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Scurvy - Causes, Symptoms, Diagnosis, and Treatment

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Scurvy is one of the oldest-known nutritional disorders of humankind. Scroll down this article to understand more about scurvy and ways to manage it.

Medically reviewed by

Dr. Hemalatha

Published At February 28, 2022
Reviewed AtDecember 23, 2022

Introduction:

Vitamins are substances that are required by our body to grow and develop normally. Vitamin C is an antioxidant. Scurvy refers to a condition that occurs when you lack vitamin C in your diet. This condition is otherwise known as scorbutus and has been known since ancient Greek and Egyptian times. But modern cases of scurvy are rare. Scurvy leads to general weakness, anemia, gum diseases, and skin hemorrhages (bleeding). It can be prevented by taking a diet that includes vitamin C-rich foods. Scurvy can be fatal if left untreated.

What Is Vitamin C?

Vitamin C is typically a water-soluble vitamin that is needed for normal growth and development. It is otherwise known as ascorbic acid and is required for your skin, bones, and connective tissues. It also promotes healing and helps the body absorb iron.

Water-soluble vitamins usually dissolve in water, and the excess amount of vitamins leaves the body through urine. Even though our body keeps a small reserve of these vitamins, we have to take these vitamins through food regularly to prevent deficiency.

The major functions of vitamin C include:

  • It forms a protein that is used to make skin, ligaments, and blood vessels.

  • It helps in wound healing and forms scar tissues.

  • It helps in repairing and maintaining cartilage, bones, and teeth.

  • Vitamin C is a rich antioxidant.

  • It aids in the absorption of iron.

NOTE: Our body cannot make vitamin C on its own, nor does it store vitamin C. Hence it is essential to include required amounts of vitamin C in the daily diet.

What Is Scurvy?

Scurvy is referred to as a severe vitamin C deficiency. This can affect the immune system, absorption of iron, metabolism of cholesterol, and other bodily functions. Studies state that vitamin C deficiency in women during pregnancy can affect the development of the fetal brain.

What Causes Vitamin C Deficiency?

Human bodies cannot synthesize vitamin C, and so it has to come from external sources. Vitamin C deficiency results from a poor diet that lacks fresh fruits and vegetables.

Who Are More Prone to Developing Scurvy?

The major risk factors or people who are prone to develop vitamin C deficiency include:

  • People above the age of 65.

  • People who consume excessive amounts of alcohol.

  • Use of any illegal drugs.

  • Restrictive diets due to allergies to certain kinds of foods.

  • Reduced access to nutritious food due to low income.

  • Residing in areas where there is poor access to fresh fruits and vegetables.

  • People with eating disorders or psychiatric conditions that involve fear of food.

  • Digestive or any metabolic disorders.

  • People having irritable bowel syndrome, Crohn’s disease, or ulcerative colitis.

  • Individuals having chronic diarrhea.

  • Dehydration.

  • People on chemotherapy or radiation therapy.

  • Kidney failure.

What Are the Common Symptoms Seen in Vitamin C Deficiency?

Generally, the signs and symptoms are seen at least after 8 weeks to 12 weeks of severe lack of vitamin C. The early signs of vitamin C deficiency include:

  • Fatigue.

  • Weakness.

  • Irritability.

  • Loss of appetite.

  • Pain in legs.

  • Low-grade fever.

The signs and symptoms developed one to three months of continual and severe lack of vitamin C intake include:

  • Gingivitis - swollen and bleeding gums.

  • Loose teeth.

  • Tooth decay.

  • Eye dryness and irritation.

  • Blurred vision.

  • Sensitivity to light.

  • Anemia.

  • Rough, dry, scaly skin.

  • Nosebleeds.

  • Skin hemorrhages or bleeding under the skin.

  • Tender and swollen joints.

  • Delayed wound healing.

  • Irritability.

  • Mood swings.

  • Headaches.

  • Gastrointestinal bleeding.

What Are Some of the Severe Complications of Scurvy?

When scurvy is left unnoticed, it can lead to serious complications like:

  • Severe jaundice.

  • Hemolysis - A form of anemia in which the red blood cells break down.

