7 Signs & Symptoms of Vitamin C Deficiency & Treatment – Research Studies

What is Vitamin C?

Vitamin C or ascorbic acid is a water-soluble vitamin, which has several therapeutic properties. Vitamin C is useful in the biosynthesis of collagen, metabolism of carnitine and catecholamine, absorption of dietary iron, and antioxidant functions. Since humans are not capable of synthesis of collagen, they are solely dependent on external sources of collagen. Vitamin C supplementation is indicated for various conditions including scurvy, collagen disorders, infections, chronic illnesses, gingivitis, asthma, arthritis, glaucoma, and heatstroke. [1]

Vitamin C is absorbed in the intestine via two different mechanisms – active transport and simple diffusion. The site of vitamin C absorption is the distal small intestine and it is regulated by the excretion process in the kidneys. The highest concentrations of ascorbic acid are present in the pituitary gland, eyes, adrenal gland, brain, and leukocytes. Vitamin C is also integral to the stabilization of folic acid and vitamin E. [1] 

Why Vitamin C is Important?

Vitamin C functions as an antioxidant, which protects the body tissues against toxins, free radicals, and pollutants. Therapeutic doses of vitamin C are used in several disorders such as cataracts, diabetes, atherosclerosis, glaucoma, cancer, cardiovascular disorders, and other conditions. [2]

7 Signs & Symptoms of Vitamin C Deficiency

1. Psychiatric Outcomes 

The deficiency of vitamin C is associated with adverse psychiatric outcomes including impaired cognition and depression. High-risk patients who present with psychiatric symptoms are those who do not consume adequate dietary vitamin C. [3]

2. Scurvy 

The clinical deficiency of vitamin C is known as scurvy. The clinical presentation of scurvy varies from person to person. The early stages of scurvy include malaise, lethargy, and fatigue. In the later stages, individuals may experience myalgia, bone pain, swelling, gum disease, mood changes, and poor wound healing. The late stages of this condition comprise hemolysis, neuropathy, death, severe jaundice, and generalized edema. [4]

3. Bleeding 

Surgical patients demonstrating normal coagulation parameters may present with diffuse bleeding associated with the deficiency of vitamin C. Vitamin C deficiency in surgical patients is associated with poor diet, prolonged hospitalization, and severe illness. Oral supplementation of vitamin C can potentially reverse the outcomes of non-specific hemorrhage in surgical patients. [5]

4. Impaired Wound Healing 

Vitamin C or ascorbic acid is associated with all stages of the wound healing cycle, including the inflammation, proliferation, and maturation stages. A deficiency of vitamin C affects the maturation stage of the wound-healing cycle by mediating the alteration in the formation of scars and the production of collagen. Therefore, a deficiency of vitamin C leads to impaired wound healing. Supplementation with vitamin C is useful for ensuring the normal progression of the wound healing cycle. [6]

5. Corkscrew Hair 

The clinical manifestations of vitamin C deficiency correspond with dilated hair follicles, non-inflammatory perifollicular hemorrhages, and corkscrew hairs with keratin plugging. The disruption of the formation of the disulfide bond causes the development of swan-neck or corkscrew hair. It takes up to 1 month to resolve corkscrew hair and complete resolution is achieved in three months. The nail findings in vitamin C deficiency include the development of splinter hemorrhages and koilonychia. [7]

6. Bone Pain 

A deficiency of vitamin C has severe consequences for bone health. Alteration in the vitamin C signaling pathways causes significant impairment of genes that are associated with the function or maturation of osteoblasts. Vitamin C deficiency and decreased bone formation also lead to an increased risk of fracture and osteoporosis. Supplementation with vitamin C aids in treating deficiency and the associated risk of bone fracture and reduced bone mineral density. [8]

7. Impaired Skin Health

There are high concentrations of vitamin C in the skin. This is important for the synthesis of collagen and the protection of the skin against photodamage caused by the ultraviolet rays of the sun. The deficiency of vitamin C gives rise to significant skin disorders. Vitamin C deficiency manifests as skin fragility. It also leads to subcutaneous bleeding and stratum corneum thickening. [9] 

Vitamin C Deficiency Treatment 

Vitamin C supplements are administered via the oral route, however, they can be administered via other routes including subcutaneous, intramuscular, and intravenous, particularly when patients have malabsorption. Adverse reactions associated with intravenous vitamin C administration can be minimized by the dilution of the drug using glucose or normal saline. The adverse effects associated with intravenous administration include headaches, dizziness, flushing, and nausea or vomiting. A higher concentration of vitamin C in the body may increase the risk of the formation of kidney stones. These vitamin supplements are contraindicated for different blood disorders. Diabetic patients must take precautions when consuming vitamin C supplements as it may increase blood sugar levels. [1]

Take advantage of free consultation with one of our Health Coach through the chat icon on the website to determine of vitamin C deficiency along with the identification of appropriate dosages for patients. Vitamin C and Bioflavonoids Supplements are recommended for patients who suffer from a deficiency of this vitamin in the body. 

References 

  1. Abdullah M, Jamil RT, Attia FN. Vitamin C (Ascorbic Acid) [Updated 2022 Oct 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499877/
  2. Chambial, S., Dwivedi, S., Shukla, K. K., John, P. J., & Sharma, P. (2013). Vitamin C in disease prevention and cure: an overview. Indian journal of clinical biochemistry : IJCB28(4), 314–328. https://doi.org/10.1007/s12291-013-0375-3
  3. Plevin, D., & Galletly, C. (2020). The neuropsychiatric effects of vitamin C deficiency: a systematic review. BMC psychiatry20(1), 315. https://doi.org/10.1186/s12888-020-02730-w
  4. Léger D. (2008). Scurvy: reemergence of nutritional deficiencies. Canadian family physician Medecin de famille canadien54(10), 1403–1406.
  5. Blee, T. H., Cogbill, T. H., & Lambert, P. J. (2002). Hemorrhage associated with vitamin C deficiency in surgical patients. Surgery131(4), 408–412. https://doi.org/10.1067/msy.2002.122373
  6. Moores J. (2013). Vitamin C: a wound healing perspective. British journal of community nursingSuppl, S6–S11. https://doi.org/10.12968/bjcn.2013.18.sup12.s6
  7. Maxfield L, Crane JS. Vitamin C Deficiency. [Updated 2022 Oct 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493187/
  8. Aghajanian, P., Hall, S., Wongworawat, M. D., & Mohan, S. (2015). The Roles and Mechanisms of Actions of Vitamin C in Bone: New Developments. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research30(11), 1945–1955. https://doi.org/10.1002/jbmr.2709
  9. Pullar, J. M., Carr, A. C., & Vissers, M. C. M. (2017). The Roles of Vitamin C in Skin Health. Nutrients9(8), 866. https://doi.org/10.3390/nu9080866