Vitamin E and Itching

Introduction to Vitamin E Toxicity

The Upper Limit (UL) for adults is set at 1000 mg (2325 μmol) of vitamin E, with toxicity rarely reported even at doses exceeding this limit 2, 1
Acute toxicity develops only with extremely high doses of natural vitamin A (>300,000 IU in adults), not vitamin E 3
Chronic vitamin E toxicity is uncommon and primarily manifests as increased bleeding risk rather than skin symptoms 1
Vitamin E excess is unlikely to cause itching, as toxic effects from high doses of vitamin E are rare even after high intake for several years, with doses up to 3200 IU per day causing no consistent adverse effects 1

Systemic causes of pruritus unrelated to vitamin E supplementation include liver disease 3
Systemic causes of pruritus unrelated to vitamin E supplementation include kidney disease 3
Systemic causes of pruritus unrelated to vitamin E supplementation include thyroid dysfunction 5
Systemic causes of pruritus unrelated to vitamin E supplementation include vitamin D deficiency 2
Systemic causes of pruritus unrelated to vitamin E supplementation include iron deficiency 5, 4
Other supplements or medications taken concurrently can cause itching 4

For patients reporting itching while taking vitamin E supplements, evaluate the dose and form of vitamin E being taken 1
Doses below 1000 mg (2325 μmol) are unlikely to cause toxicity 1
Consider discontinuing vitamin E temporarily to determine if symptoms resolve 1
If symptoms persist despite discontinuation, vitamin E is likely not the cause 1
Screen for other common causes of pruritus with basic laboratory tests, including complete blood count 5
Screen for other common causes of pruritus with basic laboratory tests, including liver function tests 5
Screen for other common causes of pruritus with basic laboratory tests, including renal function tests 3
Screen for other common causes of pruritus with basic laboratory tests, including thyroid function tests 5
Screen for other common causes of pruritus with basic laboratory tests, including ferritin and iron studies 5
Screen for other common causes of pruritus with basic laboratory tests, including vitamin D levels 5