Optimising Health With Vitamin C |Effects of Deficiency | Scurvy |Pathology | Biochemical Action

Vitamin C, also known as ascorbic acid, is a water-soluble vitamin found in various fruits and vegetables.  Vitamin C is an essential nutrient with nutritional properties that support various body functions, such as collagen synthesis, specific functional health protective functions, and iron absorption.  It is important to include foods rich in vitamin C for general health and wellness.

Sources:

🔸It is a fact that ascorbic acid cannot be synthesized by the human body.

🔸It is found in fruits, especially citrus fruits, and vegetables.

Biochemical Actions:

- Maintains and protects the integrity of intracellular structures.

- Facilitates the absorption of iron.

- Converts folic acid into folinic acid.

- Metabolizes tyrosine into phenylalanine.

- Plays a role in niacin metabolism and serum phosphatase activity in infants.

Pathology:

▪️In vitamin C deficiency, there is impaired formation of collagen and chondroitin sulfate.

▪️This leads to defective dentin formation, resulting in tooth loosening.

▪️Osteoid deficiency leads to decreased endochondral bone formation and bone fractures.

▪️Symptoms include bone degeneration, cardiac hypertrophy, bone marrow depression, and adrenal atrophy.

Effects of Deficiency:

🔹Scurvy :Many symptoms of scurvy are related to deficient collagen formation.

🔹Other effects include poor wound healing, vascular wall fragility leading to bleeding tendency, petechiae, and ecchymoses.

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🔹Excessive bleeding into the joints (hemarthroses) and subperiosteal bleeding are very painful in newborns and can lead to joint damage if not promptly addressed.

🔹This is caused by bone matrix deficiency, which leads to osteoporosis and incomplete fracture healing. In children, bone formation at the epidiaphyseal junctions is disrupted, which appears radiologically as "frayed."

🔹Blood deficiency results from impaired erythropoiesis.

Scurvy:

◾Scurvy can occur at any age but is rare in newborns because the child is born with adequate stores of vitamin C if the mother's diet is sufficient.

◾Irritability, tachypnea, gastrointestinal disturbances, and decreased appetite are vague symptoms.

Legs are commonly affected, leading to pseudoparalysis due to pain. The legs assume a typical "frog-leg position" (hips and knees flexed, with the feet turned towards us). There can be swelling along the shafts of the legs.

◾An occasional subperiosteal hemorrhage can occur.

The distal femurs may appear palpably blue.

Gum hypertrophy with sticky membranes, rapid swelling at the costochondral junction, and petechial hemorrhages in the skin and sticky membranes can occur.

◾Wound healing is delayed.

◾On X-rays of long bones (especially around the knee):

🔸The ground glass appearance of bones is evident.

🔸The cartilage "pencil point" is reduced in thickness.

🔸Epiphyseal lines are accentuated.

🔸There is a white line of Frankel (an irregular but thickened white line on metaphysics).

Good representation of calcified cartilage zones.

🔸Epiphyseal centers of ossification have a glassy appearance through a white ring.

Ruth's medical history:

▪️X-ray of long bones.

▪️Low levels of vitamin C in the blood.

▪️With appropriate treatment, recovery in newborns is rapid. Subperiosteal hemorrhages can take months to resolve.

▪️Scurvy is prevented with adequate vitamin C intake.

Dosage :

Daily intake of vitamin C therapy is 100-200 milligrams or more. The daily requirement for children is 45-60 milligrams per day.