Pirates, Scurvy, & Vitamin C

Arr ye land-lubbers! It be a fine day to talk like a pirate. In the spirit of International Talk Like a Pirate Day, here be a quick grog-blog on scurvy....and whether you can be at risk from too little or too much vitamin C.
Pirates and Scurvy
When pirates sailed the seven seas, they lacked fruits and vegetables in their diet and sometimes got a condition called scurvy. Scurvy causes muscle weakness, swollen and bleeding gums, loss of teeth, and bleeding under the skin, as well as tiredness and depression. Wounds also do not heal easily when someone has scurvy.(1) They learned the cause of scurvy early on and to combat it, the pirates brought limes on their sea voyages. Pirates earned the nickname “limeys.”

Do people still get scurvy?
Do people still get scurvy? It’s rare, especially in developed countries, but those who don’t get enough vitamin C, smoke, or drink excessive alcohol can get it. Others at risk of vitamin C deficiency include:
AIDS patients
Burn victims
Cancer patients
people with prolonged Diarrhea
people with prolonged Fever or Infection
people with Intestinal Diseases
those diagnosed with Overactive Thyroid (Hyperthyroidism)
those with Stomach Ulcers
people under continuing Stress
Patients who've had surgical removal of the stomach
Tuberculosis patients
Non-breastfed infants under 6 months receiving Almond Milk or Unfortified Formulas
Patients using an artificial kidney (on hemodialysis)
Patients who undergo surgery
Individuals who are exposed to long periods of cold temperatures (1)
Where should I get vitamin C from?
According to the National Institutes of Health, "Fruits and vegetables are the best sources of vitamin C." (2) To prevent vitamin C deficiency and scurvy, eat plenty of citrus fruits, berries, and vegetables. Excellent sources of the vitamin include:

oranges
strawberries
red peppers
grapefruit
lemons
tomatoes
broccoli
cabbage
limes
To treat vitamin C deficiency, talk to your dietitian or physician. Vitamin C will likely be prescribed either through the diet, a supplement, or intravenously. The RDA is 60 mg/day which should come from the diet if possible. (3)
Can you get too much vitamin C?
Avast! It’s important not to self-prescribe vitamin C or any other supplements. While vitamin C is a water-soluble vitamin and excess generally gets eliminated through urine, there is the potential to do harm such as "rebound scurvy." (3)
There is some research that shows with over-supplementation, the body loses the ability to absorb sufficient vitamin C, putting it at risk of conditions that mimic vitamin C deficiency.
Vitamin C is also an antioxidant, and while predicted to help prevent cancer, with over-supplementation vitamin C may actually become a pro-oxidant and lead to free radicals in the body. Free radicals are associated with increased cancer risk.(4)
Therefore, it is important to always talk to you healthcare provider before taking a supplement, which includes over-the-counter vitamins. It's best to obtain vitamins and minerals from real foods. Simply eating 8 large strawberries or a medium orange can provide all the vitamin C you need for the day, along with fiber, antioxidants, potassium, and other important nutrients.
If you have questions about supplements or whether you're getting sufficient vitamins in your diet, you can book a virtual appointment with a Registered Dietitian at ZEST Nutrition.
Alas, me beauties. Eat yer fruits & veggies!
References
Mayo Clinic. (2018). Ascorbic acid (oral route). MayoClinic.org. https://www.mayoclinic.org/drugs-supplements/ascorbic-acid-oral-route/description/drg-20068031
Office of Dietary Supplements. (2021). Vitamin C. National Institutes of Health. https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/
Dutta T. (2016). Antioxidants and its effects. Journal of Evolution of Research in Human Physiology, 2(2): 10-14.
Wilson, M.K., Baguley, B.C., Wall, C., Jameson, M.B., & Findlay, M.P. (2014). Review of high-dose intravenous vitamin C as an anticancer agent. Asia-Pacific Journal of Clinical Oncology, 10(1): 22-37. https://doi.org/10.1111/ajco.12173
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