Vitamin C, also known as ascorbic acid, is an essential water-soluble vitamin critical for numerous physiological functions. It supports collagen synthesis, enhances iron absorption, boosts immune response, and acts as a powerful antioxidant. As the human body cannot synthesize vitamin C endogenously, it must be consumed through diet.
Causes of Vitamin C Deficiency
Inadequate Dietary Intake
A primary cause of vitamin C deficiency is insufficient intake of fruits and vegetables. Populations with limited access to fresh produce or those adhering to highly restrictive diets are especially at risk.
Poor Absorption and Increased Requirements
Conditions such as Crohn’s disease, ulcerative colitis, and chronic diarrhea can impair the absorption of ascorbic acid. Furthermore, smokers, pregnant women, and individuals with chronic illnesses may have higher requirements that, if unmet, can lead to deficiency.
Alcoholism and Drug Abuse
Alcohol interferes with nutrient absorption and storage. Chronic alcohol consumption significantly increases the likelihood of vitamin C depletion.
Early Signs and Symptoms of Vitamin C Deficiency
Common Initial Symptoms
- Persistent fatigue and weakness
- Irritability
- Joint and muscle aches
- Rough, dry, or scaly skin
- Swollen and bleeding gums
Progressive Deficiency and Scurvy
If left untreated, prolonged vitamin C deficiency may develop into scurvy, a condition historically associated with long sea voyages. Symptoms include:
- Petechiae (small red or purple spots caused by bleeding under the skin)
- Poor wound healing
- Loose teeth
- Anemia
- Corkscrew-shaped body hair
Risk Groups Vulnerable to Ascorbic Acid Deficiency
Children and Elderly
Children, particularly those with limited diets, and elderly individuals living alone or in assisted living facilities may not consume adequate vitamin C.
Individuals with Eating Disorders
Anorexia nervosa and other restrictive eating patterns often result in nutritional deficiencies, including vitamin C.
Chronic Illness Patients
Patients undergoing chemotherapy, dialysis, or suffering from malabsorption syndromes require monitored intake of essential vitamins.
Clinical Diagnosis of Vitamin C Deficiency
Medical History and Physical Examination
Clinicians evaluate dietary habits, clinical symptoms, and physical signs such as gingival swelling and ecchymoses.
Blood Tests
Plasma ascorbic acid levels below 11 μmol/L (0.2 mg/dL) typically indicate deficiency. Levels under 3 μmol/L (0.05 mg/dL) are consistent with scurvy.
Treatment and Management of Vitamin C Deficiency
Supplementation
Oral vitamin C supplements are the standard treatment. For mild cases, doses of 100–500 mg daily are typically sufficient. Severe deficiency (scurvy) may require 1–2 grams daily for the first few days, followed by maintenance doses.
Dietary Correction
Encouraging the consumption of vitamin C-rich foods is vital for both recovery and prevention.
Top Sources of Vitamin C:
- Citrus fruits (oranges, lemons, grapefruits)
- Strawberries, kiwi, guava
- Bell peppers, broccoli, kale, Brussels sprouts
- Tomatoes and fortified cereals
Preventive Strategies
Daily Recommended Intake
- Men: 90 mg/day
- Women: 75 mg/day
- Pregnant women: 85 mg/day
- Lactating women: 120 mg/day
- Smokers: Additional 35 mg/day
Storage and Cooking Tips
Vitamin C is heat-sensitive and water-soluble. To preserve its content:
- Opt for steaming over boiling
- Store fruits and vegetables in cool, dark places
- Consume fresh produce promptly after cutting
Long-Term Consequences of Untreated Deficiency
Chronic deficiency can lead to:
- Increased oxidative stress
- Greater susceptibility to infections
- Poor bone and joint health
- Cognitive decline in elderly individuals
Vitamin C deficiency, though rare in industrialized countries, remains a significant health concern globally, especially among at-risk populations. With early recognition, appropriate supplementation, and dietary intervention, the condition is entirely preventable and reversible. Regular intake of vitamin C-rich foods and awareness of deficiency symptoms are key to maintaining optimal health and preventing long-term complications.
