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 D deficiency further increasing the risk of fall and bone fractures in adults. Ultraviolet B rays from sunlight is a large source of vitamin D. Fatty fish such as salmon, herring, and mackerel are also sources of vitamin D. Milk is often fortified with vitamin D and sometimes bread, juices, and other dairy products are fortified with vitamin D as well. Many multivitamins now contain vitamin D in different amounts. Vitamin D deficiency is typically diagnosed by measuring the concentration of the 25-hydroxyvitamin D in the blood, which is the most accurate measure of stores of vitamin D in the body. Vitamin