Vitamin C 🍋 🍊 & Scurvy | Most COMPREHENSIVE Explanation!

Summary

In 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

00:00

🌊 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.

05:01

🍊 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.

10:03

🩼 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.

15:04

🛡️ 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.

20:05

🩸 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.

25:05

🌟 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.

Keywords

💡Vitamin C

Vitamin C, also known as ascorbic acid, is a water-soluble vitamin that plays a crucial role in the body's physiological functions. In the video, Vitamin C is highlighted as essential for preventing scurvy, a disease resulting from its deficiency. The script mentions that Vitamin C aids in collagen synthesis, iron absorption, and acts as an antioxidant, protecting cells from oxidative stress. The video emphasizes the importance of Vitamin C in maintaining healthy connective tissues, bones, and blood vessels.

💡Scurvy

Scurvy is a disease caused by a deficiency of Vitamin C, historically common among sailors on long voyages due to limited access to fresh fruits and vegetables. The script describes scurvy through various symptoms such as bleeding gums, capillary fragility, and poor wound healing. The video uses scurvy as a central theme to discuss the critical role of Vitamin C and how its deficiency can lead to severe health complications.

💡Collagen

Collagen is a protein that provides structural support in connective tissues, skin, and bones. The script explains that Vitamin C is necessary for the hydroxylation of proline and lysine, which are essential steps in collagen synthesis. A deficiency in Vitamin C impairs this process, leading to symptoms like joint pain and skin hemorrhages, as seen in the video's discussion of scurvy.

💡Antioxidant

Antioxidants are substances that neutralize free radicals, preventing oxidative damage to cells. Vitamin C is described in the video as a potent antioxidant that protects cells from damage caused by reactive oxygen species. The video emphasizes the role of Vitamin C in regenerating other antioxidants like Vitamin E, thereby maintaining overall cellular health.

💡Hydroxylation

Hydroxylation is a biochemical process where a hydroxyl group is added to a molecule. In the context of the video, Vitamin C is essential for the hydroxylation of proline and lysine residues in collagen, which is vital for its proper structure and function. The script uses hydroxylation as an example of how Vitamin C deficiency can lead to scurvy by disrupting collagen synthesis.

💡Capillary Fragility

Capillary fragility refers to the weakness of capillary walls, making them prone to rupture and bleeding. The video script mentions capillary fragility as a symptom of scurvy, illustrating how Vitamin C deficiency affects the integrity of blood vessels. The capillary fragility test, discussed in the video, is a diagnostic method to identify scurvy by observing petechiae formation under pressure.

💡Ascorbic Acid

Ascorbic acid is the chemical name for Vitamin C. The video explains that L-ascorbic acid is the biologically active form found in citrus fruits, while D-ascorbic acid is inactive. Ascorbic acid is central to the video's discussion on the biochemical functions of Vitamin C and its deficiency's impact on health.

💡Hemochromatosis

Hemochromatosis is a genetic disorder characterized by excessive iron absorption and accumulation in the body. The video script warns that high Vitamin C intake can exacerbate iron overload conditions like hemochromatosis, as Vitamin C enhances iron absorption. This highlights the importance of balance in nutrient intake to prevent complications.

💡Hypervitaminosis C

Hypervitaminosis C refers to the condition resulting from excessive intake of Vitamin C. While the video primarily focuses on Vitamin C deficiency, it also touches upon the potential risks of overconsumption, such as the formation of calcium oxalate kidney stones. This term underscores the video's message about the importance of moderation in nutrient intake.

💡Corkscrew Hair

Corkscrew hair is a symptom of scurvy characterized by hair that appears coiled or twisted. The video script uses this term to illustrate the diverse manifestations of Vitamin C deficiency. It serves as a visual cue for medical professionals to consider scurvy in their diagnosis, especially when accompanied by other scurvy symptoms.

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

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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