Vitamin
C is an essential nutrient and must be consumed regularly to prevent
deficiency. Although the deficiency in developed countries is relatively rare
due to the supply of fresh produce and the addition of vitamin C to certain
foods and supplements, it still affects approximately 7% of adults. The most
common risk factors for vitamin C deficiency are poor diet, alcoholism,
anorexia, severe mental illness, smoking, and dialysis (According to Some
Sources). Severe vitamin C may take several months to form, and there are some
subtle signs to watch out. These are the 15 most common signs and symptoms of
vitamin C deficiency.
Vitamin
C plays a key role in the production of collagen, which is rich in connective
tissues such as skin, hair, joints, bones and blood vessels. When vitamin C
level is low, a known skin condition can develop due to keratosis pilaris. In
this case, because keratin accumulates in the pores, uneven "chicken
skin" will be formed on the back of the upper arms, thighs or buttocks .
Inadequate intake for several months was resolved with supplements intake.
However, keratosis pilaris has many other potential causes, so its existence
alone is not enough to diagnose the defect. On the arms, thighs or buttocks.
However, these masses alone are not enough to diagnose defects.
When
the level of vitamin C is low, there is a defect in the formation of cementum
material between cells in connective tissue, bones and dentin, leading to
weakening of capillaries, subsequent bleeding and bone defects in their related
structure. Injuries may cause poor bone growth. Fibrous tissue is formed
between the diaphysis and epiphysis, and the junction of costal cartilage is
enlarged. Densely calcified cartilage fragments are embedded in fibrous tissue.
Subperiosteal bleeding can occur in children or adults, sometimes due to small
fractures.
In
adults, vitamin C deficiency symptoms can occur after a few weeks or months
when vitamin C starts to deplete. Signs like Fatigue, weakness, irritability,
weight loss, and vague myalgias and arthralgias may appear earlier. Symptoms of
scurvy (related to connective tissue defects) will appear after a few months of
deficiency. Hyperkeratosis, curls, and bleeding around the hair follicle may
occur. The gums will be swollen, purple, spongy and brittle; they will bleed
easily when they are severely lacking. Over time, the teeth loosen and become
avulsed. Secondary infections can develop. Wounds heal poorly and are easy to
tear. Spontaneous bleeding may occur, especially skin bruises or bulbar
conjunctival hemorrhage of the lower extremities. Other symptoms and signs
include femoral neuropathy due to hemorrhage of the femoral sheath (similar to
deep vein thrombosis), lower extremity edema, and painful bleeding or exudation
in the joints. In infants, symptoms include irritability, pain during exercise,
anorexia, and slow growth. In infants and children, bone growth is impaired and
bleeding and anemia may occur.
In
adults, vitamin C deficiency symptoms can occur after a few weeks or months
when vitamin C starts to deplete. Signs like Fatigue, weakness, irritability,
weight loss, and vague myalgias and arthralgias may appear earlier. Symptoms of
scurvy (related to connective tissue defects) will appear after a few months of
deficiency. Hyperkeratosis, curls, and bleeding around the hair follicle may
occur. The gums will be swollen, purple, spongy and brittle; they will bleed
easily when they are severely lacking. Over time, the teeth loosen and become
avulsed. Secondary infections can develop. Wounds heal poorly and are easy to
tear. Spontaneous bleeding may occur, especially skin bruises or bulbar
conjunctival hemorrhage of the lower extremities. Other symptoms and signs
include femoral neuropathy due to hemorrhage of the femoral sheath (similar to
deep vein thrombosis), lower extremity edema, and painful bleeding or exudation
in the joints. In infants, symptoms include irritability, pain during exercise,
anorexia, and slow growth.
How
Vitamin C Difficiency is diagnosed?
As
clinical (based on skin or gum examination results and risk factors) The
diagnosis of vitamin C deficiency is usually a clinical diagnosis in patients
who have skin or gum signs and are at risk for vitamin C deficiency. May
require laboratory confirmation. blood count is performed and usually checked
for anemia. Bleeding, clotting and prothrombin time are normal. Bone X-rays can
help diagnose scurvy in children (but not adults). This change is most
pronounced at the ends of long bones, especially the knees. The first change is
similar to shrinking. The loss of trabeculae results in the appearance of
frosted glass. The crust is thinning. Calcified irregular cartilage lines
(Fraenkel white lines) can be seen in the metaphysis. The proximal and parallel
sparse areas or linear fractures may only have triangular defects visible on
the lateral edge of the bone, but it is specific. The epiphysis may be
compressed. The healing of subperiosteal hemorrhage can increase and calcify
the periosteum. Laboratory diagnosis requires the measurement of ascorbic acid
in the blood, sometimes in academic centers.
