Vitamin C 🍋 🍊 & Scurvy | Most COMPREHENSIVE Explanation!
Summary
TLDRIn this educational video, Medicosusperfxnetis delves into the world of vitamin C, also known as ascorbic acid, exploring its chemistry, sources, and crucial role in preventing scurvy. The video narrates intriguing medical cases to illustrate vitamin C's importance, highlighting its antioxidant properties and impact on collagen synthesis. It also addresses the consequences of deficiency and toxicity, emphasizing the vitamin's significance in daily health and medical practice.
Takeaways
- 🍋 Vitamin C, also known as ascorbic acid, is a water-soluble vitamin essential for human health, and its deficiency can lead to scurvy.
- 🌊 Historically, sailors suffered from scurvy due to a lack of fresh fruits and vegetables during long voyages, leading to bleeding gums and other symptoms.
- 🩺 The clinical manifestations of scurvy include bleeding gums, bruising, joint pain, and poor wound healing, often misdiagnosed in various cases presented.
- 👨⚕️ Medical professionals have missed diagnoses of scurvy, highlighting the importance of recognizing the condition's symptoms and the role of vitamin C.
- 💊 Vitamin C is crucial for the synthesis of collagen, the absorption of iron, and the metabolism of certain neurotransmitters.
- 🥦 Good sources of vitamin C include fresh fruits and vegetables like lemons, oranges, and green leafy vegetables, which should be consumed regularly.
- 🚫 Overcooking and processing can destroy vitamin C, emphasizing the need for fresh consumption to ensure adequate intake.
- 🔬 The body does not store vitamin C for long periods, and the kidneys excrete excess amounts, making regular intake necessary to prevent deficiency.
- 🩸 Scurvy can be diagnosed through simple tests like the capillary fragility test, which checks for petechiae after applying a tourniquet.
- ⚠️ Both deficiency and excess of vitamin C can have adverse health effects, with the latter potentially leading to kidney stones and increased iron toxicity.
Q & A
What is the main focus of the video script?
-The main focus of the video script is to discuss Vitamin C, also known as ascorbic acid, its importance, deficiency symptoms, sources, and the historical context of scurvy.
What are the common symptoms of Vitamin C deficiency mentioned in the script?
-The common symptoms of Vitamin C deficiency mentioned include bleeding gums, capillary fragility, poor dentition, poor wound healing, iron deficiency anemia, corkscrew hair, easy bruising, petechiae, purpura, delayed wound healing, subperiosteal hemorrhage, and decreased immunity.
What historical context is provided regarding Vitamin C deficiency?
-The historical context provided is about sailors during the era of voyages who died from scurvy due to lack of fresh fruits and vegetables, leading to Vitamin C deficiency.
What is the significance of the 12 stories mentioned in the script?
-The 12 stories are used to illustrate various cases of Vitamin C deficiency, misdiagnoses, and the importance of recognizing scurvy in patients to emphasize the importance of Vitamin C in human health.
What is the role of Vitamin C in collagen synthesis?
-Vitamin C is essential for the hydroxylation of proline and lysine residues, which is a critical step in collagen synthesis. Without adequate Vitamin C, collagen cannot be properly formed, leading to symptoms like poor wound healing and bleeding.
How does Vitamin C aid in iron absorption?
-Vitamin C helps in the conversion of ferric iron (Fe3+) to ferrous iron (Fe2+), which is more easily absorbed by the body. This conversion is necessary for proper iron absorption and can help prevent anemia.
What are some of the sources of Vitamin C mentioned in the script?
-The script mentions natural sources of Vitamin C such as lemons, limes, oranges, bananas, green leafy vegetables, and peas. It also mentions artificial sources like supplements and medications.
What is the potential risk of excessive Vitamin C intake?
-Excessive Vitamin C intake can lead to calcium oxalate kidney stones, increased iron toxicity, and in some cases, like in rats, it can cause permanent diabetes due to damage to the beta cells of the pancreas.
How can Vitamin C deficiency be diagnosed according to the script?
