Scurvy

Scurvy

1. Scurvy
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2. Vitamin C
•Vitamin C -known as ascorbic acid - is a water-soluble vitamin.
•Unlike most mammals, humans do not have the ability to make their own
vitamin C. Therefore, we must obtain vitamin C through our diet. [1]+[3]
•Fun fact: "ascorbic acid" comes from the New Latin "scorbutus" meaning
scurvy!
FIGURE 1 Chemical structure of
ascorbic acid. [2]

3. What Is Scurvy?
•Scurvy is a vitamin C (ascorbic acid) deficiency that results
from a few weeks to months of no vitamin C or 20 to 40 days
•We’ve known of it since ancient Greek and Egyptian times
•It was most common in sailors throughout the 16
th
-18
th
century
due to vitamin C deprivation for long periods of time
•Cases today are rare

4. Why Do We Need Vitamin
C?
•1.Vitamin C is essential for the production of collagen and the absorption of iron
•2.We are unable to make vitamin C on our own so we need to get it from other sources like
citrus fruits.
•Cause: It is caused by environmental factors, not genetic factors
•Deprivation of vitamin C due to famine, anorexia, restrictive diets, or difficulty orally ingesting
foods
•Who Is Susceptible? It affects all races with no sexual disposition
•It can occur at any age
•Elderly people, alcoholics, or those that have a diet with little to no fruits and
vegetables
•You will also see it in countries that suffer from famine

5. Symptoms
Early Symptoms
•Appetite loss, poor weight gain, diarrhea, rapid breathing, fever,
irritability, tenderness and discomfort in legs, swelling over long
bones, bleeding, and feelings of paralysis
Progressed Symptoms
•Bleeding of the gums, loosened teeth, petechial hemorrhage of the
skin and mucous membranes, bleeding in the eye, proptopsis of the
eyeball, constochondral beading, hyperkeratosis, corkscrew hair, and
sicca syndrome

6. Prevention
•Oranges
•Lemons
•Romaine Lettuce
•Guava
•Kiwi
•Papaya
•Tomatoes
•Strawberries
•Carrots
•Bell peppers
•Broccoli
•Potatoes
•Cabbage
•Spinach
•Paprika
•Liver
•Cereal
•Oysters
Eat foods rich in vitamin C

7. Treatment
•Adults RDA for vitamin C is 75mg to 90mg
•Smokers need 35mg more of vitamin C
•Doctors recommend 250mg of vitamin C is you have scurvy
•Eat Vitamin C rich foods
•You should start to see an improvement about 48 hours after starting treatment
•Extra vitamin C will be excreted in urine
•Surgery is unnecessary

8. Diet Plan
Day 1
Breakfast: Oatmeal with wheat toast and 1cup of orange juice 82 mg Vitamin C
Lunch: Turkey sandwich with 1 cup of cantaloupe 68 mg Vitamin C
Dinner: 12 oz. prime rib with 1cup of mashed potatoes and 1/2 cup 73 mg Vitamin C
of broccoli
Dessert: 1cup of strawberries 80 mg Vitamin C
Total:303 mg Vitamin C

9. Functions
•Synthesis of collagen, an important structural component of blood vessels,
scar tissues, tendons, ligaments, and bone.
•Synthesis of the neurotransmitters, norepinephrine critical to brain
function and are known to affect mood.
•Highly effective antioxidant protect proteins, lipids (fats), carbohydrates,
and nucleic acid (DNA and RNA) from damage by free radicals.
•Regenerate other antioxidants such as vitamin E.
• vitamin C is required for the synthesis of carnitine, a small molecule that is
essential for the transport of fat to mitochondria, for conversion to energy.
[1]+[3]

10. Sources [4]
Food Serving Vitamin C (mg(
Orange juice ¾ cup (6 ounces( 75
Grapefruit juice
¾ cup (6 ounces(
60
Orange medium 1 70
Grapefruit ½ medium 44
Strawberries cup, whole 1 82
Tomato medium 1 23
Sweet red pepper ½ cup, raw
chopped
141
Broccoli ½ cup, cooked 58
Potato 1 medium, baked 26

11. Vitamin C Deficiency
Disease result from severe vitamin C deficiency :
Scurvy
Cardiovascular Disease
Stroke
Cataracts
Lead toxicity [4]

12. Scurvy
•It has been known for many centuries as the potentially fatal disease.
•By the late 1700's the British navy was aware that scurvy could be cured
by eating oranges or lemons, even though vitamin C would not be isolated
until the early 1930's. [4]

13. Cool Scurvy Dudes:
•Captain James Cook

James Lind, a pioneer in
the field of scurvy prevention.

14. •People at risk of scurvy include:
•People with chronic malnutrition or those that eat less than 2
servings of fruits/vegetables per day
•Alcoholics
•Elderly
•Men who live alone (bachelor or widower scurvy)
•Children
•People on peculiar diets or food fads
•People with other medical conditions that may prevent the
intake and/or absorption of vitamin C
•Dialysis patients
•Malabsorption disorders
•Severe dyspepsia. [2]+[1]

15. Diagnosis
•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 here.

16. Signs & Symptoms
•Symptoms of scurvy generally develop after at least 3 months
of severe or total vitamin C deficiency, they includes:
•Weakness & fatigue
•Bruising easily & bleeding from weakening blood vessel,
connective tissue & bones due to collagen loss.
•Hair, teeth loss & gingivitis .
•Infants may be irritable, have pain when they move, and lose
their appetite. Infants do not gain weight as they
normally do. In infants and children, bone growth is impaired,
and bleeding and anemia may occur. [1]+[2]

17. Complications
•Skin problems: one of the first signs of scurvy is the development of
perifollicular hyperkeratotic papules, 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).
•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.
•Heart and lung problems: shortness of breath, low blood pressure, and
chest pain leading to shock and death. [2]

18. Figure 2 : Corkscrew hair [3]
Figure3: gingivitis

19. Treatment & Prevention
•Treatment is simply with vitamin C supplements taken orally.
•The adult dose is 800-1000mg/day for at least 1 week, then 400mg/day
untill complete recovery.
•In the U.S., the recommended dietary allowance (RDA) for vitamin C was
recently revised upward from 60 mg daily for men and women. The RDA
continues to be based primarily on the prevention of deficiency disease,
rather than the prevention of chronic disease and the promotion of
optimum health.
•Infants who are being weaned from breast milk to cow's milk need a
supplement containing vitamin C. [5]+[2]

20. References
•[1] DRI DIETARY REFERENCE INTAKES FOR Vitamin C, Vitamin E, Selenium,
and Carotenoids, Food and Nutrition Board, Institute of Medicine,
NATIONAL ACADEMY PRESS Washington, D.C. pp. 95 -115
•[2] http://dermnetnz.org/systemic/pdf/scurvy-vitamincdeficiency-
dermnetnz.pdf
•
[3] http://www.nlm.nih.gov/MEDLINEPLUS/ency/article/002404.htm
•[4] http://lpi.oregonstate.edu/infocenter/vitamins/vitaminC/
•
[5] http://en.wikipedia.org/wiki/Scurvy#Prevention