Scurvy: Causes, Symptoms and Treatments - Medical News Today Scurvy: Causes, Symptoms and Treatments Written by Peter Crosta M.A. 4 36 Scurvy is a disease caused by a diet that lacks vitamin C (ascorbic acid). Patients develop anemia , debility, exhaustion, edema (swelling) in some parts of the body, and sometimes ulceration of the gums and loss of teeth. The name scurvy comes from the Latin scorbutus. We have known about the disease in humans since ancient Greek and Egyptian times. Scurvy commonly is associated with sailors in the 16th to 18th centuries who navigated long voyages without enough vitamin C and frequently perished from the condition. Modern cases of scurvy are extremely rare. Humans cannot synthesize vitamin C, which is necessary for the production of collagen and iron absorption. We have to obtain it from external sources, i.e. from fruits and vegetables, or some foods which are fortified with vitamin C in order to prevent the vitamin C deficiency known as scurvy. Vitamin C deficiency is especially dangerous for the fetus (developing baby in the womb).

Researchers from the University of Copenhagen reported in the journal PLOS ONE that pregnant women with a vitamin C deficiency can have babies whose brain did not develop properly . What causes scurvy? The primary cause of scurvy is insufficient intake of vitamin C (ascorbic acid). This may be due to ignorance, famine, anorexia , restrictive diets (due to allergies, food fads, etc.), or difficulty orally ingesting foods. Historically, scurvy was the result of long sea voyages where sailors did not bring along enough foods with vitamin C. Who gets scurvy? Though scurvy is a very rare disease, it still occurs in some patients - usually elderly people, alcoholics, or those that live on a diet devoid of fresh fruits and vegetables. Similarly, infants or children who are on special or poor diets for any number of economic or social reasons may be prone to scurvy. Symptoms of scurvy Scurvy symptoms may begin with appetite loss, poor weight gain, diarrhea , rapid breathing, fever , irritability, tenderness and discomfort in legs, swelling over long bones, bleeding (hemorrhaging), and feelings of paralysis.

As the disease progresses, a scurvy victim may present bleeding of the gums, loosened teeth, petechial hemorrhage of the skin and mucous membranes (a tiny pinpoint red mark), bleeding in the eye, proptopsis of the eyeball (protruding eye), constochondral beading (beading of the cartilage between joints), hyperkeratosis (a skin disorder), corkscrew hair, and sicca syndrome (an automimmune disease affecting connective tissue). Infants with scurvy will become apprehensive, anxious, and progressively irritable. They often will assume the frog leg posture for comfort when struck with pseudoparalysis. It is common for infants with scurvy to present subperiosteal hemorrhage, a specific bleeding that occurs at the lower ends of the long bones. Diagnosis of scurvy Physicians initially will conduct a physical exam, looking for symptoms described above. Actual vitamin C levels can be obtained by using laboratory tests that analyze serum ascorbic acid levels (or white blood cell ascorbic acid concentration). Sometimes, radiological procedures are ordered for diagnostic purposes and to see what damage scurvy has already done.

Treatments for scurvy Scurvy is treated by providing the patient with vitamin C, administered either orally or via injection. Orange juice usually functions as an effective dietary remedy, but specific vitamin supplements are also known to be effective. How can scurvy be prevented? Scurvy can be prevented by consuming enough vitamin C, either in the diet or as a supplement. Foods that contain vitamin C include: Oranges, lemons, kiwi fruit and strawberries are all excellent natural sources of vitamin C. Oranges Scurvy | DermNet New Zealand DermNet New Zealand Author: Vanessa Ngan, Staff Writer, 2005. What is scurvy? Scurvy is a condition characterised by general weakness, anaemia, gingivitis (gum disease), and skin haemorrhages caused by a prolonged deficiency of vitamin C (ascorbic acid) in the diet. Vitamin C plays a crucial role in the formation of collagen, a major component of connective tissue. Connective tissue has structural and supportive functions which are indispensable to blood vessels and all tissues within the body. Vitamin C is also important in the proper functioning of the immune system, iron absorption, cholesterol metabolism and other biological activities.

Thus scurvy has widespread effects. Who gets scurvy? Scurvy was often seen in sailors on long ocean voyages described from the 15th century onwards. Many men died from the disease until it was discovered that scurvy could be effectively cured and prevented by consuming vitamin C through lemons, oranges and limes. The nickname for British sailors of ‘limey’ derives from the practice of giving British sailors limes. It is thought that scurvy occurs very rarely in modern societies of today as most people have access to year-round fresh fruits and vegetables which are rich sources of vitamin C. However, several groups of people are at risk. These include: People with chronic malnutrition or those that eat less than 2 servings of fruits/vegetables per day Alcoholics People on peculiar diets or food fads Psychiatric disease (delusions or fear of food, suicide attempt by self-starvation, eating disorders) People with other medical conditions that may prevent the intake and/or absorption of vitamin C Dialysis patients Inflammatory bowel disease (Crohns Disease) Malabsorption disorders Severe dyspepsia Under-developed third world countries where general malnutrition exists.

Also, in populations that subsist mainly on cereal grains and without access to fresh fruit or vegetables. What are the signs and symptoms? The diagnosis of scurvy is primarily a clinical one, based on a dietary history of inadequate vitamin C intake and the signs and symptoms described below. Symptoms of scurvy generally develop after at least 3 months of severe or total vitamin C deficiency. Patients initially complain of weakness, fatigue, listlessness and aching limbs, especially in the legs. If left untreated, scurvy can progress to the following more severe problems. Skin problems – one of the first signs of scurvy is the development of perifollicular hyperkeratotic papules, often on the shins. These appear as reddish/bluish bruise-like spots surrounding hair follicles. The central hairs are twisted like corkscrews that may break easily. The papules may join together to form large areas of palpable purpura or ecchymoses (bruises). Scurvy Extensive purpura Oral problems – gums may swell and become red, soft and spongy. Any slight friction may cause the gums to bleed. Often this results in poor oral hygiene and dental diseases.

Musculoskeletal problems – bleeding in the joints causes extreme discomfort and pain. Joints may be swollen and tender and the pain can be so severe that patients cannot walk. Eye problems – patients may complain of dryness, irritation, light intolerance, transient visual blurring and stickiness. Haemorrhaging (bleeding) beneath the conjunctiva and within the optic nerve sheath may also occur. Anaemia – this develops in 75% of patients as a result of blood loss into tissue, altered absorptions and metabolism of iron and folate, gastrointestinal bleeding and intravascular haemolysis. Heart and lung problems – shortness of breath, low blood pressure, and chest pain leading to shock and death. Treatment and prevention with vitamin C Treatment of scurvy is simply with vitamin C supplements taken orally. The adult dosage is 800-1000 mg/day for at least one week, then 400 mg/day until complete recovery. Children should be given 150-300 mg/day for one month. Some improvement of symptoms is usually noticed within 24 hours. Except for the loss of teeth through dental disease, permanent damage from scurvy does not usually occur.

