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Scurvy and vitamins

By Karen Kier
Pharmacist on behalf of the ONU HealthWise team

Scurvy is often a slang term used for someone who is mean or despicable. The Scurvy Song also known as We’ve Got Scurvy is performed by the artist Pink as a bonus track on the album Spongebob’s Greatest Hits as part of the television series Spongebob Square Pants. The song is written as a sea shanty and was released in 2009. Scurvy is usually associated with pirates since sailors were susceptible to scurvy  In a January 10, 2022 article published in the Military Health System news (health.mil), author Janet A. Aker reports 2 million sailors died of scurvy between the 16th and 18th centuries. Historians have documented that scurvy has caused the most suffering throughout history related to vitamin deficiencies.

A lack of vitamins in one’s diet can increase the risk of disease including a lack of vitamin C resulting in scurvy. Scurvy was not only common among sailors, but was a major health problem related to the great potato famine of 1845 in Ireland. Since humans are not able to make vitamin C, they must rely on their diet as an external source of vitamin C. This was confirmed in 1747 by James Lind when his controlled study evaluated diet as a cure for scurvy. He was able to identify lemons and oranges as an effective means of preventing and treating scurvy.

So why the interest in vitamins?  

Vitamins are always a hot topic for ads on the internet, social media, and the media. New advertisements are promoting the benefits of vitamins and supplements. Proctor & Gamble has recently purchased the Australian effervescent vitamin product called VÖOST® and has a strong marketing campaign. Nature Made® is promoting a new line of products called WellblendsTM, which combines vitamins with natural supplements. 

On June 21, 2022, the Journal of the American Medical Association (JAMA) published the United States Preventive Services Task Force (USPSTF) report on Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer. This report was an update to the previous report released in 2014.

One might wonder who is the USPSTF? The USPSTF was founded in 1984 to provide expert advice on health. The USPSTF is an independent, volunteer panel of experts in disease prevention and evidence-based medicine that work to improve the health of people throughout the nation by making scientifically supported recommendations about clinical preventive services. They evaluate the science and clinical studies to provide objective recommendations.  You may not realize how often the USPSTF guidance is used to provide recommendations on screenings including cancers (https://uspreventiveservicestaskforce.org/uspstf/recommendation-topics).  

The recent report on vitamins had three major takeaway points based on the science.  After evaluating the literature, the panel provided guidance on beta carotene (converted to vitamin A in the body), vitamin E, and multivitamins in both cancer prevention, as well as heart disease prevention. The panel indicated adequate evidence from studies was available for beta carotene and the science showed no benefit in prevention of heart disease or cancer with supplementation.  Likewise, the panel had adequate scientific evidence that vitamin E had no benefit in preventing heart disease or cancer. The committee reported a lack of critical scientific evidence for any benefit with multivitamins for heart disease or cancer. More studies would need to be done to answer the question of benefit for multivitamins.  

Some vitamins have evidence of harm related to an increase in the risk of certain cancers. High doses of vitamin C and beta carotene have been linked to an increase risk of lung cancers in smokers. Vitamin A (beta carotene) and vitamin E are considered fat soluble vitamins meaning the body stores the vitamins in the fat tissue. These vitamins can accumulate in the body and cause harm when higher doses are ingested. Too much vitamin E can result in excess bleeding as well as muscle weakness. Higher than normal doses of vitamin A can increase the risk for liver damage and is dangerous in pregnant women causing birth defects.  

Vitamin C, known as ascorbic acid, was discovered in 1912 and chemically produced in 1933. It comes in many different formulations and doses. In 1970, Linus Pauling declared that vitamin C prevents and alleviates the common cold. His statement was based on a study of children at a ski camp in the Swiss Alps. His study was highly questioned due to many flaws in the design.  

Studies continue to be published on the value of vitamin C in supporting the immune system including use in COVID-19. Studies have not found a benefit in improving outcomes with the use of vitamin C in managing patients with COVID-19. A large meta-analysis (a study of studies with combined data pooling) published in December 2021 concluded that vitamin C had no benefit. A 2016 meta-analysis reported the lack of vitamin C supplementation on reducing or preventing the common cold.  

The best advice continues to support getting vitamins and minerals from a healthy diet. Talk to your pharmacist about vitamin and supplementation products.

ONU HealthWise is offering COVID-19 including boosters Monday through Friday from 10:00 a.m.-5:00 p.m. Call the pharmacy for an appointment for other time slots. The ONU HealthWise pharmacy offers Moderna and Pfizer COVID-19 vaccines. Call the pharmacy to get more information.  

ONU HealthWise Pharmacy
419-772-3784
www.onuhealthwisepharmacy.com

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