title: Vitamin C deficiency is an under-diagnosed contributor to degenerative disc disease in the elderly.
abstract: The human aging process is often accompanied by significant increases in degenerative spine disease. The pathophysiology of intervertebral disc degeneration has been extensively studied, but the etiology of this aging-related problem remains poorly understood. The elderly often have lower daily vitamin C intakes and circulating ascorbic acid values than younger people because of problems with poor dentition or mobility, and also are more likely to have underlying sub-clinical diseases that can reduce plasma ascorbate concentrations. Ascorbate is essential for collagen production, and vitamin C deficiency will result in defective connective tissue, including reductions in collagen synthesis and structural stability. It is hypothesised that vitamin C deficiencies may be a key contributing factor in the development of degenerative disk disease (DDD) in the elderly. Once degenerative disc disease has begun, the tissue inflammation that accompanies DDD may further increase vitamin C requirements in the affected patient, thereby creating a cascade of positive feedbacks that potentially accelerates and contributes to further disc degeneration and low-back pain. Aggressive monitoring of patient ascorbate status, as well as more finely-calibrated RDAs for vitamin C that explicitly take into account the patient's age, may be required if aging-related degenerative disk disease is to be minimised.
authors.affiliation: Department of Ecology and Evolutionary Biology, University of Kansas, Lawrence, KS 66045, USA. vsmith@ku.edu
authors.forename: Val H
authors.initials: VH
authors.lastname: Smith
mesh_terms: D000368:Aged; D000375:Aging; D001205:Ascorbic Acid / Q000378:metabolism*; D001206:Ascorbic Acid Deficiency / Q000378:metabolism*; D003094:Collagen / Q000378:metabolism; D005109:Extracellular Matrix / Q000378:metabolism; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000150:complications / Q000378:metabolism*; D017116:Low Back Pain / Q000150:complications* / Q000209:etiology
chemical_list: D003094:Collagen; D001205:Ascorbic Acid