Vitamin D deficiency: symptoms, causes and how to fix it

It sounds strange in a sunny country, but studies have repeatedly found that a large share of people in Pakistan have low vitamin D. Indoor lifestyles, covered clothing, darker skin (which needs more sun to make vitamin D) and few fortified foods all play a part.

Why vitamin D matters

Vitamin D helps your body absorb calcium. Without enough, bones become weak and painful. In children, severe deficiency causes rickets (soft, bent bones). In adults it can cause osteomalacia (soft bones) and adds to the risk of osteoporosis.

Common symptoms

• Tiredness and low energy
• Bone pain, especially in the back, hips and legs
• Muscle aches, weakness or cramps
• Getting tired climbing stairs or getting up from the floor
• In children: delayed walking, bowed legs, slow growth

Many people have no symptoms at all, which is why testing helps.

Who is most at risk?

• People who stay indoors most of the day
• Women who cover most of their skin outdoors
• Pregnant and breastfeeding women, and their babies
• Older people
• People who are overweight, or have kidney, liver or gut problems

The test and what the result means

The blood test is called 25-hydroxy vitamin D. Labs commonly report:

• Below 20 ng/mL: deficient
• 20 to 29 ng/mL: insufficient
• 30 ng/mL and above: usually considered adequate

Reference ranges vary slightly between labs, so read your report's range and discuss it with your doctor.

How to raise vitamin D safely

• Sunlight: some time in the sun with arms and face uncovered, on most days, helps the skin make vitamin D. Avoid the harshest midday heat in summer and do not burn.
• Food: oily fish, egg yolks and fortified milk or foods give a little.
• Supplements: often needed to correct a deficiency. The right dose depends on your level, age and health, so follow your doctor's advice.

More is not better. Very high doses of vitamin D taken for a long time can raise calcium dangerously. Do not take big “injections” or high-dose sachets without a doctor's advice.

DawaaiMart stocks vitamin D and calcium supplements; ask our pharmacist which one matches your prescription.