Scurvy

Scurvy bleeding gums

Last Updated December 20th, 2021

Overview of scurvy

Diseases due to vitamin deficiency are more prevalent in the low and middle-income countries. A large percentage of the population in these countries is undernourished and lacks the essential micronutrients in the regular diets. A very common deficiency disease of this category is Scurvy that can occur in both children and adults. It arises mainly from the deficiency of Vitamin C in the body. The 18th October edition (2015) of the Times of India published that nearly 75% of the Indians suffer from Vitamin deficiency in general and a large section of this population suffers from Vitamin C deficiency in particular.

Speaking of global statistics, nearly 12.9% of the current global population in malnourished and the main reason behind this is vitamin deficiency (source: Health reports of United Nations World Food Program (WFP)). It has been found that majority of this undernourished population develop scurvy at some point of time.

 

What is scurvy?

Scurvy bleeding gumsScurvy is a group of symptoms caused by lack of Vitamin C or Ascorbic acid in the human body. The human body is incapable of producing Vitamin C and has to derive the same from the dietary sources. The dearth of Vitamin C in the body, therefore, leads to the reduced generation of collagen and reduced iron absorption. Scurvy may lead to general body weakness, gum diseases, anemia and skin hemorrhages. Research studies have shown that pregnant mothers having Vitamin C deficiency usually have children with gum diseases and scurvy. The symptoms generally start manifesting themselves between the ages of 6-13 years.

But in a few rare cases, a particular type of scurvy is observed in newborns. This is known as Barlow’s disease. Incidences of scurvy are more common in the countries of Asia, Latin America and Africa. This clearly indicates that the average intake of Vitamin C in these countries is much less than what is required by the body.

In these patients, the essential processes like the maintenance of intercellular material, binding of cells and tissues etc are hampered. In this disease, the walls of the smaller blood vessels, mainly the capillaries become extremely sensitive and fragile. This results in bleeding and haemorrhage in different body tissues, particularly the gum tissues. It also results in poor or delayed healing of wounds. The patients also suffer from anaemia due to the insufficient absorption of iron. In women, certain oral contraceptives lead to a significant dip in the concentration of plasma Vitamin C. The patients are often advised to increase the consumption of citrus fruits in order to make up for the deficiency.

 

What are the causes of scurvy?

Scurvy is caused by the following factors

  • Deficiency of Vitamin C (Ascorbic Acid) in regular diet
  • Inability of the body to utilise the Vitamin C extracted from different dietary sources
  • Very low consumption of food rich in Vitamin C (Eg: Citrus fruits like orange and lemon, green leafy vegetables, green pepper, black currant, tomato, cooked egg, non-fat yoghurt, low-fat milk)
  • Skipping meals or practicing crash dieting (common in the patients of Anorexia, Bulimia, Binge eating disorder)
  • Having processed or overcooked food from which the Vitamin C is lost during cooking or processing
  • Poor metabolism
  • Allergy to certain fruits or food items that are rich sources of Vitamin C
  • Prolonged intake of oral contraceptives that reduced plasma Vitamin C
  • Lack of knowledge of the sources of Vitamin C or the deficiency diseases

 

What are the main symptoms of scurvy?

Scurvy is mostly manifested as bleeding gums. The general symptoms of the disease are listed below-

  • Mild to moderate bleeding of the gums
  • Bleeding occurring mainly at the base of the teeth
  • Swelling and pain in the gums
  • Nosebleeds
  • Presence of blood in urine or faecal matter
  • Splinter haemorrhages (below the fingernails)
  • Subperiosteal haemorrhages
  • Poor and delayed healing of wounds in any part of the body
  • General anaemia and weakness
  • General body weakness and fatigue
  • Skin haemorrhage (petechial haemorrhage)
  • Haemorrhage of mucous membrane
  • Loss of appetite
  • Abnormally reduced weight and poor weight gain
  • Breathing problems
  • Gastrointestinal disorder (mainly Diarrhoea)
  • Fever
  • Mood changes and irritability
  • Tenderness and uneasiness in the limbs
  • Swelling over the long bones
  • Sense of paralysis (pseudoparalysis)
  • Loosening of teeth at an advanced stage
  • Bulging out eyeballs (Proptopsis)
  • Constochondral beading(found in the cartilages)
  • Hyperkeratosis (a type of skin disorder)
  • Sicca syndrome (an autoimmune disease of the connective tissue)
  • Abnormal and corkscrew hair
  • Frog-leg posture in very small children

 

What are the different types of Scurvy?

Scurvy is broadly categorised into two main types-

  • Adult scurvy: It is the general form of scurvy that occurs in teens and adults due to the deficiency of Vitamin C in the body. It is mostly characterised by bleeding gums, gum swelling, nosebleeds, skin and mucosal haemorrhage, loosening of teeth, tenderness of gums and swelling over the limb bones.
  • Infantile scurvy: It is a rare and serious form of scurvy, found mainly in newborns. It is also known as Barlow’s disease. It is more common in infants (aged 2-12 months) who feed on low grade and processed bottle milk. This happens because the heat generated during the processing of milk often destroys the Vitamin C present in milk. The main symptoms of infantile scurvy are- painful limb movements, frequent bruising, haemorrhage and frog-leg position.

 

Diagnosis , treatment, & prevention

The following diagnostic tests are useful for detecting scurvy-

  • Capillary fragility test
  • Measurement of systolic and diastolic pressure
  • Ascorbic acid level determination

Scurvy is diagnosed through laboratory investigations after a physical examination. The treatment mainly involves the replenishment of the depleted vitamin C stores of the body. In general, the registered physician prescribes vitamin C supplements based on several factors such as age, gender, state of the deficiency in the patient etc.

