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Scurvy

Scurvy

Scurvy is the name for the condition caused by a deficiency in vitamin C. Another name for vitamin C is ascorbic acid.

Scurvy used to be common among sailors on long ocean voyages in the 15th Century, and many died from the disease until a Scottish surgeon in the Royal Navy discovered it could be successfully treated with citrus fruit in 1753.

What causes scurvy?

Scurvy is caused by a prolonged lack of vitamin C. Vitamin C plays a crucial role in the formation of collagen. Collagen is a major component of connective tissue, which has structural and supportive functions and is a major component of blood vessels and all tissues in the body.

Vitamin C is also needed for the proper functioning of our immune system, for iron absorption, cholesterol metabolism, and many other bodily functions.

Symptoms reflect the breakdown of connective tissue and disruption in the functioning of other processes and include hemorrhages, anemia, gum disease, skin problems, and general weakness.

Who is at risk of scurvy?

Although scurvy is not common these days, there are several groups of people still at risk. These include:

  • People who eat less than 2 servings of fruits or vegetables per day
  • People who are chronically malnourished
  • People on fad or peculiar diets
  • Alcoholics
  • People who live alone with limited cooking skills, such as the elderly, bachelors or widowers
  • Children
  • People with issues around food (such as delusions or fear of food) or eating disorders
  • Medical conditions or absorption problems that prevent the absorption of vitamin C
  • Dialysis patients
  • People with inflammatory bowel diseases, such as Crohn’s disease or severe dyspepsia.

In some underdeveloped countries, scurvy is much more common due to general malnutrition.

    What are the symptoms of scurvy?

    It takes at least 3 months of severe or total vitamin C deficiency for the symptoms of scurvy to develop.

    Initial symptoms usually include weakness, tiredness, and aching limbs, especially in the legs. If untreated scurvy can progress and symptoms may include:

    • Reddish/bluish spots may appear surrounding hair follicles and usually on the shins. The spots may join to form large patches that look like bruises. The hairs in the middle of these spots are twisted like corkscrews and may break easily
    • Swollen gums that look red, soft and spongy and bleed easily are another sign
    • Bleeding in the joints may occur, causing swelling, extreme discomfort and pain, limiting a person’s ability to walk
    • Eye dryness, irritation, blurring, stickiness, or light intolerance may occur. Bleeding may occur beneath the conjunctiva and within the optic nerve sheath
    • Anemia develops in 75% of people due to blood loss from gastrointestinal bleeding and intravascular hemolysis, and altered absorption and metabolism of iron and folate
    • Shortness of breath
    • Low blood pressure
    • Chest pain
    • Severe untreated scurvy can lead to shock and death.

    How is scurvy diagnosed?

    Scurvy is usually diagnosed based on a person’s presenting symptoms and dietary history of inadequate vitamin C intake.

    A blood test that shows levels of ascorbic acid < 11 µmol/L in addition to a response to supplements confirms the diagnosis.

    How is scurvy treated?

    Scurvy is easily treated with daily supplementation with oral vitamin C. Some improvement of symptoms is usually noticed within 24 hours.

    By following the “5 servings of fruit and vegetables per day” rule, scurvy is easily prevented as well.