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Scurvy
Scurvy is a deficiency disease (state of malnutrition) resulting from a lack of vitamin C (ascorbic acid). Early symptoms of deficiency include weakness, fatigue, and sore arms and legs. Without treatment, decreased red blood cells, gum disease, changes to hair, and bleeding from the skin may occur. As scurvy worsens, there can be poor wound healing, personality changes, and finally death from infection or bleeding.
It takes at least a month of little to no vitamin C in the diet before symptoms occur. In modern times, scurvy occurs most commonly in neglected children, people with mental disorders, unusual eating habits, alcoholism, and older people who live alone. Other risk factors include intestinal malabsorption and dialysis.
While many animals produce their vitamin C, humans and a few others do not. Vitamin C, an antioxidant, is required to make the building blocks for collagen, carnitine, and catecholamines, and assists the intestines in the absorption of iron from foods. Diagnosis is typically based on outward appearance, X-rays, and improvement after treatment.
Treatment is with vitamin C supplements taken by mouth, or intravenously for optimal resolution. Improvement often begins in a few days with complete recovery in a few weeks. Sources of vitamin C in the diet include raw citrus fruit and several raw vegetables, including red peppers, broccoli, and tomatoes. Cooking often decreases the residual amount of vitamin C in foods.
Scurvy is rare compared to other nutritional deficiencies. It occurs more often in the developing world in association with malnutrition. Rates among refugees are reported at 5 to 45 percent. Scurvy was described as early as the time of ancient Egypt, and historically it was a limiting factor in long-distance sea travel, often killing large numbers of people. During the Age of Sail, it was assumed that 50 percent of the sailors would die of scurvy on a major trip. In long sea voyages, crews were isolated from land for extended periods and these voyages relied on large staples of a limited variety of foods and the lack of fruit, vegetables, and other foods containing vitamin C in diets of sailors resulted in scurvy.
Early symptoms are malaise and lethargy. After one to three months, patients develop shortness of breath and bone pain. Myalgias may occur because of reduced carnitine production. Other symptoms include skin changes with roughness, easy bruising, and petechiae, gum disease, loosening of teeth, poor wound healing, and emotional changes (which may appear before any physical changes). Dry mouth and dry eyes similar to Sjögren's syndrome may occur. In the late stages, jaundice, generalised edema, oliguria, neuropathy, fever, convulsions, and eventual death are frequently seen.
Scurvy, including subclinical scurvy, is caused by a deficiency of dietary vitamin C since the human liver is unable to synthesize vitamin C. Provided the diet contains sufficient vitamin C, the lack of working L-gulonolactone oxidase (GULO) enzyme has no significance. In modern Western societies, scurvy is seldom present in average adults, although underfed people (drug users, the homeless, neglected children and geriatrics) are affected. Virtually all commercially available baby formulas contain added vitamin C, preventing infantile scurvy. Human breast milk contains sufficient vitamin C if the mother has an adequate intake. Commercial milk is pasteurized, a heating process that destroys the natural vitamin C content of the milk.
Scurvy is one of the accompanying diseases of malnutrition (other such micronutrient deficiencies are beriberi and pellagra) and thus is still widespread in areas of the world dependent on external food aid. Although rare, there are also documented cases of scurvy due to poor dietary choices by people living in industrialized nations.
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Scurvy
Scurvy is a deficiency disease (state of malnutrition) resulting from a lack of vitamin C (ascorbic acid). Early symptoms of deficiency include weakness, fatigue, and sore arms and legs. Without treatment, decreased red blood cells, gum disease, changes to hair, and bleeding from the skin may occur. As scurvy worsens, there can be poor wound healing, personality changes, and finally death from infection or bleeding.
It takes at least a month of little to no vitamin C in the diet before symptoms occur. In modern times, scurvy occurs most commonly in neglected children, people with mental disorders, unusual eating habits, alcoholism, and older people who live alone. Other risk factors include intestinal malabsorption and dialysis.
While many animals produce their vitamin C, humans and a few others do not. Vitamin C, an antioxidant, is required to make the building blocks for collagen, carnitine, and catecholamines, and assists the intestines in the absorption of iron from foods. Diagnosis is typically based on outward appearance, X-rays, and improvement after treatment.
Treatment is with vitamin C supplements taken by mouth, or intravenously for optimal resolution. Improvement often begins in a few days with complete recovery in a few weeks. Sources of vitamin C in the diet include raw citrus fruit and several raw vegetables, including red peppers, broccoli, and tomatoes. Cooking often decreases the residual amount of vitamin C in foods.
Scurvy is rare compared to other nutritional deficiencies. It occurs more often in the developing world in association with malnutrition. Rates among refugees are reported at 5 to 45 percent. Scurvy was described as early as the time of ancient Egypt, and historically it was a limiting factor in long-distance sea travel, often killing large numbers of people. During the Age of Sail, it was assumed that 50 percent of the sailors would die of scurvy on a major trip. In long sea voyages, crews were isolated from land for extended periods and these voyages relied on large staples of a limited variety of foods and the lack of fruit, vegetables, and other foods containing vitamin C in diets of sailors resulted in scurvy.
Early symptoms are malaise and lethargy. After one to three months, patients develop shortness of breath and bone pain. Myalgias may occur because of reduced carnitine production. Other symptoms include skin changes with roughness, easy bruising, and petechiae, gum disease, loosening of teeth, poor wound healing, and emotional changes (which may appear before any physical changes). Dry mouth and dry eyes similar to Sjögren's syndrome may occur. In the late stages, jaundice, generalised edema, oliguria, neuropathy, fever, convulsions, and eventual death are frequently seen.
Scurvy, including subclinical scurvy, is caused by a deficiency of dietary vitamin C since the human liver is unable to synthesize vitamin C. Provided the diet contains sufficient vitamin C, the lack of working L-gulonolactone oxidase (GULO) enzyme has no significance. In modern Western societies, scurvy is seldom present in average adults, although underfed people (drug users, the homeless, neglected children and geriatrics) are affected. Virtually all commercially available baby formulas contain added vitamin C, preventing infantile scurvy. Human breast milk contains sufficient vitamin C if the mother has an adequate intake. Commercial milk is pasteurized, a heating process that destroys the natural vitamin C content of the milk.
Scurvy is one of the accompanying diseases of malnutrition (other such micronutrient deficiencies are beriberi and pellagra) and thus is still widespread in areas of the world dependent on external food aid. Although rare, there are also documented cases of scurvy due to poor dietary choices by people living in industrialized nations.