Signs and Treatment of Vitamin C Deficiency

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 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 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.

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