Scurvy is probably the oldest known disease caused by malnutrition. An undersupply of vitamin C for several months results in a variety of disease symptoms that, if left untreated, can lead to the death of the affected person. Historically, scurvy was common among sailors and soldiers, while nowadays it occurs in regions affected by famine.
What is scurvy?
Scurvy occurs as a result of a persistent deficiency of ascorbic acid, commonly known as vitamin C. Since ascorbic acid cannot be produced by the body, the supply must be secured by ingesting foods that contain an adequate amount of vitamin C. These include fruits and vegetables as well as fruit extracts such as juices. Vitamin C is also found in liver and oysters. If the metabolism lacks vitamin C, it loses the ability to form collagen, which is mainly found in connective tissue and skin, and to absorb iron. Scurvy occurs only after several months as a result of this malnutrition, although vitamin C cannot be stored in the body in stock.
Causes
Scurvy is a typical deficiency condition caused by inadequate nutrition. Usually, to avoid scurvy, a person needs a balanced diet to ensure a healthy metabolism and an adequate supply to the cells. Vitamin C is a necessary part of this and is added to the daily diet mainly in the form of fruits and vegetables. If the intake of these foods is omitted from the daily diet either voluntarily or as a result of a lack of supply of vitamin C, scurvy will result. Scurvy usually occurs only sporadically in industrialized countries and then mainly affects people who follow an unbalanced diet or who, due to age, can no longer properly compose their diet. Alcoholics who neglect healthy meals may also be affected by scurvy.
Symptoms, complaints, and signs
Scurvy is most noticeable in the form of general fatigue and exhaustion. Furthermore, wounds heal poorly or not at all. If the supply of vitamin C is lacking over a long period of time, bleeding gums and gum proliferation may also occur, as well as tooth loss and bleeding in the tongue. As the disease progresses, muscle wasting, bone pain, high fever and severe diarrhea occur. Skin problems in the form of inflammation or bleeding are also not uncommon. The weakened immune system also makes the body susceptible to infections of all kinds. Scurvy is therefore not infrequently a breeding ground for other diseases. In some cases, the disease can also be fatal. Such cases are particularly common due to cardiac insufficiency. In severe scurvy, depression can also be observed in some cases, the cause of which is not yet fully understood. Symptoms on the bones of patients are not obvious. Scurvy causes significant lifting there, which can limit movement and lead to limping. In children and adolescents, growth is also restricted. Depending on the duration and course of the disease, the bone age thereby remains about one or two years behind the biological age.
Diagnosis and course
The attending physician diagnoses scurvy based on external symptoms and extensive questioning of the patient about his or her dietary habits. To confirm the diagnosis, a blood test is performed to determine the level of ascorbic acid present in the blood. Scurvy initially begins with unexplained fatigue and weight loss in the patient. A loss of appetite that exacerbates scurvy and diarrhea are also among the initial symptoms. As the disease progresses, pain, especially in the longer skeletal bones, fever, accelerated breathing, and numbness occur. Scurvy is advanced when there is bleeding of the gums and loosening of the teeth. Symptoms of advanced scurvy include protruding eyeballs, bleeding into the skin, and severe joint pain. If left untreated, heart failure can lead to death as a result of scurvy.
Complications
If left untreated, scurvy can cause severe complications such as tooth loss and poor wound healing.In connection with the increased susceptibility to infections, tooth loss is particularly problematic – dangerous inflammations in the oral cavity can occur. As a result of the muscle atrophy, extreme fatigue occurs, which increases the risk of falls and accidents in everyday life. The loss of appetite favors the typical deficiency symptoms and can lead to chronic eating disorders. Lastly, dangerous hemorrhaging of the skin and severe joint pain may occur. As a consequence, scurvy leads to a pronounced cardiac insufficiency, resulting in a heart attack and finally in the death of the sufferer. In the treatment of scurvy, the risks come from the prescribed drugs and preparations. Ascorbic acid can cause gastrointestinal symptoms such as diarrhea and gastric pressure if taken in excess. In addition, vitamin C increases iron absorption from food, which can cause discomfort in some pre-existing conditions. Painkillers and fever medications can cause various side effects and interactions. Frequently, for example, headaches, skin irritation problems of the gastrointestinal tract occur. Allergic reactions and intolerances to the prescribed drugs and dietary supplements can also not be ruled out.