Prevention of scurvy is easily achieved by take the recommended daily intake (RDI) of vitamin C. This is between 30-60 mg/day. By following the “5 servings of fruit and vegetables per day” rule, you will be getting the RDI and maintaining sufficient body stores of vitamin C. Related information References: Book: Textbook of Dermatology. Ed Rook A, Wilkinson DS, Ebling FJB, Champion RH, Burton JL. Fourth edition. Blackwell Scientific Publications. Hirschmann JV, Raugi GJ. Adult scurvy. Journal of the American Academy of Dermatology 1999;41:895-906 Scurvy - Causes - NHS Choices Scurvy - Causes Causes of scurvy Scurvy is caused by a lack of vitamin C in your diet. If your body doesn't have enough vitamin C, it can't produce new collagen (a protein found in many different types of body tissue, including the skin and bones). Without a new supply of collagen, the body's tissue will begin to break down and deteriorate.

In the developed world, even if someone has a relatively unhealthy and imbalanced diet, it should provide an adequate supply of vitamin C. Therefore, for scurvy to develop, there are usually other contributing factors, such as: homelessness complex mental health conditions – such as severe depression or schizophrenia being elderly and unable to maintain a healthy diet – for example, elderly men who've recently been widowed and have little experience of cooking for themselves can sometimes develop scurvy treatments that cause nausea as a side effect, such as chemotherapy , can sometimes result in a person losing their appetite conditions that affect a person's ability to digest food – such as Crohn's disease or ulcerative colitis anorexia nervosa – an eating disorder where a person becomes very concerned about gaining weight and tries to control it by eating as little as possible fad diets smoking – which can reduce the amount of vitamin C absorbed by the body pregnancy or breastfeeding – as the body needs more vitamin C at these times In the UK, scurvy in children is relatively rare. It usually occurs through a combination of parents being on a low income and knowing little about nutrition.

For example, in 2009, a case of scurvy was reported in a child whose diet only consisted of bread and jam. However, delayed or unsuccessful weaning of babies and toddlers to solid food can also lead to scurvy, if these children aren't given the recommended supplementation of vitamins A, C and D from six months of age, or if they're drinking less than 500ml of formula milk. See vitamins for children for more information. Lack of vitamin C Although scurvy is rare in the UK, research has shown that a significant number of people may have a lack of vitamin C. However, it's possible to get a good supply of vitamin C by eating plenty of fruit and vegetables . The good news is that it doesn't have to cost a lot to get your 5 A DAY. Scurvy - Symptoms, Causes, Treatments Scurvy Treatments What is scurvy? Scurvy is a disease that affects the blood vessels, skin, and the body’s healing process, resulting in anemia, hemorrhaging of the skin, and gum disease (gingivitis). Scurvy occurs when your diet is deficient in vitamin C.

Scurvy is uncommon in the United States, and those most at risk are older adults and alcoholics suffering from malnutrition. Vitamin C, also known as ascorbic acid, is a water-soluble vitamin, meaning the body neither produces nor stores the vitamin. To maintain good health, vitamin C must be replenished frequently. If your diet is lacking in fruits and vegetables, you may be at risk of an inadequate level of vitamin C. Conditions that cause malnutrition may be associated with scurvy. Looking for a Doctor? Search Now Find a Nutritionist Near You You may find that the signs and symptoms of scurvy are constant or occur only periodically. The types of symptoms associated with scurvy vary among individuals. Some people with scurvy have only mild symptoms, such as fatigue, while others may develop severe anemia and recurrent infections. The 10 Best Sources of Protein Fortunately, scurvy can be readily and effectively treated with nutritional supplements to resolve deficiencies in vitamin C. Changes in your lifestyle can also reduce your risk of developing scurvy, include limiting alcohol intake, eating a well-balanced diet that includes a variety of fruits and vegetables, not smoking, and always taking all medications and supplements as prescribed.

In some cases, if left untreated, scurvy can lead to severe vitamin-deficiency anemia that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these serious symptoms, including difficulty breathing or shortness of breath, fainting or change in level of consciousness or lethargy, generalized swelling, muscle pain, uncontrollable bleeding, or rapid heart rate (tachycardia). Seek prompt medical care if you are being treated for scurvy but mild symptoms worsen, recur, are persistent, or give you any reason for concern. Vitamin C Deficiency | Patient Vitamin C Deficiency 587 Vitamin C cannot be made by the human body and so is an essential component of the diet. It is needed for the health and repair of various tissues in your body, including skin, bone, teeth and cartilage. Persistent lack of vitamin C in your diet can lead to a condition called scurvy. Symptoms of scurvy include easy bruising, easy bleeding and joint and muscle pains. Vitamin C deficiency can be treated with supplements of vitamin C and a diet rich in vitamin C. What is vitamin C?

Vitamins are a group of substances needed in small amounts by the body to maintain health. Vitamin C is also called ascorbic acid. It cannot be made by the human body and so is an essential component of your diet. Vitamin C is needed to make a substance called collagen which is required for the health and repair of various tissues in the body, including: Skin There are various foods that are rich in vitamin C, including: Citrus fruits like oranges, grapefruit, limes and lemons. Berries such as blackcurrants, strawberries, raspberries, blueberries and cranberries. Cantaloupe melon and watermelon. Kiwi fruit. Vegetables such as spinach, green and red peppers, tomatoes, cauliflower, cabbage, broccoli, Brussels sprouts and potatoes. Certain foods such as cereals are fortified with vitamin C, which means that they have vitamin C added to them. Vitamin C is also found in fresh milk, fish and offal such as liver and kidney. Around 90% of vitamin C in the human diet is from fruit and vegetables. Cooking fruit and vegetables reduces their vitamin C content by around 30-40%.

The recommended daily intake of vitamin C in the diet depends on your age and sex. Pregnant and breast-feeding women also need higher amounts of vitamin C in their diet. Children aged 1-10 years need 30 mg of vitamin C per day. Children aged 11-14 years need 35 mg of vitamin C per day. Children over the age of 15 years and adults need 40 mg per day. What is vitamin C deficiency? Deficiency, or a lack, of vitamin C in your body happens because of a lack of sufficient amounts of vitamin C in your diet. Over time, a lack of vitamin C means that new collagen cannot be formed. This causes various tissues in your body to start to break down and the health and repair of your body become affected. Persistent (chronic) vitamin C deficiency, usually over a period of around three months or more, can lead to an illness known as scurvy. Related discussions How common is vitamin C deficiency? Scurvy due to vitamin C deficiency is rare in the UK. There are certain groups of people who are more at risk of vitamin C deficiency.

