Test Id : VITAE
Vitamin A and Vitamin E, Serum
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
Monitoring of Vitamin E supplementation/treatment
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
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
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: Patient should fast overnight (12-14 hours); infants should have specimen collected before next feeding.
Supplies: Amber Frosted Tube, 5 mL (T915)
Collection Container/Tube:
Preferred: Red top
Acceptable: Serum gel
Submission Container/Tube: Amber vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot serum into light protected plastic vial within 2 hours of collection.
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
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 |
| Ambient | 7 days | LIGHT PROTECTED | |
| Frozen | 28 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
Monitoring of Vitamin E supplementation/treatment
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 is the generic term for two different groups of methylated phenol compounds with a chromane alcoholic core linked to poly-carbon chains (tocopherols and tocotrienols).
These vitamins are all free radical scavengers, with alpha-tocopherol being the most potent one in humans, as most of the related compounds are not re-secreted by the liver, thus leading to much lower circulating concentrations.
Vitamin E deficiency is very rare and mostly seen in patients with extreme malabsorption of fat and in patients with abetalipoproteinemia, a rare inborn error of metabolism. Patients with these conditions may develop peripheral neuropathy, myopathy, retinopathy, and immune deficiency.
There is a large body of scientific studies that indicates positive effects on outcomes of various diseases if regular Vitamin E supplementation is provided; however, several trials have shown evidence of increasing bleeding risks at high Vitamin E doses. Therefore, tables of tolerable doses in children and adults have been established, which should not be exceeded.
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):
Vitamin E concentrations within the healthy reference population range usually indicate adequate Vitamin A stores.
The rare occurrence of low Vitamin A levels might correlate with potential deficiency and investigation of potential fat malabsorptions should be considered.
Conversely, Vitamin E concentrations significantly above the upper healthy reference population range might indicate that Vitamin E intake exceeds the tolerable upper daily intake level(s).
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, eds. 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
5. Sodi R. Vitamins and trace elements. In: Rifai N, Chiu RWK, Young I, Burnham C-AD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:417-417.e104.
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
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.
Sunday 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.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
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.
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- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. 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. It 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.
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 |