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Proper amounts of vitamin C are required for the body to function. Having too little or too much of the vitamin stresses tissues and, in extreme cases, can lead to death. It is important to consume vitamin C every day because it is not fat-soluble and therefore cannot be stored in the body.

Because it is water-soluble, excess vitamin C is usually excreted with the urine and overdoses are rare. When they do occur, symptoms include nausea, abdominal cramps and diarrhea. Kidney stones may also result from overdoses of vitamin C, though this is most likely to occur in patients with kidney disease or gout.

Excessive vitamin C, either from substances or natural sources (e.g., grapefruit), may also interact with medical treatments or conditions. Examples of these interactions include:

• Diabetes tests. May cause false positives and false negatives.
  
  
• Anti-clotting medications. Reduces the effectiveness of these medicines used to prevent recurring strokes and blood clots.
  
  
• Iron excess. Increases absorption of iron and may worsen the symptoms of patients who already have too much iron in their bodies.

A deficiency of vitamin C affects the entire body and many of the symptoms reflect the body’s inability to synthesize collagen. Tissues may begin to break down, frequently starting with the capillaries (small blood vessels). This causes the earliest signs of a vitamin C deficiency – inflammation and bleeding gums (gingivitis) and small red spots under the skin (pinpoint hemorrhages). Over time, symptoms become more severe and affect the patient’s ability to function. Other signs of vitamin C deficiency include:

• Anemia (low levels of red blood cells)
• Difficulty fighting off infections
• Dry, scaly skin
• Nosebleeds
• Painful, swollen joints
• Slow healing of wounds
• Tendency to bruise easily
• Weakened tooth enamel
• Weight gain

Advanced vitamin C deficiency is called scurvy. Since its cause was discovered, it rarely occurs in the United States and other industrialized nations. Cases are often associated with general malnourishment due to restrictive diets or alcoholism. Possible signs and symptoms of scurvy include:

• Bleeding at hair follicles
• Skin becomes rough, brown, scaly and dry
• New wounds do not heal and old ones reopen
• Bone pain and increased risk of fracture
• Teeth become loose
• Weakness and fatigue
• Increased incidence of infections
• Hysteria
• Depression

Under a physician’s care, scurvy can be cured by correcting the vitamin C deficiency. For adults, supplements of 100 milligrams of vitamin C are given daily for one to two weeks. Treatment for infants and children varies with age, but usually includes vitamin C supplements or adding dietary sources (e.g., orange juice) of the vitamin.