They include: People dependent on drugs and/or alcohol who may not have a healthy, balanced diet. People who go on fad diets. People living on a low income who tend not to buy foods with a high vitamin C content. People with a medical condition that affects the body's ability to digest and absorb food, such as Crohn's disease and ulcerative colitis . Older people who may eat a less varied diet. Smokers . Smoking affects the absorption of vitamin C from foods and also vitamin C is used up in the body more quickly in those who smoke. Pregnant and breast-feeding women because they need higher amounts of vitamin C. Tooth loss. Weight loss. If not diagnosed and treated, vitamin C deficiency can also lead to shortness of breath, nerve problems, high temperature (fever) and fits (convulsions). Bleeding inside the brain and around the heart can cause death in some people with untreated vitamin C deficiency. However, this is extremely rare. Do I need any investigations? Your doctor may suspect vitamin C deficiency after asking you careful questions about your diet and listening to the symptoms that you have. A blood test can be taken to measure vitamin C levels and may help to confirm the diagnosis.

Your doctor may also suggest some other blood tests to check for other deficiencies in your diet. For example, vitamin C is also needed for the absorption of iron from food. Therefore, iron deficiency often occurs in people who are deficient in vitamin C. X-rays to look at your bones may also be suggested because specific changes to the bones, including 'thinning' of the bones, are often seen in someone with vitamin C deficiency. Related Wellbeing See all Wellbeing What is the treatment for vitamin C deficiency? The treatment for vitamin C deficiency is to replace the vitamin C that is lacking in your diet. This can be achieved by taking vitamin C supplements and by eating a diet rich in vitamin C. You may be referred to a dietician for help. After a period of time, vitamin C supplements can usually be stopped. However, it is important to continue to eat a diet rich in vitamin C after the supplements are stopped. This will help you to avoid becoming deficient in vitamin C again. What is the outlook (prognosis)? People with vitamin C deficiency usually make a full recovery. Once treatment to replace vitamin C is started, symptoms usually quickly improve within days or weeks. Can vitamin C deficiency be prevented?

Vitamin C deficiency can be prevented by making sure that you have a healthy, balanced diet that contains plenty of fruit and vegetables including those high in vitamin C that are listed above. As a rough guide, one large orange a day will provide you with enough vitamin C. References & Disclaimer | Provide Feedback Further reading & references Agarwal A, Shaharyar A, Kumar A, et al ; Scurvy in pediatric age group - A disease often forgotten? J Clin Orthop Trauma. 2015 Jun;6(2):101-7. doi: 10.1016/j.jcot.2014.12.003. Epub 2015 Jan 5. Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions .

Original Author: 4 Diseases Caused by a Lack of Essential Vitamins and Minerals | Mental Floss 4 Diseases Caused by a Lack of Essential Vitamins and Minerals Retronaut.com Like us on Facebook Companies pushing products with added vitamins and minerals can fool people into thinking that they’re eating a “healthy” food when they’re not—but it’s not like those vitamins and minerals are there for no reason. For much of human history, diseases of nutrient deficiency were the norm, and in some parts of the world, they still persist. Even into the 20th century, conditions caused by a lack of certain vitamins or minerals were endemic to North America and Europe. Artificially added nutrients may not make a food “healthy,” but they do stave off several debilitating, and sometimes fatal, diseases of malnutrition. Here are a few of those maladies. 1. Scurvy Courtesy of The Diseases of Infancy and Childhood The disease of pirates: the grey-death. Scurvy is caused by a lack of vitamin C, whose chemical name, ascorbic acid, is derived from the Latin term for scurvy, scorbutus.

Even though the disease was known since ancient times (described by Hippocrates around 400 BCE), it was not a scourge to those who were largely land-bound. Even though its causes were unknown, many cultures realized that eating certain herbs could reverse the symptoms, and as long as there was access to fresh food, it was generally kept under control. Scurvy didn’t become a significant problem until the Age of Discovery (beginning in the 15th century), when people at sea were not able to access that much-needed fresh food for months at a time. Preserved meats and carbohydrates contained no vitamin C, and unlike most animals, the human body is not able to create vitamin C on its own. The early symptoms of scurvy include spongy gums, pain in the joints, and blood spots appearing under the skin. As the disease progressed, the teeth would become loose, extreme halitosis (bad breath) would develop, the afflicted would become too weak to walk or work, be in too much pain to eat, and would die “mid-sentence,” often from a burst blood vessel.

Many of the early explorers lost great numbers of men to scurvy : Vasco de Gama lost 116 out of 170 men in 1499, and in 1520, Magellan lost 208 out of 230. A few deaths were attributable to other causes, but the vast majority were due to scurvy. Courtesy of TaussMarine.com Despite not being able to pinpoint the exact cause of scurvy, in the 18th century, Naval physician James Lind was able to prove , in what’s considered to be the first controlled scientific experiment, that scurvy could be prevented (and cured) by incorporating citrus fruits such as limes and oranges into the diet of sailors. Although his findings weren’t widely accepted at first, the British Navy eventually began issuing standard rations of lemon juice, and later, limes, to their sailors—which gave rise to the term “limey” in reference to the British. These days, scurvy is an extremely rare condition, almost exclusively caused by someone eating a completely unvaried diet .

In most cases, high levels of oral supplementation of vitamin C are enough to reverse the condition in a matter of weeks, and death by scurvy is almost unheard of. 2. Rickets Courtesy of Blatner.com This condition is brought on by a lack of vitamin D, which causes the body to be unable to absorb or deposit calcium. Less commonly, it can also be caused by a lack of calcium or phosphorus, but vitamin D deficiency is by far the most common cause. Unlike vitamin C, the human body is able to produce vitamin D, but only if it has the metabolic precursors available to it. When the skin is exposed to ultraviolet light (such as from the sun), cholesterol in the skin reacts and forms cholecalciferol, which is then processed in the liver and kidneys to create the active form of vitamin D. Even with a nominally healthy diet, without enough sun exposure, the body can’t produce the vitamin D precursors on its own.

This is actually re-emerging as a health concern among some increasingly-indoor groups of people, and is one of the few hypovitaminosis (lack of vitamin) conditions not considered to be a “disease of the past.” Luckily, when the deficiency is recognized, cholecalciferol can be directly taken as a vitamin supplement or acquired from eating organ meats and oils, such as cod liver oil, allowing the body to resume producing vitamin D. Rickets is a condition of children, as the deficiency’s most severe effects are on developing bones; in adults, “bone-softening,” or osteomalacia, can be caused by the same vitamin deficiency. But in adults, it both takes significantly longer to develop and tends to cause tip-off signs that something is wrong before bone warping sets in, such as extreme pain in the bones, and unexplained muscle weakness. In children, especially those that don’t or can’t receive regular check-ups, deformity and debilitation by the deficiency is often only noticed after significant damage has been done to their developing skeletons.

