The symptoms of scurvy are produced primarily by the effects of the lack of ascorbic acid on collagen formation, causing reduced health of the tissues. The first signs of depletion may be related to vitamin C’s other functions as well, where deficiency could lead to poor resistance to infection and very slow wound healing. Easy bruising and tiny hemorrhages, called petechiae, in the skin, general weakness, loss of appetite, and poor digestion may also occur. With worse deficiency, nosebleeds, sore and bleeding gums, anemia, joint tenderness and swelling, mouth ulcers, loose teeth, and shortness of breath could be experienced. During growth periods, there could be reduced growth, especially of the bones. The decrease in collagen may lead to bone brittleness, making the bones more fragile. The progression and health of the teeth and gums are also affected. In breastfeeding women, lactation may be reduced. With the elderly, vitamin C deficiency could enhance symptoms of senility. The bleeding that comes from capillary wall fragility may lead to clotting and increased risk of strokes and heart attacks.

An important note is that many medical problems have been found to be associated with low blood levels of vitamin C. These problems include various infections, colds, depression, high blood pressure, arthritis, vascular fragility, allergies, ulcers, and cholesterol gallstones.

Most of these symptoms and problems can be easily avoided with minimal supplementation of vitamin C or a diet well supplied with fresh fruits and vegetables. Since the average diet has much less vitamin C than that of our ancestors, it is important for us to be aware of our ascorbic acid intake.

Requirements: The RDA for adults is considered to be 60 mg. We need only about 10–20 mg. to prevent scurvy, and there is more than that in one portion of most fruits or vegetables. Infants need 35 mg.; about 50 mg. between ages one and fourteen and 60 mg. afterward are the suggested minimums. During pregnancy, 80 mg. are required; 100 mg. are needed during lactation. Realistically, between 100–150 mg. daily is a minimum dosage for most people.

Vitamin C needs, however, are increased with all kinds of stress, both internal (emotional) and external (environmental). Smoking decreases vitamin C levels and increases minimum needs. Birth control pills, estrogen for menopause, cortisone use, and aspirin also increase ascorbic acid requirements. Both nicotine and estrogen seem to increase copper blood levels, and copper inactivates vitamin C. In general, though, absorption of vitamin C from the intestines is good. Vitamin C (as ascorbic acid) taken with iron helps the absorption of iron (and many minerals) and is important in treating anemia, but the iron decreases absorption of the ascorbic acid. Overall, it is probably best to take vitamin C as it is found in nature, along with the vitamin P constituents (discovered later)—the bioflavonoids, rutin, and hesperidin. These may have a synergistic influence on the functions of vitamin C, although there is no conclusive research on humans to support this theory.

Vitamin C is the most commonly consumed nutrient supplement and is available in tablets, both fast-acting and time-released, in chewable tablets, in powders and effervescents, and in liquid form. It is available as ascorbic acid, L-ascorbic acid, and various mineral ascorbate salts, such as sodium or calcium ascorbate. One of my favorite formulas, which was developed by Stephen Levine at Nutricology in San Leandro, California, is a buffered powder made from sago palm that contains 2,350 mg. of vitamin C per teaspoon, along with 450 mg. of calcium, 250 mg. of magnesium, and 99 mg. of potassium. It gets into the body quickly and is very easy on and often soothing to the stomach and intestinal lining. The potassium-magnesium combination can often be helpful for fatigue, and this formula is a good vehicle for fulfilling calcium needs.