Dr. Ahmed Signs of Vitamin C Deficiency
Early Symptoms (4 to 12 weeks of insufficient vitamin C intake):
- Fatigue
- Malaise
- Lethargy
- Anorexia
Oral and Skin Symptoms:
- Bleeding gums
- Easy bruising
- Skin rashes
- Fragility
- Delayed wound healing
- Bone and joint aches
Visible Physical Examination Signs:
- Gingivitis with bleeding
- Periodontal disease
- Loss of dentition
- Mucocutaneous petechiae
- Ecchymoses
- Hyperkeratosis
- Alopecia
- Corkscrew hairs
- Swan neck hairs
Nail-related Observations:
- Koilonychia
- Splinter hemorrhages
Involvement of Various Organ Systems:
- Painful joint swelling
- Hemarthroses
- Subperiosteal hematomas
- Fragile bones are prone to fractures
Ocular symptoms:
- Dry eyes
- subconjunctival hemorrhages
- scleral icterus
Children’s Presentation (80% with musculoskeletal signs):
- Arthralgias
- Myalgias
- Hemarthroses
- Muscle hemorrhages
- Subperiosteal hematomas
- “Scorbutic rosary” (tender swellings at costochondral junctions)
Advanced Manifestations:
- Flame hemorrhages
- Cotton-wool spots
- Retrobulbar bleeding into optic nerves
- Compromised immune system
- Increased susceptibility to infections
Severe and Life-Threatening Complications:
- Profound weakness
- Dyspnea
- Anasarca
- Hemolysis
- Jaundice
- Seizures
- Organ failure
- Death
Dosage for Scurvy Treatment:
- Children:
- Up to 300 mg/d
- Adults:
- 500 to 1000 mg/d
- Alternative regimens for adults:
- Up to 2 g/d for the initial 3 days, 500 mg/d for 1 week, and 100 mg/d for 1 to 3 months.
It takes 1 to 3 months for complete resolution of signs and symptoms.
Preventing Recurrence:
- Adequate consumption of fruits and vegetables.
- Addressing the underlying causes of malnutrition.
Recommended Daily Vitamin C Intake:
- Children: 15 to 75 mg
- Men: 90 mg
- Women: 75 mg
- Pregnant women: 85 mg
- Lactating women: 120 mg
Effect of Smoking on Vitamin C Levels:
- Depletion of vitamin C levels in smokers.
- Additional vitamin C requirement: 35 mg/d for smokers.
Food Sources of Vitamin C (per serving):
- 1/2 cup red pepper: 95 mg
- 1 medium orange: 70 mg
- 1/2 cup strawberries: 49 mg
- 1/2 cup Brussels sprouts: 48 mg
- 1 baked potato: 17 mg
Vitamin C Supplements:
- Readily available for those unable to obtain sufficient vitamin C from the diet.
- Standard over-the-counter multivitamin preparations are an option.
