• Vitamin C plays an essential role in maintaining healthy skin and the integrity of blood vessels.
  
• A deficiency of this vitamin causes weak skin, poor wound healing, and weak blood vessels.  It may also be beneficial in fighting cancer, infections, heart disease, fractures, allergies, and arthritis.
  
• This disease is seen most often in those with poor diet, leading eventually to a disease called scurvy.  The major sources of Vitamin C include vegetables and fresh fruit, especially citrus.

• May begin with vague symptoms, such as feeling tired and weak.
  
• Scurvy -- occurs in those with severe Vitamin C deficiency.  Symptoms include thickened areas of skin, bleeding around hair follicles, easy Bruising or tiny purple/red spots (caused by small amounts of bleeding into the skin), bleeding gums, bleeding into joints, and low blood count.  Patients with scurvy tend to have very poor wound healing.  If scurvy is untreated, it may lead to swelling of the legs, lack of urination, bleeding in the brain, problems with sensation, and eventually, death.

• Vitamin C deficiency usually is due to a diet that lacks fresh fruit and vegetables.  Those at highest risk are alcoholics, the elderly, and the poor.
  
• Those with kidney failure and some cancer patients may also suffer from this disease.
  
• Smokers have a high risk of developing Vitamin C deficiency.

• Diagnosis is usually made by symptoms and examination.
  
• Plasma ascorbic level -- measures the amount of Vitamin C in the blood.

• This disease is easily treated with oral vitamin C doses of 300-1000 milligrams per day.
  
• Improvement generally occurs within days.
  
• Vitamin C in mega doses may help prevent some cancers and heart disease.

• A healthy diet will help prevent this disease.  Vitamin C is found mainly in citrus fruit, strawberries, broccoli, and tomatoes.

• Special considerations

- Vitamin C toxicity -- too much can lead to problems with excess gas, stomach irritation, and diarrhea.  It may also increase the risk of Kidney Stones, and may interfere with stool tests for blood and urine tests for glucose.