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 the body’s connective tissues structure and stability
- cholesterol and protein metabolism
- iron absorption
- antioxidant action
- wound healing
- creation of neurotransmitters like dopamine and epinephrine
Read on to learn more about scurvy.
Vitamin C plays many different roles in the body. A deficiency in the vitamin causes widespread symptoms.
Typically signs of scurvy begin after at least four weeks of severe, continual vitamin C deficiency. Generally, however, it takes three months or more for symptoms to develop.
Early warning signs
Early warning signs and symptoms of scurvy include:
- unexplained exhaustion
- reduced appetite
- aching legs
- low-grade fever
Symptoms after one to three months
Common symptoms of untreated scurvy after one to three months include:
- anemia, when the blood lacks enough red blood cells or hemoglobin
- gingivitis, or red, soft, and tender gums that bleed easily
- skin hemorrhages, or bleeding under the skin
- bruise-like raised bumps at hair follicles, often on the shins, with central hairs that appear corkscrewed, or twisted, and break easily
- large areas of reddish-blue to black bruising, often on the legs and feet
- tooth decay
- tender, swollen joints
- shortness of breath
- chest pain
- eye dryness, irritation, and hemorrhaging in the whites of the eyes (conjunctiva) or optic nerve
- reduced wound healing and immune health
- light sensitivity
- blurred vision
- mood swings, often irritability and depression
- gastrointestinal bleeding
Left untreated, scurvy can cause life-threatening conditions.
Symptoms and complications associated with long-term, untreated scurvy include:
- severe jaundice, which is yellowing of the skin and eyes
- generalized pain, tenderness, and swelling
- hemolysis, a type of anemia where red blood cells break down
- tooth loss
- internal hemorrhaging
- neuropathy, or numbness and pain usually in the lower limbs and hands
- organ failure
Infants with scurvy will 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 and hemorrhaging, or bleeding.
Risk factors for scurvy in infants include:
- malnourished mothers
- being fed evaporated or boiled milk
- difficulty nursing
- restrictive or special dietary needs
- digestive or absorption disorders
Your body can’t 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 don’t have a healthy diet. Scurvy impacts many people in the developing world. Recent public health surveys 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 65 years of age and over
- daily alcohol consumption
- use of illegal drugs
- living alone
- restrictive or specified diets
- low income, reduced access to nutritious foods
- being homeless or a refugee
- living in areas with limited access to fresh fruits and vegetables
- eating disorders or psychiatric conditions that involve a fear of food
- neurological conditions
- forms of inflammatory bowel disease (IBD), including irritable bowel syndrome (IBS), Crohn’s disease, or ulcerative colitis
- digestive or metabolic conditions
- immune conditions
- living in a place where the cultural diet consists almost entirely of carbohydrates like breads, pastas, and corn
- chronic diarrhea
- chemotherapy and radiation therapy
- dialysis and kidney failure
If you suspect you have scurvy, your 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 less than 11 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, talk with a doctor.
For severe, chronic, cases of scurvy, a doctor may recommend high-doses of oral vitamin C supplements for several weeks to months. 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.
Most people begin to recover from scurvy fairly quickly after starting treatment. You should see an improvement in some symptoms within a day or two of treatment, including:
- mood swings
Other symptoms may take a few weeks to improve following treatment, including:
Daily vitamin C recommendations depend on age, gender, and other health conditions.
|Age||Male||Female||During pregnancy||During lactation|
|0–6 months||40 mg||40 mg|
|7–12 months||50 mg||50 mg|
|1–3 years||15 mg||15 mg|
|4–8 years||25 mg||25 mg|
|9–13 years||45 mg||45 mg|
|14–18 years||75 mg||65 mg||80 mg||115 mg|
|19 + years||90 mg||75 mg||85 mg||120 mg|
People who smoke or have digestive conditions typically require at least 35 mg a day more than nonsmokers.
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
- Brussels sprouts
- berries, especially raspberries, strawberries, and blackberries
- pineapples and mango
- tomatoes, especially tomato pastes or juices
- cantaloupes and most melons
- green peas
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 rich foods raw, or as close to it as possible.
Scurvy is caused by a chronic vitamin C deficiency. Most cases:
- are mild
- develop in people with unbalanced diets
- are easily treatable with dietary changes or supplement use
Left untreated, chronic scurvy can cause serious health complications.
There’s no specific therapeutic dose set for vitamin C. The recommended daily allowance for most people ranges between 75 and 120 mg daily.