Vitamin C (also known as ascorbic acid) is readily available in fruits and vegetables. Many drinks and beverages are now fortified with Vitamin C and the tablet or syrup is readily available as over-the-counter (OTC) medicines in several countries. Insufficient Vitamin C intake leads to scurvy in severe cases.
Why is Vitamin C so important? It is an antioxidant that facilitates the growth and restoration of bones, gums and body tissue. So it is essential for normal body metabolism and growth.
How much Vitamin C do we need daily? This depends on several factors such as metabolic rates, weight and age. The human body ordinarily stores about 1500mg of Vitamin C. Most scientists agree that a minimum of 10mg is needed daily. Recommended daily allowance ranges from one country to another. It may be as low as 30mg for moderately active adults. According to Food and Drug Administration (US) adults need 75mg to 90mg of vitamin daily.
When the body’s store of Vitamin C is depleted, the individual begins to experience problems.
What are some common problems you should look out for?
Body weakness, Muscle and Joint pains, bruising and susceptibility to infections are early signs of Vitamin C deficiency. In Children, irritability and difficulty in walking may be seen [i]. Persisting Vitamin C deficiency may lead to appearance of additional problems such as anorexia, low grade fever, dry skin, bleeding and swollen gums, tooth loss and poor wound healing.
In severe cases, Scurvy, a life threatening becomes established. It is an uncommon health condition in developed countries. Generally, certain conditions may make you susceptible to Vitamin C deficiency:
- Conditions associated with increased need for Vitamin C
- Pregnant and breastfeeding women due to higher need for vitamin C
- Health conditions that metabolize Vitamin C eg Diabetes
- Conditions associated with inadequate intake
- Non-breast fed Babies on infant formula during the first year.
- Elderly individuals
- Persons of low socioeconomic status that don’t include fruits and vegetables in their meals
- Malnourished children or adults eg refugees
- Alcohol and drug users
- Impaired absorption and metabolism
- Chronic bowel disorders eg Crohn’s disease
- Cigarette smokers
What investigations are needed? The doctor may need a detailed assessment of your intake of Vitamin C and rule out conditions that may present in similar ways. Signs of scurvy may be seen physically. Blood and urine test may be used to determine Vitamin C levels in the body. Sometimes, X-rays may be requested to assess the impact on the bones.
Can it be treated and prevented? Yes. Vitamin C supplementation and eating vitamin C rich foods may be all that is needed to achieve a gradual and full recovery.
Although many food items like sugar, cereals and oils are now fortified with vitamin C, the healthiest choice remains fresh produce, fruits and vegetables. Oranges, lemons, tomatoes, spinach and other commonly available food items are rich in vitamin C.
You should know that fresh foods have additional nutritional benefits and retain more Vitamin C during preparation and cooking.
To retain maximum levels of Vitamin C during preparation and cooking take the following steps recommended by WHO[ii]:
- Use a small amount of water to prepare foods.
- Do not cut vegetables into small pieces before cooking.
- Cover cooking pot to reduce time, or use a pressure cooker where available.
- Cook at high temperature for a short period.
- Do not store cooked foods prior to eating them.
Yes, you can prevent Vitamin C deficiency by making a healthy, Vitamin C rich balanced diet a part of your routine.
[i] Kitcharoensakkul M, Schulz CG, Kassel R, Khanna G, Liang S, Ngwube A, Baszis KW, Hunstad DA, White AJ. Scurvy revealed by difficulty walking: three cases in young children. J Clin Rheumatol. 2014 Jun;20(4):224-8. doi: 10.1097/RHU.0000000000000101..