-Vitamin C deficiency can be diagnosed through simple clinical improvement after administering Vitamin C, urine ascorbic acid saturation test, intradermal test, and the Rumple lead test, also known as the capillary fragility test.
What is the significance of the book 'Sapera's Art and Science of Bedside Diagnoses' mentioned in the script?
-The book is mentioned as an essential medical textbook that contains valuable stories and insights into diagnoses, including those related to Vitamin C deficiency, which are not found in other commonly used medical texts.
Outlines
🌊 Scurvy and the Saga of Vitamin C Deficiency
The paragraph introduces the topic of Vitamin C, also known as ascorbic acid, and its historical and clinical significance. It recounts stories of scurvy in sailors, children with unexplained conditions, and adults with various symptoms, all linked by a deficiency in Vitamin C. The speaker emphasizes the importance of recognizing the signs of scurvy and the role of Vitamin C in preventing it. The paragraph concludes with a call to action for medical practitioners to be knowledgeable about Vitamin C's role in health and disease.
🍊 Understanding Vitamin C: Chemistry, Sources, and Functions
This section delves into the chemistry of Vitamin C, highlighting its water-soluble nature and the consequent risk of deficiency. It discusses the recommended daily intake and the importance of fresh sources like fruits and vegetables. The paragraph also covers the metabolic pathways of Vitamin C, its role in collagen synthesis, and its antioxidant functions. The speaker warns against excessive intake, which can lead to kidney stones and other issues, and underscores the necessity of a balanced approach to vitamin supplementation.
🩼 Clinical Manifestations and Treatment of Scurvy
The paragraph explores the clinical signs of scurvy, such as bleeding gums, bruising, and poor wound healing, and how they relate to Vitamin C deficiency. It discusses the diagnostic methods, including the capillary fragility test, and the treatment involving the administration of Vitamin C. The speaker also touches on the indirect benefits of Vitamin C, such as its role in collagen and hormone synthesis, and its impact on conditions like anemia and wound healing. The paragraph concludes with a discussion on the potential overuse of Vitamin C and its side effects.
🛡️ The Protective Role of Vitamin C in Antioxidant Defense
This section focuses on Vitamin C's function as an antioxidant, protecting the body from harmful free radicals. It explains how Vitamin C helps regenerate Vitamin E and its importance in maintaining the reduced form of Vitamin E for effective antioxidant activity. The paragraph also addresses the consequences of smoking, which depletes Vitamin C and increases the risk of scurvy. The speaker emphasizes the delicate balance between the benefits and potential harms of Vitamin C, advocating for a nuanced understanding of vitamin supplementation.
🩸 Scurvy's Impact on Hemostasis and Anemia
The paragraph discusses how Vitamin C deficiency affects hemostasis, leading to conditions like scurvy, which is characterized by symptoms like bleeding gums and bruising. It also links Vitamin C deficiency to iron deficiency anemia, explaining how the two deficiencies can exacerbate each other. The speaker provides insights into the diagnostic tests for Vitamin C deficiency and the importance of considering scurvy in patients presenting with certain symptoms. The paragraph concludes with a discussion on the treatment of scurvy and the importance of Vitamin C in overall health.
🌟 The Underrecognized Prevalence of Scurvy and Its Diagnostic Clues
The final paragraph addresses the misconception that scurvy is a rare condition, arguing that it is often unrecognized in modern practice. It recounts personal experiences of the speaker in diagnosing scurvy and emphasizes the importance of clinical observation, such as changes in hair texture, as diagnostic clues. The paragraph also touches on the broader implications of Vitamin C deficiency, including its impact on wound healing and the treatment of conditions like hemoglobinuria. The speaker concludes with a call to action for medical students to learn from these cases and to consider scurvy in their differential diagnoses.
Mindmap
Keywords
💡Vitamin C
💡Scurvy
💡Collagen
💡Antioxidant
💡Hydroxylation
💡Capillary Fragility
💡Ascorbic Acid
💡Hemochromatosis
💡Hypervitaminosis C
💡Corkscrew Hair
Highlights
Vitamin C, also known as ascorbic acid, is essential for various bodily functions and can be found in foods like lemons, limes, and oranges.
