Test Catalog

Test Id : VITAE

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Vitamin A and Vitamin E, Serum

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Diagnosing vitamin A deficiency and toxicity

 

Evaluating persons with intestinal malabsorption of lipids

 

Evaluating individuals with motor and sensory neuropathies for vitamin E deficiency

 

Monitoring vitamin E status of premature infants requiring oxygenation

Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.

Test Id Reporting Name Available Separately Always Performed
VITAP Vitamin A, S Yes, (Order VITA) Yes
VITE Vitamin E, S Yes Yes

Method Name
A short description of the method used to perform the test

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Vitamin A and Vitamin E, S

Aliases
Lists additional common names for a test, as an aid in searching

Alpha-tocopherol

Retinol, Serum

Vitamin A, Serum

Vitamin E, Serum

Specimen Type
Describes the specimen type validated for testing

Serum

Shipping Instructions

Ship specimen in amber vial to protect from light.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

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

Supplies: Sarstedt 5 mL Aliquot Tube (Amber) (T915)

Collection Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Submission Container/Tube: Amber vial

Specimen Volume: 1 mL

Collection Instructions: Within 24 hours of collection, aliquot serum into amber vial to protect from light.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

0.5 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus OK

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 28 days LIGHT PROTECTED
Frozen 28 days LIGHT PROTECTED
Ambient 7 days LIGHT PROTECTED

Useful For
Suggests clinical disorders or settings where the test may be helpful

Diagnosing vitamin A deficiency and toxicity

 

Evaluating persons with intestinal malabsorption of lipids

 

Evaluating individuals with motor and sensory neuropathies for vitamin E deficiency

 

Monitoring vitamin E status of premature infants requiring oxygenation

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Vitamin A:

The level of vitamin A in the plasma or serum is a reflection of the quantities of vitamin A and carotene ingested and absorbed by the intestine (carotene is converted to vitamin A by intestine absorptive cells and hepatocytes).

 

Vitamin A plays an essential role in the function of the retina (adaptation to dim light), is necessary for growth and differentiation of epithelial tissue, and is required for growth of bone, reproduction, and embryonic development. Together with certain carotenoids, vitamin A enhances immune function, reducing the consequences of some infectious diseases.

 

Degenerative changes in eyes and skin are commonly observed in vitamin A deficiency. Poor adaptation of vision to darkness (night blindness) is an early symptom that may be followed by degenerative changes in the retina. In developing countries, vitamin A deficiency is the principal preventable cause of blindness. Severe or prolonged deficiency leads to dry eye (xerophthalmia), which can result in corneal ulcers, scarring, and blindness. Another important consequence of inadequate intake is acquired immunodeficiency disease, with an increased incidence of death related to infectious diseases. In patients with HIV, vitamin A deficiency is associated with increased disease progression and mortality.

 

Vitamin A in excess can be toxic. In particular, chronic vitamin A intoxication is a concern in normal adults who ingest more than 15 mg per day and in children who ingest more than 6 mg per day of vitamin A over a period of several months. Manifestations are various and include dry skin, cheilosis, glossitis, vomiting, alopecia, bone demineralization and pain, hypercalcemia, lymph node enlargement, hyperlipidemia, amenorrhea, and features of pseudotumor cerebri with increased intracranial pressure and papilledema. Liver fibrosis with portal hypertension and bone demineralization may also result. Congenital malformations, like spontaneous abortions, craniofacial abnormalities, and valvular heart disease have been described in pregnant women taking vitamin A in excess. Consequently, in pregnancy, the daily dose of vitamin A should not exceed 3 mg.

 

Vitamin E (alpha-tocopherol):

Vitamin E contributes to the normal maintenance of biomembranes, the vascular and nervous systems, 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 has also 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 due to 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 suspected as a cause of thrombophlebitis, although this has not been definitively verified.

 

Deficiencies of vitamins A and E may arise from poor nutrition or from intestinal malabsorption. Persons at risk, 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 vitamins A and E include intrahepatic dysplasia and rubella-related embryopathy.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

VITAMIN A (RETINOL)

0-6 years: 11.3-64.7 mcg/dL

7-12 years: 12.8-81.2 mcg/dL

13-17 years: 14.4-97.7 mcg/dL

> or =18 years: 32.5-78.0 mcg/dL

 

VITAMIN E (ALPHA-TOCOPHEROL)

0-17 years: 3.8-18.4 mg/L

> or =18 years: 5.5-17.0 mg/L

Interpretation
Provides information to assist in interpretation of the test results

Vitamin A:

The World Health Organization recommends supplementation when vitamin A levels fall below 20.0 mcg/dL. Severe deficiency is indicated at levels less than 10.0 mcg/dL. Vitamin A values above 120.0 mcg/dL suggest hypervitaminosis A and associated toxicity.

 

Vitamin E (alpha-tocopherol):

Therapeutic Ranges:

0-17 years: 3.8 - 18.4 mg/L

> or =18 years: 5.5 - 17.0 mg/L

Significant deficiency: <3.0 mg/L

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Testing of nonfasting specimens or the use of vitamin supplementation can result in elevated serum vitamin concentrations. Reference values were established using specimens from individuals who were fasting.

 

Acute ethanol ingestion may result in increased serum vitamin A levels.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Ball GFM: Vitamins: Their role in the human body. Blackwell Publishing; 2004:234-255

2. Ross AC: Vitamin A and carotenoids. In: Shils ME, Shike M, Ross MC, et al: Modern Nutrition in Health and Disease. 10th ed. Lippincott Williams and Wilkins; 2006:351-375

3. Traber MG: Vitamin E. In: Shils ME, Shike M, Ross AC, et al, eds. Modern Nutrition in Health and Disease.10th ed. Lippincott Williams and Wilkins; 2006:434-441

4. Roberts NB, Taylor A, Sodi R: Vitamins and trace elements. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:chap37

Method Description
Describes how the test is performed and provides a method-specific reference

Deuterated vitamin A (d6-all-trans retinol) is added to serum as an internal standard. Vitamin A (all-trans retinol) and the deuterated internal standard are extracted from the specimens using on-line turbulent flow high performance liquid chromatography and analyzed by liquid chromatography-tandem mass spectrometry using multiple reaction monitoring in positive mode.(Unpublished Mayo method)

 

Deuterated vitamin E (d6-alpha-tocopherol) is added to serum as an internal standard. Vitamin E (alpha-tocopherol) and the deuterated internal standard are extracted from the specimens and analyzed by liquid chromatography-tandem mass spectrometry.(Unpublished Mayo method)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Friday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

2 to 5 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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 US Food and Drug Administration.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

84446

84590

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
VITAE Vitamin A and Vitamin E, S 96600-2
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
2350 A-Tocopherol, Vitamin E 1823-4
605124 Vitamin A 2923-1

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports