Ascorbic acid deficiency, symptoms

Deficiency may occur in infants if no fruits or vegetables are added to their milk formulas. In alcoholics, and in elderly subjects who consume inadequate diets vitamin C deficiencies are frequent. Severe ascorbic acid deficiency is characterized by the syndrome known as scurvy. Its manifestations are generally based on a loss of collagen. Symptoms include hemorrhages, loosening of teeth. In children cellular changes in the long bones occur. 

Table IV. Effects of Ascorbic Acid on Symptoms of Copper Deficiency in Dutch Rabbits Fed Low-Copper Diets...

The most prominent symptom of ascorbic acid deficiency is scurvy, which is a complex of disorders that result mainly from the decreased ability to synthesize collagen. This lack of collagen synthesis leads to an elevated fragility of the capillar blood system and consequently to bleeding of skin, mucous membranes, organs,... 

Ascorbic acid deficiency of infants (Moeller-Barlow disease) is characterized by decreased bone formation. Besides the symptoms that can be observed in ascorbic acid-deficient adults at the onset of the hypovitaminosis, myelofibrosis and enlargements at the epiphyses of long tubular bones and at the costae, mandible, and skull occur. These symptoms can be seen in parenteral nutrition after the sixth month, when the transplacental ascorbic acid pool fades. 

As mentioned above, ascorbic acid acts as a neuroprotective agent in in vitro models of scurvy. Therefore, it is a surprise that no symptoms of brain cell damage have been reported in conditions involving severe systemic ascorbic acid deficiency. This may be explained by the fact that the scorbutic state cannot be produced in the intact animal brain because of the brain s homeostatic mechanisms such as the highly specific ascorbic acid transport system in the choroid plexus (Spector, 1989) and the inability of ascorbic acid to cross the blood-brain barrier, which effectively isolate the ascorbic acid content of the intact brain from the rest of the body s ascorbic acid pool. The active transport of ascorbic acid from blood to cerebrospinal fluid (Spector and Eells, 1984), together with cellular uptake mechanisms, represents the base for homeostasis of brain ascorbic acid concentrations (see also Section 2). This is in agreement with the report about normal ascorbic acid concentrations in brains from patients with Parkinson s disease (Riederer et al., 1989), in which free radical damages are postulated to be involved (see below). 

A deficiency of ascorbic acid results in scurvy, a disease character ized by sore, spongy gums, loose teeth, fragile blood vessels, swollen joints, and anemia (Figure 28.9). Many of the deficiency symptoms can be explained by a deficiency in the hydroxylation of collagen, resulting in defective connective tissue. 

Ascorbic acid, or vitamin C, was discovered after scientists had searched for centuries for a cure for the disease known as scurvy. The name ascorbic acid comes from word anti-scurvy acid, because it was known to dramatically cure this disease. This disease was caused by a serious deficiency of vitamin C, and it caused its victim s small blood vessels to rupture, bones to weaken, and joints to swell, among other symptoms. These symptoms were due to the fact that without a source of vitamin C one developed severe problems concerning the body s connective tissues, which is found in bones, skin, muscles, teeth, blood vessels, and cartilage. This disease would eventually lead to death if it went untreated, and was not uncommon, especially during the winter months of the year. The disease often plagues armies, explorers, and crusaders, since these men s diets normally consisted of biscuits and salted meat that could easily be stored and kept unspoiled on a ship. 

A. The patient exhibits the classic symptoms of scurvy, a deficiency in vitamin C. In addition to being an important biological antioxidant, ascorbic acid is required for the hydroxylation of proUne and lysine residues of procollagen in the synthesis of collagen. A deficiency leads to defects in collagen synthesis, which adversely affects the intercellular cement substances in connective tissue, bones, and dentin. 

Further evidence of the interrelation of ascorbic acid and pantothenic acid is the fact that the addition of ascorbic acid (in a concentration of 2 % of the diet) to a pantothenate-deficient diet somewhat protected rats against the symptoms of pantothenate deficiency (Daft, 1951 Daft and Schwarz, 1952). 

