- Reports of GLP-1 users developing scurvy have increased in recent months.
- GLP-1 drugs can lead to malnutrition since they reduce appetite and food consumption.
- People may also consume fewer vitamin C-rich foods, such as fruits and vegetables.
- Proper meal planning and supplementation can help prevent scurvy.
Maybe you’ve been using a GLP-1 medication for a while now, and you’ve started to notice that your gums are bleeding a bit, or you seem to be bruising more easily than usual? Could the drug be related to these unusual symptoms?
It turns out that more and more people using these drugs are being diagnosed with scurvy, a severe deficiency of vitamin C.
You might know scurvy as an 18th-century illness associated with long sea voyages, when fresh fruits and vegetables were in short supply. So, why is a disease associated with pirates and sailors now making a comeback in a time when these foods are readily available?
The answer, experts say, has less to do with the medications themselves and more to do with what happens when appetite and consumption of certain foods fall dramatically.
Here’s what’s known about the connection and how to protect yourself while staying on track with treatment.
In an opinion published in the BMJ on July 21, 2025, Ellen Fallows noted the risks of prescribing GLP-1 medications to patients who already consume nutrient-poor diets, highlighting that malnutrition cases are already being reported in the U.S.
Fallows additionally pointed out that, although obesity is often thought of as a case of being “over-nourished,” the opposite is frequently true, with muscle wasting and nutrient deficiencies being just as common in these individuals as in those who are underweight.
When an already unhealthy diet is combined with caloric restriction, it can exacerbate the problem.
Inflammation of the gastrointestinal tract and nutrient deficiencies caused by common diabetes medications, such as metformin, can also contribute to malnutrition, she said.
According to Fallows, GLP-1 use is not just linked to vitamin C deficiency. It has been associated with severe thiamine and magnesium deficiencies, among several others.
However, a lack of awareness of this issue is likely leading to both underdetection and under-reporting of malnutrition, she wrote, which may lead to less favorable patient outcomes.
“Good quality wraparound care for patients taking GLP-1 agonists must go further than simple ‘dietary advice’ as recommended by the National Institute for Health and Care Excellence,” she advised. “It must include assessment of nutritional status before treatment to identify patients with malnutrition whose risks may only be mitigated with additional support.”
Fiorella DiCarlo, RDN, CDN, of FiorellaEatsTV, told Healthline that GLP-1s slow gastric emptying and motility, which causes people to feel full and lose their appetite. However, they may end up not eating enough to properly nourish their bodies.
“Some people end up eating 600-1000 calories per day without realizing it and thereby undereating vital nutrients and vitamins,” she said, explaining that this is what leads to deficiencies.
When a person doesn’t consume enough vitamin C for an extended period, they can develop scurvy.
“GLP-1 users report low appetite and early satiety, so fruits and veggies that contain Vitamin C are not consumed as often but rather replaced with toast, crackers, and processed food to accommodate GI issues like nausea instead,” said DiCarlo.
She added that food aversions to acidic foods or raw vegetables can also complicate matters.
“Vitamin C deficiencies cause weakened blood vessels, wounds that don’t heal, including acne and bleeding gums,” said DiCarlo.
However, scurvy is reversible with a multivitamin or a 100- to 200-milligram vitamin C supplement, she said.
According to DiCarlo, the best way to navigate the nutritional challenges of being on a GLP-1 medication is to work with a Registered Dietitian. These healthcare professionals are experts in nutrition and help you plan meals that best support your needs.
“I advise building meals and snacks around protein and eating on a schedule to ensure proper intake throughout the day,” she said.
DiCarlo further suggests getting plenty of fiber from fruit, vegetables, and legumes, as it can help counteract constipation associated with slow motility.
These same foods are also rich in antioxidants and vitamins, which can help reduce your risk of deficiencies, she said.
“The order the macros are eaten at a meal can be important too,” DiCarlo explained. “Begin with some protein, then vegetables to ensure that these nutrients are ingested first, particularly for those feeling fuller faster.”
DiCarlo also emphasized the importance of drinking water to reduce your risk of dehydration.
Concluding her comments, she said, “Eating while on a GLP-1 can be very challenging, and while weight loss will occur, the collateral damage from malnutrition can cause physical and psychological feelings that can affect quality of life.”
However, as DiCarlo explains, proper planning and supplementation can help mitigate the risks.