  • Tooth loss.

  • Internal hemorrhages.

  • Numbness or pain in the lower limbs and hands.

  • Convulsions.

  • Delirium (confused thinking and reduced awareness of the surroundings).

  • Organ failure.

  • Coma.

  • Death.

How Is Scurvy Diagnosed?

Scurvy is determined by checking the signs of vitamin C deficiency and by collecting the dietary history. For confirmation, doctors may suggest blood tests to determine the levels of vitamin C in the blood serum. Even imaging tests can reveal any internal damage caused due to scurvy.

How Is Scurvy Treated?

The symptoms of scurvy are severe. However, scurvy is simple to treat. Vitamin C is naturally present in fresh fruits and vegetables. When scurvy is mild, eating at least five servings of fruits and vegetables every day is the simplest way to recover from the condition. Oral vitamin C supplements are also available. If the symptoms persist even after making dietary changes, then you may have to pay a visit to your doctor.

For chronic and severe cases of scurvy, the doctor can examine and suggest high doses of oral vitamin C supplements for several months.

The daily recommended amount of vitamin C depends on the individual’s age, gender, the severity of the condition, and overall health.

In the absence of vitamin C deficiency, the daily recommended amount of vitamin C is,

For Children:

  • 6 months - 40 mg.

  • 7-12 months - 50 mg.

  • 1-3 years - 15 mg.

  • 4-8 years - 25 mg.

  • 9-13 years - 45 mg.

For Teens:

  • 14-18 years (boys) - 75 mg.

  • 14-18 years (girls) - 65 mg.

For Adults:

  • Men - 90 mg.

  • Women - 80 mg.

During Pregnancy:

  • Teens - 80 mg.

  • Women - 85 mg.

During Breastfeeding:

  • Teens - 115 mg.

  • Women - 120 mg.

What Are the Foods That Are Rich in Vitamin C?

All the fruits and vegetables contain some amount of vitamin C. Fruits that are rich in vitamin C are:

  • Citrus fruits like oranges.

  • Grapefruit.

  • Kiwi fruit.

  • Mango.

  • Papaya.

  • Pineapple.

  • Strawberries, raspberries, blueberries, and cranberries.

  • Watermelon.

Vegetables having good sources of vitamin C are:

  • Broccoli.

  • Brussels sprouts.

  • Cauliflower.

  • Green and red peppers.

  • Spinach.

  • Cabbage.

  • Sweet potatoes.

  • Tomatoes.

  • Winter Squash.

The best way to take vitamin C is through raw fruits and vegetables, as cooking vitamin C-rich foods or storing them for an extended period of time can reduce the content of vitamin C in the food. Even exposure to light can reduce the vitamin C content.

How Do I Know if My Condition Has Improved?

In most cases, people begin to recover quickly from the condition after starting the treatment. You can see improvement in symptoms within a few days of treatment. There will be an improvement in tiredness, confusion, pain, headaches, and mood swings. Other severe symptoms may take a few weeks to resolve completely.

Conclusion:

Though the symptoms of scurvy are severe, the treatment is relatively simple. Immediately switching to supplements is not the only way to include vitamin C. There are other ways to include vitamin C, such as developing a lifestyle and taking fruits and vegetables that have vitamin C. Reducing the intake of alcohol and tobacco helps the body adapt to vitamin C at its best.

Frequently Asked Questions

1.

How Much Vitamin C Is Recommended for Scurvy?

The treatment for scurvy includes vitamin C supplementation. Doctors recommend one to two grams of vitamin C be administered daily for the first two to three days, followed by 500 milligrams per day for the following week. Later, the dose is reduced to 100 milligrams of vitamin C daily for one to three months.

2.

What Are the Early Symptoms of Scurvy?

Early signs of scurvy (vitamin C deficiency) include a loss of appetite, weight loss, fatigue, irritability, and lethargy. Within the first three months, the individual may also experience anemia, myalgia, or pain, including bone pain, swollen and bleeding gums (signs of gingivitis), loose teeth, develop red or blue spots on the skin, usually on shins, skin that bruises easily.

