Who Is Most Likely to Develop Scurvy, a Vitamin C Deficiency?

October 17, 2025 •

3 min read

While once considered a disease of sailors and pirates, a recent study indicates the overall incidence of scurvy in the US has increased significantly, affecting about one in 4,000 people in 2020. To understand who is most likely to develop scurvy a vitamin C deficiency?, it is crucial to look beyond historical tales and examine modern risk factors.

Quick Summary

Certain individuals are highly susceptible to severe vitamin C deficiency due to lifestyle, dietary restrictions, age, and chronic illnesses. Key risk groups include infants on unfortified milk, older adults with limited diets, individuals with substance dependency, and those with malabsorptive conditions.

Key Points

Infants and Children: Those fed unfortified milk or following severely restricted diets, common in conditions like autism, are at increased risk for scurvy.
Older Adults: The isolated and elderly, especially those subsisting on limited diets like "tea-and-toast," are a high-risk group due to poor nutritional intake.
Substance Dependency: Chronic alcohol or drug abuse often leads to poor diet and increased vitamin C excretion, significantly raising the risk of scurvy.
Smokers: Due to increased oxidative stress, smokers require a higher daily intake of vitamin C and are at greater risk of deficiency.
Chronic Illnesses: Conditions like inflammatory bowel disease, cancer, and end-stage renal disease (dialysis) can impair vitamin C absorption or increase the body's nutritional demands.
Global Malnutrition: Refugees and populations in areas with limited food security are vulnerable due to poor access to fresh fruits and vegetables.

What Is Scurvy and Why Are Some People at Risk?

Scurvy is a disease caused by a severe, prolonged deficiency of vitamin C (ascorbic acid). Humans must get vitamin C from their diet as the body cannot produce it. Vitamin C is vital for collagen production, which supports skin, bones, and connective tissues, and also aids iron absorption. A deficiency leads to weakened tissues and symptoms like bleeding gums and poor wound healing.

Although rare in developed nations due to vitamin C-rich food access, scurvy still affects specific groups who struggle with intake or absorption. Prevention focuses on identifying these at-risk individuals and ensuring adequate nutrition.

Infants and Children with Restricted Diets

Infants are vulnerable to vitamin C deficiency, though modern formula fortification has reduced the risk. Risk factors include:

Unfortified Milk: Feeding infants unfortified cow's milk, especially if boiled, destroys vitamin C.
Restrictive Eating: Children with developmental issues or severe allergies may have very limited diets lacking in vitamin C-rich foods.

Older Adults Living Alone or in Institutions

Older adults, particularly those living alone, face several risk factors:

Poor Diet: Limited diets, often called a "tea-and-toast" diet, lack fresh fruits and vegetables.
Reduced Appetite: Depression, isolation, or medical problems can decrease food intake.
Limited Access: Difficulty accessing or affording fresh produce increases risk.

Individuals with Substance Dependency

Chronic alcohol and drug abuse significantly increase scurvy risk due to poor nutrition and diets low in fruits and vegetables. Alcohol can also increase vitamin C excretion.

Smokers and Those Exposed to Secondhand Smoke

Smoking reduces vitamin C absorption and increases the body's need for antioxidants, depleting stores faster. Smokers need more daily vitamin C than non-smokers; secondhand smoke exposure also lowers levels.

People with Chronic Diseases and Medical Conditions

Various conditions affect nutrient absorption or increase vitamin C needs:

Malabsorptive Conditions: Disorders like inflammatory bowel disease hinder vitamin C absorption.
Kidney Disease/Dialysis: Patients on dialysis may lose more vitamin C.
Cancer: Patients may have poor intake and increased needs.
Eating Disorders: Conditions like anorexia severely restrict intake, increasing deficiency risk.

Global Malnutrition and Displaced Populations

Scurvy is a threat in areas with limited food security, affecting malnourished populations and refugees who lack access to fresh produce. Historically, it plagued sailors on long voyages without fresh food.

Comparing Populations at Risk for Scurvy


Risk Category	High-Risk Population	Low-Risk Population
Dietary Intake	Very low intake of fruits and vegetables; reliance on processed or stored foods.	Regular consumption of fresh, varied fruits and vegetables.
Lifestyle Habits	Smoking, chronic alcohol or drug dependency.	Non-smoking; balanced diet despite occasional consumption of less healthy foods.
Medical Conditions	Malabsorptive disorders, dialysis, anorexia, cancer.	Generally healthy with no conditions hindering nutrient absorption.
Age and Life Stage	Infants fed unfortified milk; isolated elderly; pregnant/lactating women with poor diet.	Infants on breast milk or fortified formula; adults with consistent access to fresh food.
Socioeconomic Status	Impoverished individuals, refugees, those with limited access to nutritious food.	Access to a wide variety of affordable, fresh produce.

Conclusion: Awareness is Key for Prevention

Scurvy is preventable but still a risk for vulnerable groups. Awareness of risk factors is vital for healthcare providers and caregivers. Recognizing early symptoms like fatigue and joint pain and taking a thorough dietary history are crucial. Vitamin C supplementation treats the condition, but addressing underlying social and medical issues causing dietary deficiency is the best long-term solution.

For more information on the history and modern context of scurvy, the Wikipedia article provides a comprehensive overview.

Frequently Asked Questions

Scurvy is caused by a significant and prolonged lack of vitamin C (ascorbic acid) in the diet, typically after at least three months of insufficient intake.

Yes, infants can develop scurvy, particularly if fed evaporated or boiled milk, which lacks heat-sensitive vitamin C. Breastfeeding mothers with an adequate diet or using vitamin C-fortified infant formulas can prevent it.

Older adults may be susceptible due to poor and monotonous diets, such as 'tea-and-toast' diets, limited access to fresh produce, or a reduced appetite associated with isolation or chronic illness.

Yes, smoking and exposure to secondhand smoke increase the body's need for vitamin C due to higher oxidative stress. Smokers require a greater daily intake of vitamin C compared to non-smokers.

Medical conditions that can cause or contribute to scurvy include malabsorptive diseases (like Crohn's and celiac disease), end-stage renal disease (dialysis), eating disorders (like anorexia), and certain cancers.

Cooking methods, particularly boiling, can significantly reduce the vitamin C content in food because it is water-soluble and heat-sensitive. Eating raw fruits and vegetables or using cooking methods like steaming can help retain more of the nutrient.

Early symptoms often include fatigue, weakness, irritability, and joint pain. As the deficiency progresses, more severe signs like bleeding gums, easy bruising, and poor wound healing can appear.