Severe vitamin C deficiency causes scurvy — historically the scourge of sailors on long voyages. Scurvy is rare in developed countries but still occurs in people with very limited diets, smokers, alcoholics, and the elderly with poor nutrition. Mild vitamin C inadequacy is more common, affecting an estimated 7% of US adults.
Common symptoms
Easy bruising and bleeding gums
Slow wound healing
Fatigue and weakness
Joint pain or swelling
Small red or purple spots on the skin (petechiae) around hair follicles
Corkscrew-shaped body hairs
Loose teeth or tooth loss (advanced)
Anemia
Depression, irritability
Dry, splitting hair and rough, dry skin
At-risk groups
Smokers and people exposed to secondhand smoke (oxidative stress increases C requirement by ~35 mg/day)
People with very limited diets (food insecurity, severe picky eating, restrictive diets)
People with alcohol or substance use disorders
Older adults with poor diets, especially those who live alone
People with severe malabsorption (cachexia, end-stage renal disease)
Infants fed only evaporated or boiled cow's milk (vitamin C destroyed by heat)
People with anorexia or other eating disorders
People with extreme food allergies limiting fruit/vegetable variety
When to see a doctorEasy bruising or bleeding gums combined with poor wound healing in someone with a limited diet warrants medical evaluation. Vitamin C deficiency is easily treated and reversible with supplementation. A serum ascorbic acid test can confirm, but doctors often diagnose based on symptoms plus dietary history. If untreated, scurvy can be fatal.