A review paper in the British Medical Journal, “There has been no shortage of case reports documenting florid scurvy in chronic alcoholics, but the mechanistic links between hypovitaminosis C and chronic alcoholism remain postulates based on research from the early 1980s.
The authors call scurvy, the clinical hallmark of severe vitamin C deficiency, the “red flag” that first alerts physicians to measure plasma vitamin C levels. Scurvy manifests primarily as capillary bleeding, gingivitis, fatigue and muscle weakness. In addition to scurvy, severe vitamin C deficiency has been shown to increase the relative risk of myocardial infarction, while marginal vitamin C deficiency is also significantly associated with all-cause mortality, with a weak association with death from cancer, the authors note.
Studies from the 1980s, they say, showed that hypovitaminosis C alone is likely to have a significant effect on chronic alcohol consumption and vice versa. Since then, however, there has been a lack of follow-up research on these key findings, which could play a significant role in the detoxification or withdrawal program of the chronic alcoholic, the authors regret, pointing to successful trials of vitamin C substitution in the 1980s.
The conclusions are clear to the authors: “Given the considerable public health burden of chronic alcoholism and the relatively inexpensive means of replacing vitamin C, we would urge an urgent response to the “pressing need to study the effect of vitamin C as a one-time dietary supplement in carefully defined populations,” as Lykkesfeldt and Poulsen so aptly judged. There is a need to build on and not forget the insightful and robust evidence from the 1980s and 1990s in developing studies and research to replace vitamin C deficiency in chronic alcoholics in order to review and further substantiate current guidelines.”
