AN ancient disease has been making a comeback and it could be caused by an acid reflux drug, a new study has warned.
Health experts have recently suggested scurvy – a condition caused by a lack of vitamin C that can cause bleeding gums, teeth to fall out, and even be fatal – is re-emerging.
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The condition is thought to be making a comeback due to poor eating habits and the cost of living crisis
But a recent report has suggested it’s not just these factors behind the rise in cases.
Writing in the journal British Medical Journal Case Reports, doctors at the Sir Charles Gairdner Hospital in Western Australia, warned proton pump inhibitors (PPIs), such as omeprazole, could trigger the condition.
PPIs can increase the risk of scurvy by reducing the body’s ability to absorb vitamin C.
The doctors reported the case of a man in his 50s who earlier this year developed scurvy after taking PPIs.
The first sign of the illness was a red-brown pinpont rash (one of the recognised symptoms of scurvy) that covered the man’s legs and spread to his hands and arms.
Blood tests revealed he had no vitamin C in his bloodstream, and low levels of other key nutrients, which can be another sign of scurvy.
After being given daily vitamin C (1000mg), vitamin D3, folic acid, and multivitamin supplements, his rash disappeared and his vitamin C levels returned to normal.
Doctors discovered in addition to taking PPIs, he had not been eating fruit and vegetables and often skipped meals.
H’d also recently undergone a bariatric weight loss surgery and couldn’t afford to buy the nutritional supplements he’d been prescribed.
Weight loss surgery can make it harder for your gut to absorb vitamins and minerals from food.
This is known as malabsorption and can lead to malnutrition and deficiencies.
Patients are usually given a strict diet to follow and given supplements to prevent this from happening.
Dr Andrew Dermawan, from Sir Charles Gairdner Hospital, said the rising cost of living has made it harder for families to afford good quality nutritious foods.
He added there have been numerous reports of scurvy arising from complications following bariatric surgery.
Dr Dermawan noted other risk factors for scurvy include alcoholism, smoking, eating disorders, low household income, obesity, kidney dialysis, and drugs that interfere with vitamin C absorption, such as steroids and PPIs.
Proton pump inhibitors (PPI)
About 15 per cent of the UK population takes proton pump inhibitors (PPIs).
In 2022-23, the NHS in England dispensed 73 million PPI prescriptions, which was 6 per cent of all prescriptions
PPIs are usually described by your doctor if you have symptoms such as indigestion, acid regurgitation or dyspepsia (an upset stomach) or have a history of stomach ulcers.
They are also used to protect you stomach against other medications you are taking (such as aspirin or steroids) even if you have no symptoms of indigestion or dyspepsia.
Some PPIs are available to buy over the counter at pharmacies and supermarkets.
What is scurvy and are you at risk?
Scurvy describes severe vitamin C deficiency, and until now has been considered rare.
The condition is caused by not having enough vitamin C in your diet over a long period of time, with vitamin C mainly found in fruit and vegetables.
The NHS says you could be at risk of scurvy if:
- have no fresh fruits or vegetables in your diet for a while
- eat very little food at all – possible reasons include treatments that make you feel very sick all the time (such as chemotherapy) or an eating disorder such as anorexia
- smoke, as smoking reduces how much vitamin C your body gets from food
- have a long-term dependency on drugs or alcohol that affects your diet
- have a poor diet while pregnant or breastfeeding, because the body needs more vitamin C at these times
Babies, children and older people who find it hard to have a healthy diet may also be more at risk of scurvy.
If you think you or your child is at risk of scurvy, see a GP.
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