Vitamin C deficiency in older people increases risk of bleeding and fatigue, study says

A new study suggests that older adults who experience abnormal bleeding, fatigue and weakness should be evaluated for scurvy, a disease caused by vitamin C deficiency. Despite being commonly associated with 18th century sailors, scurvy remains relevant today, especially among vulnerable populations. The study, published in the Canadian Medical Association Journal (CMAJ), reveals the importance of recognizing this condition, particularly in older adults who face challenges related to diet and mobility.

The investigation focused on a case involving a 65-year-old Toronto woman who suffered from leg pain, weakness, skin lesions and discoloration. The woman had limited mobility due to chronic health problems, making it difficult for her to perform daily activities such as grocery shopping and cooking. As a result, his diet consisted mainly of soup and canned fish, with little to no fresh fruits or vegetables, a key factor in causing his vitamin C deficiency.

“This case presents a complex example of food insecurity manifesting as a rare diagnosis,” said Dr. Sarah Engelhart, a general internist at Mount Sinai Hospital and the University of Toronto. The patient’s condition underscores the link between food insecurity and nutritional deficiencies, particularly in older adults.

The researchers noted that while scurvy is often considered a disease of the past, it is more common in the 21st century than many health professionals might expect. However, diagnosing the condition can be difficult as its symptoms are non-specific and can be easily confused with other health problems. Symptoms such as fatigue, weakness, shortness of breath, and abnormal bleeding are often attributed to other conditions, making vitamin C deficiency an often overlooked diagnosis.

In addition to her poor diet, the patient also smoked, which aggravated her vitamin C deficiency. Smoking reduces vitamin C levels in the body, which puts people who smoke at greater risk of contracting the disease. Once the woman began taking vitamin C supplements, her symptoms improved significantly and a blood test confirmed the diagnosis of scurvy.

“Physicians should be alert for vitamin C deficiency when evaluating patients, including children and isolated older adults,” the study authors emphasized. They urged health care professionals to consider scurvy as a possible diagnosis for patients with abnormal bleeding and nonspecific symptoms, particularly in those with dietary restrictions or social isolation.

The study also identified several groups of people at increased risk of developing scurvy. These include people who follow restrictive diets, such as those with autism spectrum disorder or people who follow a “tea and toast” diet, as well as those who smoke or have substance use disorders. Additionally, people with malabsorption syndromes, which affect the body’s ability to absorb essential nutrients, are also at increased risk.

Study findings

The case study highlights the importance of a well-balanced diet rich in fresh fruits and vegetables, especially for older adults who face mobility issues or other barriers to accessing nutritious foods.

By considering scurvy as a possible diagnosis in patients with vague symptoms, health experts can help address nutritional deficiencies that would otherwise go undetected, improving the quality of life for those at risk.