Historically, sailors suffered from scurvy due to a lack of fresh fruits and vegetables rich in vitamin C during long voyages.
A 9-year-old girl with severe hypertension was misdiagnosed until her vitamin C deficiency was identified.
A patient with bleeding issues was diagnosed with scurvy after a capillary fragility test revealed petechie.
A 29-year-old male with bad breath and bleeding into joints was found to have scurvy due to a poor diet.
Formula-fed infants in the early 20th century in New Zealand developed symptoms of scurvy due to a lack of vitamin C in formula.
An infant with head trauma was misdiagnosed until the signs of scurvy became apparent.
Vitamin C deficiency can cause symptoms like corkscrew hair, which was observed in a group of senior citizens in Australia in 2002.
A child with transverse ridging of teeth was found to have scurvy, highlighting the importance of vitamin C in dental health.
A patient with a retro-orbital hemorrhage and proptosis was diagnosed with scurvy, illustrating the vitamin's role in eye health.
Vitamin C is crucial for the hydroxylation of proline and lysine, which is essential for collagen synthesis.
A 26-year-old male with a gastrocnemius muscle tear was found to have scurvy, which was missed by multiple specialists.
A premature infant with hyperpigmentation was misdiagnosed with alcaptonuria, but actually had scurvy.
Vitamin C is a powerful antioxidant that helps regenerate vitamin E and protect cells from free radicals.
High doses of vitamin C can lead to hypervitaminosis C, which has been linked to kidney stones and increased iron toxicity.
Vitamin C deficiency can be diagnosed through simple tests like the capillary fragility test, without the need for expensive lab work.
Iron overload can paradoxically lead to scurvy as the body uses up vitamin C to help absorb the excess iron.
Vitamin C's role in collagen synthesis is critical for wound healing, and its deficiency can delay this process.
Transcripts
hey guys it's medicosusperfxnetis where
medicine makes perfect sense we continue
our biochemistry playlist we're talking
about vitamins the last video is vitamin
b12
now it's time for vitamin c or the
ascorbic acid with that said now
let's get started i will tell you 12
stories and please try to find the
common thread
during the era of voyages 40 percent of
sailors
used to die after they bleed from their
gums
and they bleed from everywhere next we
have a 9 year old
girl with severe hypertension and
doctors where doofus says they could not
figure out why
a patient was complaining of bleeding
the doctor did this test to him
he wrapped the blood pressure cough
around his arm inflated it to somewhere
between
systolic and diastolic so let's say a
hundred or something
and waited for about five minutes and
inside that doozy circle here
which is the diameter of equator the
patient developed
lots of petique next we have a 29 year
old male
with saddle echemosis and hemorrhages
bleeding into joints and he smelled
so bad he smelled like two dead fish
having sex together
this patient lived on canned spaghetti
and meatballs
pastries and beer doctors thought
oh maybe it's a nutritional deficiency
let's refer him to
an expat in the field a freaking
nutritionist then it just
said everything is fine never trust a
nutritionist the diagnosis was missed
for
three weeks story number five comes from
new zealand in the first half of the
20th century
formula fed infants developed this kind
of particular rash
and hemorrhages elevated periosteum and
bony tenderness
they were misdiagnosed never trust a
freaking pediatrician
next we have an infant after
experiencing a head
trauma presented with periorbital
hemorrhages and scalp
bruising he was also misdiagnosed next
let's go to
2002 australia 10 of senior citizens
admitted to
a care of the elderly department showed
symptoms of patikia purpura echemosis
bleeding gum
and corkscrew hair as you see right here
doc look at my hair i don't like it
might
here is another kid with transverse
ridging of teeth if this is the molar or
the premolar or whatever and this is the
biting surface you see those
ridges transverse ridges and of course
the freaking dentist
did not know what's up next we have
another kid with the eyeball
bulging forwards bilaterally due to
retro-orbital hemorrhage
this bulging is known as proptosis
another patient presented with vitreous
hemorrhage and subdural hemorrhage a 26
year old male
at the armed forces thank you for your
