Vitamin C deficiency, scurvy, pharmacologic use of vitamin C in various diseases

1. Vitamin C deficiency
Domina Petric, MD

2. Factors contributing to vitamin C
deficiency
• Vitamin C deficiency can be caused
by low dietary intakes.
• Deficiency may be also 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.
April 14, 2018
Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
2

3. Factors contributing to vitamin C
deficiency
April 14, 2018
Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
3

4. General signs of vitamin C deficiency
Organ system/function Signs
Appetite Decreased
Growth Decreased
Immunity Decreased
Heat resistance Decreased
Muscular Skeletal muscle atrophy
Vessels Increased capillary
fragility, hemorrhage
Nervous Tenderness
April 14, 2018
Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
4

5. 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.
April 14, 2018
Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
5

6. Scurvy
Defects in collagen formation are manifested as:
• impaired wound healing
• edema
• hemorrhage (due to deficient formation
of intercellular substance) in the skin,
mucous membranes, internal organs and
muscles
• weakening of collagenous structures in
bone, cartilage, teeth and connective
tissues
April 14, 2018
Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
6

7. Scurvy
Scorbutic adults may present with
swollen, bleeding gums with tooth loss.
April 14, 2018
Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
7
Wikipedia.org

8. Scurvy
• Patients also show lethargy, fatigue,
rheumatic pains in the legs, muscular
atrophy, skin lesions, massive sheet
hematomas in the thighs, ecchymoses
and hemorrhages in many organs
(intestines, subperiosteal tissues
and eyes).
• These features are frequently
accompanied by psychological changes:
hysteria, hypochondria and depression.
April 14, 2018
Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
8

9. Moeller-Barlow disease
• In children the syndrome is
called Moeller-Barlow disease.
• It is seen in non-breastfed
infants usually at about 6
months of age: when maternally
derived stores of vitamin C have
been exhausted.
April 14, 2018
Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
9

10. Moeller-Barlow disease
It is characterized by:
• widening of bone-cartilage boundaries,
particularly of the rib cage
• stressed epiphyseal cartilage of the
extremities
• severe joint pain
• anemia
• fever
April 14, 2018
Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
10
Wordnik

11. Moeller-Barlow 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.
• Response to vitamin C is dramatic:
clinical improvements are seen
within a week of vitamin C therapy.
April 14, 2018
Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
11

12. Pharmacologic uses of vitamin C
• Saturation of vitamin C occurs at
intakes of about 100 mg/day.
• Higher intakes can result in elevated
concentrations of the vitamin in
extracellular fluids (plasma,
connective tissue fluid, humors of
the eye): pharmacologic antioxidant
action.
April 14, 2018
Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
12

13. Gram-size doses of vitamin C have been
advocated for the prophylaxis/treatment of:
• common cold
• Herpes simplex
• general immune support
• cardiovascular diseases
• hypercholesterolemia
• hypertension
• hypertriglyceridemia
• diabetes
• some types of cancer
April 14, 2018
Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
13

14. Literature
• Combs GF. The Vitamins. Fundamental Aspects in
Nutrition and Health. Elsevier Inc. 2008.
April 14, 2018 14