Scurvy symptoms

There is, without doubt, a wide spread between the amount of vitamin C needed to prevent frank scurvy and that required for the maintenance of best health. In young growing guinea pigs about 0.5 mg. ascorbic acid per day will protect against scurvy symptoms, but there are distinct gains in health when the intakes are up to 10 times this amount.46... 

With respect to human beings there is some question as to what level of tissue saturation should ideally be maintained. In guinea pigs defects in developing incisors appear when the tissue concentrations are about 40 per cent of the maximum. Scurvy symptoms do not appear until the tissue saturation has reached a much lower level (about 20 per cent saturation). It seems logical to suppose that in different individuals the manifestations of mild vitamin C deficiency would be different and that a high degree of saturation would be safest from the standpoint of all the vulnerable tissues. 19... 

Although accounts of scurvy symptoms are described as far back as the ancient Egyptians, the recognition and search for a scurvy cure began with the severe... 

The first clues to the treatment of scurvy occurred in 1535—1536 when Jacques Cartier, on advice from Newfoundland Indians, fed his crew an extract from spmce tree needles to cure an epidemic. Various physicians were recommending the use of citms fmits to cure scurvy in the mid-sixteenth century. Two hundred years later, in 1753, it was proved by Dr. James Lind, in his famous clinical experiment, that scurvy was associated with diet and caused by lack of fresh vegetables. He also demonstrated that oranges and lemons were the most effective cure against this disease. In 1753, inM Treatise on the Scurvy[ Lind pubhshed his results and recommendations (7). Eorty-two years later, in 1795, the British Navy included lemon juice in seamen s diets, resulting in the familiar nickname "limeys" for British seamen. Evidence has shown that even with undefined scorbutic symptoms, vitamin C levels can be low, and can cause marked diminution in resistance to infections and slow healing of wounds. 

Vitamin C occurs as L-ascorbic acid and dihydroascorbic acid in fruits, vegetables and potatoes, as well as in processed foods to which it has been added as an antioxidant. The only wholly undisputed function of vitamin C is the prevention of scurvy. Although this is the physiological rationale for the currently recommended intake levels, there is growing evidence that vitamin C may provide additional protective effects against other diseases including cancer, and the recommended dietary allowance (RDA) may be increased in the near future. Scurvy develops in adults whose habitual intake of vitamin C falls below 1 mg/d, and under experimental conditions 10 mg/d is sufficient to prevent or alleviate symptoms (Bartley et al., 1953). The RDA is 60 mg per day in the USA, but plasma levels of ascorbate do not achieve saturation until daily intakes reach around 100 mg (Bates et al., 1979). Most of the ascorbate in human diets is derived from natural sources, and consumers who eat five portions, or about 400-500 g, of fruits and vegetables per day could obtain as much as 200 mg of ascorbate. 

If one reads an account of the outbreak of scurvy on shipboard in the days of long voyages on sailing vessels, he finds indications of individual differences in vitamin C need. For example, in Dana s Two Years before the Mast, one member of the crew was described as suffering from severe scurvy and was about to die of the disease, while many of the crew were quite free from any symptoms. Since they had been living for the same length of time on vitamin C-deficient diets, they would, if uniformly constituted, have all been attacked at about the same time. 

In 1753 Lind pnblished his famons Treatise on Scurvy. Since this is snch a remarkable publication, some parts of it are presented here to illustrate the care he took in describing the terrible symptoms of scurvy and the signihcance of the discussion at that time. 

The formation of Hyp and Hyl residues in procollagen is catalyzed by iron-containing oxygenases ( proline and lysine hydroxylase, EC 1.14.11.1/2). Ascorbate is required to maintain their function. Most of the symptoms of the vitamin C deficiency disease scurvy (see p. 368) are explained by disturbed collagen biosynthesis. 

The deficiency state scurvy is characterized by degenerative changes in the capillaries, bone, and connective tissues. Mild vitamin C deficiency symptoms may include faulty bone and tooth development, gingivitis, bleeding gums, and loosened teeth. 

Deficiency may occur in infants if no fruits or vegetables are added to their milk formulas. In alcoholics, and in elderly subjects who consume inadequate diets vitamin C deficiencies are frequent. Severe ascorbic acid deficiency is characterized by the syndrome known as scurvy. Its manifestations are generally based on a loss of collagen. Symptoms include hemorrhages, loosening of teeth. In children cellular changes in the long bones occur. 

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. 

C. Early symptoms of vitamin C dehciency, or scurvy, include malaise. Hemorrhages, especially of the gums, may result from capillary fragihty. 

In vitamin C avitaminosis, or scurvy, the joints become painful and the gums bleed and deteriorate, resulting in tooth loss. Gangrene and infections may also occur, and wounds do not heal properly. These symptoms all result from impaired collagen synthesis and... 

