nutritional disorders
Vitamin C Deficiency
Key Points
The need for vitamin C is increased by fever, inflammation, diarrhea, smoking, hyperthyroidism, iron deficiency, cold or heat stress, surgery, burns, and protein deficiency. After weeks or months, the deficiency causes nonspecific symptoms (eg, weakness, lassitude, irritability, arthralgias, myalgias); later, connective tissue is affected, causing follicular hyperkeratosis, coiled hair, swollen and bleeding gums, loose teeth, poor wound healing, and spontaneous hemorrhages. In patients who have skin or gingival symptoms or risk factors for the deficiency, measure theascorbic acidlevel. Treat with supplementalascorbic acidand a nutritious diet. 