Learn About the 15 Signs and Symptoms of Vitamin C Deficiency.

Some of the common signs of vitamin C deficiency are fatigue, bumpy skin, and easy bruising. There are also some medical problems, such as anorexia, which increase the risk of having this deficiency. Vitamin C is one of the most vital nutrients, which humans need to consume on a regular basis for good health. Vitamin C deficiency is relatively rare in countries that are developed, as there is easy availability of fresh products compounded with the addition of vitamin C to some supplements and foods; however, around 7% of Americans are still affected with this deficiency ⁽¹⁾.

Some of the risk factors for vitamin C deficiency are poor diet, anorexia, alcoholism, acute mental illness, dialysis, and smoking ^{(2), (3)}.

The symptoms of acute vitamin C deficiency can take many months to occur; however, there are some faint indications to look for.

Given below are 15 commonest signs and symptoms of vitamin C deficiency:

Bumpy and Rough Skin
Vitamin C has a huge role in the production of collagen, which is a protein found in abundance in connective tissues, such as hair, skin, bones, joints, and blood vessels ⁽⁴⁾.

In case of low levels of vitamin C, there is the development of keratosis pilaris which is a skin condition. This condition is characterized by bumpy “chicken skin” seen commonly on the back of the upper arms, buttocks, or thighs due to the accumulation of keratin within the pores ⁽⁵⁾. Keratosis pilaris occurs as a result of vitamin C deficiency with the duration of insufficiency of this vitamin for about three to five months and it resolves with adequate vitamin C supplementation ⁽⁶⁾^.
Hair Follicles that are Bright Red in color
Hair follicles present on the skin’s surface have many minute blood vessels which supply nutrients and blood to the area. In case of vitamin C deficiency in the body, these blood vessels increase in fragility and easily break resulting in the development of small, bright red spots surrounding the hair follicles. This is known as perifollicular hemorrhage and is a classic sign of acute vitamin C deficiency ⁽⁷⁾. This condition is easily resolved in a couple of weeks by taking vitamin C supplements ⁽⁸⁾.
Development of Corkscrew-Shaped Body Hair
Deficiency of vitamin C can also cause the hair to grow in coiled or bent shapes due to defects in the hair protein structure ⁽⁹⁾. Corkscrew-shaped hair is one of the important features of vitamin C deficiency; however, it may not be clear to the eye, as these hairs that are damaged can easily break or fall out ⁽¹⁰⁾. Abnormalities of the hair often resolve within a month of taking treatment consisting of sufficient amounts of vitamin C ⁽¹¹⁾.
Spoon-Shaped Fingernails with Lines or Red Spots
Spoon-shaped nails are concave in shape along with being brittle most of the times. This kind of nails is commonly seen with iron deficiency anemia; however, also are seen with vitamin C deficiency ⁽¹²⁾.

Vertical lines or red spots seen in the nail bed are also known as splinter hemorrhage and can be caused by vitamin C deficiency due to fragile blood vessels which break easily.
Bruising Easily
Bruising is a result of rupturing of blood vessels beneath the skin leading to seepage or leakage of blood to the surrounding regions. Bruising easily is one of the common indications of vitamin C deficiency because poor collagen production results in weak blood vessels that cause easy bruising ⁽¹³⁾. Bruises that are related to vitamin c deficiency can be large in size or can look like small, purple dots present under the skin ^{(14), (15)}.
Dry and Damaged Skin
Skin that is healthy contains a lot of vitamin C, more so in the epidermal layer of the skin ⁽¹⁶⁾. Vitamin C helps in keeping the skin healthy by preventing oxidative damage caused by exposure to pollutants and sun ^{(17), (18)}. Vitamin C also helps in promoting the production of collagen, which is responsible for keeping the skin youthful and plump ⁽¹⁹⁾. Increased intake of vitamin C gives better skin quality and reduced intake of vitamin C is associated with a 10% increased risk of having wrinkled and dry skin ⁽²⁰⁾. Vitamin C deficiency can cause dry and damaged skin; however, there are other causes also.
Delayed Healing of the Wounds
As vitamin C deficiency delays the rate of collagen formation, there is slow healing of the wounds ⁽²¹⁾. Studies have shown that individuals having chronic leg ulcers, which are non-healing are more likely to be deficient in vitamin C than those without chronic leg ulcers ⁽²²⁾. In people with extreme vitamin C deficiency, there can also be reopening of old wounds, which increases the risk of infection ^(23),⁽²⁴⁾. Delayed wound healing is one of the advanced indications of vitamin C deficiency and is usually not seen till the patient has been deficient for several months ^{(25), (26)}.
Weak Bones
Bone health also gets affected with vitamin C deficiency. Decreased consumption of vitamin C is associated with increased risk of osteoporosis and fracture ^{(27), (28)}. According to studies, vitamin C plays an important role in the formation of bones. So, any deficiency causes rapid bone loss ⁽²⁹⁾. The bones of children are more affected by deficiency of vitamin C, as they are still in the growing and developing stage ^{(30), (31)}.
Swelling and Pain in the Joints
There is a lot of connective tissue rich in collagen present in the joints and can be affected by vitamin C deficiency. Severe joint pain associated with vitamin C deficiency has been seen in patients so much that it can cause difficulty walking or cause the patient to limp ⁽³²⁾.