The most telling symptoms of rickets are at the epiphyses (growth plates) of bones: The body is unable to lengthen bones by depositing calcium, and ends up with bones that flare outward in a “cupping” appearance. This leads to costochondral swelling, or what’s known as the “rachitic rosary” along the ribcage of the child, as well as widened wrists and “thick” joints. Before widened wrists or rachitic rosary appears, the softening of the skull bones can lead to “Caput Quadratum”—a square-headed appearance, and often the first sign of skeletal growth problems. If left untreated, rickets also can cause an extremely curved back, stunted growth, and frequent fractures—all of which can lead to permanent and debilitating deformity. 3. Beriberi Courtesy of Wikimedia Commons This condition is largely confined to Asia, especially in countries where boiled rice is a staple.

The Sinhalese term “beri-beri” means, “I cannot, I cannot,” and derives from the inability to perform even the simplest of tasks once the polyneuritis (nerve inflammation) caused by the deficiency of vitamin B1 (thiamine) has permanently damaged the neurons, when the condition has progressed to the end-stage. Although beriberi was known to exist in rice-eating countries several centuries back , its prevalence boomed with the introduction of steam-driven rice-polishing mills from Europe. The superior taste of the milled white rice led many locals to abandon the local (unpolished) brown rice, and in doing so, abandon their primary source of thiamine. From the 1860s to the turn of the 20th century, people whose plant consumption was limited to the polished white rice would often come down with weakness, pain, weight loss, difficulty walking, and emotional disturbances. Beriberi became one of the leading causes of mortality in the region.

In the 1880s, a doctor named Christiaan Eijkman began researching the causes of this epidemic at a laboratory in the Dutch East Indies (now Jakarta, Indonesia), and initially believed that the condition was caused by a bacterial infection. However, after years of study, he came to the conclusion that “white rice is poisonous.” He discovered this by feeding a group of chickens solely white rice, and another group unpolished brown rice. The chickens that ate the white rice came down with beriberi-like symptoms, while the others stayed healthy. Eijkman also discovered that when the chickens fed white rice were subsequently fed brown rice, they recovered from their illness! Later dietary testing on prisoners confirmed his results. Even though he didn’t know the cause of the condition, Eijkman proved that white rice was the culprit, and shared the 1929 Nobel Prize in Medicine for his discovery. Beriberi is occasionally seen in the modern world, but its primary cause is chronic alcoholism —the poor diets of some chronic alcoholics, combined with the decreased absorption of what thiamine is consumed, leads to symptoms that unfortunately are sometimes left undiagnosed until it’s too late.

Recently, beriberi was also seen in Haitian prisons , when the prison system began buying imported polished rice from the United States, and stopped feeding their inmates the local brown rice. 4. Pellagra Courtesy of Open Library What causes blistering of the skin in the sun, pale skin, a craving for raw meat, blood dripping from the mouth, aggression, and insanity? If you answered “vampirism,” you’re close—the myth of the vampire may have its roots in the condition known as “pellagra.” Pellagra is caused by a lack of vitamin B3 (niacin). First identified and commonly diagnosed in the Asturian Empire (now Northern Spain), it was originally called “Asturian leprosy.” However, the condition was seen throughout Europe, the Middle East, and North Africa, wherever a large percentage of food energy was derived from corn, and fresh meat was not available. The area of highest prevalence was Northern Italy, where Francesco Frapoli of Milan called it “pelle agra,” meaning “sour skin.” It was initially believed that either the corn itself, or some insect associated with corn, was causing pellagra.

This belief was reinforced when much of France eliminated corn as a food staple and virtually eradicated the condition. Between the era that corn was introduced to Europe (the early 16th century) and the late 19th century, pellagra was found almost everywhere that poor people subsisted on cornmeal and little else. Around the turn of the 20th century, people began to notice that despite subsisting on just as much corn as poor Europeans, poor Mesoamerican natives didn’t come down with the condition. It was eventually discovered that this was because the traditional processing of corn in the Americas involved “ nixtamalization ,” in which the kernels were soaked in limewater before hulling them. The alkali solution freed up the niacin that was present in the grain, but previously inaccessible. Despite the extensive work of Dr. Joseph Goldberger in the 1910s and 1920s , which proved that pellagra wasn’t caused by a germ but by a dietary deficiency, the condition was occurring in epidemic proportions in the rural Southern US until the 1940s.

Today, pellagra is most common in the poorest regions of the world, especially places that rely upon food aid programmes. Some countries still ship unfortified cornmeal rather than corn masa (nixtamalized corn) or fortified cornmeal to developing countries or to their own impoverished populations. China, parts of Africa, Indonesia, and North Korea all have endemic pellagra among their lowest classes. ******* The discovery of important vitamins and how to produce them has been so significant to human health that many of those who were integral to the discoveries have been awarded the Nobel Prize in Medicine; more than 10 Nobel Prizes have been divided among almost 20 eminent scientists for the discovery or isolation of vitamins A, B1, B12, C, D, E, and K. Over the second half of the 20th century, after the beginning of widespread supplementation to everyday food items, the incidences of the conditions covered here went down dramatically across much of the world. Of course, the minerals essential to the human body play similarly important roles in maintaining health. However, humans have not historically had a widespread significant problem acquiring these nutrients, as most plants absorb many minerals from the soil.

With the increased processing of our food throughout the 20th century, however, some of these minerals have been lost, and have had to be re-added to the average Western diet through supplementation. In the rest of the world, displacement due to war, and unfortified food from aid programmes, has left survivors with enough calories, but not enough nutrients. Supplementation of assistance food and local fortification of salt and flour is beginning to help give displaced people (especially displaced children) a new chance at life without these and other nutritional diseases. In the developed world, you won’t be the healthiest bloke on the block if you eat nothing but breakfast cereal and cartons of juice—but the food industry has ensured that you at least won’t die of malnutrition. Even people with healthy diets benefit from the supplementation of vitamins and minerals in common foodstuffs, and adding the nutrients costs next to nothing. Doctors and nutritionists still agree that the healthiest way to acquire your necessary vitamins and minerals is by eating a balanced diet and spending time outdoors each day, but in the course of modern life, that’s not always possible, and if people are going to eat poorly either way, we may as well keep them from dropping dead of scurvy!

Scurvy: Background, Pathophysiology, Etiology Pathophysiology Overview Background Scurvy is a state of dietary deficiency of vitamin C (ascorbic acid). The human body lacks the ability to synthesize and make vitamin C and therefore depends on exogenous dietary sources to meet vitamin C needs. Consumption of fruits and vegetables or diets fortified with vitamin C is essential to avoid ascorbic acid deficiency. Although scurvy is uncommon, it still occurs and can affect adults and children who have chronic dietary vitamin C deficiency (see the image below). Anteroposterior radiograph of the lower extremities shows ground-glass osteopenia, a characteristic of scurvy. See 21 Hidden Clues to Diagnosing Nutritional Deficiencies , a Critical Images slideshow, to help identify clues to conditions associated with malnutrition. Next: Pathophysiology Humans, other primates, and guinea pigs are unable to synthesize L-ascorbic acid (vitamin C); therefore, they require it in their diet.

