Vitamin C & It’s

Deficiencies
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Introduction:

▪ Vitamin C exists in natural

sources as L-ascorbic acid.
▪ It is a hexose derivative and
closely resembles
monosaccharides in structure.
▪ It is a water-soluble vitamin and
easily destroyed by heat, alkali
and storage. In the process of
cooking, 70% of vitamin C is lost.
▪ It is readily absorbed from the
small intestine and is stored in
many tissues, most abundantly
in adrenal cortex.
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Biosynthesis of Vitamin C in
Animals:
▪ Most animals and plants can synthesize vitamin C
from glucose via uronic acid pathway.
▪ Man, some primates, guinea pigs and bats are the
only species which cannot synthesize it due to the
deficiency of an enzyme namely L-gulonolactone
oxidase.
▪ They lack the genes responsible for the synthesis of
this enzyme. The vitamin therefore should be
supplied in the diet of these species.
▪ Vitamin C is excreted in urine as such or as its
metabolites.
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➢ Sources of Vitamin C:

▪ Citrus fruits, gooseberry

(amla), guava, kiwi, green
vegetables (cabbage,
spinach, broccoli), tomatoes,
potatoes (particularly skin)
are rich in vitamin C.
▪ It is present in small amounts
in meat and milk.
▪ The vitamin is easily
destroyed by heating so
boiled or pasteurized milk
may lack vitamin C.
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Requirement of Vitamin C:

▪ Recommended daily allowance is 75 mg/day.

▪ Official recommended minimal daily intakes are:

1. Infants: 30mg/day
2. Adults: 75mg/day
3. Adolescence: 80mg/day
4. Pregnant woman: 100mg/day
5. Lactating woman: 150mg/day
▪ Requirement is increased in presence of infections.
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Functions of Vitamin C:
▪ The physiologic functions of vitamin C are due to its ability to
carry out oxidation-reduction reactions which are as follows:
1. Ascorbic acid is required for hydroxylation of proline to
form hydroxyproline which is essential component of
collagen.
2. Besides collagen, it is necessary for the ground
substance of other mesenchymal structures such as
osteoid, chondroitin sulfate, dentin and cement
substance of vascular endothelium.
3. Vitamin C being a reducing substance has other
functions such as:
I. Hydroxylation of dopamine to norepinephrine.
II. Maintenance of folic acid levels by preventing
oxidation of tetrahydrofolate.
III. Role in iron metabolism in its absorption, storage
and keeping it in reduced state.
▪ Vitamin C helps in preventing and even treating
gum diseases like periodontitis.
▪ Vitamin C is a strong antioxidant. As an antioxidant,
it reduces the risk of cancer, cataract and coronary
heart diseases.
▪ Vitamin C is required for bone formation as the
bone tissues possess an organic matrix, collagen.
▪ Vitamin C is useful in iron and hemoglobin
metabolism.
▪ Recently, vitamin C has been found to play a role in
synthesis of neurotransmitters, neuropeptide
hormone synthesis and in immune response.
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Vitamin C
Deficiency
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Factors Contributing to Vitamin C
Deficiency:

▪ Total body storage of vitamin C is 1500 mg, and

clinical features of deficiency occurs after the level
is reduced to 350 mg.
▪ Vitamin C deficiency can be caused by low dietary
intakes.
▪ Deficiency may also be caused by conditions in
which the metabolic demands for ascorbic acid may
exceed the rate of its endogenous biosynthesis,
thus increasing the turnover of the vitamin in the
body.
▪ Risk factors for vitamin C deficiency includes:
▪ Alcoholism
▪ Babies who are fed only cow milk during the 1st year of life.
▪ Seniors only consuming tea and toast diet.
▪ Smokers
▪ Type 1 diabetes patients who have high vitamin C
requirements.
▪ Poor people who are not able to afford fruits and vegetables.
▪ Individuals with eating disorders.
▪ Individuals with GIT disorders like inflammatory bowel
diseases.
▪ Individuals with iron overload, which leads to wasting of
vitamin C by the kidneys.
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General Signs of Vitamin C
Deficiency:

Organ System/Function Signs

Appetite Decreased

Growth Decreased

Immunity Decreased

Heat Resistance Decreased

Muscular Skeletal Muscle Atrophy

Increased capillary fragility,
Vessels
hemorrhage
Nervous Tenderness
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Scurvy:

▪ Vitamin C deficiency in food or as a conditioned

deficiency results in scurvy.
▪ Classic scurvy is manifested in human adults after
45-80 days of stopping vitamin C consumption.
▪ Signs of the disease occur primarily in mesenchymal
tissues.
▪ The deficiency of Vitamin C in non-breastfeeding
infants of 6 to 12 months is called Infantile Scurvy or
Moeller-Barlow’s disease.
▪ Scorbutic children may present with a limp or an
inability to walk, tenderness of the lower limbs,
bleeding of the gums and petechial hemorrhages.
▪ The lesions and clinical manifestations of scurvy are
seen more commonly at two peak ages: in early
childhood and in the very aged. These are as under:
1. Lesions in Teeth & Gums:
➢ Scurvy may interfere with development of dentin.

➢ The gums are soft and swollen, may bleed readily and
get infected commonly.
2. Anemia:
➢ Anemia is common in scurvy. It may be the result of
hemorrhage, interference with formation of folic acid or
deranged iron metabolism.
➢ Accordingly, anemia is most often normocytic
normochromic type; occasionally it may be
megaloblastic or even iron deficiency type.
 • Lesions in Teeth
& Gums

• Lesions in scurvy
3. Hemorrhagic Diathesis:
➢ A marked tendency to bleeding is characteristic of
scurvy.
➢ This may be due to deficiency of intercellular
cement which holds together the cells of capillary
endothelium.
➢ There may be hemorrhages in the skin, mucous
membranes, gums, muscles, joints and underneath
periosteum.
4. Skeletal Lesions:
➢ These changes are more pronounced
in growing children.
➢ The most prominent change is
deranged formation of osteoid matrix
and not deranged mineralization.
➢ Growing tubular bones as well as flat
bones are affected.
➢ Due to vitamin C deficiency, laying
down of osteoid matrix by osteoblasts
is poor and results in failure of
resorption of cartilage.
➢ Consequently, mineralized cartilage
under the widened and irregular
epiphyseal plates project as scorbutic Scorbutic Rosary
rosary.
5. Delayed Wound Healing:
➢ There is delayed healing of wounds in scurvy due to:

• Deranged collagen synthesis.

• Poor preservation and maturation of fibroblasts.

• Localization of infections in the wounds.

6. Skin Rash:
➢ Hyperkeratotic and follicular rash may occur in
scurvy.
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Treatment:
▪ Involves administering vitamin C supplements by
mouth or by injection.
▪ The recommended dosage for adults is
▪ 1000 mg per day for at least 1 week
▪ 300-500 mg for 1 week
▪ Within 24-72 hours, people can expect to see an
improvement in fatigue, lethargy, pain, anorexia, and
confusion. Bone changes can take a few weeks to
resolve.
▪ After 3 months, a complete recovery is possible. Long-
term effects are unlikely, except in the case of severe
dental damage.
 Guided by :- Dr. Paresh Sir & Dr. Charmi Ma’am

Thank You For

Your Attention

Prepared by :- Sajidhusain Vijapura (115), Purva Vingle (116), Purva Virpariya (117),
Mayur Vora (118), Priyanka Wankhede (119), Kush Zinzala (120)