As food insecurity continues to grow across Canada, doctors are starting to be on the lookout for scurvy, a disease that results from a lack of vitamin C commonly associated with 18th-century sailors who’ve been away at sea for long periods of time.
The Canadian Medical Association Journal published a report on Monday detailing the case study of a 65-year-old woman who was diagnosed with scurvy at a Toronto hospital in 2023.
The woman’s diagnosis led the authors to make the case that doctors should be considering the disease as a possibility, especially among patients who have a higher risk of being nutrient deficient like older adults who live alone and those living in poverty.
While discussing her diagnosis, the report concluded that she had a social history which revealed “a several-years-long period of substantial limitations in her instrumental activities of daily living, including grocery shopping and meal preparation, owing to difficulties ambulating, attributed to symptoms of leg claudication,“ reads the report.
“She reported little social and family support. This social isolation had resulted in a sustained period of dietary intake limited to predominantly nonperishable foods — specifically, canned soup and tuna fish, along with white bread and processed cheese.”
In addition to a poor diet, the woman was not taking any supplements or vitamins.
According to the report, people with a lower income are more likely to skip meals and eat food with reduced nutritional value when they do eat.
Foods known to offer a natural source of vitamin C are citrus fruits such as grapefruits, lemons and oranges as well as vegetables like spinach and broccoli.
There is currently no data available on whether cases of scurvy are on the rise in Canada, however, what research is available regarding cases in the U.S. and U.K., shows that the disease is far from being antiquated.
“Data from the 2017–2018 National Health and Nutrition Examination Survey showed that the prevalence of vitamin C deficiency in the United States was 5.9%, while reports from the United Kingdom suggest that the prevalence of deficiency may be as high as 25% in some groups with low socioeconomic status,” reads the report.
Statistics Canada released data in May that reported 16.9% of Canadians faced moderate or severe food insecurity in 2022, compared with 12.9% the year before.
“Although hypovitaminosis C is often asymptomatic and rarely represents the primary concern for presentation to acute care, the condition should not be considered only an archaic diagnosis of 18th-century seafarers,” reads the CMAJ report.
“Several modern-day case reports of hypovitaminosis C from Canadian centres as well as a report showing a 12% prevalence of symptoms in patients admitted to an acute care geriatric ward, suggest the need for its consideration in the differential diagnosis of abnormal bleeding, as well as more nebulous presentations such as fatigue, edema, or dyspnea.”
Scurvy symptoms may typically appear within eight to 12 weeks of consistent vitamin C deficiency, which may come in the form of fatigue, large patches of bruising, bleeding gums and others. If left untreated the disease can result in spontaneous internal bleeding, the killing of red blood cells and death.