hey everyone this lesson is on vitamin C deficiency so in this lesson we're gonna
talk about the signs and symptoms of vitamin C deficiency we're also going to
talk about the condition known as scurvy we're also going to talk about why we
get those particular signs and symptoms and we're gonna talk about what we can
do to diagnose it and what we can do to treat it so vitamin c deficiency is
caused by a reduced dietary intake particularly of citrus fruits and other
fruits and vegetables if you haven't watched my other lesson on vitamin C
absorption and metabolism please check out that lesson for more
details so if we do have a reduced dietary intake for whatever reason we
can have issues with collagen synthesis catecholamine synthesis and carnitine
biosynthesis so vitamin c plays a critical role in collagen synthesis
catecholamine synthesis and carnitine biosynthesis along with synth
synthesizing nitric oxide and prostaglandin metabolism as well so
there are many functions with which vitamin C is critically important and a
lot of the symptoms have to do with issues in each of these downstream
pathways so we're going to talk about how and why these symptoms occur but
first vitamin C deficiency what is it what we actually call it we actually
call a condition of vitamin C deficiency as scurvy so what do we get it who gets
vitamin C deficiency well vitamin C deficiency or scurvy is
considered a historical condition but it can still happen in today's society it
generally occurs in severely malnourished individuals as we talked
about before it's due to a reduced dietary intake particularly of citrus
fruits and other vegetables so patients or people who get vitamin C deficiency
or get scurvy include institutionalized patients chronic alcohol abusers and
individuals with a chronic illness these three sets of patients are the big
category of patients that are at risk for scurvy or at risk for vitamin C
deficiency in vitamin C deficiency symptoms can begin within three months
of decreased vitamin C intake so in one of these individuals that we
talked about before if there's been about three months or more of reduced or
absent dietary intake of vitamin C we can start to see symptoms even within
three months and symptoms usually occur when vitamin C levels go below a certain
level and that's levels about less than 0.2 milligrams per deciliter or less
than eleven micromoles per litre so what are the signs and symptoms of scurvy or
vitamin C deficiency I've broken them down into specific categories the first
one is dental so these include gingivitis bleeding gums receding gums
and dental caries so these people are at risk so you can see in this image here
receding gums you can see that there's likely more issues with dental caries as
well so more cavities and this is again because of that requirement of vitamin C
for collagen synthesis a lot of this the dentin and teeth and other structures
are synthesized in made with collagen so if we don't have proper collagen
production we're gonna have issues with these structures another category of
symptoms and signs include hematological and connective tissue issues
these include ecchymosis so bruising petechiae and hemolytic anemia so all of
these can be caused by issues in other pathways as well another category of
signs and symptoms include integrity and rheumatological issues this includes
impaired wound healing this makes sense we need collagen for wound healing scars
are made of collagen we also get follicular hyperkeratosis we also get
what we call coiled hair so the quality of hair is just not the same as it used
to be peri follicular hemorrhages also occur so you may see a picture or see a
patient with their skin and all are surrounding their follicles of hair we
see these little dots of hemorrhage we can also see joint pain again joints and
the articular surfaces all require good collagen and good collagen
and maintenance we can also see a sort of Sjogren's syndrome as well systemic
issues of scurvy include psychiatric issues like depression we can also have
fatigue weakness anorexia neuropathy we can also have hypotension again vitamin
C is required for synthesizing catecholamines like nor epinephrine and
norepinephrine acts as a vase of and stricter so that helps us with
maintaining our blood pressure so we're gonna get hypotension we're also gonna
see dis me as well and if scurvy and vitamin C deficiency lasts and is
prolonged it can actually lead to sudden death as well so very serious condition
that cannot be missed that should be picked up because the treatment is very
simple and we'll talk about that in the next slide so now that we know the signs
and symptoms of vitamin C deficiency in scurvy how to make the diagnosis the
diagnosis is via checking a plasma and leukocyte in vitamin C level measurement
so generally speaking leukocyte vitamin C levels are the better measurement so
check the leucocyte vitamin C levels so you're generally gonna see with vitamin
C deficiency or scurvy low plasma and leukocyte vitamin C levels that makes
sense and so that can help you with the diagnosis you're also going to see a lot
of these other signs and symptoms we talked about earlier so once we make the
diagnosis how do we treat it treatment is simple again it just requires vitamin
C supplementation so we just have to replenish the patient's vitamin C and we
generally break this down depending on if the patient's a child or an adult in
children we use 100 milligrams of vitamin C three times a day for one week
and then we go to 100 milligrams once a day for several weeks until symptoms and
other issues have resolved in adults we use 300 to 1000 milligrams of vitamin c
daily for one month and resolution of symptoms can be quite quick so some of
the constitutional symptoms can actually resolve within 24 hours and besides
simply supplementing with vitamin C you there are dietary option
to get vitamin C from food sources these again include fruits so citrus fruits
tomatoes strawberries some of the things we've talked about before and also a
number of vegetables as well potatoes Brussels sprouts broccoli cauliflower
cabbage spinach those types of vegetables a quick recap of the lesson
so we get vitamin C from our diet it's an essential vitamin that's found in a
variety of fruits and vegetables if we don't get enough vitamin C we get a
deficiency leading to the condition known as scurvy and scurvy has a wide
variety of signs and symptoms including dental issues like
receding gums and dental caries we also can see issues with hematological
conditions we can see issues with intake matteri rheumatological systems and we
can have systemic issues like depression fatigue weakness and others as well and
once we see those signs of symptoms we can confirm the diagnosis through
checking a leukocyte vitamin C level which is going to be low and we're gonna
treat the condition with vitamin C supplementation and remember it's
different with children and adults generally symptoms like the
constitutional symptoms will generally resolve within 24 hours and some of the
other symptoms like bleeding gums may last for a few weeks and instead of just
taking a pill for the vitamin C you can get vitamin C from your diet as well
again some of those fruits like citrus fruits tomatoes strawberries and a
variety of vegetables as well so if you haven't already please check out my
lesson on vitamin C absorption and metabolism and if you haven't already
please consider liking subscribing and clicking the notification Bell to help
support the channel and thank you so much for watching and I hope to see you
next time