Rishi Desai, MD, MPH

Vitamin C deficiency

First Aid 

VITAMIN C DEFICIENCY osms.it/vitamin-c-deficiency PATHOLOGY & CAUSES  SIGNS & SYMPTOMS  ▪ Insufﬁcient vitamin C for body’s metabolic needs ▪ Body cannot synthesize, must obtain in diet ▪ Active form: L-ascorbic acid  ▪ ↓/no intake → symptoms within one month ▪ Mucocutaneous signs ▫ Spongy gums → loose teeth ▫ Capillary fragility → petechiae, ecchymoses, perifollicular hemorrhage, subperiosteal hemorrhage ▫ Hair structure changes → corkscrew hair ▪ Inability to maintain bone matrix ▫ Arthralgias, bone structure changes ▪ Anemia ▫ Fatigue, malaise ▪ Impaired wound healing  RDA ▪ 9–13 years old: 45mg ▪ 14–18 years old: 75 mg (biologically-male); 65mg (biologically-female) ▪ 19+ years old: 90 mg (biologically-male); 75mg (biologically-female) ▪ Pregnancy: 85mg ▪ Lactation: 120mg ▪ Smokers: ↑ 35mg/day  RISK FACTORS Insufﬁcient diet ▪ Food insecurity ▪ Self-imposed dietary restrictions ▪ Chronic systemic disease, mental illness, advanced age ▪ Feeding infants evaporated/boiled cow’s milk ↑ oxidative stress ▪ Smoking, secondhand smoke  COMPLICATIONS  ▪ Scurvy, related sequelae (e.g. periodontal disease; bone, joint disorders) ▪ Impaired wound healing ▪ Weakened immune system ▪ Depression ▪ Microcytic anemia  306 OSMOSIS.ORG  DIAGNOSIS DIAGNOSTIC IMAGING MRI ▪ Sclerotic, lucent metaphyseal bands, soft tissue edema  TREATMENT OTHER INTERVENTIONS  ▪ ↑ dietary/supplementation vitamin C ▫ Present in many fruits, vegetables (especially citrus, tomatoes, broccoli, bell peppers, potatoes) ▫ Supplements, enriched grains ▪ Address complications   

Amino acid metabolism

Nitrogen and urea cycle

Citric acid cycle

Electron transport chain and oxidative phosphorylation

Gluconeogenesis

Glycogen metabolism

Glycolysis

Pentose phosphate pathway

Physiological changes during exercise

Cholesterol metabolism

Fatty acid oxidation

Fatty acid synthesis

Ketone body metabolism

Biochemistry and metabolism

Alkaptonuria

Cystinuria (NORD)

Hartnup disease

Homocystinuria

Maple syrup urine disease

Ornithine transcarbamylase deficiency

Phenylketonuria (NORD)

Essential fructosuria

Galactosemia

Glucose-6-phosphate dehydrogenase (G6PD) deficiency

Hereditary fructose intolerance

Lactose intolerance

Pyruvate dehydrogenase deficiency

Abetalipoproteinemia

Familial hypercholesterolemia

Hyperlipidemia

Hypertriglyceridemia

Glycogen storage disease type I

Glycogen storage disease type II (NORD)

Glycogen storage disease type III

Glycogen storage disease type IV

Glycogen storage disease type V

Mucopolysaccharide storage disease type 1 (Hurler syndrome) (NORD)

Mucopolysaccharide storage disease type 2 (Hunter syndrome) (NORD)

Fabry disease (NORD)

Gaucher disease (NORD)

Krabbe disease

Leukodystrophy

Metachromatic leukodystrophy (NORD)

Niemann-Pick disease type C

Niemann-Pick disease types A and B (NORD)

Tay-Sachs disease (NORD)

Cystinosis

Disorders of amino acid metabolism: Pathology review

Disorders of carbohydrate metabolism: Pathology review

Disorders of fatty acid metabolism: Pathology review

Dyslipidemias: Pathology review

Glycogen storage disorders: Pathology review

Lysosomal storage disorders: Pathology review

Metabolic disorders

Biochemistry

Carbohydrates and sugars

Fats and lipids

Proteins

Carbohydrates, fat and protein

Excess Vitamin A

Excess Vitamin D

Vitamin D deficiency

Vitamin K deficiency

Kwashiorkor

Marasmus

Iodine deficiency

Zinc deficiency

Beriberi

Folate (Vitamin B9) deficiency

Niacin (Vitamin B3) deficiency

Vitamin B12 deficiency

Wernicke-Korsakoff syndrome

Fat-soluble vitamin deficiency and toxicity: Pathology review

Water-soluble vitamin deficiency and toxicity: B1-B7: Pathology review

Zinc deficiency and protein-energy malnutrition: Pathology review

Nutritional disorders

Nutrition

Vitamin C deficiency

Videos

Notes