Scurvy, Hamilton, Dr Kayla Dowd Gar discussed on Quirks and Quarks
When you hear the words scurvy you probably think of life on the high seas a few centuries ago for sailors aboard their tiny wooden ships on voyages that could take months vitamin rich fruit and vegetables? Both were as rare as mermaids and scurvy the result of vitamin C deficiency was the result. But I imagine you'd have assume that scurvy had gone the way of those sailing ships. Well think again scurvy is still with us today in Canada in the twenty first century. That was the surprising conclusion season of a new study by Dr Kayla Dowd Gar who investigated modern scurvy as a medical student at McMaster university in Hamilton. She's currently a resident at the Ottawa. Hospital Dr Daddy are welcomed quirks and quarks. Thanks for having me. Let's begin with the disease itself. What exactly is scurvy? What are the symptoms CBS? So scurvy deficiency of vitamin C as you mentioned and you can develop a variety of symptoms from feeling generally unwell too easy bruising bleeding thing tooth loss and a number of other sort of feeling generally unwell a facts but in the most severe cases death has even occurred from scurvy. And that's just from lack of vitamin C me. We're not talking virus here or anything like that. No just lack of vitamin C.. Vitamin C is actually very important For a number of things including Collagen production and Collagen is essential for forming blood vessels. And your hair and things like that so it is quite important. Well we think of scurvy is a disease from another era. How did you investigate? It's modern face. Yeah so my my research supervisor. Dr neary actually diagnosed a case of scurvy in his clinic. And when I heard about that I was quite interested in wanted to you. Know more and understand what led people in modern Hamilton and other major North American cities to develop scurvy. So how did you pursue that. So we did a review of all of the vitamin C. levels levels in Hamilton over a eight year period and then looked at all the levels. That would be low enough to cause scurvy and went through the charts of those individuals visuals to get a sense of what their symptoms were What their causes of scurvy were thought to be by their clinicians and then if they had a response monster vitamin C.? When they were given supplementation the how many people were involved in that so overall we had fifty two patients that were that had vitamin C. levels low enough to cause scurvy and then thirteen of those patients actually have documented signs and symptoms? That would suggest that they actually had clinical scurvy. who were the people who you found that had developed scurvy so there were a number of individuals that had varying reasons since for developing scurvy but in general There were patients with alcohol misuse disorder which often leads to vitamin deficiencies because these individuals tend not ought to consume very much food at all in not much Fruit or vegetables and another category would be patients who had bariatric surgery. Those individuals tend to have vitamin deficiencies. Because we've bypass some of their digestive tract and it's more difficult for them to absorb nutrients as well as Komo ball normal people in our communities who were either afflicted by other mental illnesses very isolated impoverished. Just it just didn't really have the support or access to fresh fruits and vegetables now. Were there illnesses accurately recognized by caregivers. Jason and medical workers there were a few charts that were quite completes that documented all of the signs and symptoms that we would expect with scurvy. But I would. I'd say the vast majority were sort of lacking in the complete assessment that you would hope to have if you're considering scurvy and I think part of that is because we don't often as health providers consider scurvy as a diagnosis. A lot of the symptoms are skirt of scurvy are very nonspecific and and there are a lot of different diagnosis that that could have been causing those symptoms and you really have to think about scurvy and ask about their nutritional. Oh intake in order to come to that conclusion. Well scurvy is because of vitamin C deficiency vitamin CS. Really easy to get these these days. So how much do you need to get rid of this curvy to prevent scurvy. You really only need ten milligrams of vitamin C.. or less per dave And for context an Orange has about five times that amount. So you really need a very monotonous diet over months to develop disease Aziz like this for so how easy is it to get over it then. The patients that we reviewed who were given Vitamin C supplementation Asian actually recovered quite quickly within days. So it is rapidly reversible by providing patients with vitamin C.. So do you think it's it's possible. That scurvy is significantly underdiagnosed in Canada. I would imagine so even you know. This study had a number of limitations nations in order to be included in the study you would have to present to one of the Hamilton hospitals because we didn't include outside labs a doctor would have to have thought out of scurvy and decided to do a vitamin C.. Level because if you were confident that a patient had low vitamin C intake and had symptoms. That might be related to that. What you might just consider giving them vitamin C supplementation? Since it's such an easy treatment so the stepfamily didn't capture all of the patients that would have had low vitamin C. levels in the community and I couldn't really say how many more there are. But I imagine that we're have under reported the the number of cases in that timeframe. So what's the lesson we can learn from your research. I think the lesson is on one hand as a society. We should be looking at how we can do. Better to support individuals like this Who might be isolated and not have access to nutritious foods and because it's such preventable disease? We should have a goal of looking at where the needs are in our communities and pudding some steps in place to prevent this and on the other hand I think that healthcare practitioners should think of scurvy when they see patients that maybe have symptoms similar to this and and ask about their nutritional status and their food intake to get a better idea of whether this is diagnosis. They should be considering and for the rest of his issue. Fruit and vegetables. Yes that would be actually tag are thank you very much for your time. Things are having the doctor. Kayla Guard car is currently a resident at the Ottawa Hospital..