Vitamin C deficiency in a Northern Saskatchewan Population, Canada

Vitamin C deficiency, shaped by systemic inequities and disrupted food systems, remains a concern in remote Indigenous communities. In Northern Saskatchewan, clinicians observed increasing suspected scurvy among adults from geographically isolated First Nations communities. We conducted an exploratory retrospective review of adults who underwent clinician-initiated serum ascorbic acid testing at the La Ronge Medical Clinic from January 2011 to March 2024. Testing was based on clinical suspicion or perceived risk rather than population-based screening. Vitamin C deficiency was defined as <11 µmol/L and hypovitaminosis C as 11-23 µmol/L. Demographic, clinical, and testing-indication data were extracted, with exploratory comparisons by First Nations status, sex, age, and documented characteristic scurvy features. Study governance followed OCAP principles through partnerships with Lac La Ronge Indian Band Health Services and the Northern Inter-Tribal Health Authority. Among 48 individuals with analyzable results, 27 (56%) had vitamin C deficiency and 10 (21%) had hypovitaminosis C. Deficiency was more common among First Nations than non-First Nations patients (66% versus 20%, p = 0.014). Dermatologic and oral manifestations were common indications for testing, although deficiency was also identified among patients without documented characteristic scurvy features. The high proportion of deficiency among tested patients suggests that vitamin C deficiency is an important clinical concern in this setting. However, this clinically selected sample should not be interpreted as estimating population-level prevalence. Given restricted laboratory access and the technical challenges of serum ascorbic acid testing, empiric supplementation may be a practical option for high-risk individuals. Longer-term responses should prioritize Indigenous-led food sovereignty, culturally grounded interventions, and policies addressing food access and underlying structural inequities.