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Vitamin C, also called L-ascorbic acid, is an essential nutrient for your health. When you don’t get enough of this vitamin and develop a vitamin C deficiency, your body has a more challenging time producing crucial substances like collagen, specific proteins, and neurotransmitters (Li, 2007; NIH, 2021).
Because your body can’t make vitamin C on its own, you need to consume it from the foods you eat. Read on to learn more about what causes a vitamin C deficiency, what you can do to prevent it, and, if needed, what healthcare providers do to treat it.
What is vitamin C, and what does it do?
Vitamin C is a water-soluble vitamin that is critical to your body’s health and maintenance. Because water-soluble vitamins are not stored in the body very long, you need to consume vitamin C regularly to ensure your body has adequate amounts of the vitamin (Lykstad, 2021).
Vitamin C is also an antioxidant, helping to neutralize “free radicals” that can be harmful to the body. By doing this, vitamin C may help prevent damage to your body’s cells (NIH, 2021; NIH, 2013).
Additionally, it helps the body make collagen—a protein that plays an essential part in helping your body have healthy skin, tendons, ligaments, and bones. Collagen also helps your body to heal wounds (Wu, 2020; Dosedel, 2021).
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Your body needs vitamin C so it can have a healthy immune response and properly fight infection (Carr, 2017). There are theories that vitamin C may help prevent cardiovascular disease and cancer by curbing the damaging effects of free radicals. However, the current research suggests that vitamin C does not help prevent cancer or cardiovascular disease.
Some evidence links taking vitamin C supplements to shorter durations of the common cold. But the medical community needs more research to determine the full benefits of vitamin C and its role in treating and preventing certain diseases (NIH, 2021). Some preliminary evidence also suggests that it could impact cognitive function, with some research linking depression and other mental health issues to vitamin C deficiency (Plevin, 2020).
Sources of vitamin C
You can get vitamin C from many different sources. While it is possible to take vitamin C supplements, you can get vitamin C naturally from many foods. Most fruits and vegetables, especially citrus fruits, contain vitamin C. Some common sources of vitamin C include oranges, lemons, limes, potatoes, spinach, red peppers, tomatoes, grapefruits, kiwifruit, strawberries, and broccoli (NIH, 2021; Maxfield, 2021).
Most people get enough vitamin C from food sources, like fresh fruits. For adults ages 19 and older, a recommended dietary allowance for vitamin C is about 90 mg a day for men and 75 mg a day for women. Some people might require more vitamin C, like people who smoke, are pregnant, or breastfeeding (NIH, 2021).
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Causes of vitamin C deficiency
Vitamin C deficiency is uncommon, particularly in developed countries. Historically, sailors who did not have access to fruits and vegetables on long journeys would become deficient in vitamin C (NIH, 2021).
While people in low and middle-income countries have an overall greater risk for vitamin C deficiency, specific subgroups in high-income countries may also be at risk. For example, people who don’t have access to fruits and vegetables or who rely on staple foods like grains as a primary food source may be at risk for vitamin C deficiency. Institutionalized people and those who live in nursing homes, also have a greater tendency toward vitamin C deficiency (Carr, 2020).
Some people are at a higher risk of developing vitamin C deficiency due to certain health conditions or lifestyle choices. For example, people who smoke are at a higher risk. This is partly because their bodies metabolize vitamin C faster, and they tend to consume less of it (Carr, 2017).
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People with severe malnourishment, diets devoid of fruits and vegetables, and drug and alcohol disorders are also at a higher risk for vitamin C deficiency (Smith, 2011).
People with digestive issues like inflammatory bowel disease might not be able to absorb vitamin C well. Others with specific allergies or eating disorders might not consume enough vitamin C in their diets. Finally, some people, like those with type 1 diabetes, might have to take it in higher levels and are thus at a higher risk for being deficient in it (Maxfield, 2021).
