All About Scurvy

Scurvy is better known as severe vitamin C deficiency.

Vitamin C, or ascorbic acid, is an essential dietary nutrient. It plays a role in the development and functioning of several bodily structures and processes, including:

• the proper formation of collagen, the protein that helps give your body’s connective tissues structure and stability
• iron absorption
• antioxidant action
• wound healing
• creation of neurotransmitters, like dopamine and epinephrine

Additionally, vitamin C may have a role in cholesterol and protein metabolism.

Read on to learn more about scurvy.

Vitamin C plays many different roles in your body. A deficiency in the vitamin causes widespread symptoms.

Typically, signs of scurvy begin after at least 4 weeks of severe, continual vitamin C deficiency. Generally, however, it takes 3 months or more for symptoms to develop.

Early warning signs

Early warning signs and symptoms of scurvy include:

• weakness
• unexplained exhaustion
• reduced appetite
• irritability
• aching legs

Symptoms after 1 to 3 months

Common symptoms of untreated scurvy after 1 to 3 months include:

• anemia, when your blood lacks enough red blood cells or hemoglobin
• gingivitis, which causes red, soft, and tender gums that bleed easily
• skin hemorrhages, or bleeding under your skin
• bruise-like raised bumps at your hair follicles — often on your shins — with central hairs that appear corkscrewed (twisted) and break easily
• large areas of reddish-blue to black bruising, often on your legs and feet
• tooth decay
• tender, swollen joints
• shortness of breath
• chest pain
• eye dryness, irritation, and hemorrhaging in the whites of your eyes (conjunctiva) or optic nerve
• reduced wound healing and immune health
• light sensitivity
• blurred vision
• mood swings — often irritability and depression
• gastrointestinal bleeding
• headache

If left untreated, scurvy can cause life threatening conditions.

Complications associated with long-term, untreated scurvy include:

• severe jaundice, which is the yellowing of your skin and eyes
• generalized pain, tenderness, and swelling
• hemolysis, a type of anemia where red blood cells break down
• fever
• tooth loss
• internal hemorrhaging
• neuropathy, or numbness and pain usually in your lower limbs and hands
• convulsions
• organ failure
• delirium
• coma

Untreated scurvy can be a life threatening condition and cause death.

Infants with scurvy may be irritable, anxious, and difficult to soothe. They may also appear to be paralyzed, lying with their arms and legs extended halfway out. Infants with scurvy may also develop weak, brittle bones prone to fractures as well as hemorrhaging.

Risk factors for scurvy in infants include:

• having malnourished birthing parents
• being fed evaporated or boiled milk
• having difficulty nursing
• having restrictive or special dietary needs
• having digestive or absorption disorders

Your body cannot make vitamin C. That means you have to consume all of the vitamin C your body needs through food or drinks, or by taking a supplement.

Most people with scurvy lack access to fresh fruits and vegetables or do not have a healthy diet. Scurvy impacts many people in the developing world.

Public health surveys published in 2008 have shown that scurvy may be far more prevalent in developed nations than once thought, especially in at-risk segments of the population. Medical conditions and lifestyle habits also increase the risk of the condition.

Risk factors for malnutrition and scurvy include:

• being a child, or being 65 years of age or older
• drinking alcohol daily
• using illegal drugs
• living alone
• having restrictive or specified diets
• having low income, and thus reduced access to nutritious foods
• being homeless or a refugee
• living in areas with limited access to fresh fruits and vegetables
• having eating disorders or psychiatric conditions that involve a fear of food
• having neurological conditions
• having disabilities
• living with irritable bowel syndrome (IBS), or forms of inflammatory bowel disease (IBD), including Crohn’s disease or ulcerative colitis
• having digestive or metabolic conditions
• having immune conditions
• living in a place where the cultural diet consists almost entirely of carbohydrates, like bread, pasta, and corn
• having chronic diarrhea
• being dehydrated
• smoking
• receiving chemotherapy and radiation therapy
• receiving dialysis and having kidney failure

If you suspect you have scurvy, a doctor will ask questions about your dietary history, check for signs of the condition, and order a blood test.

The blood test will be used to check the levels of vitamin C in your blood serum. Generally, people with scurvy have blood serum levels of vitamin C that are less than 11 micromoles per liter (µmol/L).

Though the symptoms can be severe, scurvy is fairly simple to treat.

Vitamin C is naturally found in many fruits and vegetables. It’s also often added to juices, cereals, and snack foods. If you suspect you have a mild case of scurvy, eating at least five servings of fruits and vegetables daily is the easiest way to treat the condition.

Oral vitamin C supplements are also widely available, and the vitamin is included in most multivitamins. If symptoms continue after a few days of dietary changes, speak with a doctor.

There’s no consensus on a specific therapeutic dose for severe scurvy. For these cases, a doctor may recommend high doses of oral vitamin C supplements for several weeks or longer.

Daily recommended vitamin C

Daily vitamin C recommendations depend on age, sex, and health conditions.

People who smoke or have digestive conditions typically require at least 35 milligrams (mg) per day more than people who do not smoke.

Sources of vitamin C

Citrus fruits, like oranges, limes, and lemons, have traditionally been used to prevent and treat scurvy. Several other fruits and vegetables contain higher doses of vitamin C than citrus fruits. Many prepared foods, like juices and cereals, also contain added vitamin C.

Foods with high levels of vitamin C include:

• sweet peppers
• guavas and papayas
• dark, leafy greens, especially kale, spinach, and Swiss chard
• broccoli
• Brussels sprouts
• kiwifruits
• berries, especially raspberries, strawberries, and blackberries
• pineapples and mango
• tomatoes, especially tomato pastes or juices
• cantaloupes and most melons
• green peas
• potatoes
• cauliflower

Vitamin C dissolves in water. Cooking, canning, and prolonged storage can greatly reduce the vitamin content in foods. It’s best to eat vitamin C foods raw, or as close to it as possible.

Most people begin to recover from scurvy fairly quickly after starting treatment. You should see an improvement in some symptoms within 1 to 2 days of treatment, including:

• pain
• exhaustion
• confusion
• headache
• mood swings

Other symptoms may take a few weeks to improve following treatment, including:

• weakness
• bleeding
• bruising
• jaundice

Scurvy is caused by a chronic vitamin C deficiency. Most cases:

• are mild, if treated
• develop in people with unbalanced diets
• are easily treatable with dietary changes or supplement use

If left untreated, chronic scurvy can cause serious health complications.

The recommended daily allowance for most people 14 years or older ranges between 65 and 120 mg daily.