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Bleeding Gums Can Be Sign Of Low Vitamin C Levels

Bleeding gums are usually considered a sign of gingivitis, and the typical advice is to brush and floss more. However, new research suggests that bleeding gums can also be due to low vitamin C levels, and that extra vitamin C in the diet or supplements could help reverse the bleeding in these cases.

After reviewing fifteen studies, the authors found that bleeding in the eye (retinal hemorrhaging) and cerebral strokes are associated with an increased tendency for gum (gingival) bleeding, and that vitamin C supplementation (e.g. ascorbic acid) reverses the retinal bleeding associated with low vitamin C  levels in the blood.

These bleeding tendencies may reflect trouble in the person's microvascular system (microvascular fragility), which can be reversed with increased vitamin C (ascorbic acid) intake. [microvascular means the tiny vessels (e.g.venules and capillaries) of the circulatory system.] The researchers point out that current recommended vitamin C (ascorbic acid) doses are enough to prevent scurvy, but may be too low to prevent microvascular fragility.

Getting more vitamin C in the diet is easy to do by eating more fruits and vegetables. Especially high levels of vitamin C are in orange juice, oranges, citrus fruits, kiwis, red peppers, broccoli, strawberries, brussels sprouts, and grapefruit.

From Medical Xpress: Bleeding gums may be a sign you need more vitamin C in your diet

Current advice from the America Dental Association tells you that if your gums bleed, make sure you are brushing and flossing twice a day because it could be a sign of gingivitis, an early stage of periodontal disease. And that might be true. So if you are concerned, see your dentist. However, a new University of Washington study suggests you should also check your intake of vitamin C. 

"When you see your gums bleed, the first thing you should think about is not, I should brush more. You should try to figure out why your gums are bleeding. And vitamin C deficiency is one possible reason," said the study's lead author Philippe Hujoel, a practicing dentist and professor of oral health sciences in the UW School of Dentistry.

Hujoel's study, published Feb. 1 in Nutrition Reviews, analyzed published studies of 15 clinical trials in six countries, involving 1,140 predominantly healthy participants, and data from 8,210 U.S. residents surveyed in the Centers for Disease Control and Prevention's Health and Nutrition Examination Survey. The results showed that bleeding of the gums on gentle probing, or gingival bleeding tendency, and also bleeding in the eye, or retinal hemorrhaging, were associated with low vitamin C levels in the bloodstream. And, the researchers found that increasing daily intake of vitamin C in those people with low vitamin C plasma levels helped to reverse these bleeding issues.

Of potential relevance, says Hujoel, who is also an adjunct professor of epidemiology in the UW School of Public Health, both a gum bleeding tendency and retinal bleeding could be a sign of general trouble in one's microvascular system, of a microvascular bleeding tendency in the brain, heart and kidneys.

Consequently, Hujoel does recommend people attempt to keep an eye on their vitamin C intake through incorporation of non-processed foods such as kale, peppers or kiwis into your diet, and if you can't find palatable foods rich in vitamin C to consider a supplement of about 100 to 200 milligrams a day.

The association between gum bleeding and vitamin C levels was recognized more than 30 years ago. In fact, two studies co-authored by former dean of the UW School of Dentistry Paul Robertson (published in 1986 and 1991) identified gum bleeding as a biological marker for vitamin C levels.

Hujoel's literature review also determined that "retinal hemorrhaging and cerebral strokes are associated with increased gingival bleeding tendency, and that (vitamin C) supplementation reverses the retinal bleeding associated with low (vitamin C) plasma levels."

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