[ 1 ] The enzyme, L-gluconolactone oxidase, which would usually catalyze the conversion of L-gluconogammalactone to L-ascorbic acid, is defective due to a mutation or inborn error in carbohydrate metabolism. The total body pool of vitamin C is approximately 1500 mg. The absorbed vitamin is found ubiquitously in body tissues, with the highest concentrations in glandular tissue and the lowest concentrations in muscle and stored fat. Ascorbic acid is metabolized in the liver by oxidation and sulfation. The renal threshold for excretion by the kidney in urine is approximately 1.4 mg/100 mL plasma. Excess amounts of ascorbic acid are excreted unchanged or as metabolites. When body tissue or plasma concentrations of vitamin C are low, excretion of the vitamin is decreased. Scurvy occurs after vitamin C has been eliminated from the diet for at least 3 months and when the body pool falls below 350 mg. One study identified a genetic polymorphism of the human plasma protein haptoglobin, Hp 2, that may be an important non-nutritional modifying factor in the pathogenesis of vitamin C deficiency.

The Hp 2-2 polymers are less efficient inhibitors of hemoglobin-driven oxidative stress, leading to ascorbic acid depletion. The Hp 2-2 phenotype is present in 35% of whites and 50% of South Asians and East Asians and may help identify patients who are more prone to develop clinically significant vitamin C deficiency. [ 2 ] Vitamin C functionality Vitamin C is required as a redox agent, reducing metal ions in many enzymes and removing free radicals. In this capacity, it protects DNA, protein, and vessel walls from damage caused by free radicals. Vitamin C is functionally most relevant for the triple-helix formation of collagen; a vitamin C deficiency results in impaired collagen synthesis. The typical pathologic manifestations of vitamin C deficiency, including poor wound healing, are noted in collagen-containing tissues and in organs and tissues such as skin, cartilage, dentine, osteoid, and capillary blood vessels. Pathologic changes in affected children and adults are a function of the rate of growth of the affected tissues; hence, the bone changes are often observed only in infants during periods of rapid bone growth. Defective collagen synthesis leads to defective dentine formation, hemorrhaging into the gums, and loss of teeth.

Hemorrhaging is a hallmark feature of scurvy and can occur in any organ. Hair follicles are one of the common sites of cutaneous bleeding. The bony changes occur at the junction between the end of the diaphysis and growth cartilage. Osteoblasts fail to form osteoid (bone matrix), resulting in cessation of endochondral bone formation. Calcification of the growth cartilage at the end of the long bones continues, leading to the thickening of the growth plate. The typical invasion of the growth cartilage by the capillaries does not occur. Preexisting bone becomes brittle and undergoes resorption at a normal rate, resulting in microscopic fractures of the spicules between the shaft and calcified cartilage. With these fractures, the periosteum becomes loosened, resulting in the classic subperiosteal hemorrhage at the ends of the long bones. Guidelines for the evaluation of fractures in infants and young children have been established. [ 3 ] Intra-articular hemorrhage is rare because the periosteal attachment to the growth plate is very firm.

Although the clinical manifestations are unclear, vitamin C is a cofactor in the metabolism of tyrosine and cholesterol and the synthesis of carnitine, neurotransmitters (eg, norepinephrine), peptide hormones, corticosteroids, and aldosterone. Vitamin C also affects hematopoiesis by enhancing the absorption of iron from the small intestine by reducing dietary iron from the ferric form to the ferrous form. This may contribute to the anemia seen with vitamin C deficiency, in which the availability of intracellular iron is reduced. Vitamin C is also necessary to convert folic acid to its active metabolite, folinic acid. Previous Next: Etiology Scurvy is caused by a prolonged dietary deficiency of vitamin C. Humans obtain 90% of their intake of vitamin C from fruits and vegetables, and cooking these sources decreases vitamin C content 20-40%. The US Food and Drug Administration (FDA) recommends a daily dietary allowance of vitamin C of 75 mg for women and 90 mg for men. The body's pool of vitamin C can be depleted in 1-3 months.

Ascorbic acid is prone to oxidation in vivo, and body stores are affected by environmental and lifestyle factors (eg, smoking), biological conditions (eg, inflammation, iron excess), and pathologic conditions (eg, malabsorption) that may alter its oxidation.

Risk factors for vitamin C deficiency include the following: [ 4 ] Babies who are fed only cow's milk during the first year of life Alcoholic individuals [ 1 ] and those who conform to food fads Elderly individuals who eat a tea-and-toast diet; retired people who live alone and those who eat primarily at fast food restaurants Economically disadvantaged persons, who tend to not purchase foods high in vitamin C (eg, green vegetables, citrus fruits) [ 5 ] Refugees who are dependent on external suppliers for their food and have limited access to fresh fruits and vegetables Cigarette smokers: These individuals require an increased intake of vitamin C because of lower vitamin C absorption and increased catabolism Pregnant and lactating women and those with thyrotoxicosis: These individuals require an increased intake of vitamin C because of increased utilization People with anorexia nervosa or anorexia from other diseases such as acquired immunodeficiency syndrome (AIDS) or cancer [ 6 ] People with type 1 diabetes have increased vitamin C requirements, as do those on hemodialysis and peritoneal dialysis [ 7 , 8 ] People with disease of the small intestine such as Crohn, Whipple, and celiac disease, as well as

 after gastric bypass surgery, [ 9 ] because vitamin C is absorbed in the small intestine Individuals with iron overload disorders - These may lead to renal vitamin C wasting Other factors that may lead to vitamin C deficiency include ignorance (eg, boiling of fruit juices), restrictive diets imposed by food allergies, and neurodevelopmental disabilities associated with compromised oral intake of foods.

A case report of vitamin C deficiency in a patient on coumadin raises the possibility of risk in the vitamin K–restricted diet, since overlap exists in foods containing vitamin K and vitamin C. [ 10 ] Recent evidence shows that iron is important in the absorption of vitamin C, and iron deficiency may lower the expression of the sodium-dependent vitamin C transporter in intestinal cells, leading to vitamin C deficiency. [ 11 ] Besides poor diet and anorexia in cancer patients, another mechanism of vitamin C deficiency has been proposed. In a study of cancer patients with adequate daily intake but low serum vitamin C levels, authors proposed increased use of vitamin C possibly to scavenge lipid peroxides or vitamin C sequestration by tumor cells. [ 12 ] Previous Epidemiology United States statistics Data from the National Health and Nutrition Examination Survey (NHANES 2003-2004) that assessed the prevalence of vitamin C deficiency in the United States among a sample of 7277 children and adults (older than age 6 y) found that men aged 20-39 and those older than 60 years had a higher prevalence of deficiency than similarly aged women.

