**1.1 Muscle weakness**

L-ascorbic acid (AsA), commonly known as vitamin C, is a water-soluble antioxidant vitamin that has the potential to combat Reactive Oxygen Species (ROS) such as hydroxyl radicals, singlet oxygen, and superoxide radicals, which can compromise muscle health. Skeletal muscle consists of thousands of fibers, each with its own morphology and function. Muscles operating under optimal physical conditions exhibit reduced fatigue response. However, the substantial production of ROS during strenuous activity can lead to damage to biomolecules like proteins, lipids, and DNA, as well as muscle autofluorescence. Additionally, elevated oxygen levels associated with conditions like sarcopenia contribute to muscle aging and disease.

Studies on animals with decreased levels of vitamin C have shown an increase in oxygen levels and carbon protein production. When vitamin C levels are low, performance declines in muscles such as the gastrocnemius, soleus, plantaris, tibialis anterior, and extensor digitorum longus (EDL), resulting in performance decreases of 74%, 83%, 77%, 74%, and 76%, respectively. Conversely, maintaining adequate levels of vitamin C can help prevent muscle disease [1–3].

Vitamin C is crucial for bone health, and its deficiency is often observed in patients with impaired bone nutrition, which can increase the risk of osteoporosis. Reduced intake of fresh fruits and vegetables leads to a decline in the body's vitamin C levels. Ascorbic acid plays a vital role in carbohydrate metabolism, melanin synthesis, and the regeneration of vitamin E and glutathione, thereby enhancing nutrient absorption. It is recommended that women consume 65 mg of vitamin C daily and men consume 75 mg [4].

Low levels of vitamin C can elevate the risk of osteoporosis, especially in individuals with inflammatory bowel disease (IBD). In IBD patients, there is an increased risk of tumor necrosis factor α (TNF-α) levels, partly due to varied nutrient intake, including vitamin C. Research indicates that many children diagnosed with IBD have low serum vitamin C levels. Addressing this deficiency by consuming adequate vitamin C can help reduce the risk of osteoporosis by as much as 33% [5].

The absorption of vitamin C in the digestive tract typically ranges from 70–90% of the total amount consumed, especially when intake is around 200 mg. However, if intake surpasses 1250 mg, absorption decreases to around 30%, occurring through diffusion or active transport mechanisms. Vitamin C deficiency can result in scurvy, characterized by symptoms such as gingival swelling, tooth loss, ecchymosis, delayed wound healing, fatigue, vision issues, and neurological complications. These manifestations are often linked to alterations in the extracellular matrix of bones, blood vessels, and tendons, leading to bone fragility and hemorrhaging [4].

Maintaining the stability of essential nutrients is crucial for enhancing resistance against diseases like premature aging. Vitamin C is particularly vulnerable to loss due to factors such as poor food quality, advancing age, smoking, and alcohol consumption. A decrease in vitamin C levels leads to a decline in overall performance and affects blood plasma levels. In India, there is a notable decrease in the percentage of vitamin C in blood with age, correlating with a reduction in the nutritional value of the diet [6].

Fruits and vegetables serve as the primary sources of vitamin C intake in the body. Vitamin C plays a role in neutralizing heavy metals like iron and copper. Deficiency in vitamin C increases the risk of malnutrition and scurvy [7].

A deficiency in AsA or vitamin C leads to skeletal muscle weight loss, fiber atrophy, and reduced physical performance. This deficiency heightens the risk of ROS impacting skeletal muscle endurance, cellular function, and gene expression [3].

Vitamin C stored in the body lasts for approximately five months in adolescents. However, if this vitamin is depleted, clinical symptoms such as gingivitis, tooth loss, swelling in the lower extremities, and perifollicular hemorrhages may occur. Additional symptoms include sensations of alternating hot and cold, dizziness, lightheadedness, excessive sweating, hemorrhagic spots in the eyes, dry skin, excessive keratosis, curly body hair, and impaired wound healing [8].

## **1.2 Hampered wound healing**

Vitamin C serves as a co-substrate in numerous enzyme reactions within the body. It is essential for the synthesis of collagen, a crucial protein in connective tissues, and aids in wound healing. Unlike plants and certain animal species, humans lack the enzyme gulonolactone oxidase necessary for synthesizing their own vitamin C. Therefore, humans must obtain vitamin C from dietary sources such as fruits and vegetables.

Deficiency in vitamin C can lead to various diseases, such as impaired wound healing (scurvy), which can manifest as bleeding, swelling due to weak muscles, and
