Yar me maties, today I found out what be causing scurvy.

Like most people, I already knew that scurvy is caused by a lack of vitamin C and that it was a major problem aboard ships out to sea for a good length of time and is still somewhat of a problem in places where people are malnourished.  But I previously had no idea what the actual symptoms of scurvy are and why it should be such a life threatening thing; indeed, untreated scurvy is fatal, though if you ever find you have scurvy, all that’s required to cure it are healthy doses of Vitamin C.

So what are the major signs of scurvy; I’m glad you asked:

• tiredness
• loss of appetite
• irritability
• inability to gain weight
• muscle weakness or pseudoparalysis
• joint and muscle aches and stiffness
• rashes, particularly on your legs; generally looking like tiny red blisters and eventually large purple blotches
• bleeding gums which turn blue-ish purple and feel spongy
• bulging eye balls
• corkscrew hair (only in non-infantile scurvy), particularly noticeable on your arms and legs
• loosened teeth which will eventually fall out in the advanced stages of scurvy
• fever
• swollen legs, particularly swelling over the long bones of your body
• diarrhea
• vomiting
• lethargy
• scar tissue will break down and you’ll begin bleeding again from these formerly healed areas
• slow wound healing
• anemia
• depression
• unusual paleness
• bleeding under the skin and from hair follicles
• eventual death due to cardiac failure

Ya, scurvy is pleasant apparently.  Luckily for adults, it will typical take several weeks and possibly even a couple months for a Vitamin C deficiency to cause symptoms of scurvy.  In babies and children, this is not the case.

So what’s really going on here?  How does the loss of one little amino acid in your system cause such a systemic problem in your body?  Simply speaking, ascorbic acid, Vitamin C, is not only important for our immune system, but also is important for the proper development of connective tissues; *warning: medical nerdery ahead* it’s also important for lipid and vitamin metabolism, bio-synthesis of neurotransmitters, and wound healing.

For those who don’t know, “lipid” is just a name for a broad group of hydrophobic or amphiphilic small molecules, such as  fats and fat-soluble vitamins (such as Vitamins A, D, E, and K) among others.  So from that, already you can see why a lack of Vitamin C would create a variety of problems in your body, if nothing else by diminishing your ability to metabolize several some other important vitamins and fats.  Oh but it gets better and much more serious.

Another principal problem caused from a lack of Vitamin C is the inability to properly develop collagen in your body.  Collagen is quite literally the glue that holds you together; from your muscles (makes up about 1-6% of your muscle tissue, depending on the specific muscle) to scar tissue; to your skin (one of the principle things along with keratin that gives your skin strength and elasticity); also gives bones some elasticity and strength (without it bones are quite brittle); it strengthens blood vessels; is essential in your eye and lens; plays an important role in weight management (hydrolyzed collagen); the list goes on and on and on.

*Warning: EXTREME medical nerdery ahead for the benefit of my paramedic brother who was curious about this; for everybody else, skip to the bonus factoids, because seriously ;-)*  What’s going on here is Vitamin C is required as a cofactor for prolyl hydroxylase and lysyl hydroxylase; these enzymes need an Fe2+ ion to be present.  The problem being, that Fe2+ is unstable and will oxidize very easily.  Vitamin C though, which is a water-soluble antioxidant, will end up keeping the Fe from going to the more stable 3+ form, rather keeping it at the required 2+ form.

Now these prolyl hydroxylase and lysyl hydroxylase enzymes are then responsible for the hydroxylation of the proline and lysine amino acids in collagen (knee bone connected to the, thigh bone, thigh bone connected to the hip bone…).  These stabilize the collagen by cross-linking the propeptides in collagen.

So bottom line, without the Vitamin C, the collagen can’t synthesize properly which in turn affects all the stuff collagen is in, which is pretty much most of your body.  If the collagen development is impaired, effectively, you’re screwed (eventually).  Not only would this eventually cause a lot of the symptoms of scurvy and eventual death, but after you died from cardiac failure (remember the collagen in your muscles?), your body wouldn’t even be good for making premo-jello jigglers. (if you got this far you probably already knew that jello is made from collagen, right? … yummy)

And then of course if all these above problems aren’t enough, there is the problem with the lack of vitamin C affecting the biosynthesis of neurotransmitters, which are chemicals that relay, amplify, and modulate signals between neurons and another cell (ya, that’s not important at all and yes, I looked up that definition).  Without vitamin C, many essential conversions in synthesizing some of these neurotransmitters can’t take place and thus your body can’t synthesize them.

So bottom line, go eat some oranges, cause seriously… seriously.

*note: this article was by request.  if there is anything you’d like to know, feel free to send me an email and if I think it’s something worth doing an article on, I’ll write it up.

