Can GLP-1 Receptor Agonists Cause Scurvy?
No, GLP-1 receptor agonists do not cause scurvy. There is no evidence in the medical literature linking GLP-1 receptor agonist therapy to vitamin C deficiency or scurvy.
Why This Question Arises
The concern likely stems from the well-documented gastrointestinal effects of GLP-1 receptor agonists, which can theoretically impact nutritional intake:
- Nausea occurs in 17-44% of patients taking GLP-1 receptor agonists, with vomiting in 7-25% and diarrhea in 12-32%, which are typically mild-to-moderate and decrease over time 1
- Delayed gastric emptying is a primary mechanism of action, leading to prolonged feelings of fullness and reduced meal size 1
- Appetite suppression through hypothalamic pathways results in decreased caloric intake, which is the intended therapeutic effect for weight loss 1
Documented Nutritional Adverse Events
The FDA Adverse Event Reporting System analysis reveals the actual metabolic and nutritional concerns with GLP-1 receptor agonists:
- Dehydration is the most frequent serious metabolic adverse event, occurring in 23.93% of serious cases with liraglutide, 20.90% with dulaglutide, 25.10% with semaglutide, and 32.86% with tirzepatide 2
- Semaglutide shows the highest association with metabolism and nutrition disorders (ROR 3.34), followed by liraglutide (ROR 2.78) and exenatide (ROR 2.15) 2
- The time to onset of dehydration follows an early failure-type profile for liraglutide, dulaglutide, and semaglutide, meaning it occurs early in treatment 2
No Evidence of Vitamin C Deficiency
- Scurvy (vitamin C deficiency) is not listed among the metabolic or nutritional adverse events in comprehensive pharmacovigilance studies of GLP-1 receptor agonists 2
- The documented adverse events focus on dehydration, electrolyte disturbances, and general malnutrition—not specific micronutrient deficiencies like vitamin C 2
Clinical Monitoring Recommendations
While scurvy is not a concern, clinicians should monitor for:
- Signs of dehydration, particularly in the first 3 months of therapy when gastrointestinal effects are most prominent 2
- Nutritional status and weight loss progress at every 3-month visit after reaching maintenance dose 1
- General malnutrition in patients with severe nausea or vomiting that persists beyond the typical 4-8 week adaptation period 1
Common Pitfall to Avoid
- Do not attribute general malaise or fatigue to scurvy in patients on GLP-1 receptor agonists without first ruling out dehydration, which is far more common and occurs in up to one-third of patients experiencing serious adverse events 2
- Do not delay treatment with GLP-1 receptor agonists due to unfounded concerns about vitamin C deficiency, as the cardiovascular and metabolic benefits (26% reduction in cardiovascular death, nonfatal MI, or stroke with semaglutide) far outweigh theoretical nutritional risks 1