Vitamin C Deficiency Linked to Abnormal Bleeding in Older Adults: Study Highlights Importance of Early Diagnosis

New Delhi: In a recent study published in the Canadian Medical Association Journal (CMAJ), researchers from the University of Toronto have shed light on a growing, yet often overlooked health concern—vitamin C deficiency, or scurvy, manifesting in older adults.

The study details the case of a 65-year-old woman presenting with abnormal bleeding, fatigue, and skin lesions, revealing that scurvy is not just a disease of the past.

The patient, who visited a Toronto hospital with complaints of leg pain, weakness, and skin discolouration, was found to be suffering from severe vitamin C deficiency.

Her restrictive diet, largely limited to non-perishable foods like canned soup and fish due to mobility issues and social isolation, lacked essential fresh produce. This led to symptoms of scurvy, including gingival bleeding, perifollicular petechiae, and ecchymoses (bruising), classic signs of vitamin C deficiency.

Smoking, a known risk factor for vitamin C deficiency, further contributed to her condition. While the disease is often associated with 18th-century seafarers, the case highlights the continued relevance of scurvy in today’s world, particularly among older adults with poor dietary intake and food insecurity. The woman’s condition improved significantly after initiating vitamin C supplementation.

Dr Sarah Engelhart, a general internist at Mount Sinai Hospital and co-author of the study, stressed the importance of recognizing non-specific symptoms, such as fatigue, weakness, and abnormal bleeding, in diagnosing vitamin C deficiency. “Clinicians should maintain a high index of suspicion, particularly in older adults with limited diets or those at risk of food insecurity,” she said.

The researchers emphasized that scurvy, though uncommon, can still occur in populations with limited access to fresh fruits and vegetables, as well as in those with restrictive diets or smoking habits.

The study calls for increased awareness among healthcare professionals to consider vitamin C deficiency in patients with unexplained symptoms and abnormal bleeding, as early intervention can lead to swift recovery with appropriate supplementation.

Vitamin C deficiency is more widespread than previously thought, with data showing that up to 25% of individuals from low socioeconomic groups may be affected in some regions. The study highlights the critical role of nutrition in preventing such avoidable conditions and urges healthcare providers to assess the dietary habits and social situations of their patients more closely.

This case underscores the ongoing challenge of food insecurity in developed countries and its impact on health. It serves as a reminder that even in the 21st century, scurvy remains a potential diagnosis, particularly in vulnerable populations.