What’s Scurvy?! And What Does It Do To Bone?

Most of us enjoy hearing stories about the squash-buckling pirates of the high seas in days long past! Often romanticized, their tales told of adventurers and rebels who lived and died by their own code. Johnny Depp and Disney has built a franchise off of these stories.

However, life at sea was no picnic. Pirates along with other seafaring folks, like the navy, spent a large amount of time and effort battling a multitude of diseases. But I want to talk about scurvy!

Recently, the news featured a story about an 11 month old baby with scurvy! I’ll summarize: the infant was feeding on almond milk, a plant-based substitute, for baby formula. Breast milk, cow’s milk, baby formula, and actual fruits and veggies have vitamin C in them. But the baby wasn’t getting any of those, so he got scurvy.

By middle school, many of us were taught that scurvy was a lack of vitamin C. But what does it actually do?!

Let’s look at the bones! Here is a reference skull so that you can visualize the angle that we are looking towards with this piece of skull (let’s thank www.infovisual.info for this great image).

Here is a skull that shows signs of scurvy

The sections that I’ve highlighted are how scurvy looks on the bone. It can be identified by the layers of new bone growing on the normal bone surface. Except, instead of this bone being smooth, it usually looks like a sponge with lots of tiny holes, or is very porous.

Bones with scurvy lack collagen. The lack of collagen cause tiny little blood vessels called capillaries to bleed because they get super weak! The blood signals to the bone that it needs to heal, so the bone starts trying to form new bone. This process is kind of like what happens when you break or fracture a bone.
Children who have scurvy experience severe lower limb pain caused by subperiosteal bleeding, aka bone bruises. This is when blood pools or collects underneath the periosteal of the bone which is the outer membrane that covers the bone.

Illustration from Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013.

This sounds horrible, right?! As you can imagine, being at sea for extended amount of time without access to fresh foods and milk, was definitely a recipe for scurvy. However, pirates aren’t the only ones who were afflicted with the disease.

In fact, ANYONE with a restricted diet or suffering from malnutrition can suffer the effects of vitamin C deficiency. Children can be effected in such high numbers because they grow so rapidly early on in life. Year one nutrition is imperative. Even though the baby had only had the plant based veggie diet for about 9 months, this was long enough for an infant to experience the painful scurvy symptoms.

The initial symptoms of scurvy can include lethargy, moodiness, loss of appetite, fever, and diarrhea to name a few.

“After 1-3 months of severe or total vitamin C deficiency, patients develop shortness of breath and bone pain… Skin changes with roughness, easy bruising and petechiae, gum disease, loosening of teeth, poor wound healing, and emotional changes occur” (Lynne Goebel, MD et. al.)

The treatment of scurvy is to give the patient vitamin C. In about two weeks after some proper nutrition, patients should feel better, but if not treated early, some of the effects to the bone may be long lasting, or the patient may die.

Scurvy in adults is not often seen in developed nations anymore. Picky children and kids with lack of access may still deal with the issue more commonly than should be seen. However, there are still some cases usually” because of dietary imbalances related to advanced age or homelessness” (Fain O).

For more reading checkout:

Musculoskeletal Manifestations of Scurvy: http://www.ncbi.nlm.nih.gov/pubmed/15797491

http://www.slate.com/articles/health_and_science/medical_examiner/2015/11/scurvy_is_common_and_should_be_diagnosed_and_treated.html