service presented with
gastrokinemius muscle tear went to the
hospital the doofus at the hospital did
not know what's up
six weeks later the freaking
dermatologist
figured out the cause of the
gastrocnemius tear
the surgeons missed it the freaking
family doctor missed it
the rheumatologist missed it only the
freaking dermatologist figured it out
this is when you know that there is
always hope there is just no chance
the last story is about a premature
infant
with these discolorations look at this
black
skin around the eye black tip of the
nose black cartilage in the ear
hyperpigmentation everywhere if this kid
passes away and we do an autopsy we'll
see black
bones what is this oh i know medical
says this is an inherited condition
known as el capitaneria you're very
close but here
it was not el capitanuria what all these
patients have in common was
vitamin c deficiency just by giving them
vitamin c
many of them improved tremendously so if
you want to be a good doctor
you better get your head out of your
sphincter hey mitychosis where did you
get these stories from
from the best medical textbook ever
sapira's art and science of bedside
diagnoses
harrison's internal medicine did not
have these stories
davidsons did not goldman says nope
up to date is not up to date enough only
seperas
did it if you have not read sepeera's
please do not consider yourself a doctor
sorry if i hurt your feelings because as
the art of medicine is being lost
the science is also threatened so today
we'll talk about
vitamins in general vitamin c in
particular the chemistry of vitamin c
sources metabolism and deficiency what
causes scurvy
clinical picture of scurvy diagnosis and
treatment of scurvy
and what happens during hypervitaminosis
c
as i've told you bazillion times in my
biochemistry playlist vitamins are
called vitamins because we thought that
they are vital amines organic molecules
micronutrients and they are essential
your body cannot make them therefore you
have to eat them in your diet
vitamins are divided into water soluble
and fat soluble vitamin c
as you see is water soluble therefore
deficiency is more likely
toxicity is less likely throughout
history
scurvy was way way way way way more
common than hypervitaminosis c
b1 is thyme and b2 is riboflavin b3 is
nice and b5 is pantothenic acid b6 is
pyrodoxin b7 is biotin b9 is folate
b12 is it cobalamin vitamin c is the
ascorbic acid
and if you look at this nice bottle of
multivitamins you see vitamin c here
60 milligrams which is about 67 percent
of your daily requirement
hey walmart you can do better so for
most people
taking 100 milligrams of vitamin c every
day
is perfect there are some variations and
it depends on your age but this is a
good
rule of thumb these are the functions of
vitamin b's from b1 to b12
vitamin c has many names it's ascorbic
acid anti-sorbitic
factor because scurvy is known as
scorpius so this is the antiscorbitas
factor
or you can call it the ascobate
chemically speaking vitamin c
is an enordial lactone of an acid who
cares it's a strong acid
no kidding by the way l ascorbic acid
is active this is the one that you find
in lemon
lime oranges etc however the d-ascorbic
acid
is inactive it is useless when it comes
to treating scurvy
so when you squeeze some lemon and eat
them
it gets absorbed here in your intestine
and goes to your bloodstream from the
blood it will go to
most tissues specifically your pituitary
gland adrenal gland
and many many other tissues but it's not
gonna be stored in the liver for long
if you do not get vitamin c for a month
you might start to suffer some symptoms
of scurvy
next who's gonna get rid of the vitamin
c your kidney
why because it's water soluble and the
kidney can get rid of anything that's
water soluble for you moreover
ascorbic acid gets metabolized into
oxalic acid oxalic acid will be excreted
in the kidney
if you eat tons of vitamin c and i mean
tons of vitamin c this can lead to
calcium oxalate
kidney stones do you remember this
mnemonic yup first you iron your clothes
then you
fold them and then you put them in the
closet because iron gets absorbed first
in the duodenum
folate in the jejunum and cobalamin in
the terminal ileum
thank you ellie for this great mnemonic
vitamin c
can help with iron absorption how come
let's say that you ate
the ferric form of iron you cannot
absorb
ferric you can only absorb ferrous the
fa2
plus and the mnemonic is fe2 goes into
the bloodstream who's going to convert
fe3 into fe2