Overall, 8.2 % of men and 6% of women (7.1% overall prevalence) were deficient in vitamin C, which is decreased from the NHANES 1994, which showed 14% of men and 10% of women deficient. [ 13 ] NHANES 2005-2006 showed a lower prevalence of 3.6% of vitamin C deficiency among men and women older than 6 years. [ 14 ] Patients at risk include those with chronic malnutrition, who are elderly or alcoholic, who subsist on diets devoid of fresh fruits and vegetables, and men who live alone (widower scurvy). Infants and children on restrictive diets because of medical, economic, or social reasons are at risk for scurvy. Occurrence of scurvy is uncommon in those younger than 7 months, although infants fed evaporated or condensed milk formulas may develop this disease. If a mother has an adequate diet, breast milk contains sufficient vitamin C for a baby's needs. Commercially available formulas and many prepared fruit juices are fortified with vitamin C.

Other reported cases include people with monotonous or peculiar diets, including patients undergoing dialysis as well as those with cognitive disorders, [ 15 , 16 ] psychiatric illnesses, [ 17 ] malabsorption, inflammatory bowel disease , cancer chemotherapy, Whipple disease , or dyspepsia (those who avoid acidic foods). International statistics The international occurrence of scurvy is unknown. Scurvy is a problem when general malnutrition exists, as in some impoverished, underdeveloped third world countries. Scurvy also occurs in epidemic proportions in international refugee camps and in populations that subsist mainly on cereal grains. A study of nonhospitalized patients in Paris found that 5% of women and 12% of men were deficient [ 18 ] ; in those older than 65 years, this proportion increased to 15% of women and 20% of men.

In a case series from Thailand that reviewed 28 cases of scurvy in infants and children (10 mo to 9 y and 7 mo; median age, 29 mo) hospitalized over a 7-year period (1995-2002), investigators noted prolonged consumption of heated milk (ultra-high temperature [UHT] milk) and inadequate intake of vegetables and fruits were the risk factors for the development of scurvy. [ 19 ] In tests of plasma vitamin C levels in the low-income/materially deprived population of the United Kingdom, carried out between 2003 and 2005 (433 men; 876 women), the Low Income Diet and Nutrition Survey found evidence of vitamin C deficiency in an estimated 25% of men and 16% of women. [ 5 ] Another 20% of the study population had vitamin C levels in the depleted range. According to the report, predictors of plasma vitamin C levels at or below the depleted range include being male, having a low dietary intake of vitamin C, not taking vitamin supplements, and smoking.

[ 5 ] A study of healthy elderly (age 70-75 y) persons living in Padua, Italy took a baseline and 10-year follow-up dietary history and found vitamin C deficiency rose over the 10-year span, from 3-6% in men and 2.3-4.5% in women, which led the authors to recommend multivitamin supplementation in healthy elderly persons. [ 20 ] Race, sex, and age differences in incidence According to NHANES 2004, non-Hispanic white men (11.8%) (had a slightly increased risk of vitamin C deficiency compared with non-Hispanic black men (8.9%) and Mexican American men (7.7%). [ 13 ] Similarly, the non-Hispanic white women (8.2%) had higher rates of vitamin C deficiency compared with non-Hispanic black women (5%) and Mexican American women (4.2%). Mexican American males and females had a lower risk of vitamin C deficiency probably because the traditional Mexican diet is rich in chilies, tomatoes, and squashes, which are high in vitamin C.

[ 13 ] Some studies show vitamin C deficiency to be more common among men, whereas others show equal distribution among men and women. NHANES 2004 shows slightly higher prevalence for men (8.2%) than for women (6%). NHANES 2007-2008 data showed that among American males older than 20 years, the daily intake was 26 mg higher than for females. In fact, teenage females had the lowest intake, followed by preadolescent females and women in their sixties. [ 21 ] Although scurvy can occur at any age, the incidence of scurvy peaks in children aged 6-12 months who are fed a diet deficient in citrus fruits or vegetables as well as in elderly populations, who sometimes have "tea-and-toast" diets deficient in vitamin C. Scurvy is uncommon in the neonatal period. Previous Next: Prognosis Typically, scurvy carries an excellent prognosis if diagnosed and treated appropriately.

Manifestations of scurvy, including the following, tend to dramatically improve, resolving within weeks, if adequate oral vitamin C is given in daily doses to recoup body stores: Spontaneous bleeding stops within 1 day Muscle and bone pain abate quickly Bleeding and sore gums heal in 2-3 days Ecchymoses heal within 12 days In advanced scurvy, serum bilirubin normalizes in less than 1 week, and anemia is corrected in less than a month. Complications The predominant morbidity associated with this disease is a result of hemorrhage into various tissues and depends on the site of involvement. Subperiosteal hemorrhages cause pain and tenderness, resulting in pseudoparalysis. Loss of function at the site of the hemorrhage and anemia are typical sequelae of the hemorrhages observed in scurvy. Subperiosteal hemorrhage in the tibia and femur causes excruciating pain. Laboratory data suggest that the neonatal brain is particularly susceptible to vitamin C deficiency and that this condition may adversely affect early brain development.

[ 22 ] Until minimal daily requirements of vitamin C were supplied, scurvy plagued prolonged naval voyages and military campaigns as personnel succumbed to its devastating effects. Lethargy, fatigue, and hemorrhagic manifestations of impaired collagen synthesis affecting oral, ophthalmic, musculoskeletal, cardiac, and gastrointestinal structures and functions incapacitated or killed more people than enemy action in many cases. Previous Coauthor(s) Mose July, MD Fellow in Endocrinology, Diabetes and Metabolism, Marshall University School of Medicine Mose July, MD is a member of the following medical societies: American Association of Clinical Endocrinologists , Endocrine Society Disclosure: Nothing to disclose. Specialty Editor Board Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Received salary from Medscape for employment. for: Medscape.

Arthur B Chausmer, MD, PhD, FACP, FACE, FACN, CNS Professor of Medicine (Endocrinology, Adj), Johns Hopkins School of Medicine; Affiliate Research Professor, Bioinformatics and Computational Biology Program, School of Computational Sciences, George Mason University; Principal, C/A Informatics, LLC Additional Contributors Janet J Wong, MD Consulting Dermatologist, Department of Dermatology, University of Connecticut School of Medicine Janet J Wong, MD is a member of the following medical societies: American Academy of Dermatology Disclosure: Nothing to disclose. Van Perry, MD Assistant Professor, Department of Medicine, Division of Dermatology, University of Texas School of Medicine at San Antonio Van Perry, MD is a member of the following medical societies: American Academy of Dermatology Disclosure: Nothing to disclose. Kathryn Schwarzenberger, MD Associate Professor of Medicine, Division of Dermatology, University of Vermont College of Medicine; Consulting Staff, Division of Dermatology, Fletcher Allen Health Care Kathryn Schwarzenberger, MD is a member of the following medical societies: Women's Dermatologic Society , American Contact Dermatitis Society , Medical Dermatology Society , Dermatology Foundation , Alpha Omega Alpha , American Academy of Dermatology Disclosure: Nothing to disclose.

