What Disease Depletes Vitamin C? Exploring Scurvy and Other Risk Factors

December 16, 2025 •

5 min read

While severe vitamin C deficiency is relatively uncommon in developed countries like the U.S., affecting an estimated 7.1% of the population, the classic disease that depletes vitamin C is scurvy, a historical ailment now linked to poor diet and underlying health issues. A deficiency develops when the body's stores fall too low, impacting critical functions.

Quick Summary

A severe, prolonged lack of vitamin C causes scurvy, but chronic illnesses, inflammation, intestinal malabsorption disorders, and lifestyle factors like smoking significantly deplete vitamin C levels.

Key Points

Scurvy is the result of severe deficiency: The most direct disease depleting vitamin C, scurvy manifests after several months of inadequate intake.
Chronic conditions increase demand: Diseases causing prolonged inflammation, such as diabetes and rheumatoid arthritis, accelerate the use of the body's vitamin C stores.
Malabsorption impairs intake: Conditions like Crohn's disease, celiac disease, and effects of bariatric surgery hinder the small intestine's ability to absorb vitamin C.
Smoking causes significant depletion: Oxidative stress from smoking significantly reduces vitamin C levels, requiring smokers to have a higher daily intake.
High fever and trauma use stores rapidly: Severe infections, burns, and surgery cause rapid vitamin C consumption to support the body's immune and healing processes.
Limited storage makes intake critical: Since the body doesn't store large amounts of vitamin C, a consistent daily intake from diet is necessary to prevent depletion.
Diagnosis is based on symptoms and blood tests: A doctor will evaluate clinical signs like bleeding gums and bruising, and may use blood tests to measure vitamin C levels.

Scurvy: The Classic Disease of Severe Deficiency

Scurvy is the definitive illness caused by a significant and prolonged lack of vitamin C, or ascorbic acid, in the diet. The human body cannot synthesize this vital nutrient and relies entirely on dietary intake to maintain sufficient levels. Symptoms typically emerge after one to three months of insufficient intake and arise due to impaired collagen synthesis. Collagen is a crucial structural protein for healthy connective tissues, blood vessels, bones, and skin. When production is disrupted, tissues become weak and fragile.

Early signs often include fatigue, general weakness, irritability, and muscle or joint aches. As the deficiency worsens, classic symptoms appear:

Bleeding and swollen gums
Petechiae (tiny red or blue spots under the skin) and easy bruising
Dry, rough, and scaly skin
Hair that becomes dry, brittle, and coiled (corkscrew hairs)
Impaired wound healing
Anemia

In severe, untreated cases, scurvy can lead to more serious complications, such as jaundice, neuropathy, and potentially death.

Chronic Conditions That Increase Vitamin C Requirements

While scurvy is primarily caused by dietary inadequacy, several chronic diseases can increase the body's need for vitamin C, leading to depletion even with a seemingly sufficient diet. These conditions accelerate the body's consumption of the vitamin and can include:

Type 1 Diabetes: Individuals with type 1 diabetes often have increased vitamin C requirements. Studies show that high blood sugar levels can impact the transport and utilization of vitamin C in the body.
Chronic Inflammatory States: Diseases characterized by chronic inflammation, such as rheumatoid arthritis and inflammatory bowel disease, increase the body's production of free radicals and its need for antioxidants like vitamin C. The resulting oxidative stress consumes the body's vitamin C reserves more rapidly.
End-Stage Renal Disease (ESRD): Patients on chronic hemodialysis for ESRD can experience significantly low vitamin C concentrations due to increased renal losses of the vitamin during treatment.
Cancer and Cachexia: Some cancer patients, particularly those with cachexia (body wasting), are at increased risk of vitamin C inadequacy due to poor nutrient intake and the disease's metabolic demands.

Malabsorption Syndromes and Vitamin C Depletion

Proper absorption of vitamin C occurs in the small intestine. Diseases that cause intestinal malabsorption can significantly hinder this process, preventing the body from acquiring adequate amounts of the vitamin from food, regardless of dietary intake. Examples include:

Crohn's Disease and Celiac Disease: These inflammatory conditions of the digestive tract damage the intestinal lining, impairing nutrient absorption, including vitamin C.
Cystic Fibrosis: This genetic disease disrupts nutrient absorption, increasing the risk of vitamin C deficiency.
Bariatric Surgery: Surgical procedures that alter the digestive tract, such as gastric bypass, can significantly reduce the surface area available for vitamin C absorption.
Chronic Diarrhea: Prolonged episodes of diarrhea can flush nutrients out of the body before they can be properly absorbed.

