Are You Getting Enough Vitamin C?

We absolutely can't go without our White Element every morning for our daily dose of Vitamin C (and lot's of other goodies!) but things weren't always like this... 

As someone with 1st hand experience of vitamin C deficiency, today's blog post will dive into the key factors behind a lack of Vitamin C and the common symptoms of the deficency, such as weakness, anemia, poor skin health, to name just a few.

 

How much Vitamin C do I need?

Vitamin C supports immunity, development of collagen and boosts absorption of iron, and therefore is a necessary nutrient for good health. 

Vitamin C or ascorbic acid is naturally found in fresh fruits and vegetables; for example, grapefruits, oranges, lemons, limes, potatoes, spinach, broccoli, red peppers, and tomatoes. Up to 90% of vitamin C is consumed in the form of vegetables and fruits. However, as vitamin C is water soluble and heat-sensitive, a vast amount of the nutritional value of the food is lost during preparation (boiling or cooking).

Your body doesn't make or store vitamin C, so you have to eat it every day. Adult women (who aren't pregnant or breastfeeding) need 75 milligrams of vitamin C per day; men, 90 milligrams.⁠ The Mayo Clinic's recommended daily amount for vitamin C is 65 to 90 milligrams (mg) a day, and the upper limit is 2,000 mg a day for adults. 

A diet lacking in fresh fruits and vegetables can lead to vitamin C deficiency. Additionally, those with a poor diet, heavy drinkers, and smokers will need additional vitamin C (approx 35 milligrams per day) to help repair the damage caused by free radicals that form when you expose yourself to those stressors. Clinical signs of vitamin C deficiency occur at intakes of less than 10mg per day (adults). If you're not getting enough vitamin C, you'll notice symptoms within 3 months.⁠

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Here are the 15 most common signs and symptoms of vitamin C deficiency:

1. Rough, Bumpy Skin

Vitamin C plays a key role in collagen production, a protein that is abundant in connective tissues like skin, hair, joints, bones and blood vessels. When vitamin C levels are low, a skin condition known as keratosis pilaris can develop.

In this condition, bumpy “chicken skin” forms on the back of the upper arms, thighs or buttocks due to a buildup of keratin protein inside the pores. Keratosis pilaris caused by vitamin C deficiency typically appears after three to five months of inadequate intake and resolves with supplementation.

However, there are many other potential causes of keratosis pilaris, so its presence alone is not enough to diagnose a deficiency.

 

2. Corkscrew-Shaped Body Hair

Vitamin C deficiency can also cause hair to grow in bent or coiled shapes due to defects that develop in the protein structure of hair as it grows. Corkscrew-shaped hair is one of the hallmark signs of vitamin C deficiency but may not be obvious, as these damaged hairs are more likely to break off or fall out. Hair abnormalities often resolve within one month of treatment with adequate amounts of vitamin C

3. Bright Red Hair Follicles

Hair follicles on the surface of the skin contain many tiny blood vessels that supply blood and nutrients to the area. When the body is deficient in vitamin C, these small blood vessels become fragile and break easily, causing small, bright red spots to appear around the hair follicles. This is known as perifollicular hemorrhage and a well-documented sign of severe vitamin C deficiency. Taking vitamin C supplements typically resolves this symptom within two weeks.

4. Spoon-Shaped Fingernails With Red Spots or Lines

Spoon-shaped nails are characterised by their concave shape and often thin and brittle. They are more commonly associated with iron deficiency anemia but have also been linked to vitamin C deficiency.

Red spots or vertical lines in the nail bed, known as splinter hemorrhage, may also appear during vitamin C deficiency due to weakened blood vessels that rupture easily. While the visual appearance of fingernails and toenails may help determine the likelihood of vitamin C deficiency, note that it’s not considered diagnostic.

5. Dry, Damaged Skin

Healthy skin contains large amounts of vitamin C, especially in the epidermis, or outer layer of skin. Vitamin C keeps skin healthy by protecting it from oxidative damage caused by the sun and exposure to pollutants like cigarette smoke or the ozone. It also promotes collagen production, which keeps skin looking plump and youthful.

High intakes of vitamin C are associated with better skin quality, while lower intakes are associated with a 10% increased risk of developing dry, wrinkled skin. While dry, damaged skin can be linked to vitamin C deficiency, it can also be caused by many other factors, so this symptom alone is not enough to diagnose a deficiency.

6. Easy Bruising

Bruising occurs when blood vessels under the skin rupture, causing blood to leak into the surrounding areas. Easy bruising is a common sign of vitamin C deficiency since poor collagen production causes weak blood vessels. Deficiency-related bruises may cover large areas of the body or appear as small, purple dots under the skin. 

7. Slowly Healing Wounds

When you get hurt, levels of vitamin C in your blood and tissue go down. Your body needs it to make collagen, a protein that plays a role in each stage of repairing the skin. And vitamin C helps neutrophils, a type of white blood cell that fights off infection, work well.

