Researchers diagnose 27 cases of scurvy in northern Sask. community

The discovery of 27 cases of scurvy in a northern Saskatchewan community is raising concerns about grocery prices and access to fresh food as income inequality increases.

Earlier this year, a doctor in La Ronge suspected that a patient was suffering from scurvy, a disease caused by a deficiency of vitamin C. The test came back positive, raising questions about the prevalence of scurvy in the community.

The Lac La Ronge Indian Band worked with Dr. Jeff Irvine and the Northern Inter-Tribal Health Authority to investigate. Irvine is a physician in La Ronge and works at Northern Medical Services, an offshoot of the Medical University of Saskatchewan.

They tested 51 blood samples – all but one taken in 2023 or 2024 – and found 27 cases of low or undetectable vitamin C levels. These results were followed by a physical examination, which confirmed the diagnosis of scurvy in all 27 cases. The ages of the patients range from 20 to 80 years and 79 percent are indigenous.

Confirmed cases of scurvy are rare Individual cases often form the basis of entire investigations.

“There aren't really large groups of populations that have been tested in this way in the past, let alone diagnosed with scurvy,” Irvine said in an interview.

Scurvy is not just a disease that sailors developed centuries ago during long voyages. It happens when a person does not eat enough foods containing vitamin C, such as fruits and vegetables. Symptoms include fatigue and joint pain, which can easily be misdiagnosed, but more serious symptoms include bleeding gums, loose teeth, and wounds that heal slowly.

The findings indicate that more serious health and social issues are at play, Irvine said.

“It's just the tip of an iceberg,” Irvine said. “Vitamin C isn't the only thing that's ever going on. So what other health problems are there or what other things in people's lives are keeping them from getting the proper nutrition they need?”

Scurvy can be treated with supplements or by eating more foods rich in vitamin C, such as citrus fruits and green vegetables.

Preventing scurvy basically comes down to eating fruits and vegetables. Irvine said traditional consumables in the north that help prevent scurvy include rosehip and Labrador tea, as well as the heart, liver and kidneys of some animals.

“People want more traditional foods and want more access to healthy foods, but there have been studies showing that people can't afford to eat balanced meals,” Irvine said.

Scurvy cases are indicators of larger problems, such as income inequality and rising costs of living, said Dr. Rachel Engler-Stringer, a professor of community health and epidemiology at the University of Saskatchewan.

“What we know from research is that when people are struggling financially, they tend to cut fruits and vegetables first because they are relatively expensive compared to how satiating they are,” Engler-Stringer said.

That means people on a budget may opt for processed foods, which are cheaper and more satisfying but lack nutrients. The options become smaller the further north one lives.

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A 2022 Saskatchewan Health Authority report found that northern residents pay more for quality food on average than southern residents when it compared the price of the “national nutritious food basket” – minimally processed produce such as fresh and frozen fruits and vegetables , cheese and milk, rice, meat, beans and lentils – throughout the province.

That basket costs an average family of four in the north $358.79 a week, compared to $279.89 for the same family in the south of the province.

“And not only are food costs higher, but the food itself may not be available at all,” says Engler-Stringer. “And so the further away you go, the less fruit and vegetables you're often going to find in the shops that are available locally.”

A Study from the University of Toronto Measures of food security across Canada found that 20 per cent of households in Saskatchewan – or about 224,000 people – experienced some level of food insecurity in 2022.

Last month, the Saskatoon Food Bank said the number of users has increased by 40 per cent in the past five years. Nationally, Food Banks Canada said more than two million people visited a food bank in March of this year, breaking the previous record.

Irvine said the research team is not advocating widespread testing of vitamin C levels in patients, but he hopes the findings show that doctors should test for scurvy in specific cases of patients with symptoms.