Vitamin C is a water-soluble vitamin that is primarily involved in healing and repairing wounds. Individuals with blood levels of less than 0.2 mg/dL are considered deficient.
Dry, brittle, and coiled hair that hang in a spiral shape, bleeding around hair follicles, and gum bleeding are one of the most characteristic signs of Vitamin C deficiency.
Poor intake of fresh fruits and vegetables, restrictive diets, smoking, pregnancy along with some medical conditions such as Crohn’s disease, inflammatory bowel disease (IBD), and eating disorders increases the risk of Vitamin C deficiency.
Daily consumption of fresh fruits and vegetables such as guava, strawberry, papaya, kiwi, spinach, carrots, and bell peppers are the best way to prevent this deficiency. Treatment options include a diet rich in Vitamin C sources along with dietary supplements.
All age groups
Both men and women but more common in men
Skin
Teeth
Gums
Hair
Eyes
Immune system
Immune thrombocytopenic purpura
Henoch-Schonlein purpura
Disseminated intravascular coagulation
Rocky mountain spotted fever
Meningococcemia
Hypersensitivity vasculitis
Blood tests
Leukocyte test
Dermoscopy
Skeletal X-ray
Vitamin C supplementation
General physician
Internal medicine specialist
Pediatrician
Vitamin C also known as ascorbic acid performs the following functions in the body:
Helps in synthesizing collagen. Collagen is the primary building block of skin, muscles, bones, and connective tissues.
Supports blood vessels through managing structure of collagen
Serves as an antioxidant which helps prevent the deposition of cholesterol in the blood vessels
Aids in absorption of iron in the small intestine
Humans are unable to produce Vitamin C. The deficiency occurs as a result of sustained dietary deficiency for several months. Symptoms start to develop when the total body stores are reduced from 1500 mg to 300 mg.
The signs and symptoms of Vitamin C deficiency start to develop 8 to 12 weeks after inadequate intake of Vitamin C.
The major characteristic signs of Vitamin C deficiency are:
Corkscrew hair (dry, brittle, and coiled hair)
Perifollicular hemorrhage (bleeding around hair follicles)
Gingival bleeding (gum bleeding)
The other signs and symptoms include:
Weakness
Fatigue
Poor wound healing
Shortness of breath
Poor appetite
Fever
Anemia
Swelling of gum
Loss of teeth
Mucocutaneous petechiae (pinpoint-sized spots of bleeding under the skin or mucous membranes)
Ecchymosis (discoloration of the skin resulting from bleeding underneath)
Hyperkeratosis (increased thickness of the skin)
Swan-neck hair (bending of hair)
Edema (swelling caused by too much fluid trapped in the body's tissues)
Koilonychia (depression of the central portion of the nails)
Painful hemarthrosis (bleeding into the joint cavity)
Exclusive cow’s milk diet (in children)
Exclusive tea and toast diet (mostly seen in elderly)
Absence of fruits and vegetables in the diet
Restrictive diets
Eating disorders
Type 1 diabetes
Gi disorders such as inflammatory bowel disease, celiac disease, and Crohn disease
Iron overload
Cancer
Psychiatric illnesses such as depression
Smokers have been found to have least concentration of Vitamin C in the blood.
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Alcohol increases the excretion of Vitamin C. The excessive consumption of alcohol (>80 g/day) is associated with an increased risk of Vitamin C deficiency.
Pregnant women are more prone to the deficiency of Vitamin C due to the increase in requirement.
Hemodialysis increases the risk of Vitamin C deficiency due to its loss during the procedure. Studies have shown a 50% decrease in Vitamin C after dialysis treatment.
Fresh fruit and vegetables are the major dietary source of vitamin C. Individuals with low socioeconomic status are more likely to develop Vitamin C deficiency due to limited access to these sources.
Did you know? Children who skip breakfast may have poor nutritional profiles.
The diagnosis of Vitamin C deficiency is made primarily by the evaluation of risk factors. Physical examination is also required in order to evaluate the symptoms and their severity.
In most of the cases, the disease is confirmed with the recovery of supplementation.
It includes testing the blood concentration of Vitamin C. A blood concentration below 0.3 mg/dl indicates deficiency. However, this test is not much reliable as it reflects the recent intake rather than body stores.
2. Other nutrients
The other nutritional deficiency can be concomitantly associated with Vitamin C deficiency. The level of other nutrients such as Vitamin B12, folate, calcium, zinc, and iron are also assessed during Vitamin C deficiency.
3. Leukocyte test
Leukocyte is a type of blood cell which is able to maintain vitamin C concentrations several times higher than blood. It indicates the long-term dietary intakes of Vitamin C.
A leukocyte vitamin C level of less than 7 mg/dL indicates deficiency.
This procedure involves examination of the skin lesions using an instrument called dermatoscope. It helps in evaluating the follicular purpura and corkscrew hairs which are the characteristic feature of Vitamin C deficiency.
This is used to confirm the skeletal changes in children as a result of Vitamin C deficiency. Most of the changes are seen at the end of long bones specifically at the knee.
