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VITAMIN C
Dr. Shivani Pandey, Department of Biochemistry,
K.G. Medical University, Lucknow

Vitamin C
• Vitamin C -known as ascorbic acid - is a water-soluble vitamin.
• Unlike most mammals, humans do not have the ability to make their own
vitamin C. Therefore, we must obtain vitamin C through our diet.
• Fun fact: "ascorbic acid" comes from the New Latin "scorbutus" meaning
scurvy!
FIGURE 1 Chemical structure of ascorbic acid.
Dr. Shivani Pandey, Department of Biochemistry

Vitamin C Deficiency
▪ Disease result from severe vitamin C deficiency
Scurvy
Cardiovascular Disease
Stroke
Cataracts
Lead toxicity

Scurvy
• Bleeding gums
• petechiae
• easy bruising
• impaired wound healing and bone repair
• joint pain
• anemia

Scurvy
• It has been known for many centuries as the
potentially fatal disease.
• By the late 1700's the British navy was aware that scurvy
could be cured by eating oranges or lemons, even though
vitamin C would not be isolated until the early 1930's.

History of Vitamin C
• 17th century – sailors got scurvy on ships and
ship surgeon, James Lind, prescribed lemon
experiment that proved that lemon
juice as preventative. Performed an
juice
prevents scurvy.
• We now know today that it is because of the
Vitamin C in the lemon that prevents scurvy or
a vitamin C deficiency.

Cool Scurvy Dudes:
Captain James Cook
James Lind, a pioneer in
the field of scurvy prevention

People at risk of scurvy include:
• People with chronic malnutrition or those that eat less than 2
servings of fruits/vegetables per day
• Alcoholics
• Elderly
• Men who live alone (bachelor or widower scurvy)
• Children
• People on peculiar diets or food fads
• People with other medical conditions that may prevent the
intake and/or absorption of vitamin C
• Dialysis patients
• Malabsorption disorders
• Severe dyspepsia

Diagnosis
The diagnosis of scurvy is primarily a
clinical one, based on a dietary history of
inadequate vitamin C intake and the
signs and symptoms described here.

Signs & Symptoms
• Symptoms of scurvy generally develop after at least 3 months
of severe or total vitamin C deficiency, they includes:
• Weakness & fatigue
• Bruising easily & bleeding from weakening blood vessel,
connective tissue & bones due to collagen loss.
• Hair, teeth loss & gingivitis .
• Infants may be irritable, have pain when they move, and lose
their appetite. Infants do not gain weight as they
normally do. In infants and children, bone growth is impaired,
and bleeding and anemia may occur. [1]+[2]

Complications
• Skin problems: one of the first signs of scurvy is the development of
perifollicular hyperkeratotic papules, These appear as reddish/bluish
bruise-like spots surrounding hair follicles. The central hairs are twisted
like corkscrews that may break easily. The papules may join together to
form large areas of palpable purpura or ecchymoses (bruises).
• Oral problems: gums may swell and become red, soft and spongy. Any
slight friction may cause the gums to bleed. Often this results in poor oral
hygiene and dental diseases.
• Musculoskeletal problems: bleeding in the joints causes extreme
discomfort and pain. Joints may be swollen and tender and the pain can
be so severe that patients cannot walk.
• Heart and lung problems: shortness of breath, low blood pressure, and
chest pain leading to shock and death. [2]

Figure 2 : Corkscrew hair [3]
Figure3: Gingivitis

Treatment & Prevention
• Treatment is simply with vitamin C supplements taken orally.
• The adult dose is 800-1000mg/day for at least 1 week, then
400mg/day until complete recovery.
• In the U.S., the recommended dietary allowance (RDA) for
vitamin C was recently revised upward from 60 mg daily for
men and women. The RDA continues to be based primarily on
the prevention of deficiency disease, rather than the
prevention of chronic disease and the promotion of optimum
health.
• Infants who are being weaned from breast milk to cow's milk
need a supplement containing vitamin C. [5]+[2]

Toxicity of Vitamin C
• UL adults: 2000mg/d
• Osmotic diarrhea
• Oxalate kidney stones
• Decreases uric acid reabsorption resulting
in increased risk of gout
• Affects diagnostic tests in feces and gout
– fecal blood
– urinary glucose

Vitamin Chemical name
B1 Thiamine
B2 Riboflavin
B3 Nicotinamide (niacin)
B4 Adenine (no longer considered a vitamin)
B5 Pantothenic acid
B6 Pyridoxine
B7 Biotin
B8 Inositol
B9 Folacin (folic acid)
B
1
0
B
1
1
p-aminobenzoic acid (PABA) / H1
L-carnitine / b-hydroxy-g-trimethylammonium butyrate
(or choline)
B12 Cyanocobalamin
Vitamin B-complex

Inositol (Vitamin Bh)
• Inositol is part of the vitamin B-complex.
• Since it is not essential in the human diet, it cannot be
considered a vitamin.
• Inositol is naturally present in foods high in fiber (wheat,
legumes, bran, etc).
• It is required for:
– For proper formation of cell membranes.
– For formation of lecithin
– It is not a vitamin per se, but it works synergistically with many
vitamins and nutrients.
• functions closely with a B complex vitamins, Choline, folacin,
Vitamins B-6 and B-12.
– Inositol is necessary for proper function of nerves, brain, and
muscles in the body.
– This nutrient is also often used to counter depression; indeed,
serotonin needs inositol for proper functioning.
– Exists in all human cells, where it plays an important role in cell
proliferation and differentiation.
• Low levels of this nutrient may result in depression and some
research has shown that increased levels of Inositol appear to
be a promising treatment for depression.

P-amino benzoic acid (Bx)
• A substance required for the synthesis of folic acid by many
organisms.
• PABA is an essential nutrient for some bacteria and is
sometimes called Vitamin BX.
• Para-aminobenzoic acid is included in the B-vitamin complex,
although it is not an essential nutrient for humans and it
varies in its activity from other B vitamins.
• Although humans lack the ability to synthesize folate from
PABA, it is sometimes marketed as an essential nutrient under
the premise that it can stimulate intestinal bacteria.
• It also absorbs ultraviolet light and is used as aminobenzoic
acid, as a topical sunscreen. Abbreviated PAB or PABA.
• The potassium salt is used as drug against fibrotic skin
disorders.

Structure
Folic acid
PABA (vitamin Bx)

L-CARNITINE (B11)
• L-carnitine
– Is made in the body from the amino acids lysine
and methionine,
– Is needed to release energy from fat.
– It transports fatty acids into mitochondria, the
powerhouses of cells.
– In infancy, and in situations of high energy needs,
such as pregnancy and breast-feeding, the need
for L-carnitine can exceed production by the body.
• Therefore, L-carnitine is considered a
"conditionally essential" nutrient.

L-carnitine
• L-carnitine’s actions appear to be particularly
important in the heart.
• As an example, patients with diabetes and
high blood pressure were given 4 grams of L-
carnitine per day in a preliminary study.
• After 45 weeks, irregular heartbeat and
abnormal heart functioning decreased
significantly compared with nonsupplemented
patients.

Sources of L-carnitine
• Dairy and red meat contain the greatest amounts of
carnitine. Therefore, people who have a limited
intake of meat and dairy products tend to have lower
L-carnitine intakes.
• Carnitine deficiencies are rare, even in strict
vegetarians, because the body produces carnitine
relatively easily.
• Rare genetic diseases can cause a carnitine
deficiency.
• Also, deficiencies are occasionally associated with
other diseases, such as diabetes and cirrhosis.
• Most people do not need carnitine supplements. For
therapeutic use, typical amounts are 1–3 grams per
day.

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