Deficiency symptoms In vitamin C deficiency scurvy develops. It is characterized by ecchymosis, petechiae, swollen and bleeding gums, subperiosteal haemorrhage, bones are painful to touch, impaired wound healing, anaemia, loosening of teeth and gingivitis. 

A deficiency of ascorbic acid results in scurvy, a disease character ized by sore, spongy gums, loose teeth, fragile blood vessels, swollen joints, and anemia (Figure 28.9). Many of the deficiency symptoms can be explained by a deficiency in the hydroxylation of collagen, resulting in defective connective tissue. 

The nutritional need for accessory food factors was first stated explicitly in 1905-1906, although the influence of diet in preventing or curing some diseases such as scurvy had long been known. The name vitamine was proposed in 1912, but the terminal e was dropped when it was realized that not all these compounds are nitrogenous bases. The vitamins serve as coenzymes in various metabolic processes, and the necessary quantities are usually supplied by an adequate diet or by synthesis by the intestinal flora. Vitamin deficiency can arise from a failure to absorb the compound from the gut. The symptoms of deficiency vary in different animal species, and not all the substances found necessary in other species have been shown to be essential for human nutrition. Vitamins are used for the prevention or cure of deficiency diseases and for some other pathological conditions,... 

The antiscorbutic factor of fresh fruits, which prevents the development of the typical symptoms of scurvy in humans, is a carbohydrate derivative known as vitamin C or ascorbic acid. This substance is not a carboxylic acid, but a lactone, and owes its acidic properties (and ease of oxidation) to the presence of an enediol grouping. It belongs to the l series by the glyceraldehyde convention ... 

Symptoms of deficiency include loose teeth and bleeding gums, bruises, loss of appetite, dry skin, poor healing. In extreme cases, scurvy and internal hemorrhages. 

The richest sources of vitamin C are citrus fruits (e.g., lemon, oranges), tomatoes, potatoes, green chilies, and human milk. Severe deficiency causes scurvy and is prevalent in malnourished infants, children, adults, alcoholics, and drug addicts. Symptoms such as bleeding gums, deformed teeth, brittle bones, impaired wound healing, anemia, and growth retardation are observed. 

It is used in the treatment of scurvy, postoperative cases, and healing bedsores and chronic leg ulcers. Vitamin C increases the absorption of iron during anemia and is frequently combined with ferrous salts. It is used in urinary tract infections to acidify urine. Large doses of vitamin C have been tried to cure everything from the common cold to cancer, with not much success. The usefulness of vitamin C in asthma, cancer, atherosclerosis, psychologic symptoms, and fertility is doubtful. Ascorbic acid is well tolerated in large doses and may cause rebound scurvy on withdrawal. There is a possibility of forming urinary stones. 

Vitamin C cannot be synthesized in the human body and must be obtained from the diet (e.g., citrus fruits, broccoli, turnip greens, sweet peppers, tomatoes) or by taking synthetic vitamin C (e.g., vitamin C tablets, high-C drinks, and other vitamin C-fortified commercial foods). The minimum recommended adult daily requirement of vitamin C to prevent scurvy is 60 mg. Some people, among them the late Linus Pauling, twice Nobel Laureate, suggested that very large daily doses (250 to 10,000 mg) of vitamin C could help prevent the common cold, or at least lessen the symptoms for many individuals. No reliable medical data support this claim. At present, the human quantitative requirement for vitamin C is still controversial and requires further research. 

What enzyme is oxidized in the absence of vitamin C and causes the symptoms of scurvy Which natural product is synthesized by this enzyme ... 

Efficiency in vitamin C, unlike the case with most vitamins, is associated with a specific disease. This disease is scurvy. The symptoms of scurvy include swollen or bleeding gums and hemorrhages under the skin. These symptoms occur when the body s ascorbate is depleted to the point where plasma ascorbate levels are under 0.2 mg/100 mi. Controlled studies with human subjects revealed that symptoms of the disease may develop within 4 weeks with the consumption of an ascorbate-free diet. Scurvy is rarely encountered in developed countries, though it may occur in chronic alcoholism. The disease in humans may be prevented by consuming 10 to 15 mg ascorbic acid per day. 

Echinacea species (coneflower, black Sampson hedgehog, Indian head, snakeroot, red sunflower, scurvy root) have become increasingly popular, particularly for the prophylaxis and treatment and prevention of cold and flu symptoms. However, the claimed efficacy of Echinacea in the common cold has not been confirmed in a randomized, double-blind, placebo-controlled trial (20) or a systematic review (21). Echinacea is claimed to have antiseptic and antiviral properties and is under investigation for its immunostimulant action. The active ingredients are glycosides (echinacoside), polysaccharides, alkamides, and flavonoids. 

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