vitamin c is needed for this
transformation where do i get vitamin c
from you have natural sources and you
have artificial sources artificial
is the supplements medications natural
sources
lemons limes lemonade oranges
bananas green leafy vegetables and even
peas
some organisms can synthesize vitamin c
but humans cannot therefore you have to
consume it in your diet
moreover vitamin c is destroyed on
cooking
storage and processing it's gotta be
fresh baby
let's make gordon ramsay happy what are
the functions of vitamin c
it's an antioxidant it aids in iron
absorption
it aids in fibroblasts and osteoblast
formation fibroblasts will give you
connective tissue osteoblasts will give
you bones
hydroxylation of proline and lysine
residue this will help you make collagen
you need collagen in your bones in your
vessels and your hair
these three structures are destroyed
when you have scurvy
hydroxylation of dopamine into
norepinephrine hydroxylation of
tryptophan into serotonin hydroxylation
of tyrosine into
homogeneitisic acid and that's why the
kid
in story number 12 had an el
capitaneria-like
condition he had dark discoloration
everywhere especially carthages also
vitamin c can help you with
reduction oxidation reactions it can
form a thf the famous folate
and it can form ferritin the storage
form of iron in your body benefits of
vitamin c we have direct
benefits and we have indirect benefits
indirect benefits this is
benefits of vitamin c we have clinical
benefits and we have biochemical
benefits we have talked about them
and we will elaborate soon let's talk
about the clinical uses you can use
vitamin c to treat a patient with scurvy
awesome you can use vitamin c to treat a
patient with metahemoglobinemia
you can use vitamin c to treat ulcers
burns
and even allergic reactions this is
controversial
also vitamin c might have an
oxytocin-like action
if mommy is during labor mommy is
pushing and pushing and pushing
the doofus baby is not coming out you
can give oxytocin i don't have
accidental oxytocin or
mommy is super allergic to oxytocin
she's going to develop an anaphylaxis
what should i do
try vitamin c will it work i don't know
let's hope for the best what do you have
to lose
but but but the guidelines who cares who
gives
a rip i want you to be a freaking doctor
not a box checker
vitamin c can help you make doozy
collagen fiber what's cauldron this is
the main protein
in the extracellular matrix we have many
types of collagen
type 1 you find in bone type 2 is in
cartolidge which means cartilage type 3
look at 3 3 is very flexible
it's in your blood vessels because your
blood vessels are super super duper
flexible
type 4 is under the floor this is the
basement membrane
type 5 is in your hair and the placenta
look at this corkscrew
got some coil action going and therefore
if i have scurvy
collagen is toast my bone is going to
suffer cartilages can suffer blood
vessels suffer big time i'm bleeding
everywhere basement membranes suffer my
gums are weak
even my teeth they might start to fall
off
hair is corkscrew and curly if i have
vitamin c deficiency
but you got to ask the patient did you
have coiled hair throughout your life
if the answer is yes maybe it's not
scurvy if the answer is no and this is a
new phenomenon
it's pretty much going to be scurvy my
clinical sense is off the charts
let's talk about the process of collagen
synthesis we call it collagen
modification it's a
post-translational modification let's
start
we start with pre-pro collagen remember
insulin pre-pro
insulin and pro you remember this stuff
here right pre-pro cauldron
pro collagen and then you form
hydroxylation when you hear
hydroxylation
i want you to say vitamin c
hydroxylation of what of proline
and lysine what the flavor are these
amino acids and then you have a lovely
triple helix with hydroxyl ions where
did i get from
from the hydroxylation process doofus
what's the name of this enzyme
anything that has hydroxylase at the end
doofus all of this
happened in the rough endoplasmic
reticulum now let's leave the rer
and go to the cytosol and then out of
the cell pro-collagen
and then it becomes strobe collagen and
then collagen fibrils and then collagen
fibers
if you have scurvy which is vitamin c
deficiency you will not be able
to hydroxylate your proline and lysine
residue your collagen is gonna be pieces
of trash your blood vessels will suffer
bone is gonna suffer cartilage is gonna
suffer hair is gonna suffer etc
collagen baby here is proline by an
