Researchers have highlighted the potential dangers of vitamin C deficiency in the elderly, suggesting that symptoms such as abnormal bleeding, fatigue, and weakness could be indicative of scurvy. This disease, historically associated with 18th-century sailors, is not confined to the annals of history but remains a present-day concern, particularly among older adults.
The study, conducted by researchers from the University of Toronto, Canada, and published in the Canadian Medical Association Journal (CMAJ), detailed the case of a 65-year-old woman. This patient, who suffered from mobility issues and social isolation, presented with leg pain, weakness, skin lesions, and discoloration. Her restricted mobility limited her ability to perform daily activities such as grocery shopping and cooking, leading to a diet primarily consisting of canned soup and fish, devoid of fresh produce. Dr. Sarah Engelhart, a general internist at Mount Sinai Hospital and the University of Toronto, described this case as a complex example of food insecurity manifesting as an uncommon diagnosis. The patient's diet, coupled with her smoking habit, contributed to her vitamin C deficiency. However, her symptoms improved significantly once she began vitamin C treatment. A subsequent blood test confirmed the diagnosis of vitamin C deficiency.
The researchers emphasized that vitamin C deficiency is more common in the 21st century than one might expect. However, diagnosing this deficiency can be challenging due to the nonspecific nature of the symptoms, which can include fatigue, weakness, and shortness of breath. They urged clinicians to consider scurvy as a potential diagnosis in patients presenting with abnormal bleeding and nonspecific symptoms. This case study serves as a stark reminder of the importance of adequate nutrition, particularly in older adults. It also underscores the potential health risks associated with restrictive eating patterns, smoking, substance use disorders, and malabsorption syndrome, all of which can contribute to vitamin C deficiency and, consequently, scurvy.
Historically, scurvy was a common affliction among sailors during the Age of Exploration, due to the lack of fresh fruits and vegetables on long sea voyages. The disease was virtually eradicated among this population once the link between vitamin C and scurvy was discovered, and citrus fruits were included in sailors' diets. However, this case study demonstrates that scurvy remains a potential health risk today, particularly among populations with limited access to fresh produce or those with restrictive eating habits.
The researchers' findings highlight the importance of considering nutritional deficiencies in the differential diagnosis of nonspecific symptoms. They also underscore the need for healthcare providers to be aware of the potential health risks associated with social isolation and food insecurity, particularly among older adults. This study serves as a reminder of the importance of adequate nutrition and the potential health risks associated with vitamin C deficiency. It underscores the need for healthcare providers to consider scurvy as a potential diagnosis in patients presenting with nonspecific symptoms and abnormal bleeding. Furthermore, it highlights the importance of addressing social determinants of health, such as food insecurity and social isolation, in the provision of comprehensive healthcare.
