Extreme diets and/or lack of access to foods (typically fruits) containing vitamin C
Risk Factors
Following gastric bypass surgery, with impaired absorption of multiple nutrients, most commonly: iron, B12, calcium, vitamin D; less commonly thiamine (B1), zinc and copper,
extreme diets
Extreme lack of access to foods
Extreme lack of interest in healthy diet (e.g. substance abuse)
Symptoms
Fatigue
Generalized weakness from myopathy and anemia (impaired iron absorption, hypo proliferative)
Recurrent falls (from weakness)
Orthostatic dizziness (lack of vitamin C impairs synthesis of catecholamines)
Easy bruising, tooth loss from gingival disease (impaired collagen building, capillary fragility)