Bonus Facts:

• May 2nd is Scurvy Day.  So happy belated Scurvy day to you.
• The word “scurvy” is from the Latin, scorbutus; this same Latin word is where we get the name “ascorbic acid”, which is Vitamin C or “scurvy acid”.
• Vitamin C was isolated by the Nobel Prize winning biochemist Szent-Györgyi in 1927.  It was 5 years later when the connection was made between scurvy and a Vitamin C deficiency.  Researchers discovered that guinea pigs also contracted scurvy.  This was the first time any animal other than humans was shown to contract the illness.  Guinea pigs happen to be one of the few animals besides humans who cannot synthesize their own Vitamin C.  Once researchers discovered that guinea pigs could get scurvy, thus having an animal to experiment on, it was simply a matter of isolating which nutrient cured the scurvy in the guinea pigs and since it was already known that fresh citrus fruits cured it, it made it easier yet.
• Besides guinea pigs and humans, fruit bats and other primates are about the only other animals not able to synthesize our own vitamin C; thus, we need to consume it regularly to keep our bodies supply up or quite literally our bodies start to fall apart.
• Refined carbohydrates accelerate the process of depleting Vitamin C from your body.  The insulin in the bloodstream ends up causing amino acids to be stored as fat (except for tryptophan).  The tryptophan then competes with the vitamin C to enter the bloodstream, causing less of the vitamin C to be available in the body.  This further made sailors susceptible to scurvy, as their daily rations tended to be heavy in refined carbohydrates, such as hard biscuits and the like.
• Documented cases of scurvy go all the way back to the ancient Egyptians in 1550 BC and Hippocrates around 460 BC.  Interestingly, various cures for scurvy have popped up off and on throughout history, only to be forgotten and then later re-discovered.  The ones that worked obviously were all centered around Vitamin C intake, though it has only been recently that it has been known what actually cures scurvy.
• Consistent cures for scurvy were hard to identify for much of history because of the lack of isolating Vitamin C and also because when Vitamin C is exposed to air or copper, it is destroyed.  So for instance, when the British sailors became convinced that citrus fruits cured scurvy, they began storing lime juice and the fruit aboard ships (though the fruit itself would go bad very quickly).  So the whole limes did a great job of curing the scurvy, but as soon as those ran out and they relied on the lime juice, it seemed that limes didn’t cure scurvy.  The problem was that the lime juice was not only exposed to air, but also run through copper pipes when originally processed.  So this destroyed most all the vitamin C and made it appear as if limes didn’t actually cure scurvy.  This same type of misdirection manifested itself among a variety of the other things used to cure scurvy, such as  fruits, herbs, certain tree needles, fresh meat, etc.  The problem with creating a cure, until recently, was that no one knew what about these various cures was actually doing the curing.
• The problem of finding the cause of scurvy was further exacerbated due to the fact that fresh meat, particularly organ meat, also cures scurvy due to its Vitamin C content.  Thus, it was popularly believed that any fresh food would cure scurvy.
• The fact that fresh meat contains Vitamin C is essential to people who live in frigid climates where fresh fruits are hard to come by, such as the case with the Eskimos.
• British sailors and eventually British people were given the nickname “limey” due to the fact that in the 1790’s the royal navy took Bachstrom and Lind’s recommendation of using fresh lemons and limes to cure scurvy.  So each sailor was given a ration of these fruits, by the Merchant Shipping Act,  hence, “limey”. Though it was still quite hard to keep these fruits fresh over long voyages so cases of scurvy persisted.
• The British eventually ended up using limes over lemons due to the fact that they had an abundant supply of limes in the British Caribbean colonies.  Interestingly, these limes actually contained about 1/4 of the Vitamin C than the lemons they were originally using.  In addition to this, they were also often served in juice form, as described above, which even further diminished their Vitamin C content.
• The recommended amount of Vitamin C for adults is around 50-60 mg per day; for infants it’s only about 30 mg per day; and 40-45 mg per day for children aged 1-14.  Pregnant women need a slightly higher dosage at around 70 mg per day and more like 90-95 mg per day when they are breastfeeding.
• Babies and lactating mothers will develop scurvy if the mother doesn’t up her vitamin C intake accounting for the fact that she needs to take in enough vitamin C for two people.
• Infants weaned from breastfeeding to drinking pasteurized cow milk will need to take additional supplements of Vitamin C or they will develop scurvy.  The pasteurization process destroys the Vitamin C in the milk; this resulted in a large amount of infantile scurvy cases in the early 19th century.
• Smoking, stress, and a variety of medications also causes need for more Vitamin C intake than most people need.
• When talking about scurvy in babies, it is often referred to as “Barlow’s disease”, named after Sir Thomas Barlow, who was a physician who studied it.
• A British civilian in 1614, nearly stumbled on the actual thing that cured scurvy, when he theorized that it was the acidic principles of citrus fruit that did the curing and thus it was a dietary deficiency.  Unfortunately, he thought that any acid would cure scurvy and never went on to discover that it was specifically something now called citric acid or more commonly Vitamin C that was doing the curing.
• It was once common for ship crews to eat the fat scrubbed from copper pans after cooking things.  This actually increased the likelihood of the sailors to contract scurvy as the fat on the hot copper would absorb substances which irritated the gut and reduced the ability of their bodies to absorb vitamins.