In scorbutic animals, elastin becomes increasingly deficient in hydroxyproline. Vitamin C protects folic acid reductase, which converts folic acid to folinic acid, and may help release free folic acid from its conjugates in food. Vitamin C facilitates the absorption of iron. Severe deficiency results in scurvy, an acute or chronic disease characterized by hemorrhagic manifestations and abnormal osteoid and dentin formation. In adults, primary deficiency is usually due to food idiosyncrasies or improper diet.
Diarrhea increases fecal loss, and achlorhydria decreases the amount absorbed.
Pathology Formation of intercellular cement substances in connective tissues, bones, and dentin is defective, resulting in weakened capillaries with subsequent hemorrhage and defects in bone and related structures. Hemorrhagic areas are organized avascularly, so that wounds heal poorly and break open easily. Endochondral growth ceases because osteoblasts fail to form osteoid tissue, resulting in bone lesions. Instead, a fibrous union forms between the diaphysis and the epiphysis, and costochondral junctions enlarge. Densely calcified fragments of cartilage are embedded in this fibrous tissue.