Scurvy is possibly the oldest known nutritional disease, having been described in medical writings as early as 400 B.C. It is a deficiency disorder that is caused by a lack of vitamin C, or ascorbic acid, in the diet. It is also called vitamin C deficiency or scorbutus. Vitamin C is a very important anti-oxidant that is required for the production of collagen, which is necessary for healthy development of tissues, for the functioning of the immune system, and for the healing of wounds. It is found in certain fruits and vegetables, especially citrus fruits, and green leafy vegetables such as spinach and broccoli. It was once common in sailors and soldiers, who were away from sources of fresh fruits and vegetables for long periods of time; though it was known that scurvy was nutrition-related, it wasn’t until the 20th century that the exact cause of it was identified. In contemporary times, scurvy is rare in countries where fresh fruits and vegetables are easily accessible, and where vitamin C is added to some foods.
Symptoms of scurvy usually begin to appear about one to three months after the intake of vitamin C has stopped. Scurvy is characterized by tiredness, weakness in the muscles, fainting, aches in the joints and muscles, a rash on the legs, hair growing in a spiral pattern, anemia, and bleeding gums. In children, it presents as painful swelling of the legs, as well as fever, diarrhea, and vomiting. Adult symptoms include malaise, as well the appearance of spots that can appear as tiny red blood blisters to large purplish blotches on the skin of the legs. Gums may swell and bleed easily, turn blue and bruised, and eventually the teeth are loosened. Other symptoms can include irritability, pain in the legs, paralysis, swelling, lung and kidney problems, and hemorrhaging. If the progress of scurvy is not halted, it will result in death.
Scurvy is primarily caused by a lack of vitamin C in the diet. In babies, scurvy can develop if they are weaned from breast milk to cow’s milk and are not given a vitamin C supplement. It can also occur in babies whose mothers took high doses of vitamin C during pregnancy. Stress, either emotional or physiological, also contributes to scurvy.
Scurvy is usually diagnosed visually, by evaluating the symptoms present. A dietary history may be taken, in which you tell your doctor about your diet, so that a vitamin C deficiency can be discerned. In some cases, a blood test can be given to test the level of ascorbic acid in the blood. Sometimes a dermatologist must be consulted to evaluate the different spots on the skin that can be caused by scurvy or may be a symptom of something else, and an internal medicine specialist can evaluate other symptoms that may affect the internal organs.
SCURVY RISK FACTOR
In general, those who do not get enough vitamin C in their diets are at risk for scurvy. This includes people from populations where malnutrition is a threat, and it can also include children and teenagers in developed countries. Babies whose mothers did not have sufficient nutrition during pregnancy and babies who were premature are at high risk, and scurvy is one of the most serious illnesses affecting American teenagers in the present day. It is also a risk for people who drink heavily and for elderly populations that have nutrition deficiencies. Others at risk are those who are taking oral contraceptives, those who are pregnant, breastfeeding, those with inflammatory diseases or burns, those who have undergone surgery, those who are exposed to excessive heat or cold, those who are in dialysis, those who have other nutritional deficiencies, and those who live in high traffic areas where there are high levels of carbon monoxide.
The worst complication of scurvy is death. Scurvy can cause cardiac failure, both in infants and adults. It can cause hemorrhaging into various tissues that results in death, and also cause low energy, depression, and excruciating pain. If damage from scurvy does occur, it is irreversible.
The treatment for scurvy is simply to make up for the deficiency that caused the illness in the first place. Adults should be given 300 to 1000 milligrams of vitamin C every day until the scurvy is resolved. For infants, the dosage should be about 50 milligrams, three or four times a day.
If scurvy is treated, people usually recover, but it is dangerous to leave it untreated. Scurvy can be prevented by eating a healthy diet, rich in vitamin C, which would include fresh fruits and vegetables, including grains, legumes, oranges, lemons, limes, guavas, strawberries, papaya, olives, grapefruit, blackcurrants, tomatoes, broccoli, kiwi fruit, sprouts, cantaloupe, spinach, green peppers, potatoes and sweet potatoes, milk, liver, kidney, fish and cabbage. It is also recommended that you take a vitamin C supplement in order to insure that you are getting enough of it to keep you healthy. Babies, especially those who are being weaned from breast milk, should also be given a supplement. There are also certain medications that can be used in the treatment of severe scurvy. Some of these include high level ascorbic acid supplements such as Ascor, Ascot, Betac, Cecon, Cemill, or Protexin.
There are many natural or home remedies that can be effective in treating scurvy, in addition to vitamin C supplements. Indian gooseberry is known to be very effective, and is, in fact, the richest known source of vitamin C. Lime and lemon, as has been mentioned, is effective, and should be drunk with water, in a solution sweetened with honey. Another fruit that is high in ascorbic acid content is the mango, and mango powder has an even higher vitamin C content than limes. Potatoes are comprised of almost 20% vitamin C content, and history has shown that when potato crops flourished, scurvy did not, but when potato crops failed, scurvy spread rapidly. The leaves of the jaundice plant are also high in ascorbic acid and can be boiled and the juice drunk to treat scurvy.
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