Overview
Vitamin C, also known as L-ascorbic acid, is a water-soluble vitamin that is naturally present in many foods, added to others, and widely used as a dietary supplement. Humans are unable to synthesize vitamin C endogenously, making it an essential dietary nutrient. A major limitation is that vitamin C is highly sensitive to heat, and cooking can lead to loss of nearly seventy percent of its content. Vitamin C is vital for normal growth, tissue repair, and maintenance of multiple metabolic functions.
Symptoms
Vitamin C deficiency presents with a broad spectrum of clinical manifestations. Early symptoms include fatigue, weakness, depression, and reduced immunity. As deficiency progresses, patients may develop dry and rough skin, corkscrew hair, red patches on the skin, anemia, and impaired wound healing. Severe deficiency leads to scurvy, characterized by bleeding gums, swollen and painful joints, easy bruising, petechiae, conjunctival and retinal hemorrhages, and connective tissue defects. In infants and children, deficiency may impair bone growth and cause anemia and bleeding tendencies.
Causes
Vitamin C deficiency is primarily caused by inadequate dietary intake, particularly in individuals with low consumption of fresh fruits and vegetables. Excessive cooking and food processing significantly reduce vitamin C content in food. Malabsorption, chronic illness, smoking, alcoholism, and increased physiological demands such as pregnancy, lactation, and infections contribute to deficiency. Smokers require higher intake due to increased oxidative stress and metabolic turnover of vitamin C. Rarely, excessive supplementation may lead to toxicity.
Risk Factors
Individuals at increased risk include people with poor nutritional intake, elderly individuals, smokers, alcohol dependent patients, and those with chronic diseases. Populations with limited access to fresh produce, infants fed improper diets, and individuals with malabsorption disorders are also vulnerable. Laboratory evaluation is often indicated in patients with unexplained fatigue, anemia, recurrent infections, depression, poor wound healing, or signs of connective tissue weakness. Improper sample handling, delayed serum separation, or inadequate storage can affect test accuracy.
Prevention
Prevention of vitamin C deficiency focuses on adequate dietary intake, proper food preparation, and early detection. Regular consumption of vitamin C-rich foods such as amla, guava, lemon, green leafy vegetables, and certain animal products supports sufficient levels. Avoiding overcooking and consuming fresh or minimally processed foods helps preserve vitamin C content. Blood samples should be collected in plain tubes, serum separated promptly, and samples refrigerated or frozen as recommended to ensure reliable measurement. Early diagnosis and appropriate supplementation prevent complications such as scurvy, anemia, and irreversible connective tissue damage.