3.

How Is Scurvy Diagnosed?

A blood test - To check vitamin C levels. Levels lower than 11 micromoles per liter (µmol/L) are considered vitamin C deficiency. Vitamin C levels are also checked in the leukocytes (white blood cells), which may show a clearer picture of vitamin C stores. Leukocyte vitamin C levels ranging from 0 to seven milligrams per decilitre indicate a vitamin C deficiency and scurvy. X-rays may also be taken to check for any bone abnormalities and deformities due to lack of vitamin C since vitamin C deficiency can also affect bone formation. 

4.

What Fruits Are Rich in Vitamin C?

Citrus fruits like oranges, grapes, kiwi, papaya, mango, strawberries, blueberries, cranberries, raspberries, plumps, pineapples, green apples, sweet limes, raw mango, and peaches contain vitamin C in high amounts. Doctors recommend a daily intake of fruits rich in vitamin C can prevent vitamin C deficiency and scurvy. 

5.

What Is the Treatment for Scurvy?

Treatment for scurvy depends on the severity of vitamin C deficiency. In mild cases having at least five servings of fruits and vegetables rich in vitamin C is the simplest way to recover from the condition. In severe cases, oral vitamin C supplements are prescribed. If the symptoms persist after making dietary changes, one must visit a doctor and monitor their vitamin C levels. Doctors prescribe high doses of oral vitamin C supplements for several months for chronic and severe cases of scurvy.

6.

Is Scurvy a Serious Health Condition?

Scurvy is a disease caused by extremely low levels or deficiency of vitamin C. Scurvy is usually not a serious health condition; however, not eating enough fruits and vegetables rich in vitamin C can cause severe vitamin C deficiencies. If left untreated, scurvy can lead to gum problems like bleeding gums, loose teeth, and bleeding under the skin.

7.

What Organs Are Affected by Scurvy?

- Scurvy affects the body’s healing process, skin, and blood vessels.
- Skin - A lack of vitamin C can cause easy bruising, corkscrew and swan neck hairs, and spontaneous breakdown of old wounds.
- Blood vessels - It impairs collagen tissue formation in the connective tissue, which is necessary for the support and structure of blood vessels.
- Wound healing - Vitamin C helps heal wounds, and a deficiency can cause delayed wound healing.

8.

What Are the Symptoms of Vitamin C Deficiency?

Symptoms of vitamin C deficiency include rough and bumpy skin, cork-screw-shaped body hair, bright red hair follicles, dry and damaged skin, spoon-shaped nails, easy bruising, painful and swollen joints, weak bones, poor immunity, persistent deficiency of iron levels (anemia), consistent fatigue and poor mood, slow healing of wounds, poor gum health and loose teeth.

9.

What Is the Daily Recommended Dose of Vitamin C?

The recommended daily amount for vitamin C is 75 milligrams (mg) for females and 90 mg daily for males. During pregnancy, doctors recommended a daily dietary dose of 120 mg of vitamin C. This is achievable through the daily dietary intake of citric fruits and vegetables rich in vitamin C. Excess vitamin C is expelled from the body since it is a water-soluble vitamin. 

10.

How Painful Is Scurvy?

Scurvy or vitamin C deficiency affects the joints and muscles. In severe stages of scurvy, the patient tends to remain immobilized from subperiosteal pain, with flexion of hips and knees. The condition may be excruciating, and the patient may be miserable. Later, as the condition advances, the symptoms include generalized edema, fever, severe jaundice, seizures, acute spontaneous bleeding, and death

11.

What Causes Low Vitamin C?

Here are the causes of low vitamin C levels:
- Individuals above 65 years of age.
- Excessive consumption of alcohol.
- Use of any illegal drugs.
- Restrictive diets due to allergies to certain kinds of foods.
- Reduced dietary intake of vitamin C and malnutrition.
- Poor awareness of vitamin C-rich foods.
- Eating disorders or psychiatric conditions that involve fear of food.
- Digestive or any metabolic disorders.
Dr. Chithranjali Ravichandran
Dr. Chithranjali Ravichandran

Dentistry

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