enzyme known as a pro two collagen
proline hydroxylase which requires
vitamin c will give you hydroxyproline
lysine by an enzyme known as protocology
lysine hydroxylase requires vitamin c as
a cofactor
will get rehydroxylyzine both of these
will help you make
robust collagen fibers vitamin c will
help
absorb iron as we have discussed and
please watch my videos on iron
absorption because they were epic
vitamin c can help us make this doozy
tetrahydrofolate which will become
dihydrofolia during this step d ump will
become
dtmp dtmp can help you make dna
dna can help you replicate your cell
regenerate your tissue
and that's why when you have scurvy
everything is not regenerating
and you have poor wound healing
abilities
medicine makes so much sense once you
understand what the flip you're talking
about
the tetrahydrofolate is important
because it gives you formal
tetrahydrofolate
helps you with purine synthesis to make
dna and rna
therefore vitamin c can help thf
make dna cell replication and rna
protein transcription and translation
and you will end up with
some very good proteins including
collagen
the active form of folate is known as
tetrahydrofolate and that's why
vitamin c is just awesome what kind of
reaction is this
it's a reduction reaction remember redox
reaction
vitamin c can help with reduction
oxidation reactions
as you know your adrenal gland has a
cortex comes from the mesoderm and
a medulla comes from the ectoderm
specifically the neural crest cells
this adrenal medulla is a modified
ganglion therefore here is a
preganglionic fiber secreting
acetylcholine it's going to stimulate
your adrenal medulla and then your
geometry is going to secrete epinephrine
and norepinephrine and maybe some
dopamine these three are known as
your catecholamines how do i make
norepinephrine and epinephrine
sing the song with me phenylalanine
tyrosine
dopa dopamine norepinephrine epinephrine
phenylalanine tyrosine
dopa dopamine nor adrenaline adrenaline
from dopamine to norepinephrine you need
a hydroxylase whenever you see
hydroxylase you can say vitamin c
moreover
vitamin c also is a cofactor for this
enzyme known as
poh phenylpyruvate which converts
tyrosine
into homogeneitisic acid but hey
mitychosis let's say you have vitamin c
deficiency
wouldn't this decrease homozygotic acid
and therefore
i'm not going to have those dark
pigmentation of cartilages
yes my friend theoretically yes but
let's say i have vitamin c deficiency
and this enzyme is not working
tyrosine is going to build up like crazy
okay eventually
eventually some of this tyrosine in fact
lots of it will become homogenic acid
even in absence of vitamin c
and this can lead to alcaptenuria like
symptoms
but let's say that i'm a normal subject
and i have a normal level of vitamin c
it will convert tyrosine into homogenic
acid homogenisic acid will give you
eventually fumarate into the tca cycle
gives you
energy tryptophan to serotonin
tryptophan
has two paths i can give you serotonin
and therefore melatonin
or i can give you niacin if i choose to
give you a serotonin i need a
hydroxylation reaction please
provide vitamin c vitamin c as
antioxidant what do you mean by
antioxidant first let me tell you what i
mean by
oxidant okay an oxidant is something
that let's put it this way i have good
news i have bad news
these oxidant materials known as free
radicals or reactive oxygen species
can kill your bacteria awesome they can
also kill your own cells
not awesome mitochosis i don't want my
own cells to die
there comes the free radical scavengers
these are your vitamins
including vitamin c vitamin c itself
is antioxidant vitamin e is antioxidant
vitamin c helps regenerate vitamin e
both are antioxidants
so the reactive oxygen species can kiss
your calcaneus
here are those bad harmful free radicals
these are reactive oxygen species they
can kill bacteria cool
they can kill your own cells not cool
how do i prevent this damage
you can detoxify them how do i do it you
need vitamin e for this but the vitamin
e has to be in the reduced form of
vitamin e but after vitamin e is
consumed
to neutralize and detoxify the radicals
it will get oxidized we want to
replenish it back into the doozy reduced
form
and vitamin c will do this by the way
cigarette smoking
has tons of free radicals and this will
consume
all of vitamin c because it's working
like crazy and that's why if you smoke
cigarettes
you may suffer from scurvy anything in
life has pros and cons two little
