Arrrrrr you kidding?
Scurvy, a vitamin C deficiency disease that plagued sailors and pirates centuries ago, appears to be re-emerging thanks to the rising cost of living and the popularity of weight loss surgery, a new study finds.
“Scurvy is still seen as a disease of the past, especially in developed countries,” Australian doctors wrote Tuesday in the journal BMJ Case Reports. “However, sporadic cases of scurvy occur, especially in the elderly, patients with alcoholism and children with psychiatric or developmental problems.”
The physicians, from Sir Charles Gairdner Hospital in western Australia, report the case of a 50-something unemployed ex-smoker who complained of a painful rash on both legs that seemingly came out of nowhere.
Blood was found in his urine, and he was suffering from anemia, a low red blood cell count.
ER personnel were a bit baffled as the unidentified man tested negative for inflammatory, autoimmune and blood disorders. Scans revealed no evidence of internal bleeding, and a skin biopsy yielded no clues.
Meanwhile, his rash spread while he was in the hospital, leading to more bruising, swelling and pain in both legs.
Finally, a nutritional panel showed undetectable vitamin C levels and other nutritional deficiencies.
The doctors learned that the Aussie’s “living circumstances were poor.”
“He had financial constraints and therefore neglected his diet. His meals mostly comprised processed food, lacking in vegetables or fruit,” the case report read. “Sometimes he would skip meals, which occurred more frequently in recent weeks. He had also stopped taking the vitamin and mineral supplements prescribed following gastric bypass surgery as he was unable to afford them.”
Eight years prior, the patient had undergone a sleeve gastrectomy to remove a large portion of his stomach so he could lose weight.
Upon his scurvy diagnosis, the man took 1,000 milligrams of vitamin C, 125 micrograms of vitamin D3, 5 milligrams of folic acid and a multivitamin daily.
A dietitian devised a meal plan, and the man started eating a lemon every day. His rash subsided and there was no more blood in his urine.
The study authors report that the risk factors for scurvy include poor nutrition, gastric bypass surgery, dialysis, alcoholism, psychiatric history and eating disorders.
“This disease is easily reversible with supplementation, with a dramatic response seen within 24 hours,” the doctors wrote. “Failure to treat may lead to catastrophic hemorrhage, hence, early recognition and prompt treatment are vital.”
In the US, recent research found that the incidence of scurvy in children more than tripled from 8.2 per 100,000 cases in 2016 to 26.7 per 100,000 cases in 2020.
Patients tended to be younger, male, obese and from low-income families. Nearly 65% had been diagnosed with autism.
The recommended daily vitamin C intake is 90 milligrams for adult men and 75 milligrams for adult women. Pregnant and breastfeeding women, smokers, some cancer patients and those taking certain medications may need more.
Scurvy signs can appear as early as a month after consuming less than 10 milligrams of vitamin C a day, the researchers say.
Dr. Theodore Strange, chairman of medicine at Staten Island University Hospital, said he hasn’t seen a case of scurvy since medical school.
“As [the study] authors state, it is still very rare in developed countries, especially here in the USA, as many foods and supplements contain enough [vitamin C] to prevent this disease from re-emerging,” Strange told The Post. “If there’s any concern, a good multi-vitamin can never hurt.”