Steven M Schwarz, MD, FAAP, FACN, AGAF Professor of Pediatrics, Children's Hospital at Downstate, State University of New York Downstate Medical Center Steven M Schwarz, MD, FAAP, FACN, AGAF is a member of the following medical societies: American Academy of Pediatrics , American College of Nutrition , American Association for Physician Leadership , New York Academy of Medicine , Gastroenterology Research Group , American Gastroenterological Association , American Pediatric Society , North American Society for Pediatric Gastroenterology, Hepatology and Nutrition , Society for Pediatric Research Disclosure: Nothing to disclose.

Anne Elizabeth Laumann, MBChB, MRCP(UK), FAAD Professor of Dermatology, Chief of General Dermatology, Director of the Collagen Vascular Disorders Clinic, Northwestern University, The Feinberg School of Medicine Anne Elizabeth Laumann, MBChB, MRCP(UK), FAAD is a member of the following medical societies: American Academy of Dermatology , Association of Professors of Dermatology , British Association of Dermatologists , Chicago Dermatological Society , Chicago Medical Society , Illinois Dermatological Society , Illinois State Medical Society , Medical Dermatology Society , Society for Investigative Dermatology , Women's Dermatologic Society Disclosure: Nothing to disclose. Henry Driscoll, MD Farrell Professor of Endocrinology, Chief, Department of Medicine, Section of Endocrinology, Joan C Edwards School of Medicine at Marshall University Henry Driscoll, MD is a member of the following medical societies: American College of Physicians , American Diabetes Association , American Federation for Medical Research , American Medical Association , Endocrine Society , Massachusetts Medical Society , Sigma Xi , West Virginia State Medical Association Disclosure: Nothing to disclose.

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology Disclosure: Nothing to disclose. Julia Sanger Minocha, MD Resident Physician, Department of Medicine, Northwestern University, The Feinberg School of Medicine Julia Sanger Minocha, MD is a member of the following medical societies: Alpha Omega Alpha , American College of Physicians , Phi Beta Kappa Disclosure: Nothing to disclose. Bradley S Buckler, MD Fellow in Neonatal-Perinatal Medicine, Medical College of Georgia Disclosure: Nothing to disclose. Acknowledgements The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Anjali Parish, MD, Kumaravel Rajakumar, MD, and Tarita Thomas, PhD, MBA,to the development and writing of the source articles. Scurvy - Better Health Channel Scurvy Scurvy is a disease caused by severe and chronic vitamin C (ascorbic acid) deficiency. Good sources of dietary vitamin C include citrus fruits and green vegetables.

Overdosing on vitamin C can cause problems, so never take more than the recommended dose of a vitamin C supplement without your doctor’s knowledge and approval. Scurvy is a disease caused by severe and chronic vitamin C (ascorbic acid) deficiency. Most people think of scurvy as a disease of the past, when sailors had to spend months at sea without access to fresh fruit and vegetables. While scurvy may be uncommon in modern society, it does still exist. Anyone whose diet is inadequate in vitamin C is at risk. The onset of symptoms of scurvy depends on how long it takes for the person to use up their limited stores of vitamin C. The human body is unable to make vitamin C. For example, if the diet includes no vitamin C at all, the average onset of symptoms is about four weeks. The many roles of vitamin C Vitamin C is important for many metabolic processes, including: Collagen formation – collagen is used in different ways throughout the body. Its primary role is to strengthen the skin, blood vessels and bone. The body also relies on collagen to heal wounds. Antioxidant function – the metabolism of oxygen within the body releases molecular compounds called ‘free radicals’, which damage cell membranes.

Antioxidants are substances that destroy free radicals, and vitamin C is a powerful antioxidant. Iron absorption – the process of iron absorption is aided by vitamin C, particularly non-haem iron (the form of iron found in plant foods such as beans and lentils). Infection fighting – the immune system, particularly cells called lymphocytes, requires vitamin C for proper functioning. Other roles – vitamin C is used to produce other important substances in the body such as brain chemicals (neurotransmitters). Early symptoms of scurvy Many of the early symptoms and signs of scurvy are similar to various mild complaints. A person may not visit their doctor because they believe, for example, that they have the flu or some other self-limiting illness.

Some of the non-specific symptoms of scurvy may include: generally feeling unwell Symptoms and signs of severe scurvy are more specific and may include: swollen, spongy and purplish gums that are prone to bleeding loose teeth bleeding into the skin (severe and easy bruising) scaly, dry and brownish skin very dry hair that curls and breaks off close to the skin slow-healing wounds opening of previously healed scars bleeding into the joints and muscles, which causes areas of swelling over the bones of the arms and legs premature stopping of bone growth (in babies and children). Complications of scurvy In babies and young children with scurvy, the growth of the long bones in the arms and legs is typically stunted. This is because the lack of vitamin C prompts the growth plates in the bones to prematurely harden. In people of all ages, untreated scurvy may lead to complications including anaemia, heart attack or death. Regular dietary intake is important Dietary intake of vitamin C (from food and drinks) is essential, because the human body cannot make this vitamin from other compounds. We also need to have vitamin C as a regular part of our diet because the body cannot store vitamin C for very long.

High-risk groups for scurvy There are various factors or lifestyle issues that might increase the risk of scurvy. These include: unhealthy diet – people who regularly neglect their diet such as alcoholics, illicit drug users, the elderly or the mentally ill crash dieting – particularly some diets that exclude food groups (for example, extreme versions of the high-protein, low-carbohydrate diet) dependency – some elderly people or young children who are not given adequate care allergy diets – that are very restrictive in an attempt to manage particular allergies eating disorders – like anorexia nervosa or bulimia smoking – because smokers need more vitamin C to cope with the extra stress on their body fussy eating – some fussy eaters will not eat fruits and vegetables. Diagnosis of scurvy Tests used to diagnose scurvy may include: physical examination detailed questions about dietary habits blood tests to check vitamin C and iron levels x-rays of joints including the knee, wrist and ribs. Treatment of scurvy Scurvy is relatively easy to treat – the person simply needs to increase their daily intake of vitamin C. A doctor may recommend a short-term course of vitamin C supplements (usually a minimum of 250 mg per day) to speed relief of symptoms.