vitamins you get vitamin deficiency in
this case it is called scurvy
too much vitamins you get
hypervitaminosis in this case it's
hypervitaminosis c
both are bad let's start by talking
about vitamin c deficiencies
the bleeding sailor the sailors were
bleeding because they were not eating
enough
fresh fruits and vegetables because the
voyage can take
months or years and of course you cannot
just
bring like fresh lemons they will be
fresh for the first
like few days after this they are not
fresh anymore
moreover vitamin c gets destroyed on
storage so when you store it for a long
time
it's no longer fresh this young girl had
hypertension because of vitamin c
deficiency the patekia that you see on
this capillary fragility test
is due to scurvy this person with saddle
echemosis please remember these two
words
settle echemosis think vitamin c
deficiency
has your professor heard of this no
because he's a doofus
back in the day formula fit infants were
vitamin c deficient because the formula
did not have vitamin c how about today
look at the look at the freaking label
on the formula if it says vitamin c then
it has vitamin c
use your brain mommy's milk has enough
vitamin c
mommy's milk is not deficient of vitamin
c however mommy's milk is deficient of
three things i call them the fedk iron
vitamin d and vitamin k mommy's milk
does not have enough
iron does not have enough vitamin d or
enough vitamin k
other than that mommy's milk is just
terrific you cannot buy this on freaking
amazon
the baby had bruising and bleeding due
to vitamin c deficiency
this old guy had curled hair got some
coiling action going and cor
screw hair due to vitamin c deficiency
this baby had those
transverse ridging on his teeth due to
vitamin c deficiency
retro-orbital bleeding complicated by
proptosis due to vitamin c deficiency
intracranial bleed in this case it was
subdural hemorrhage
and intravitrous hemorrhage was due to
vitamin c deficiency
the soldier who has torn his
gastrocnemius muscle
remember achilles tendon was suffering
from vitamin c deficiency
what are the symptoms of vitamin c
deficiency or scurvies while
in gums bleeding gums gum hypertrophy
capillary fragility
poor dentition poor wound healing iron
deficiency anemia
with all of the symptoms of anemia tired
and pale pale and tired sometimes i get
angina sometimes i have a flow murmur
also dizziness exercise intolerance
shorts of breath
etc but what's the most common cause of
shorts of breath
lack of physical fitness get your butt
off the couch and go to the gym
or run or do whatever corkscrew hair
provided that this is a new phenomenon a
new sign
and provided that the patient did not
have corkscrew hair
throughout his or her life easy bruising
and petiki and not just patekia petikia
purpura or echemoses
delayed wound healing parafollicular
hemorrhage this is important
sub periosteal hemorrhage and decreased
immunity what are the causes of gingival
hyperplasia or gum hypertrophy or
whatever
phenytoin can do it cyclosporine can do
it calcium channel blockers can do it
and yes
scurvy can do it for you if you remember
my bleeding and coagulation playlist
which was awesome we have talked about
hemostasis you need many steps
vasoconstriction
plated plug coagulation factors any
problem in any of these steps you can
suffer from ptk appropriate or
chemosis if i have primary hemostasis
the effect namely my platelets are toast
i can get skin bleeding and mucosal
bleeding skin bleeding include patekia
smallest purpura in between echimosis
the biggest
these three are subcutaneous hematomas
one condition can cause a range of
different stigmata this is old school
any defect in the vessel wall or
platelets or
coagulation factors can lead to
subcutaneous hematoma which will lead to
peticia purpia or chemosis in scurvy
the vessel is weak because there is no
collagen because there is no
hydroxylation of proline or lysine
residues because i do not have vitamin c
and that's why i get patekia purple
chemosis and scurvy
trauma or scurvy for that matter can
cause any of these due to disruption
of the vessel wall vitamin c deficiency
can lead to
iron deficiency anemia and here is an
example of a vitamin deficiency
leading to a mineral deficiency patients
with iron deficiency anemia like any
anemia tardin pale pale and tired
sometimes i have angina sometimes i have
a murmur also exercise intolerance
dizziness shorts of breath and many
others don't forget that
koilonykia when your nails like a spoon
you can pour water here
