Caused by severe and chronic deficiency of vitamin C or ascorbic acid, scurvy is a disease that occurs in countries where fresh fruits and vegetables that are the main sources of vitamin C, are not available. Although many people think that Scurvy is a disease of the past and it does not occur in the present era, are oblivious to the fact that it still exists in those countries, where proper nutrition is not available.

Scurvy

What is Scurvy?

Scurvy is a disease that is caused by a deficiency of vitamin C or ascorbic acid in the diet.
Scurvy is characterised by a group of phenomena and they are anemia, caused by disrupted healing process of the skin, blood vessels, gum disease or gingivitis, haemorrhaging of the skin etc.

Why does it occur?

Vitamin C or ascorbic acid is a very important antioxidant that is associated with lipid and vitamin metabolism, development of the connective tissues, immune function, biosynthesis of neurotransmitters and also healing of wounds. To specify its functions, it can be categorised as –

  • Vitamin C is an antioxidant that destroys the 'free radicals' or molecular compounds, released by the metabolism of oxygen within the body that is responsible for damaging the cells
  • Vitamin C helps in the formation of collagen that strengthens the skin, blood vessels and bone as well as heals the wound.
  • The non-haem iron that is acquired from the pants and lentils, are aided by the Vitamin C to be absorbed in the body.
  • Vitamin C helps the immune system of the body, especially the lymphocytes, to fight infection.

Hence, deficiency of vitamin C or inadequate consumption of vitamin C is a primary reason for the disruption of all these functions that are supposed to be managed and taken care of by this vitamin.

Signs and Symptoms of Scurvy:

There are various signs and symptoms of Scurvy. But the most common ones are –

  • Tender gums
  • Loss of teeth
  • Sunken eyes
  • Poor healing capacity of wounds
  • Gradual weakening
  • Pain in the joints
  • Lethargy, fatigue and loss of appetite
  • Internal bleeding
  • Pale skin and liver spots
  • Nausea
  • Fever
  • Diarrhoea
  • Pin point bleeding from skin.

Apart from these general signs and symptoms, the more severe complications and symptoms that are associated with Scurvy are –

  1. Skin Problems Associated with Scurvy- Development of perifollicular hyperkeratotic papules or reddish/bluish bruise-like spots around the hair follicles is the first sign of Scurvy. The hairs that come out of the follicles are usually twisted like corkscrew and are brittle. When the areas of such bruise-like spots join together, they become ecchymoses or palpable purpura.
  2. Muscular and Skeletal Problem Associated with Scurvy – At extreme conditions of Scurvy, the patients will have severe pain and swollenness in the muscular and bone joints and the pain can be so severe that the patient might be unable to walk.
  3. Anemia – Since scurvy or vitamin C deficiency is associated with blood loss within the tissue, gastrointestinal bleeding, changed metabolism of iron and folate and also intravascular haemolysis is a persistent cause of anaemia, in almost 75% of the scurvy patients.
  4. Oral Problems in Scurvy– Soft, red and spongy gums are consistent problems in Scurvy. Gums are easily swollen and even a very slight friction may cause them to bleed. This condition leads to other complications associated with oral unhygienic conditions and dental diseases.
  5. Eye Problems in Scurvy– Severe eye problems and complications are consistent difficulties associated with Scurvy. Dryness of eyes, light intolerance, bleeding or haemorrhaging beneath the conjunctiva, irritation in eyes, stickiness, bleeding or haemorrhaging within the optic nerve sheath and transient visual blurring are common symptoms.
  6. Heart and Lung Problems in Scurvy– Low blood pressure, shortness of breath and chest pain also occur in many patients that can lead to shock and death.

Causes and Risk Factors Associated with Scurvy:

The root cause of Scurvy is vitamin C or ascorbic acid deficiency. However, there are other causes that are associated with the reason behind the inadequate supply of vitamin C. These are – ignorance in having a proper diet with good and adequate supply of vitamin C, anorexia, famine, difficulty in consuming foods orally, restrictive diets with no supply of vitamin C due to other diseases.

During the 15th century sea voyages, Scurvy was seen to occur in sailors, who travelled to far off lands with their stock of preserved food and no supply of fresh fruits and vegetables like lime, oranges and lemons. As a result, many of them died during the sea voyages. It is a strong belief that Scurvy does not occur in the present era as there is always a supply of fresh fruits and vegetables, the rich sources of vitamin C throughout the year. Since, even the preserved and processed foods too have an additional supply of vitamin C or ascorbic acid in them, Scurvy does not occur much in the developed countries and societies. However, there are groups in which there is still a high chance of Scurvy to be occurring and they are –

  • People with malnutrition
  • Elderly people
  • Those, who are extremely alcoholic
  • Patients of Crohns' disease
  • Dialysis patients
  • Patients with malabsorption disorders
  • Those, who have severe dyspepsia.

People belonging to the poor class are often seen to develop Scurvy in them, as they fail to afford a proper diet with supply of fresh fruits and vegetables.

Diagnosis of Scurvy:

Scurvy is a disease that can easily be diagnosed by simply going through the symptoms. Sometimes, the dietary history can properly indicate the absence of any kind of citrus fruit or vegetables from the diet. However, the doctor will also run a test to check for the level of vitamin C in the blood.

Treatments for scurvy:

Scurvy is a disease that is not too common in the present era. However, amongst groups and societies, where people are deprived and where citrusy fresh fruits and vegetables are not accessible easily, scurvy can occur. If Scurvy is not treated on time, it can be invariably fatal. In contrary, the positive aspect of Scurvy is that it can be treated completely just with the help of a proper diet with adequate supply of vitamin C or ascorbic acid. The usual treatment procedure for scurvy includes 300 to 1000 mg of ascorbic acid dosage per day for an adult and 50 mg of ascorbic acid dosage up to four times in each day for children.

Home Remedies for Scurvy:

Along with the vitamin C supplements and dosage, regular diet must also include –

  • Fruits like oranges, limes, lemons, grapefruits, kiwifruits, mangoes, blackcurrants and strawberries are useful home remedy for Scurvy
  • Vegetables like tomatoes, green peppers, spinach, broccoli and cabbage.

Prevention of Scurvy:

Scurvy is a disease that occurs or may occur, only if the diet does not have adequate amount of vitamin C or ascorbic acid supply. Hence, the prevention of Scurvy is as easy as having an adequate amount of fruits and vegetables that are rich sources of this vitamin. The fruits that are good sources of vitamin C and are recommended for the treatment of Scurvy are also good as preventive diet. Pickled vegetables are also a good way of consuming vitamin C. However, no diet is self-sufficient and complete, if there is not a good deal of immune system development. Hence, regular walking and cycling, swimming and other physical activities are also a must for preventing Scurvy.

Proper diagnosis can manage and treat scurvy. However, the diagnosis is very important before it is too late. With proper care and diet plan, Scurvy can be avoided and prevented. If the symptoms and signs of the disease are bothering a lot, it should be assisted with other line of treatment.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: July 6, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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