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 Older adults suffering from abnormal bleeding, fatigue, and weakness, must be assessed for scurvy -- a disease caused by vitamin C deficiency, suggests a study on Monday. 

Detailing a case study of a 65-year-old woman with mobility issues and social isolation, the study published in CMAJ (Canadian Medical Association Journal) showed that scurvy, or vitamin C deficiency, is not just an 18th-century seafarers’ disease.

Researchers from the University of Toronto in Canada implored clinicians to consider scurvy in patients with abnormal bleeding and nonspecific symptoms.

The elderly patient visited the emergency department at a downtown Toronto hospital for leg pain and weakness, skin lesions, and discoloration. She also had several chronic health conditions.

Mobility issues restricted her ability to go grocery shopping, cook, and perform other daily activities. She lived largely on canned soup and fish, with no fresh produce.

“This case presents a complex example of food insecurity manifesting as an uncommon diagnosis,” said Dr. Sarah Engelhart, a general internist at Mount Sinai Hospital and the University of Toronto.

The researchers noted that vitamin C deficiency is more common than expected in the 21st century. However, its diagnosis is often challenging as symptoms are often nonspecific, such as fatigue, weakness, and shortness of breath.

The patient also smoked, which further contributes to vitamin C deficiency. Her symptoms improved once she started on vitamin C treatment, and a blood test for vitamin C deficiency eventually confirmed the diagnosis, said the doctors.

“Clinicians should be alert to vitamin C deficiency when assessing patients, including children and isolated older adults,” the doctors said.

The team noted that people who follow restrictive eating patterns (for example, those with autism spectrum disorder or those on a tea and toast diet), who smoke cigarettes, who have a substance use disorder, or who have malabsorption syndrome, can also be at risk of scurvy.