The initial symptoms of scurvy, caused by vitamin C deficiency, are generally non-specific. The disease may begin with complaints such as fatigue, general weakness, loss of appetite, and inability to gain weight. As scurvy progresses, more distinct symptoms like shortness of breath, bone and muscle pain can develop within a few months; muscle pain typically results from insufficient carnitine production. In advanced stages, signs and symptoms observed include rough skin, easy bruising, pinpoint rashes, delayed wound healing, gum bleeding and tooth loss, emotional changes, leg pain and tenderness, bleeding disorders, and swellings over long bones. If left untreated, severe complications such as widespread edema, jaundice, fever, intracranial hemorrhage, and internal organ bleeding can lead to death.