Test ID: VAE
Vitamin A and Vitamin E, Serum
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
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 |
|---|---|---|---|
| VITA | Vitamin A, S | Yes | 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)
Specific quantitation of retinol and alpha-tocopherol.
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Vitamin A, Serum
Vitamin E, Serum
Alpha-tocopherol
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Collection Container/Tube: Red top
Submission Container/Tube: Amber vial (Supply T192)
Specimen Volume: 0.5 mL
Collection Instructions:
1. Fasting-overnight (12-14 hours) (infants-draw prior to next feeding).
2. Send specimen in amber vial to protect from light.
Additional Information: Vitamin A, vitamin E, and carotene analysis can be performed on 1 tube. However, the total volume of serum must be > or =3.5 mL. Aliquot 3 mL into an amber vial and label for carotene. Pour the remaining serum into an amber vial and label for vitamin A and/or vitamin E.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | Mild reject; Gross reject |
| Lipemia | Mild reject; Gross reject |
| Icterus | Mild OK; Gross OK |
| Other | Serum gel tube |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum Red | Refrigerated (preferred) | 14 days |
| Ambient | 14 days | |
| Frozen | 14 days |
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) that 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 >15 mg per day, and in children who ingest >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:
Vitamin E contributes to the normal maintenance of biomembranes, the vascular system, and the nervous systems; and provides antioxidant protection for vitamin A. The level of vitamin E in the blood plasma or serum after a 12- to 14-hour fast reflects the individual's reserve status.
Currently, the 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 also has 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. In addition, low blood levels of vitamin E may be associated with abetalipoproteinemia, presumably as a result of 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, especially children, at risk 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
Significant deficiency: <3.0 mg/L
Significant excess: >40 mg/L
Interpretation Provides information to assist in interpretation of the test results
Vitamin A:
The World Health Organization recommendations supplementation when vitamin A levels fall below 20.0 mcg/dL. Severe deficiency is indicated at levels <10.0 mcg/dL. Vitamin A values >120.0 mcg/dL suggest hypervitaminosis A and associated toxicity.
Vitamin E (alpha-tocopherol):
-Values that indicate need for supplementation:
-Premature: <2.0 mg/L
-Neonate: <2.0 mg/L
-Child (3 months): <3.0 mg/L
-Child (2 years): <3.0 mg/L
-Adults: <3.0 mg/L
-Values that indicate significant excess:
-Adults: >40.0 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 plasma vitamin concentrations. Reference values were established in patients who were fasting.
Acute ethanol ingestion may result in increased serum vitamin A levels.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Ball GFM: Vitamins: their role in the human body. Oxford, Blackwell Publishing, 2004, pp 133-187, 234-255
2. Ross AC: Vitamin A and Carotenoids. In Modern Nutrition in Health and Disease. 10th edition. Edited by ME Shils, M Shike, AC Ross, et al. Philadelphia, Lippincott Williams and Wilkins, 2006, pp 351-375
3. Traber MG: Vitamin E. In Modern Nutrition in Health and Disease.10th edition. Edited by ME Shils, M Shike, AC Ross, et al. Philadelphia, Lippincott Williams and Wilkins, 2006, pp 434-441
Method Description Describes how the test is performed and provides a method-specific reference
Deuterated Vitamin A (d[5]-all-trans retinol) and Deuterated Vitamin E (d[6]- alpha-tocopherol) are added to serum as an internal standards. Vitamin A (all-trans retinol), Vitamin E (alpha-tocopherol) and the deuterated internal standards are extracted from the specimens using on-line turbulent flow HPLC and analyzed by liquid chromatography-tandem mass spectrometry using multiple reaction monitoring in positive mode. (Unpublished Mayo Method)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Friday; 1st shift
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
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 The location of the laboratory that performs the test
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's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
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 Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
84446-Vitamin E
84590-Vitamin A
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| 7597 | Free Retinol(Vit A) | 17527-3 |
| 2350 | A-Tocopherol, Vitamin E | 1823-4 |
External
link
PDF
document
Excel
document
Word
document