Since vitamin C deficiency slows the rate of collagen formation, it causes wounds to heal more slowly. Research has shown that people with chronic, non-healing leg ulcers are significantly more likely to be deficient in vitamin C than those without chronic leg ulcers.

In severe cases of vitamin C deficiency, old wounds may even reopen, increasing the risk of infection. Slow wound healing is one of the more advanced signs of deficiency and typically not seen until someone has been deficient for many months.

8. Painful, Swollen Joints

Since joints contain a lot of collagen-rich connective tissue, they can also be affected by vitamin C deficiency. There have been many reported cases of joint pain associated with vitamin C deficiency, often severe enough to cause limping or difficulty walking. Bleeding within the joints can also occur in people who are deficient in vitamin C, causing swelling and additional pain. Yet, both of these symptoms can be treated with vitamin C supplements and commonly resolve within one week.

9. Weak Bones

Vitamin C deficiency can also affect bone health. In fact, low intake has been linked to increased risk of fracture and osteoporosis. Research has found that vitamin C plays a critical role in bone formation, so a deficiency can increase the rate of bone loss.

10. Bleeding Gums and Tooth Loss

Red, swollen, bleeding gums are another common sign of vitamin C deficiency. Without adequate vitamin C, gum tissue becomes weakened and inflamed and blood vessels bleed more easily. In advanced stages of vitamin C deficiency, gums may even appear purple and rotten. Eventually, teeth can fall out due to unhealthy gums and weak dentin, the calcified inner layer of teeth.

11. Poor Immunity

Since vitamin C has several jobs related to your immune system, it shouldn't surprise you to learn you're more likely to get sick and may have a harder time recovering. There's some evidence that vitamin C can help protect you from illness such as pneumonia and bladder infections. It may even lower your odds of heart disease and some types of cancer.

Studies show that vitamin C accumulates inside various types of immune cells to help them combat infection and destroy disease-causing pathogens. Vitamin C deficiency is associated with poor immunity and a higher risk of infection, including serious illnesses like pneumonia. 

12. Persistent Iron Deficiency Anemia

Vitamin C and iron deficiency anemia often occur together. Signs of iron deficiency anemia include paleness, fatigue, trouble breathing during exercise, dry skin and hair, headache and spoon-shaped fingernails (40Trusted Source).

Low levels of vitamin C may contribute to iron deficiency anemia by reducing the absorption of iron from plant-based foods and negatively affecting iron metabolism. Vitamin C deficiency also increases the risk of excessive bleeding, which can contribute to anemia. If iron deficiency anemia persists for a long time with no obvious causes, it may be wise to check your vitamin C levels.

13. Fatigue and Poor Mood

In a very small study, 6 of the 7 men who had low levels of vitamin C said they felt tired and irritable. That suggests a link, though other things could be playing a role. Another study of 141 office workers found that giving them vitamin C made them feel less tired within 2 hours, especially if their level was lower to start with. Then the effect lasted for the rest of the day.

Two of the earliest signs of vitamin C deficiency are fatigue and poor mood. These symptoms can even appear even before a full-blown deficiency develops. While fatigue and irritability may be some of the first symptoms to appear, they typically resolve after just a few days of adequate intake or within 24 hours of high-dose supplementation.

14. Unexplained Weight Gain

Early research has found a link between low levels of vitamin C and higher amounts of body fat, especially belly fat. This vitamin may also play a role in how well your body burns fat for energy.

Vitamin C may help protect against obesity by regulating the release of fat from fat cells, reducing stress hormones and decreasing inflammation. Research has found a consistent link between low intake of vitamin C and excess body fat, but it’s not clear whether it is a cause and effect relationship.

Interestingly, low blood levels of vitamin C have been linked to higher amounts of belly fat, even in normal-weight individuals. While excess body fat alone is not enough to indicate a vitamin C deficiency, it may be worth examining after other factors have been ruled out.

15. Chronic Inflammation and Oxidative Stress

Vitamin C is one of the body’s most important water-soluble antioxidants. It helps prevent cellular damage by neutralising free radicals that can cause oxidative stress and inflammation in the body.

Oxidative stress and inflammation have been linked to many chronic illnesses, including heart disease and diabetes, so reducing levels is likely beneficial. Low intakes of vitamin C have been linked to higher levels of inflammation and oxidative stress, as well as an increased risk of heart disease.

One study found that adults with the lowest blood levels of vitamin C were nearly 40% more likely to develop heart failure within 15 years than those with the highest blood levels, even though they were not deficient in vitamin.

Recommendations

The Australian Guide to Healthy Eating recommends 5-6 serves of vegetables per day for adult women and men (19-50 years of age) respectively; 1 serve of vegetables = 1⁄2 cup cooked vegetables or 1 cup of salad vegetables; 1 serve of fruit = 150g.

Table 1: Common vitamin C rich foods

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