Bleeding can also occur within the joints in people suffering from vitamin C deficiency causing swelling and increased pain ⁽³³⁾. However, these symptoms are easily treatable with vitamin C supplements and usually subside in a week ⁽³⁴⁾.
Tooth Loss and Bleeding Gums
Gums that are bleeding and are red and swollen are another common sign of vitamin C deficiency. Lack of sufficient vitamin C causes the gum tissue to become weak and inflamed and leads to easy bleeding from the gums ⁽³⁵⁾. In severe cases of vitamin C deficiency, the gums can also turn purple in color and start to rot ⁽³⁶⁾. With time, the patient loses their teeth because of unhealthy gums and fragile dentin ⁽³⁷⁾.
Weak Immunity
According to studies, vitamin C accumulates within different forms of immune cells to help in fighting infection and killing the disease-causing pathogens ^{(38), (39)}. Vitamin C deficiency causes poor immunity and increased risk of infection, such as pneumonia ^{(40), (41)}. Many people suffering from scurvy, which is a disease caused by deficiency of vitamin C; pass away eventually due to infection caused from weak immune system ⁽⁴²⁾.
Long-Term Iron Deficiency Anemia
Vitamin C and iron deficiency anemia often go hand in hand. Signs of iron deficiency anemia consist of fatigue, headache, paleness, difficulty in breathing when exercising, dry hair and skin; and spoon-shaped fingernails ⁽⁴³⁾. Decreased levels of vitamin C also can be a contributing factor of iron deficiency anemia; low vitamin C means low absorption of iron ^{(44), (45)}. The risk of excessive bleeding is also there with vitamin C deficiency, which can cause anemia ⁽⁴⁶⁾.
Poor Mood and Fatigue
Bad mood and fatigue are two of the initial signs of vitamin C deficiency ⁽⁴⁷⁾. These symptoms can also be seen before a complete deficiency of vitamin C occurs or other symptoms appear ⁽⁴⁸⁾. Irritability and fatigue might be the initial first symptoms to appear when suffering from vitamin C deficiency, they; however, often resolve after a few days of sufficient vitamin C intake or in case of high-dose supplementation within 24 hours ⁽⁴⁹⁾.
Oxidative Stress and Chronic Inflammation
Vitamin C is one of the vital water-soluble antioxidants of the body. This vitamin helps in preventing damage to the cells by neutralizing the free radicals causing inflammation and oxidative stress in the body. Inflammation and oxidative stress are also associated with many chronic diseases, such as diabetes and heart disease ^{(50), (51)}.

Reduced intakes of vitamin C are also associated with increased inflammation and oxidative stress along with a higher risk of heart disease ^{(52), (53)}. A study showed that individuals with extremely low blood levels of vitamin C were almost at a 40% increased risk of developing heart failure within 15 years compared to those having maximum blood levels of this vitamin ⁽⁵⁴⁾.
Unintentional Weight Gain
Vitamin C helps in protecting against obesity by managing the release of fat from the fat cells, decreasing the stress hormones and alleviating inflammation ⁽⁵⁵⁾.

There are a lot of studies showing the link between excess body fat and low intake of vitamin C; however, it is not clear if it is a cause and effect relationship ^{(56), (57)}. Reduced blood levels of vitamin C are also associated with an increased amount of belly fat, even in individuals who are at their normal weight ⁽⁵⁸⁾.

What are the Best Food Sources of Vitamin C?

The recommended daily intake of vitamin C for women is 75 mg and for men is 90 mg ⁽⁵⁹⁾. People who smoke need an additional 35 mg per day, as tobacco decreases the absorption of vitamin C along with increasing the body’s use of the nutrient ⁽⁶⁰⁾.

Prevention of scurvy requires very little vitamin C as much as 10 mg in a day, which is more or less found in the juice of half a lemon or one tablespoon of fresh bell pepper ^{(61), (62)}. Some of the best food sources of vitamin C are: guava, acerola cherry, blackcurrants, kiwifruit, sweet red pepper, lychee, orange, lemon, strawberry, papaya, parsley, and broccoli.

Vitamin C breaks down rapidly upon exposure to heat, so raw vegetables and fruits are better sources of vitamin C than cooked ones ⁽⁶³⁾. As the body does not store huge amounts of vitamin C, therefore, it is advised to consume fresh vegetables and fruits daily. Vitamin C supplements are not usually harmful; however, taking more than 2,000 mg in a day can cause diarrhea, abdominal cramps, and nausea along with increasing the risk of having oxalate kidney stones in males ^{(64), (65)}. Excessive vitamin C, which is more than 250 mg in a day, can also hinder tests results that are done to detect blood in the stomach or stool and therefore should be discontinued about a minimum of two weeks before any testing ⁽⁶⁶⁾.

Conclusion

Vitamin C deficiency is seen relatively less in developed countries; however, it can still affect more than 1 in 20 individuals. As humans cannot produce vitamin C or store it in huge quantities, it needs to be consumed on a regular basis in the form of foods, such as vegetables and fruits to prevent deficiency. Most of the signs and symptoms of vitamin C deficiency are associated with problems in collagen production or insufficient consumption of antioxidants.

Common initial signs of vitamin C deficiency are: rough, bumpy skin, red gums, fatigue, easy bleeding and bruising, and joint pain. As there is worsening of vitamin C deficiency, there is an increase in the bones and nails becoming brittle along with deformities of hair, delayed healing of the wounds, and weakening of the immune system.

Iron-deficiency anemia, inflammation, and unexplained weight gain are other signs to look out for. The good thing is all the symptoms of vitamin C deficiency are commonly resolved after replenishment of vitamin C.

Referral Links:

Learn About the 15 Signs and Symptoms of Vitamin C Deficiency.

Given below are 15 commonest signs and symptoms of vitamin C deficiency:

What are the Best Food Sources of Vitamin C?

Conclusion

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Learn About the 15 Signs and Symptoms of Vitamin C Deficiency.

Given below are 15 commonest signs and symptoms of vitamin C deficiency:

What are the Best Food Sources of Vitamin C?

Conclusion

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