In countries with low rates of food insecurity, vitamin C deficiency can occur from a diet low in vitamin C, but severe deficiency (causing scurvy) is uncommon.
Not eating enough fresh fruits and vegetables can cause the deficiency.
People feel tired, weak, and irritable.
Severe deficiency, called scurvy, causes bruising, gum and dental problems, dry hair and skin, and anemia.
The diagnosis is based on symptoms and sometimes blood tests.
Increasing consumption of fresh fruits and vegetables or taking vitamin C supplements by mouth usually corrects the deficiency.
Causes of Vitamin C Deficiency
In adults, vitamin C deficiency usually results from
A diet low in vitamin C
For example, vitamin C deficiency may result from a diet deficient in fresh fruits and vegetables. Also, cooking can destroy some of the vitamin C in food.
The following conditions can significantly increase the body’s requirements for vitamin C and the risk of vitamin C deficiency:
Pregnancy
Breastfeeding
Disorders that cause a high fever or inflammation
An overactive thyroid gland (hyperthyroidism)
Diarrhea that lasts a long time
Surgery
Burns
Smoking, which increases the vitamin C requirement by 30%
Did You Know...
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Scurvy
Severe vitamin C deficiency causes scurvy. Scurvy in infants is rare because breast milk usually supplies enough vitamin C and infant formulas are fortified with the vitamin. Scurvy is rare in the United States but may occur in people with alcohol use disorder and older people who are malnourished.
Symptoms of Vitamin C Deficiency
Adults feel tired, weak, and irritable if their diet is low in vitamin C. They may lose weight and have vague muscle and joint aches.
The symptoms of scurvy develop after a few months of deficiency. Bleeding may occur under the skin (particularly around hair follicles or as bruises), around the gums, and into the joints. The gums become swollen, purple, and spongy. The teeth eventually loosen. The hair becomes dry, brittle, and coiled (like a corkscrew), and the skin becomes dry, rough, and scaly. Fluid may accumulate in the legs. Anemia may develop. Infections may develop, and wounds do not heal.
Infants may be irritable, have pain when they move, and lose their appetite. Infants do not gain weight as they normally do. In infants and children, bone growth is impaired, and bleeding and anemia may occur.
Diagnosis of Vitamin C Deficiency
Physical examination
Sometimes blood tests
In children, x-rays of the bones
The diagnosis of scurvy is based on symptoms. Measuring the vitamin C level in blood can help establish the diagnosis, but this test is not always available.
Blood tests may be done to check for anemia.
In children, x-rays are done to check for impaired bone growth.
Prevention of Vitamin C Deficiency
Vitamin C deficiency can be prevented by consuming the recommended amounts of fresh fruits and vegetables or by taking the recommended amount of vitamin C in daily supplements. People who smoke require more.
Treatment of Vitamin C Deficiency
Vitamin C supplements
A nutritious diet with increased consumption of fresh fruits and vegetables
For scurvy, high doses of vitamin C supplements
Scurvy is treated with high doses of daily vitamin C supplements, followed by a nutritious diet that supplies 1 to 2 times the daily recommended amount of vitamin C. The diet should include increased consumption of fresh fruits and vegetables.
Most symptoms disappear after 1 to 2 weeks. Gum problems may last longer.