Symptoms of vitamin C deficiency
The total amount of vitamin C content in the human body ranges from 300 mg to 2g. Someone whose level of vitamin C is at 300 mg is close to developing scurvy. Usually, symptoms do not happen unless someone’s intake of it gets below 10 mg in a day for about a month (NIH, 2021).
When someone develops severe vitamin C deficiency, the person may develop scurvy. If you do not treat scurvy, it is fatal (NIH, 2021). The beginning symptoms of scurvy are irritability and anorexia (Maxfield, 2021).
People with scurvy may have various other symptoms (Dosedel, 2021):
- Swollen and bleeding gums
- Muscle pain and weakness
- Weight loss or weight gain related to swelling
- Poor wound healing
- Loss of teeth
- Spontaneous bruising
- Joint pain
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Treatment of vitamin C deficiency
The symptoms of scurvy can be severe, but treatment for scurvy is relatively simple and involves the direct intake of vitamin C. The amount of vitamin C needed will depend on factors like age and the severity of the deficiency. In children, vitamin C oral intake for treating vitamin C deficiency is up to 300 mg daily. In adults, the oral intake needed to correct the deficiency is between 500 to 1000 mg daily (Maxfield, 2021)
Treatment may also involve correcting the underlying cause. For example, suppose someone is vitamin C deficient because of an eating disorder. In that case, healthcare providers may take steps to help treat the eating disorder (Maxfield, 2021).
Although unlikely, it is possible to take in too much vitamin C. If people take in too much vitamin C, they may have unpleasant side effects like diarrhea and abdominal cramps (NIH, 2021).
While vitamin C deficiency is uncommon, getting vitamin C in adequate amounts and at regular intervals is essential. Talk with your primary care provider if you think you aren’t getting enough vitamin C or have questions about vitamin C sources. Always consult your primary care provider before starting any vitamin C supplements.
- Carr, A. C., & Maggini, S. (2017). Vitamin C and Immune Function. Nutrients, 9(11), 1211. doi: 10.3390/nu9111211. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707683/
- Carr, A. C., & Rowe, S. (2020). Factors Affecting Vitamin C Status and Prevalence of Deficiency: A Global Health Perspective. Nutrients, 12(7), 1963. doi: 10.3390/nu12071963. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400679/
- Doseděl, M., Jirkovský, E., Macáková, K., Krčmová, L. K., Javorská, L., Pourová, J., Mercolini, L., et al (2021). Vitamin C-Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination. Nutrients, 13(2), 615. doi: 10.3390/nu13020615. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918462/
- Li, Y., & Schellhorn, H. E. (2007). New developments and novel therapeutic perspectives for vitamin C. The Journal of Nutrition, 137(10), 2171–2184. doi: 10.1093/jn/137.10.2171. Retrieved from https://academic.oup.com/jn/article/137/10/2171/4664436
- Lykstad, J., & Sharma, S. (2021). Biochemistry, water soluble vitamins. [Updated Mar 07, 2021]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK538510/
- Maxfield, L., & Crane, J. S. (2021). Vitamin C deficiency. [Updated Jul 18, 2021]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK493187/
- NIH. (2013). Antioxidants: In depth. Retrieved October 13, 2021 from https://www.nccih.nih.gov/health/antioxidants-in-depth
- NIH. (2021). Office of dietary supplements – vitamin C. Retrieved October 12, 2021 from https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/
- Plevin, D., & Galletly, C. (2020). The neuropsychiatric effects of vitamin C deficiency: a systematic review. BMC Psychiatry, 20(1), 315. doi: 10.1186/s12888-020-02730-w. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302360/
- Smith, A., Di Primio, G., & Humphrey-Murto, S. (2011). Scurvy in the developed world. CMAJ : Canadian Medical Association Journal = Journal de l’Association Medicale Canadienne, 183(11), E752–E755. doi: 10.1503/cmaj.091938. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3153547/
- Wu, M., Cronin, K., & Crane, J. S. (2020). Biochemistry, Collagen synthesis. [Updated Sep 11, 2020]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK507709/
Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.