate, are known to increase homocysteine levels. Elevated levels of homocysteine is associated with increased risk of a range of health problems including atherosclerosis, stroke, and neurological diseases, and vitamin Bs including vitamin B6 helps facilitate the breakdown of homocysteine and may be helpful in reducing homocysteine levels.
Fenofibrate has been shown in studies to increase the toxic effect of ultraviolet (UV) radiation that may lead to side effects such as hives, itching, and skin rash. Taking vitamin E before UV exposure is found in research to significantly help block UV-fenofibrate effects on the skin. Vitamin E supplementation should be considered when taking this drug therapy.
Fenofibrate has been shown in studies to increase the toxic effect of ultraviolet (UV) radiation that may lead to side effects such as hives, itching, and skin rash. Taking vitamin C before UV exposure is found in research to significantly help block UV-fenofibrate effects on the skin. Vitamin C supplementation should be considered when taking this drug therapy.