Who Needs Vitamin C the Most? Understanding High-Risk Groups

January 11, 2026 •

3 min read

The National Institutes of Health recommends an extra 35 mg of vitamin C per day for smokers due to increased oxidative stress. While most people get enough from a balanced diet, certain populations, such as heavy drinkers and those with specific chronic diseases, are at a higher risk of deficiency and need more vitamin C to maintain optimal health.

Quick Summary

An overview of the populations most vulnerable to vitamin C inadequacy, detailing the increased needs for smokers, pregnant and breastfeeding individuals, those with limited diets, and specific chronic diseases.

Key Points

Smokers and secondhand smoke exposure: Increased oxidative stress from tobacco smoke significantly depletes vitamin C levels, necessitating a higher daily intake.
Pregnancy and breastfeeding: Physiological demands increase during these life stages to support both the parent and the infant, requiring a higher daily allowance.
Limited diets: Individuals with limited access to or variety of food, including the elderly and those with substance abuse issues, are at a greater risk of deficiency.
Chronic illness and malabsorption: Conditions like end-stage renal disease, certain cancers, and intestinal disorders can hinder absorption or increase the body's need for vitamin C.
Scurvy prevention: Severe vitamin C deficiency can cause scurvy, characterized by fatigue, bleeding gums, and poor wound healing, making adequate intake vital for prevention.

Groups at an Increased Risk of Vitamin C Inadequacy

While severe vitamin C deficiency, or scurvy, is rare in developed countries, certain populations are more susceptible to suboptimal intake. These groups often require a higher daily amount due to increased physiological demand or reduced absorption.

Smokers and Individuals Exposed to Secondhand Smoke

Tobacco smoke increases the body's oxidative stress, which depletes the body's vitamin C stores. To counteract this damage from free radicals, people who smoke require a higher daily intake. The National Institutes of Health recommends an additional 35 mg per day for smokers compared to non-smokers. Individuals regularly exposed to secondhand smoke also have lower vitamin C levels and should ensure they meet the recommended dietary allowance.

Pregnant and Breastfeeding Individuals

Pregnancy and breastfeeding significantly increase a person's nutritional needs, including vitamin C, to support both the parent and the developing infant. Breast milk naturally contains adequate levels of vitamin C, but the breastfeeding parent must consume sufficient amounts to produce this nutrient-rich milk.

People with Limited Food Variety

A diet lacking in fresh fruits and vegetables is a primary cause of vitamin C deficiency. This can affect several demographics, including:

Older, malnourished individuals who may have limited access to or ability to prepare food.
Individuals with alcohol or drug abuse issues.
People with restrictive diets due to food fads, mental illness, or allergies.
Infants fed evaporated or boiled cow's milk, which contains very little vitamin C.

Individuals with Malabsorption and Chronic Diseases

Certain health conditions can interfere with the body's ability to absorb and utilize vitamin C, or increase the body's usage of it. These conditions include:

Severe intestinal malabsorption issues (e.g., Crohn's disease, celiac disease).
Some types of cancer.
End-stage renal disease requiring chronic hemodialysis.
Hyperthyroidism.
Chronic inflammatory conditions or persistent diarrhea.

The Role of Vitamin C in the Body

Vitamin C, or ascorbic acid, is a water-soluble nutrient with several vital functions that explain why certain groups require more.

Key functions include:

Antioxidant Protection: It protects cells from damage caused by free radicals, which are produced through natural bodily processes and exposure to pollutants like cigarette smoke.
Collagen Synthesis: It is essential for producing collagen, a protein vital for wound healing and maintaining healthy skin, bones, tendons, ligaments, and blood vessels.
Immune Function: Vitamin C supports the immune system, helping the body fight off infections.
Iron Absorption: It significantly improves the absorption of nonheme iron from plant-based foods.

Recommended Daily Intake: High-Risk vs. General Population


Life Stage/Group	Recommended Daily Allowance (RDA) (mg/day)	Reason for Increased Need
Adult Men	90	Standard recommendation
Adult Women	75	Standard recommendation
Smokers (Men)	125 (90 + 35)	Counteracting oxidative stress from smoking
Smokers (Women)	110 (75 + 35)	Counteracting oxidative stress from smoking
Pregnant Women	85	Fetal growth and development
Breastfeeding Women	120	Supplying sufficient nutrients via breast milk
Elderly	Varies, but often higher than average	Malnutrition, reduced dietary intake
Chronic Illness	Varies, may require supplementation	Malabsorption, increased utilization

Potential Consequences of Deficiency

Even a low-grade vitamin C inadequacy can lead to a host of health problems. The most severe form of deficiency is scurvy, though it is very rare today. Less severe symptoms that may point to low intake include:

Fatigue and irritability
Slow wound healing
Bleeding gums and easily bruised skin
Joint pain
Dry, rough, or scaly skin

Conclusion: Prioritizing C for Those Most in Need

While a vitamin C deficiency is uncommon for many, prioritizing this nutrient is crucial for high-risk individuals. Whether due to lifestyle choices like smoking, physiological demands from pregnancy, or underlying chronic health conditions, ensuring adequate daily intake is essential for preventing complications. A diet rich in fresh fruits and vegetables is the best approach for most people, but certain cases may warrant medical consultation for supplementation. For more detailed information on nutrient guidelines, consult the NIH Office of Dietary Supplements fact sheet.

Frequently Asked Questions

The general recommended dietary allowance is 90 mg per day for adult men and 75 mg per day for adult women.

Smokers require an additional 35 mg of vitamin C per day because tobacco smoke increases oxidative stress, which depletes the body's vitamin C stores.

Yes, a severe and prolonged lack of vitamin C in the diet can lead to scurvy, a potentially fatal condition if untreated.

The most effective way to get vitamin C is from a balanced diet rich in fruits and vegetables, as foods contain other beneficial nutrients. For at-risk individuals, supplementation may be necessary after consulting a healthcare provider.

The tolerable upper intake level for adults is 2,000 mg per day. Consuming excessively high doses can cause gastrointestinal discomfort and diarrhea.

Excellent non-citrus sources include bell peppers, broccoli, kiwi, strawberries, brussels sprouts, and papaya.

While vitamin C supports immune function, research indicates it does not prevent the common cold for most people. However, regular intake may slightly shorten the duration or severity of symptoms.