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Proper amounts of vitamin C are required for the body to function. Having too little or too much vitamin C stresses tissues and, in extreme cases, can lead to death.

Because it is water soluble, excess vitamin C is usually excreted with 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 a tendency toward gout.

Excessive vitamin C intake may also interact with medical treatments or conditions. Examples of these interactions include:

• Diabetes tests. May cause false positives and false negatives.

• Anticoagulants. Reduces the effectiveness of these medicines used to prevent recurring strokes.
  

• Iron excess. Increases absorption of iron and may worsen the symptoms of patients who already have too much in their bodies. People with the condition hemochromatosis are encouraged to discuss vitamin C use with their physician.

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. This causes the earliest signs of vitamin C deficiency – bleeding gums and small red spots under the skin (pinpoint hemorrhages). With time, symptoms become more severe and affect the patient’s ability to function.

Advanced vitamin C deficiency is called scurvy. Scurvy was a common problem during long sea voyages in previous centuries, when supplies of fresh fruit were limited. Since its cause was discovered, scurvy 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
• Rough, brown, scaly and dry skin
• Poor wound healing
• Bone pain and increased risk of fracture
• Loosened teeth
• Weakness and fatigue
• Increased incidence of infections
• Irritability
• 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).

Treatment may also involve consulting a registered dietitian to ensure adequate vitamin C is consumed in the diet to prevent recurrence of the deficiency. Without treatment, scurvy may lead to death through sudden cardiac failure or internal bleeding.