When should you go to the doctor?
Scurvy is one of those diseases that have many signs. If there is increased bleeding of the gums and fatigue, a doctor can be consulted. However, there is no need to go to an emergency room right away. Only a progressing scurvy disease, which already manifests itself with heart failure and similar serious symptoms, is a medical emergency. Overall, the symptoms of scurvy are so varied that they can justify a trip to the doctor even on their own. For skin problems, a dermatologist should be consulted, and gum problems can be evaluated by a dentist. For general symptoms, a family doctor will be helpful. The diagnosis of scurvy is quite clear and can be made by any doctor. Therefore, the doctor can be seen even if a vitamin C deficiency is suspected. However, those affected would do well to also take immediate action to compensate for this nutrient deficiency if it is suspected. In case of doubt, the family doctor should always be consulted. The suspicion of scurvy is closer to certain risk groups. These are older people, people with a very one-sided diet and smokers. All these groups of people occasionally take too little vitamin C.
Treatment and therapy
Scurvy is cured by administration of ascorbic acid. At the onset of deficiency symptoms, ingestion of foods high in vitamin C is sufficient to quickly resolve symptoms and cure scurvy. Historically, this was recognized as early as the 18th century by the English physician James Lind, whose prescription of lime juice successfully curbed scurvy among sailors in the English navy. Modern treatment of advanced symptoms of scurvy consists of oral administration of high doses of ascorbic acid or injections, which take effect quickly. Mild deficiency symptoms of scurvy, which can occur as a result of a faulty diet, can also be compensated for by orange juice. In addition, in the case of scurvy, the administration of painkillers and medications against diarrhea and fever to achieve relief of the accompanying symptoms.
Prevention
Scurvy is usually easily prevented by paying attention to the proper food composition in the daily diet. Fruits and vegetables, as well as fruit juices, contain enough vitamin C to prevent scurvy. In the case of a one-sided diet, which is always to be discouraged, care should at least be taken to ensure that enough vitamin C is supplied in the form of dietary supplements. Travelers to regions with deficiencies can prevent scurvy by taking an adequate supply of vitamin C tablets.
Aftercare
After successful treatment of scurvy, the goal of follow-up care is to maintain healthy vitamin C levels. Only adequate vitamin C intake will prevent recurrence of the disease. The supply of vitamin C is best achieved through food. A balanced diet is the most important measure after treatment is completed. Healthy, fresh foods provide the body with sufficient vitamin C. Fruits and vegetables in particular should be included in the diet in sufficient quantities.If not enough vitamin C is absorbed through food, then vitamin C supplements and dietary supplements are mandatory. It should be noted that too much vitamin C can also have negative consequences for the body. The body excretes too much absorbed vitamin C via the kidneys. Diarrhea or flatulence can be the first warning signs of an oversupply. In the worst case, the body can form kidney stones, which can lead to colic and severe pain. Affected individuals should pay sensitive attention to their bodies to sense the first warning signs. If symptoms of a renewed vitamin deficiency appear, a doctor must be consulted immediately. Once the cause of the disease has been identified, the trigger should be avoided in the future. This is the only way to rule out a recurrence of the disease.
What you can do yourself
To counter scurvy, consumption of fresh fruits and vegetables is advised. Five servings of these should be consumed daily by people anyway, according to the recommendation of scientists. This represents the best prevention against scurvy and a number of other diseases. Those affected should therefore fundamentally change their diet. At the same time, it is advisable to avoid nicotine and alcohol. Certain vitamin tablets from the drugstore are also enriched with vitamin C and promise to contribute to the cure. A one-sided diet should be avoided. It is known from Asian countries that the exclusive consumption of rice can cause the typical complaints. Whether self-treatment promises success depends on the extent of the symptoms. A severe course is present today exclusively in regions where there is famine. Self-treatment in industrialized nations regularly leads to cure due to the abundance of vitamin-containing products. In case of an unfavorable course, on the other hand, only intravenous administration of vitamin C helps. This is especially true if a severe loss of strength has already occurred. In this case, one should contact a doctor as soon as possible. There is a danger to life.