Mental symptoms (depression) accompany the physical symptoms of vitamin-C deficiency disease (scurvy). In 1957, Akerfeldt reported that the serum of schizophrenics had been found to have greater power of oxidizing N,N-dimethyl-p-phenylenediamine than that of other persons. Several investigators then reported that this difference is due to a smaller concentration of ascorbic acid in the serum of schizophrenics than of other persons. This difference has been attributed to the poor diet and increased tendency to chronic infectious disease of the patients (Benjamin, 1958 Kety, 1959), and has also been interpreted as showing an increased rate of metabolism of ascorbic acid by the patients (Hoffer and Osmond, 1960 Briggs, 1962). It is my opinion, from the study of the literature, that many schizophrenics have an increased metabolism of ascorbic acid, presumably genetic in origin, and that the... 

Since farm animals can synthesise vitamin C, deficiency symptoms normally do not arise. However, it has been suggested that under certain conditions, e.g. climatic stress in poultry, the demand for ascorbic acid becomes greater than can be provided for by normal tissue synthesis, and a dietary supplement may then be beneficial. 

Ascorbic acid, vitamin C, is a water-soluble vitamin of great importance. A deficiency of vitamin C in the diet leads to scurvy, a disease characterized by loss of weight, general weakness, hemorrhagic condition of the gums and skin, loosening of the teeth, and other symptoms. Sound tooth development seems to depend upon a satisfactory supply of this vitamin, and a deficiency is thought to cause a tendency to incidence of a number of diseases. 

The total vitamin C requirement is met by foods, especially potatoes (that cover about 20-30%), vegetables (about 30-40%) and fruits (30-35%). Milk covers less than 10% of the vitamin need. Deficiency or hypovitaminosis manifests in a number of non-specific symptoms, most commonly known as spring fatigue. The best-known syndrome of acute avitaminosis is scurvy. According to some new findings, dehydroascorbic acid has somewhat lower activity than ascorbic acid. 

A water soluble vitamin which cannot be synthesized by man and therefore has to be obtained from the diet. It is found extensively in vegetables and fruit, especially the citrus varieties. Since the vitamin is carried mainly in the leukocytes, its measurement in these cells gives some indication of the vitamin C status of the body. The ascorbic acid saturation test can also be used to assess the vitamin status. The biochemical role of the vitamin is obscure although it does seem to be required for collagen formation. Deficiency of the vitamin causes scurvy, the symptoms of which can be related to poor collagen formation. These include poor wound-healing, osteoporosis (due to bone matrix deficiency), a tendency to bleed (due to deficiences in the vascular walls) and anaemia. 

Vitamin C (L-ascorbic acid, l-AA), is an essential nutrient for humans and some animal species [9] (Figure 10.1). l-AA is a cofactor of at least eight enzymatic reactions, which are crucial for collagen synthesis. Deficiency in L-AA could cause the most severe symptoms of scurvy in humans [10]. L-AA can also act as an antioxidant [11], and is required for a range of essential metabolic reactions in all animals and plants [9,12]. It is produced internally by almost all organisms with the exception of some species of birds and fish [12, 13]. All species that do not synthesize ascorbate require it in their diet. L-AA is also widely used as a food additive to prevent the oxidation of other nutrients or some food dyes [14]. The global vitamin C production is currently estimated at about 11000 tons annually. The main producers include DSM (Scotland) and other four producers in China (Northeast Pharmaceutical Co. Ltd., North China Pharmaceutical Co. Ltd.,... 

Vitamin C or ascorbic acid is a well known antioxidant nutrient that functions as a coenzyme in hydroxy-lation reactions for collagen formation. It is found in citrus fruits, tomatoes and berries. Severe deficiency leads to scurvy. Intake of approximately 1 g/day decreases the severity of symptoms of colds but does not reduce their incidence. Intakes of over 2 g/day may cause kidney stones due to accumulation of oxalic acid, the end product of vitamin C metabolism. 

On the other hand, organic acids are more difficult to measure in the labs. Usually, these are measured by GC or HPLC. However, CE offers speed, precision, and specificity over other methods. Organic acids are important in inborn errors of metabolism, in infection, and different metabolic disorders. Many of these compounds have been measured by CE directly, or by indirect UV absorbency after addition of a UV absorbing compound such as benzoate, naphthalene sulfonate, imidazole, or benzylamine. For example, oxalate and citrate, which are important in stone formation, have been measured after urine dilution by both direct and indirect detections. Lactate, pyruvate, ascorbate, and oxalate were measured by CE in the CSF of patients in 10 min. Methylmalonic acid, which is a sensitive measure of vitamin Bi2 deficiency preceding any clinical symptoms or changes in the serum, has been determined in m-ine by CE after sample extraction and concentration. 

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