How Oxidative Stress Accelerates Vitamin C Loss

Oxidative stress, an imbalance between free radicals and antioxidants, is a major factor in vitamin C depletion. Vitamin C is a potent antioxidant and is rapidly consumed when the body is under oxidative attack. Conditions that cause heightened oxidative stress include:

Smoking: One of the most significant lifestyle factors, smoking introduces large amounts of free radicals into the body. Smokers require substantially more vitamin C than non-smokers to counteract this damage. Even exposure to secondhand smoke can deplete vitamin C levels.
Burns and Severe Infections: The body's immense inflammatory response to trauma, such as burns, or severe infections like pneumonia, rapidly consumes its vitamin C stores.
Alcoholism: Chronic alcohol abuse often leads to poor dietary habits and can impair nutrient absorption, contributing to vitamin C depletion.

Lifestyle and Environmental Factors Affecting Vitamin C Levels

Beyond chronic disease, several everyday factors contribute to lower vitamin C status. Poor dietary habits, often associated with lower socioeconomic status or mental illness, can result in diets lacking in fresh fruits and vegetables. The elderly, particularly those with limited access to fresh food or who live alone, are also at heightened risk. Furthermore, the preparation of food can affect vitamin C content, as the vitamin is heat-sensitive and can be destroyed by cooking. Juices stored in opaque containers are often better for preserving vitamin C than those in clear bottles, as light can also cause degradation.

Comparison of Key Factors Depleting Vitamin C


Factor	Mechanism of Depletion	Resulting Vitamin C Status	At-Risk Population Examples
Scurvy	Lack of dietary vitamin C intake for 1-3 months.	Severe deficiency, potentially fatal if untreated.	Elderly, individuals with mental illness, alcoholics, malnourished children.
Chronic Inflammation	High oxidative stress and increased antioxidant demand from inflammatory conditions.	Can lead to subclinical deficiency or inadequacy.	Individuals with rheumatoid arthritis, type 1 diabetes.
Malabsorption Diseases	Impaired intestinal absorption due to disease or surgery.	Varies, but risk of severe deficiency increases over time.	Crohn's, celiac disease, bariatric surgery patients.
Smoking	Introduction of massive free radicals from smoke, overwhelming antioxidant capacity.	Significantly lower vitamin C levels, require 35+ mg/day extra.	Active smokers and those exposed to secondhand smoke.
High Fever/Infection	Rapid consumption of vitamin C to support immune system functions.	Rapid, temporary depletion during severe illness.	Critically ill patients, individuals with sepsis or pneumonia.
Pregnancy/Lactation	Increased metabolic demand and active transfer to the fetus/infant.	Lower vitamin C status, requiring higher intake.	Pregnant or breastfeeding women.

Conclusion: Prioritizing Vitamin C in Prevention

While the historic disease of scurvy remains the most severe outcome of prolonged vitamin C deficiency, it is crucial to recognize the many chronic diseases and lifestyle factors that silently deplete the body's supply. Understanding that conditions such as chronic inflammation, malabsorption disorders, and high levels of oxidative stress from sources like smoking can all accelerate this depletion highlights the importance of adequate intake beyond just preventing the most severe disease. Maintaining sufficient vitamin C levels, primarily through a diet rich in fruits and vegetables, is essential for supporting immune function, healing, and overall health. Addressing underlying medical conditions and lifestyle choices, under the guidance of a healthcare provider, is the most effective strategy for preventing vitamin C depletion. For individuals with specific risk factors, discussing supplementation may be a necessary step to maintain optimal health. For comprehensive information on dietary recommendations, consult authoritative sources such as the National Institutes of Health. National Institutes of Health.

Frequently Asked Questions

The primary disease caused by severe and prolonged vitamin C deficiency is scurvy. It results from the body's inability to produce collagen, a vital protein for connective tissue, skin, and bones.

Early symptoms of vitamin C deficiency can be vague, including fatigue, weakness, irritability, and muscle or joint aches. As it progresses, signs like swollen and bleeding gums, easy bruising, and poor wound healing appear.

Smoking significantly depletes vitamin C by causing high levels of oxidative stress. The body uses up its antioxidant reserves, including vitamin C, to combat the free radicals from cigarette smoke.

Chronic illnesses that can increase the body's need for vitamin C include inflammatory conditions like rheumatoid arthritis, Type 1 diabetes, and end-stage renal disease (ESRD). Conditions involving high fever or systemic inflammation also increase requirements.

Yes, malabsorption syndromes can lead to vitamin C depletion. Conditions such as Crohn's disease, celiac disease, and certain surgical procedures like gastric bypass can impair the body's ability to absorb the vitamin from food.

Severe vitamin C deficiency leading to scurvy is rare in developed countries due to widespread food availability. However, low-grade deficiency (inadequacy) is more common, particularly in individuals with limited food access, mental illness, alcoholism, or restrictive diets.

Diagnosis is based on evaluating a patient's symptoms and dietary history, often confirmed with blood tests measuring plasma and leukocyte vitamin C levels. Treatment involves vitamin C supplementation and addressing underlying dietary or medical causes.

Yes, periods of severe physical stress, such as recovering from burns or surgery, cause the body's demand for vitamin C to increase dramatically as it works to heal and fight infection.