Vitamin C Deficiency and Scurvy
Scurvy sounds like a pirate problem, but it still turns up in Australia, sometimes in people who eat plenty of calories but few fresh fruit and vegetables.
Symptoms
- Early (about a month of very low intake): tiredness, aches and sore, puffy gums
- Small red or purple spots around hair follicles, easy bruising and corkscrew-shaped body hairs
- Bleeding gums and loose teeth
- Wounds that won’t heal
- Joint pain and swelling, low mood, and iron deficiency anaemia
- Untreated, scurvy is fatal
Who’s at risk
- Diets with little fresh fruit and vegetables, including very restricted or “beige” diets
- Overcooking vegetables: heat and long storage destroy vitamin C
- Smoking (smokers need more)
- Heavy alcohol use, eating disorders, older people living alone
- Kidney dialysis, malabsorption and some cancers
- Children with autism or other conditions who eat a very narrow range of foods
Treatment
- Vitamin C tablets for a few weeks. Gums and tiredness often improve within days; bruising and wounds over weeks.
- Long term: fruit and vegetables every day. Just 1 orange or a handful of strawberries covers an adult’s daily 45 mg.
Food sources
- Capsicum, kiwifruit, citrus, strawberries, broccoli, Brussels sprouts, tomatoes and potatoes. Raw or lightly cooked keeps the most.
Save your money
- Mega-dose vitamin C for coldsTaking it after a cold starts doesn’t help. Regular use may shorten colds slightly but doesn’t prevent them in most people.
- Grams a day “for immunity”Extra is passed in urine, and high doses can cause diarrhoea and, in some people, kidney stones.
See your GP if
- Your gums bleed and you bruise easily
- A wound isn’t healing, especially if you have diabetes
- Someone you care for eats very few fruits or vegetables
Weird history
- In 1747, Scottish naval surgeon James Lind ran one of the first controlled trials: sailors with scurvy given oranges and lemons recovered fastest.
- Vitamin C itself wasn’t identified until 1932. Albert Szent-Györgyi won the 1937 Nobel Prize for the work.
- In 2016, doctors at Westmead Hospital in Sydney found scurvy in several patients with wounds that wouldn’t heal. Most ate vegetables, but overcooked them.
Common questions
Does scurvy still exist in Australia?
Yes. It’s uncommon, but cases are still found, including in people with diabetes and slow-healing wounds, very restricted diets, heavy alcohol use or eating disorders.
What are the first signs of scurvy?
Tiredness, aches and sore gums, then small red spots around hair follicles, easy bruising, bleeding gums and poor wound healing.
How much vitamin C do adults need?
About 45 mg a day in Australia, more for smokers. One orange or a cup of capsicum or strawberries is enough.
Does vitamin C prevent colds?
Not for most people. Regular intake may shorten colds slightly. Taking it once a cold starts doesn’t help.
How long does it take to get scurvy?
Signs can appear after about a month of very low intake (under about 10 mg a day).
Helpful resources
- Healthdirect: Vitamins and mineralsPlain-English Australian Government guide. Free.
- Dietitians AustraliaFind an Accredited Practising Dietitian near you.
Evidence and more information
- NIH Office of Dietary Supplements: Vitamin C
- Westmead Institute: Surprise scurvy cases suggest nutrient deficiencies (2016)
- Nutrient Reference Values for Australia and New Zealand (Eat for Health)
maladywise.com/vitamin-c/