Expansion
Collagen hydroxylation, antioxidant activity and iron absorption
Expansion
Functions
- Cofactor for prolyl and lysyl hydroxylase in collagen synthesis
- Antioxidant, regenerating vitamin E
- Reduces dietary iron from ferric to ferrous, enhancing absorption
- Cofactor in carnitine, noradrenaline and bile acid synthesis
Scurvy develops after about 8 to 12 weeks of deficiency, and every feature follows from defective collagen:
- Perifollicular haemorrhage and corkscrew hairs
- Bleeding, swollen gums and loose teeth
- Easy bruising, poor wound healing, reopening of old scars
- Impaired bone growth in children, with subperiosteal haemorrhage
- Anaemia, partly from bleeding and partly from impaired iron absorption
- Fatigue and arthralgia
At risk: severe dietary restriction, alcohol dependence, isolated older people, psychiatric illness, and restrictive eating disorders. It still occurs in high income countries and is easily missed.
Treatment produces a dramatic response within days, which is itself diagnostically supportive. Note that high dose supplementation causes oxalate stones and interferes with glucose meters.