The symptoms of Vitamin C deficiency can range from mild to severe. Consult the doctor in case of the following symptoms:
Loss of teeth
Dry and damaged skin
Hair loss
Loss of appetite
Swelling of gum
Doctors who can help you diagnose and treat Vitamin C deficiency include:
General physician
Internal medicine specialist
Orthopedics
Gastroenterologist
Hematologist
Pediatrician (in case of children)
A general physician will examine your symptoms and initiate treatment.
In case of severe cases, they may refer you to an Internal Medicine specialist who provides comprehensive care for adult patients, managing complex cases and addressing underlying health conditions.
Orthopedics can be consulted to manage the symptoms related to the musculoskeletal system (bones, muscles, joints, and soft tissues).
Gastroenterologist can also be consulted to treat the cases where Vitamin C deficiency is developed as a result of malabsorption.
Hematologist can be consulted to treat symptoms that developed as a result of excessive bleeding.
You can consult a pediatrician if you notice any signs and symptoms of Vitamin C deficiency in children.
Fresh fruits and vegetables such as guava, strawberry, papaya, kiwi, spinach, carrots, and bell peppers are a very good source of Vitamin C. The best way to prevent Vitamin C deficiency is to have a balanced diet.
The daily requirement of Vitamin C is
45 mg per day for children
90 mg per day for men
75 mg per day for women
120 mg per day for lactating women.
Five servings of most fruits and vegetables (recommended daily) provide > 200 mg of vitamin C.
People who smoke should consume an additional 35 mg/day.
Here are 10 Vitamin C rich foods in less than Rs 5 per day.
People with underlying health conditions such as celiac disease and cystic fibrosis affect the absorption of nutrients. Therefore treating the underlying condition may help in maintaining the optimum level of Vitamin C.
Fad diets generally lead to vitamin deprivation. Avoiding restrictive diets may help prevent the deficiency.
Know from our expert how to find complete nutrition from healthy eating habits.
They are mostly available in tablet form. However, it can also be given intravenously or intramuscularly as per the need of the individual.
It can be either one of the two recommended patterns:
300 mg daily for children
500 mg to 1000 mg daily for adults for 1 month
1 to 2 g for up to 3 days followed by 500 mg daily for a week followed by 100 mg daily for up to 3 months.
The time period can be extended if symptoms persist.
Explore our wide range of Vitamin C supplements.
The severe deficiency of Vitamin C can also cause anemia as a result of persistent bleeding in some individuals. Such people may require blood transfusion.
It is performed in individuals having severe eye problems such as dry eyes as a result of prolonged Vitamin C deficiency. During the surgery, vitreous fluid (a gel-like substance that fills the space within the eye) is replaced with another solution.
Children with bone disease may require surgery if symptoms do not resolve with supplements.
1. Citrus fruits: Citrus fruits such as lemon and orange are a very good source of Vitamin C.
2. Papaya: It is an excellent source of Vitamin C. It is known as a powerhouse of nutrients. It can be consumed either in the form of salad or juice.
3. Guava: It is a good source of Vitamin C also along with fiber and antioxidants. A single guava fruit (100g) contains around 200 mg of Vitamin C.
4. Tomato: They should be added in daily cooking as they are also a very good source of Vitamin C along with Vitamin A.
5. Indian gooseberry (amla): It is known from years for its medicinal properties. It is a very rich source of Vitamin C. Amla can be either eaten raw, as salads or in the form of juice.
6. Cruciferous vegetables: Broccoli, cabbage, cauliflower are all examples of cruciferous vegetables. They are also rich sources of vitamin C.
The severe Vitamin C deficiency can cause:
Vitamin C deficiency mostly resolves within 3 months with conscious eating and dietary supplements. The following measures might help in faster recovery:
Vitamin C is abundantly found in fresh fruits and vegetables. The common sources include oranges, green peppers, watermelon, papaya, grapefruit, strawberries, kiwi, mango, broccoli, tomatoes, cauliflower, and cabbage.
Green leafy vegetables such as turnip and spinach), red and green peppers are also rich sources of vitamin C. These foods are easily accessible and should be included in the daily diet.
It is advised to eat fruits and vegetables raw or very lightly cooked for the maximum effect. It is because Vitamin C is sensitive to heat and overcooking can degrade it.
Smoking serves as a trigger for Vitamin C deficiency. It is advised to completely avoid smoking or to limit it. Individuals who smoke require higher amounts of supplements.
Here are some tips that may help you to quit smoking.
In most cases, the deficiency of Vitamin C is developed as a result of poor dietary intake. This may lead to other deficiencies also. So, it is important to screen for other nutritional deficiencies.
It is advised to consult health care professionals before starting supplements. The doctor prescribes the right dose as per your need. Vitamin C also interacts with other medications which a doctor may help you to find and fix.
Is your child a fussy eater? Things to consider while buying a health supplement.
Vitamin C supplements increase urination. Make sure to keep yourself hydrated to compensate the water loss.
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The higher doses of Vitamin C can cause diarrhea, gas, or stomach upset. It is always advised to take the recommended amount of Vitamin C. Seek immediate medical consultation if you're experiencing any such signs.
