Scurvy fever, convulsions, and eventual death are frequently seen. Scurvy, including subclinical scurvy, is caused by a deficiency of dietary vitamin C since humans are unable to metabolically make this chemical. Provided diet contains sufficient vitamin C, the lack of working GULO enzyme has no significance, and in modern Western societies, scurvy is rarely present in adults, although infants and elderly people are affected. Virtually all commercially available baby formulas contain added vitamin C, preventing infantile scurvy. Human breast milk contains sufficient vitamin C, if the mother has an adequate intake. Commercial milk is pasteurized, a heating process that destroys the
Vitamin B12 deficiency anemia intrinsic factor, it is not preventable. Vitamin B deficiency due to other causes may be prevented with a balanced diet or with supplements. Pernicious anemia can be easily treated with either injections or pills of vitamin B. If the symptoms are severe, injections are typically recommended initially. For those who have trouble swallowing pills, a nasal spray is available. Often, treatment is lifelong. Pernicious anemia due to autoimmune problems occurs in about one per 1000 people. Among those over the age of 60, about 2% have the condition. It more commonly affects people of northern European descent. Women are more