Scurvy Stress

The dehciency disease associated with a lack of ascorbic acid is called scurvy. Early symptoms include malaise and follicular hyperkeratosis. Capillary fragility results in hemorrhages, particularly of the gums. Abnormal bone and tooth development can occur in growing children. The body s requirement for vitamin C increases during periods of stress, such as pregnancy and lactation. 

Deficiency in vitamin C leads to the disease scurvy due to the role of the vitamin in the post-translational modification of collagens. Scurvy is characterized by easily bruised skin, muscle fatigue, soft swollen gums, decreased wound healing and hemorrhaging, osteoporosis, and anemia. Vitamin C is readily absorbed and so the primary cause of vitamin C deficiency is poor diet and/or an increased requirement. The primary physiological state leading to an ihcreased requirement for vitamin C is severe stress (or trauma). This is due to a rapid depletion in the adrenal stores of the vitamin. The reason for the decrease in adrenal vitamin C levels is unclear but may be due either to redistribution of the vitamin to areas that need it or an overall increased utilization. 

Recently it has been proposed (Eisenstein and Shank, 1951 Pirani, 1952) that scurvy itself is just another nonspecific stress. The changes seen in the adrenals in this disease can then be simply explained on the assumption of cortical stimulation by the anterior pituitary. The dietary deficiency of ascorbic acid is thus no longer necessary to explain the reduction of ascorbic acid in the cortexl A more interesting question than Is scurvy a stress is Does stress precipitate scurvy The answer is certainly, yes. 

Reasonable and clear definitions of terms such as gross deficiencies, minimal, adequate, optimal, and even average are essential for the proper description and intelligent use of tables of requirements. Even the clinical criteria for such definitions are unsatisfactory (Thomson and Duncan, 1954). It is possible with some nutrients, such as ascorbic acid, to draw some distinction between amounts that will cure scurvy and amounts (minimal ) that will permit normal odontoblast development. A further definition of a much higher level of intake (optimal ) that will saturate body tissues can also be offered. Under conditions of stress, such as fever, the body tissues rapidly lose ascorbic acid, and a still higher intake can be defined that is needed to rebuild some specified amount of ascorbic acid in the plasma, for example. 

In recent times, very few persons are known to have died from scurvy, except, perhaps, prisoners of war and malnourished infants. However, mild cases of scurvy may occur in infants, especially when they re raised on cow s milk in adults who eat few vegetables or fruits and in older persons who live on reduced incomes and under stress. 

Although it has been estimated that as little as 1 0 mg per day of ascorbic acid will prevent scurvy, such a low intake is not likely to provide a reserve against such unexpected stresses as disease, trauma, and chilling. The Recommended Dietary Allowances (RDAs) are 60 mg per day of ascorbic acid for adult males and for females who are neither pregnant nor lactating. 

The early symptoms of vitamin C deficiency are fatigue, lassitude, loss of appetite, drowsiness and insomnia, feehng run-down, irritability and low resistance to infections. Severe deficiency causes a weakening of these tissues (scurvy), resulting in capillary bleeding. Fish, like humans, are dependent on a vitamin C supply via the diet. The other food-producing animals are able to synthesize vitamin C themselves. However, under conditions of stress, this production may not be sufficient to support optimum health and performance. 

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