and restless leg syndrome and the famous
pica which is
craving of anything how do i diagnose
vitamin c deficiency and instead of
spending thousands of dollars on some
crazy sophisticated lab tests you can
just give the patient vitamin c if the
symptoms improve you have your diagnosis
thank you mr obvious urine ascorbic acid
saturation test
intradermal test and the rumple lead
test known as the tony k test also known
as capillary fragility test
how do i do it you mark an area like
a circle on the patient's forearm the
exact size
of a us quota inflate the blood pressure
cuff
between 120 and 80 and wait for 5
minutes
if you see petike in the circle count
them if they are
think more than three or more than five
whatever you have your diagnosis but if
you suspect
scurvy delay the reading of the petika
for 30 minutes
vitamin c deficiency is bad
hypervitaminosis
is also bad it can lead to calcium
oxalate kidney stones
it can increase your iron toxicity
because vitamin c helps iron absorption
too much iron absorption will need to
increase our toxicity which is
especially horrible
if you already have hemochromatosis or
if you receive repeated blood
transfusions
due to anemia leukemia sickle cell
anemia
beta thalassemia or any other disease
moreover
in rats tons of vitamin c can lead to
permanent diabetes due to damage of the
beta cells of the pancreas
so everything is good within limits
cause there are no solutions in life
only freaking incremental trade-offs
some pers for the pros
iron overload can actually lead to
scurvy oh i all understand how come
because if you have iron overload you
have tons of iron to absorb
yes you will consume all of your vitamin
c trying to help the iron
leaving less vitamin c for other organs
leading to
scurvy your blood vessel is crude
because all of the vitamin c now is
helping the iron
perfect iron overload hemochromatosis
plus
excessive intake of vitamin c can worsen
the iron overload
as i've said vitamin c deficiency or
copper deficiency can lead to delayed
wound healing specifically the second
phase vitamin c plus methylene blue can
treat
hemoglobin my mnemonic is when the
patient is blue
give them methylene blue and vitamin c
vitamin c deficiency increases excretion
of
phenyl pyruvate phenylalactate and
homogeneitisic acid and that's why
kid number 12 had alkeptonuria-like
symptoms
iron deficiency anemia can benefit from
taking vitamin c
oh doctor i have like a heavy menstrual
bleeding
and i'm iron deficient yeah take iron
also take vitamin c
because it will help you absorb the iron
by more than 10
and this is true whether you are
deficient or you are a normal doofus
sapera has famously said i do not
examine individual hairs unless i'm
considering the diagnosis of scurvy
notice he did not say i do not examine
hair he said i do not examine
individual hairs unless i'm considering
scurvy because of the
curly action the coiled hairs the
corkscrew
well actually i've never examined a
patient's hair screw
you the same book also said although
scurvy is thought to be rare
it is not it is simply unrecognized
the author continues i saw two cases and
was shown
two more in a 10-month period while this
chapter
was in preparation man because students
today will be like oh i kind of sort of
ish
showed up to the lecture i read my
professor's powerpoint and i got this
medicine thing figured out therefore i
deserve respect
so you believe in predestination you do
not know anything yet
you ain't get nothing figured out and
you deserve no respect how about that
i'm just joking because i want you to be
excellent please watch my previous
videos on vitamins because i had
even more interesting stories lemon and
lemonade is not just a good source for
vitamin c
they help me differentiate between
leukemia and lymphoma watch my video
titled
distinctions in oncology i have videos
about
antibiotics on my website
medicosisperfictionalis.com it has 40
videos about
antimicrobials antivirals antifungals
and
anti-parasitic medications the next 27
students can get a 40
discount towards any course on my
website just use discount code for the
off
thank you for watching please subscribe
hit the bell and click on the join
button you can support me here or here
go to my website to download my courses
thank you for watching as always be safe
stay happy
study hard this is mitochosis perfect
scenarios where medicine makes perfect
sense
now i'm gonna go squeeze some lemons
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