Bleeding in the skin and gums should stop within 24 hours of effective treatment. Joint and muscle pain may take a few weeks to settle. Other nutritional deficiencies, such as anaemia, may need treatment with an improved diet and the short-term use of supplements. Underlying problems such as eating disorders or alcoholism may need to be addressed. The doctor may also recommend that the patient consult with a dietitian. Sources of vitamin C Dietary sources of vitamin C include: fruits such as oranges, lemons, limes, grapefruits, blackcurrants, mangoes, kiwifruits, tomatoes and strawberries vegetables, particularly green vegetables such as cabbage, capsicum, spinach and broccoli kidney and liver. Precautions in taking vitamin C Taking large quantities of vitamin C supplements may be harmful. Never take more than the recommended dose of a vitamin C supplement without your doctor’s knowledge and approval. Overdosing on vitamin C can cause problems, including: nausea, abdominal cramps and diarrhoea decreased effect of some prescription medications, such as certain blood-thinning drugs kidney stones in people with kidney disease or a history of kidney stones. Where to get help Dietitians Association of Australia Tel.

1800 812 942 Things to remember Scurvy is a disease caused by severe and chronic vitamin C (ascorbic acid) deficiency. Good sources of dietary vitamin C include citrus fruits and green vegetables. Overdosing on vitamin C can cause problems, so never take more than the recommended dose of a vitamin C supplement without your doctor’s knowledge and approval. Scurvy: MedlinePlus Medical Encyclopedia Browse the Encyclopedia A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission ( URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy , editorial process and privacy policy . A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation ( The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions.

Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 1997-2017, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing by ADAM Health Solutions. Six signs you are vitamin C deficient - NaturalNews.com Six signs you are vitamin C deficient Tuesday, December 18, 2012 by: PF Louis Popular on Facebook 62K EVERYTHING IS RIGGED: Medicine, science, elections, the media, money, education, search engines, social media... you are living in a fabricated fairy tale 40K All-out effort to destroy Trump PROVES he's not part of the establishment... NOT an insider... 'Trump' movement has grown way beyond one man's actions or words 37K Hexavalent chromium (chromium-6) was just found in 75% of drinking water... the mass chemical suicide of America is under way 36K Electoral victory for Hillary already LOCKED IN via massive bribery... George Soros admits on video... democracy be damned...

THEFT of the presidency already complete 35K Chaos will erupt across America in less than 100 days... no matter who wins the election 27K The defeat of Hillary Clinton just dealt a devastating blow to Monsanto, Big Pharma and the corrupt vaccine industry 23K Libertarian candidate Gary Johnson just sold out to Big Pharma... says children should be forcibly injected with mercury at gunpoint... claims government 'science' overrides medical freedom 23K Facebook goes full ORWELLIAN... now blocking all stories mentioning the keyword phrase 'm-nd-t-ry v-cc-n-t--ns' 20K Hillary the CHEAT! Clinton caught wearing covert earpiece during last night's debate with Trump... brazen dishonesty on display yet again 19K Staged Zika pandemic was engineered by globalist governments to justify the aerial bombardment of awakening populations with toxic chemicals 18K TRUMP MIRACLE... DEPLORABLES TAKE BACK AMERICA...

LEFTISTS TOTAL FREAK OUT 17K Natural News announces economic boycott of CNN corporate sponsors, including GEICO, WellsFargo, Sprint, Dodge and ETrade 16K The defeated left turns to HATE: Liberals unleash beatings, death threats and calls for mass murder of Trump supporters 15K Tweet (NaturalNews) The common disease directly attributed to vitamin C deficiency is scurvy. Scurvy creates a malaise of fatigue and lethargy, affects bone and muscle strength, and stifles the immune system. Some nutritional experts consider scurvy a manifestation of acidosis, extreme acidity or low pH. That condition gives rise to many other diseases, even cancer. Thanks to using citrus to curb the two million earlier sailors' scurvy, scurvy's occurrence has greatly diminished from the late 18th century till now. But it does still occur. Due to terrible diets or practicing bulimia to become anorexic, there has been a scurvy surge among teens. It can also afflict alcoholics or older people whose ability to absorb vitamin C has diminished from excessive medications or poor diets.

Even infants who are not breast fed by a healthy mom can become scorbutic (manifesting scurvy symptoms). Although not a wise choice due to toxic additives, most infant formulas are fortified with vitamin C. Most animals can create their own vitamin C. That's why they can recover from disease or injury quickly. The problem with us humans, Guinea pigs, and a few other primates is the gene involved with internal vitamin C manufacturing is missing. The remedy is simple. Introduce more vitamin C food sources into the diet and/or add ascorbic acid supplementation. Early signs of encroaching scurvy (1) Chronic low energy, strength, and/or depression. Even bone strength is affected. Since acidosis and scurvy are similar, the classic acidosis symptom of wasting away becomes evident while losing weight. (2) Bleeding gums, loose teeth, or gingivitis. This is an obvious and easy to notice sign that the collagen needed for building and maintaining tissue is deteriorating. Vitamin C is vital for collagen. (3) Rapid mood changes, short tempers, and irritability can be an early sign of scurvy . Add more vitamin C to your diet or look into other possibilities before seeking pharmaceutical interventions.

(4) Bruises that occur easily, and often linger may be an indication of vitamin C deficiency . Low healing of minor wounds and dryer hair may also point to inadequate vitamin C levels. (5) Chronic limb or joint pain is another sign for you to check into low vitamin C as a missing nutrient. Sometimes scurvy gets to a point where bleeding occurs within joints, causing severe pain. (6) Anemia is another sign of possible vitamin C deficiency. If you seem to catch every cold or flu that comes your way, maybe more vitamin C will help elevate your immune system. Vitamin C deficiency creates neurological problems A recent study conducted at the Vanderbilt University Medical Center, Department of Neuroscience in Nashville, Tennessee and recorded in the Journal of Neurochemistry October, 2012, came up with some interesting observations. They used mice which were genetically engineered to deactivate the genes that normally provide their own vitamin C. Of course, those mice are kept alive and healthy by externally providing them vitamin C with ascorbic acid (AA). But for the purposes of this study, they created periods of not providing AA and then reintroducing it. Before and after each period, blood samples were taken. During each deprivation period, behavioral patterns were observed and noted.

Depressive and submissive behavior was noted during the initial absence of AA. Compulsions for consuming glucose above all other food types was observed. After depriving the mice of AA a second time, blood samples indicated "... decreased blood glucose levels, oxidative damage to lipids and proteins in the cortex, and decreases in dopamine and serotonin metabolites in both the cortex and striatum." In other words, neurological damage. The miraculous results of IV mega-dose vitamin C or liposomal high cellular absorption vitamin C have been achieved by orthomolecular medical MDs who have used mega-dose minerals and vitamins for decades, resolving extreme physiological and psychological problems. Mainstream medicine still won't go there. But you can. ( ) Sources for this article include:

Question: A deficiency of which vitamin is the predominant cause of scurvy?
Answer: C