Arrrrrr are you kidding me?
Scurvy, a vitamin C deficiency disease that plagued sailors and pirates centuries ago, appears to be making a resurgence 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 do occur, especially in the elderly, patients with alcoholism, and children with psychiatric or developmental problems.”
Doctors, from the Sir Charles Gairdner Hospital in Western Australia, report the case of a 50-year-old unemployed ex-smoker who complained of a painful rash on both legs that appeared to come out of nowhere.
Blood was found in his urine and he suffered from anemia, a low number of red blood cells.
ER personnel were a little confused after 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 levels of vitamin C and other nutritional deficiencies.
Doctors learned that Aussie’s “living conditions were poor”.
“He had financial constraints and therefore neglected his diet. His meals mainly consisted of processed foods, without vegetables or fruits,” the case report states. “Sometimes he would skip meals, which happened more often in the last few weeks. He had also stopped taking prescribed vitamin and mineral supplements after gastric bypass surgery as he was unable to afford them.
Eight years earlier, the patient had undergone a sleeve gastrectomy to remove a large portion of his stomach so he could lose weight.
After 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 nutritionist created a meal plan and the man began eating a lemon every day. His flushing subsided and there was no more blood in his urine.
The study authors report that risk factors for scurvy include poor nutrition, gastric bypass surgery, dialysis, alcoholism, psychiatric history and eating disorders.
“This disease is easily reversible with supplements, with a dramatic response seen within 24 hours,” the doctors write. “Failure to treat can lead to catastrophic bleeding, so early recognition and prompt treatment are vital.”
In the US, recent research found that the incidence of scurvy in children 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% were diagnosed with autism.
The recommended daily intake of vitamin C 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.
Signs of scurvy can appear as early as a month after consuming less than 10 milligrams of vitamin C per day, researchers say.
Dr. Theodore Strange, chairman of medicine at Northwell’s Staten Island University Hospital, said he hasn’t seen a case of scurvy since medical school.
“How [the study] the authors say it is still very rare in developed countries, especially here in the US, as many foods and supplements contain enough [vitamin C] to prevent this disease from reoccurring,” Strange told The Post. “If there’s any concern, a good multi-vitamin can never hurt.”
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