Vitamin C (ascorbic acid) is needed for amino acid formation, heals wounds, helps people recover from burns, helps produce carnitine, collagen, supports immune system, helps in the absorption of iron and is a very important antioxidant. Vitamin C deficiency can occur due to under nourishment.
Causes of Vitamin C Deficiency
Those who eat limited variety of foods can suffer from vitamin C deficiency. Acute deficiency causes scurvy. Some people can develop signs of scurvy within a month, while others may take longer. This depends on the body’s store of vitamin C and the amount of intake. No intake or less than 10mg / day can cause deficiency. Initial signs of scurvy will start with general malaise and continue to poor collage synthesis, weakened connective tissue, poor wound healing, corkscrew hairs, hyperkeratosis etc. Swollen and bleeding gums, loss of teeth are two prominent signs of scurvy. Scurvy is rarely found in developed countries.
Some of the groups at risk of vitamin C deficiency include:
Smoker’s and those who live around them and inhale second-hand smoke have lower leukocyte and plasma vitamin C levels. This is due to excessive oxidative stress. Hence, smokers require higher levels of vitamin C (35mg) than non-smokers do. There is no recommendation about the levels required by non-smokers although it has been recommended that they take the RDA levels for their age.
Babies who drink evaporated or boiled cow’s milk can be deficient in vitamin C as this contains low levels of this vitamin and boiling can destroy it too. If infants are fed breast milk or infant formula, they get their daily requirement.
Poor food variety can be another cause of low levels of vitamin C. Fruits, vegetables mainly contain vitamin C. Through a daily diet, people should get sufficient vitamin C to prevent a deficiency. Poor people, elderly, sick people, drug addicts, alcoholics, those who follow specific diets, some children and those who are mentally ill are some who may have a limited food variety.
Chronic diseases, cancer, intestinal malabsorption or cachexia can all cause a deficiency of vitamin C. some illnesses also require reduced intake of vitamin C. Patients who are on chronic hemodialysis due to end-stage renal failure also cannot absorb required quantities of vitamin C.
Other causes for deficiency of Vitamin C
- High blood pressure
- Gallbladder diseases
- Certain forms of cancer
Symptoms of Vitamin C deficiency
Symptoms of Vitamin C deficiency include:
- Follicular hyperkeratosis
- Perifollicular hemorrhage
- Impaired wound healing
- Internal bleeding
- Poor bone development in babies and children
- Hemorrhagic manifestations
- Abnormal osteoid
- Dentin formation
Diagnosis of vitamin C deficiency is mostly through gingival findings, other risk factors and by examining the skin. Anemia, bleeding, prothrombin and coagulation are other common signs. In infants, skeletal x-rays can reveal the evidence of scurvy. Treatment is usually through a nutritious diet and taking vitamin C supplements.
Vitamin C Supplements
Adults require 40mg of vitamin C per day, and this can be got through diet and vitamin C supplements. Vitamin C is available as synthetic or natural supplements. You can get it as tablets (both chewable and non-chewable), capsules, and effervescent, powdered crystalline and liquid forms. Most vitamin C doses range from 25mg – 1000 mg.
Those who suffer from side effects of taking vitamin C supplements, like those that have stomach upsets can take buffered ascorbic acid or an esterified version that will be easy on the stomach especially if they suffer from frequent heart burn.
Vitamin C Supplements : Precautions
Vitamin C has a diuretic effect, so you must make sure you drink plenty of fluids when you take it. Those sensitive to corn must take an alternate form from sago palm sources as most vitamin C is made from corn. The body gets rid of excess vitamin C and hence, most people do not suffer from an overdose. If pregnant women take more than 6000mg of vitamin C, their babies can develop rebound scurvy as their ingestion of vitamin C will drop after birth.
Vitamin C does not cause very serious adverse effects even if we take more quantities that we require. Common side effects include certain gastrointestinal disturbances like diarrhea, abdominal cramps, flatulence nausea etc. A study conducted on post-menopausal women who also had diabetes, an intake of 300mg or more of vitamin C supplements increased the risk of death due to cardiovascular diseases.
High concentrations of vitamin C in the body can also form kidney stones due to the increased uric acid and urinary oxalate excretion. People with renal disorders are more susceptible to this. There are conflicting studies regarding this and the actual role vitamin C plays in forming kidney stones.
High intake of vitamin C can also result in excessive absorption of iron, oxidative damage if vitamin C acts as a pro-oxidant under certain circumstances and reduced levels of vitamin B12 and copper, erosion of teeth enamel etc. However, further studies are needed on all these responses.
Another result of vitamin C toxicity is a condition known as glucose-6-phosphate dehydrogenase deficiency (G6PD). This is an inherited condition, that affects the red blood cells and those who have this must be careful about their daily intake of vitamin C.
Do not take vitamin C immediately after an angioplasty as it can interfere with the healing process. Those being treated for cancer must speak to their oncologist before taking vitamin C. those taking medications like NSAIDs, acetaminophen, antacids with aluminum, barbiturates, chemotherapy drugs, contraceptives or HRT pills, protease inhibitors, tetracycline, warfarin must all be careful before taking vitamin C supplements.
Although vitamin C deficiency is rare in this modern day in developed countries, there are certain people at risk because of age, gender or certain illnesses. It is always best to check with your health care provider to make sure you are taking the right dosage to prevent any health problems.