Signs and Treatment of Vitamin C Deficiency

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

Treatment of Vitamin C Deficiency:

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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Written by Dr. Ahmed

I am Dr. Ahmed (MBBS; FCPS Medicine), an Internist and a practicing physician. I am in the medical field for over fifteen years working in one of the busiest hospitals and writing medical posts for over 5 years.

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