Alcohol Withdrawal: Possible Risk of Latent Scurvy Appearing as Tiredness: A STROBE-Compliant Study

BACKGROUND: Little is known about the prevalence of vitamin C deficiency in the population of individuals who are withdrawing from alcohol, and about possible consequences of latent scurvy. The aim of this study was to evaluate the prevalence of vitamin C deficiency in patients who were withdrawing from alcohol, its correlation with latent scurvy (mainly tiredness and weakness) and the change in the latter symptoms at 3 months after oral vitamin C supplementation. METHODS: A total of 47 patients (33 males, 14 females) who volunteered to undertake alcohol detoxification were included prospectively between January 2014 and November 2016. Determination of vitamin C blood levels was performed, and selected clinical signs of latent scurvy were recorded in a structured questionnaire. The decrease of tiredness after vitamin C supplementation was also studied 3 months after the inclusion of patients who had no other explanation for their weakness. RESULTS: About 57.44% of the patients were affected by vitamin C deficiency (< 11.4 mol/L). Less than one-third (29.70%) had a normal plasma vitamin C level. There was a clear correlation between decreased vitamin C levels and the presence of tiredness (P = 0.003) and no correlation between gum inflammation or purpura (P = 0.97 and 0.44 respectively). After 3 months of alcohol withdrawal and vitamin C supplementation, 89% of the patients reported a decrease of tiredness. CONCLUSIONS: Vitamin C deficiency is prevalent in patients undertaking alcohol detoxification. Patients with this vitamin deficiency status often suffer from tiredness, which may be symptoms of latent scurvy. Even if tiredness is a highly nonspecific symptom, presence of fatigue should draw attention and the vitamin C level should be determined. Our preliminary data suggest that vitamin C supplementation, may decrease fatigue and improve patient’s quality of life. This last evolution needs to be confirmed by a double-blind randomized study.