Understanding Vitamin C Deficiency

In summary

Vitamin C deficiency occurs when your body does not receive enough vitamin C, also known as ascorbic acid, over time. Vitamin C supports immune function, collagen formation, wound healing and iron absorption. Severe deficiency can cause scurvy and symptoms such as fatigue, swollen or bleeding gums and poor wound healing.

Key takeaways 

• Vitamin C is an essential nutrient required for several physiological functions.
• Vitamin C supports collagen formation and wound healing.
• It helps the body absorb iron from plant-based foods.
• Severe vitamin C deficiency can lead to scurvy.
• Fruits and vegetables are important dietary sources of vitamin C.
• Diagnosis and treatment depend on the severity and underlying cause of deficiency.

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Vitamin C deficiency occurs when your body does not receive enough vitamin C, also known as ascorbic acid, for normal physiological functions. Humans cannot produce vitamin C, so you need to obtain it through food or supplements. Prolonged deficiency can lead to scurvy, a condition associated with impaired collagen formation and wound healing. Common symptoms can include fatigue, weakness, swollen or bleeding gums, easy bruising and slow wound healing. The severity of symptoms depends on the extent and duration of the deficiency.

Vitamin C is a water-soluble vitamin that supports collagen production, wound healing, immune function and iron absorption. It also acts as an antioxidant, helping protect cells from oxidative stress caused by free radicals.

Vitamin C deficiency can result from inadequate dietary intake, reduced absorption or increased nutritional requirements. People who smoke require 35 mg more vitamin C per day than non-smokers because smoking increases oxidative stress and vitamin C requirements.

The signs and symptoms of vitamin C deficiency develop as vitamin C stores decline and can progress to scurvy. Symptoms result mainly from impaired collagen formation and weakened connective tissues. Common signs include:

1. Fatigue and weakness: Low vitamin C levels can cause fatigue, weakness and general malaise.
2. Mood changes: Irritability and depression can occur as deficiency progresses.
3. Keratosis pilaris: Follicular hyperkeratosis can cause rough, thickened skin around hair follicles.
4. Perifollicular haemorrhage: Small areas of bleeding can develop around hair follicles.
5. Corkscrew-shaped hair: Hair can become coiled, dry and brittle.
6. Bleeding gums: Gums can become swollen, inflamed and prone to bleeding.
7. Easy bruising: Weakened blood vessels can cause bruising and small skin haemorrhages.
8. Slow wound healing: Impaired collagen formation can delay wound healing.
9. Joint pain: Deficiency can cause joint pain, muscle aches and, in some cases, bleeding around joints.
10. Weak bones: Severe deficiency can impair bone formation and growth, particularly in children.
11. Iron-deficiency anaemia: Reduced iron absorption and blood loss can contribute to anaemia.
12. Secondary infections: Connective-tissue damage and untreated scurvy can be associated with secondary infections.

These symptoms can have other causes, so persistent or multiple symptoms require medical assessment.

Vitamin C deficiency is diagnosed through a combination of a clinical assessment and blood test. A healthcare professional may examine symptoms such as bleeding gums, skin changes, easy bruising, joint pain and poor wound healing. A blood test can measure the plasma vitamin C or ascorbic acid level to assess vitamin C status. The results are interpreted alongside symptoms, dietary history and relevant medical conditions. Severe deficiency can indicate scurvy, particularly when characteristic symptoms are present. NIH guidance identifies plasma vitamin C measurement as the usual laboratory method for assessing vitamin C status.

Vitamin C deficiency is treated by increasing vitamin C intake through a nutritious diet and supplements when required. Foods such as citrus fruits, strawberries, peppers and broccoli provide vitamin C. For scurvy in adults, one clinical regimen uses 500–1,000 mg of ascorbic acid orally once daily for 1–2 weeks, under medical supervision.

Common supplement forms include ascorbic acid, sodium ascorbate and calcium ascorbate. Research has not established that one form is better than another.

Treatment should account for the underlying cause, particularly when deficiency results from malabsorption or another medical condition.

You can prevent vitamin C deficiency by meeting your daily vitamin C requirement through a varied diet and appropriate supplementation when needed. Adults need 75 mg per day for women and 90 mg per day for men. People who smoke need an additional 35 mg per day because smoking increases vitamin C requirements.

• Eat vitamin C-rich foods: Include citrus fruits, guava, strawberries, peppers, broccoli and tomatoes in your diet.
• Preserve vitamin C during cooking: Eat some foods raw or lightly cooked. Steaming or microwaving can reduce nutrient losses compared with prolonged cooking in water.
• Avoid smoking: Smoking increases vitamin C requirements and can lower vitamin C status.
• Consider supplements: If your diet does not provide enough vitamin C, discuss supplementation with a healthcare professional.

Adult men need 90 mg of vitamin C per day, while adult women need 75 mg per day. Requirements vary by age and life stage. Pregnant and breastfeeding women require higher amounts. People who smoke need an additional 35 mg per day because smoking increases vitamin C requirements.

Fruits and vegetables are important sources of vitamin C, including citrus fruits, peppers, kiwi, strawberries and broccoli. Indian sources such as amla (Indian gooseberry) and guava also provide vitamin C. Acerola cherries and blackcurrants are particularly rich sources. The table shows vitamin C content and the percentage of the 90 mg Daily Value provided by each serving.

People who smoke, follow highly restrictive diets, have limited food variety, or have conditions that affect nutrient absorption are more likely to develop inadequate vitamin C intake. People receiving chronic haemodialysis can also have low vitamin C levels.

Eating a varied diet containing fruits and vegetables can help you meet your vitamin C requirement and prevent deficiency. Indian choices such as guava, amla and tomatoes can be included alongside global sources such as oranges, peppers, kiwi and strawberries. Vitamin C is sensitive to heat and water, so prolonged cooking can reduce its content. Choose fresh foods where practical, and use steaming or microwaving to limit cooking losses.