Pakistan’s Vitamin D Crisis: Doctors warn against over-testing

KARACHI (News Desk): Despite abundant sunshine, around 73 per cent of Pakistani adults have insufficient vitamin D levels, a paradox driven by indoor lifestyles, covered clothing, air pollution and poor diet, while doctors have warned against unnecessary testing and indiscriminate use of high-dose supplements, experts said at a medical summit in Karachi on Monday.

The Connect Summit, organised by Scotmann Pharmaceuticals, brought together specialists to discuss the burden and evidence-based management of vitamin D deficiency in Pakistan.

Presenting a review of national data, Dr Sellal Ahmed, associate professor at KIMS and consultant at Tabba Heart Institute, said a review of 18 publications reported 84.82 per cent prevalence of vitamin D deficiency or insufficiency, while an audit of 60,937 laboratory records found a prevalence of 61.1 per cent.

Experts at the summit cautioned that differences in study populations, age groups and diagnostic thresholds meant that neither figure could be considered a true national estimate, highlighting the lack of standardized national data on the condition.

In his talk titled Mapping the Burden, Mastering the Management, Dr Ahmed said limited sunlight exposure, indoor lifestyles, covered clothing, air pollution and dietary deficiencies were the major contributing factors behind widespread deficiency in a sunny country like Pakistan.

He said the situation called for an evidence-based approach rather than panic-driven supplementation. He recommended targeted testing only for patients with clinical indications such as skeletal disease, muscle weakness, malabsorption syndromes and other high-risk conditions, rather than routine screening of healthy adults.

He stressed individualised supplementation based on clinical assessment, appropriate dosing and proper monitoring, and warned against prescribing repeated megadoses without reassessment, a practice he said had become common.

Speaking on From Childhood to Aging – Vitamin D, A Lifetime Partner in Bone Health, Dr Pervez Ali, associate professor of orthopedics at Jinnah Postgraduate Medical Centre, said research indicated that about 73 per cent of Pakistani adults had insufficient vitamin D despite abundant sunshine.

He highlighted that vitamin D management should start early, noting that nearly 90 per cent of peak bone mass is acquired by the end of adolescence. Deficiency during childhood and teenage years, he warned, could compromise bone health for a lifetime.

Other speakers discussed the specific impact on women’s health. Dr Farzana Amir, in her presentation on vitamin D across women’s reproductive and post-menopausal years, outlined its potential links with menstrual disorders, polycystic ovary syndrome, insulin resistance, infertility and pregnancy complications, including gestational diabetes and preeclampsia.

She added that deficiency may also contribute to bone loss, muscle weakness and increased fracture risk after menopause, making it a critical concern across all stages of a woman’s life.

Speakers including Dr Fakhra Sanjrani, Dr Yousuf Kamal, Dr Jagdesh Kumar, Prof Dr Ahmed Iqbal Mirza and Dr Avenash Punshi also spoke on various aspects of vitamin D management.

The summit concluded that vitamin D deficiency in Pakistan should be addressed through clinical assessment, rational testing and safe, monitored treatment, rather than routine testing of healthy individuals and indiscriminate high-dose supplementation.

Experts agreed that public awareness about safe sunlight exposure, dietary sources and evidence-based treatment was needed to tackle the deficiency without creating new health risks from over-treatment.