Efficacy of water-soluble vitamin E in the treatment of vitamin E malabsorption in short-bowel syndrome 1-3

A water-soluble form of vitamin E, tocopheryl succinate polyethylene glycol 1000 (TPGS), was used as an oral vitamin E supplement in a 71-y-old patient with severe fat malabsorption and vitamin E deficiency secondary to short-bowel syndrome. An absorption test with deuterium-labeled TPGS demonstrated that TPGS was absorbed and the released α-tocopherol was transported normally in lipoproteins. The disappearance portion of the deuterated α-tocopherol curves were parallel to those in control subjects, suggesting normal metabolic turnover of α-tocopherol. Long-term (3 y) supplementation with orally administered TPGS (10360 mg or 4000 IU/d) maintained normal plasma α-tocopherol concentrations, raised adipose tissue α-tocopherol concentrations, and prevented further progression of the neurological abnormalities resulting from vitamin E deficiency. Thus, TPGS can be an effective vitamin E supplement in short-bowel syndrome despite severe fat malabsorption.