Scurvy vitamin CThe prescribed dose of vitamin C is as follows:

  • In adults and teenagers- the dose is approximately 500 mg a day for at least 2 weeks.
  • In children- the prescribed dose is approximately 100 mg to 300 mg per day for at least 2 weeks.
  • Vitamin C supplements are available in tablet, liquid and powder form.

Scurvy can be prevented by sticking to a diet plan having lots of fresh fruits and vegetables. Some fruits and vegetables rich in vitamin C are- Gooseberry, citrus fruits (orange, lemon etc.), tomatoes, potatoes, broccoli, green peppers, strawberries, kiwi fruit, Brussels sprouts, cantaloupe, apricots, mango, guava etc.

 

Facts

  • The disease of scurvy is not limited to human beings only. Many pets such as hamsters and guinea pigs also suffer from this disease, which is quite lethal in such animals.
  • Since vitamin C is mostly found in fresh fruits and vegetables, sailors often suffered from scurvy since they didn’t have a wide access to such foods.
  • The most recent outbreak of scurvy was observed in Afghanistan, as an after effect of the war and famine. It was also observed during the Irish Potato Famine and the American Civil War.

Facts

  • Though this disease is highly treatable, if left undiagnosed it can claim the life of the individual owing to complete suppression of immunity.
  • Currently, almost 27 million Americans have very low levels of vitamin C putting them at high risk for scurvy.
  • This disease is more common amongst lower income population since they have lesser access to healthy fresh produce.

Facts

  • With a diet completely devoid of vitamin C, vitamin C stores of the body will last for around 2-3 months
  • According to the World Health Organization (WHO), the recommended daily requirement of vitamin C is 75 mg in females and 90 mg in males.

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Dos and Don'ts

Dos
  • Make sure that you are consuming the minimum required levels of Vitamin C through your diet – adult men 90 mg and adult women 75 mg per day.
  • Consume more of berries, citrus fruits, potatoes, guavas, and tomatoes to keep your vitamin C at healthy levels.
  • Patients of Crohn’s disease are at high risk of developing this condition. Make sure such individuals receive good amount of Vitamin C through their diet or supplements.
Don'ts
  • Indulge in smoking, as it  reduces the vitamin C absorption in the body and makes you susceptible to scurvy.
  • Consume alcohol in large amounts as it may interfere with the vitamin C absorption in the body.
  • Neglect your nutrient inatke if you are undergoing chemotherapy. They are susceptible to vitamin C deficiency and should take appropriate doses of vitamin C after consulting an oncologist.

 

 

 

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Anti-Hepatitis B Core Antigen (AHBc) Total Anti-hepatitis B core antigen (AHBC ) is a blood examination and the only serological marker of infectious blood…
woman with abdominal pain holding ovulation calendar
Ovulation – facts to know about ovulation Learn how and when ovulation occurs, demystify common misconceptions, identify symptoms, methods of detection and right period for…
Optavia diet
The features of an Optavia diet The Optavia diet endorses pre-packaged meals and snacks called "fuelings" that are tasty, low in calorie, and incorporates…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…
Erythritol: A healthy sugar substitute or yet another marketing ploy? Erythritol is a popular choice of a healthy alternative sweetening agent in foods. But how healthy can a…
Experts reveal the safest ways to perform an enema at home The idea of pushing some up your rectal area might make you queasy but an enema could actually…
Bubble Tea: Bubbling with nutrition or a hidden sugar mine? The tapioca pearls present in the tea looks like bubbles and hence the name bubble tea became popular.…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
blood elements analysis
Blood Element Analysis Test A blood element analysis is a blood test performed to measure the level of toxic elements such as…
antiHEV IgM test
Anti hepatitis E virus (Anti HEV) IgM Test Anti HEV IgM test determines the level of the IgM antibodies in the blood, The disease is often…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
pilonidal sinus
Pilonidal sinus Pilonidal sinus is more common in young men than women. Learn about treatment options, surgical management, risks, and…
acne removal tips
Anatomy of acne: 7 instant steps to kiss those zits goodbye Blackheads, whiteheads, or pimples-call them what you may. Acne is never good news.Did you know some of the…
gout diet purines
Gout Diet : Get relief from painful joints by eating these foods Are you a victim of this painful condition? Are medications providing only short relief? Find a list of…
Horny Goat Weed: Can it improve libido in human beings too? This plant got its name as Horny Goat Weed when one of the goats feeding on the plant…
Rick Simpson’s Oil: The truths and controversies of this cannabis product Rick Simpson's Oil is an extract from the much-controversial plant, Cannabis. What is the actual truth behind the…
dandelion weight loss
Caralluma Fimbriata: How to eat this cactus to lose weight Caralluma fimbriata is a miracle cactus that can be safely consumed by most for losing weight and boosting…
Carb Cycling: Weighing the pros vs the cons of this diet routine Completely discarding carbs from your life will do you more harm than good. Read more about carb cycling,…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
Appendix pain: Recent findings on this not-so vestigial organ The exact function of the appendix is still not clear. Some consider it as an organ that once…
SIBO Diet: The important dos and don’ts of this gut-healing diet A SIBO diet is a diet that works by eliminating certain sugars from your diet and adding fibers…
Atkins diet weight loss
Atkins Diet: The right steps to carb control that can help you lose those pounds fast The Atkins diet is a high fat, low-carb diet with proven weight loss benefits that is flexible enough…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
hidden benefits walking
9 benefits of walking we bet you didn’t know! Did you know walking can be the miracle pill for eternal youth? Everyone knows walking is good for…
aspartame or sugar
Aspartame – Hidden truths about this storm in a teacup Aspartame, the artificial sweetener, has gone under the scanner on several occasions for allegedly doing more harm than…