Das, Bhagwan

Nadeem, Sarah

English

eCommons@AKU

eCommons@AKU Section of Diabetes, Endocrinology and Metabolism Department of Medicine 9-2020 Vitamin D usage among Pakistani population - Too much of a good thing Bhagwan Das Sarah Nadeem Follow this and additional works at: https://ecommons.aku.edu/pakistan_fhs_mc_med_diabet_endocrinol_metab  Part of the Endocrinology, Diabetes, and Metabolism Commons, and the Nutritional and Metabolic Diseases Commons LETTER TO THE EDITORJournal  of  the College of  Physicians and Surgeons Pakistan 2020,  Vol.  30(09):  10021002Vitamin D Usage among Pakis-tani Population – Too Much ofa Good ThingSir,Vitamin D deficiency (VDD) is one of the most common nutri-tional  disorders  worldwide.  This  is  also  true  in  Pakistan  asreported by Riaz and colleagues in their study, revealing VDD in53.5% and insufficiency in 31.2% study participants.1 There isgrowing awareness of VDD in the Pakistani population, whichhas resulted in vitamin D becoming a popular supplement in thecommunity and is being used as one of the most common overthe  counter  medicines.  It  is  also  being  prescribed  morefrequently  by  physicians;  with  supplements  ranging  fromvitamin D capsules to high dose (50,000 IU, 200,000 IU, and600,000  IU)  injections.  Sometimes,  these  are  continued  forindefinite periods without baseline checking or follow-up moni-toring of 25-OH vitamin D levels.As a result of this increased consumption of vitamin D supple-ments by the general population and overcorrection of VDD bysome healthcare practitioners, it is becoming a leading cause ofhypervitaminosis D and hypercalcemia, also called as vitamin Dtoxicity  (VDT).2,3  In  literature,  VDT  has  been  reported  fromvarious  parts  of  the  world  to  be  associated  with  significantmorbidity and mortality.4 We are also witnessing many patientsreferred to our clinics and also as inpatient with VDT and seriousproblems. The true prevalence of VDT in the Pakistani popula-tion is not known so far, but is not uncommon, as reported byKhan et  al;5  27% of  their  patients  with  hypercalcemia  werefound to have VDT, where multiple high dose injections weregiven weekly to these patients for six to eight weeks.5 Our intentin  sending  this  communication  is  to  help  create  awarenessamongst health professionals regarding VDT and appropriatereplacement of vitamin D based on baseline 25-OH vitamin Dlevels, age and associated risk factors. Furthermore, generalpublic should also be educated about the toxic consequences ofthis over the counter medicine.CONFLICT OF INTEREST:The authors declared no conflict of interest.AUTHORS’ CONTRIBUTION:BD: Came up with idea to write this letter and design it.SN:  Revised  it  critically  and  approved  final  version  to  bepublished.REFERENCESRiaz H, Finlayson A, Bashir S, Hussain S, Mahmood S,1.Malik  F,  et  al.  Prevalence  of  vitamin  d  deficiency  inpakistan and implications for the future. Expert Rev ClinPharmacol 2016; 9(2):329-38.Dudenkov DV, Yawn BP, Oberhelman SS, Fischer PR,2.Singh RJ, Cha SS, et al. Changing incidence of serum25-hydroxyvitamin D values above 50 ng/mL: A 10-yearpopulation-based study. Mayo Clin Proc  2015; 90(5):577-86.Tebben  PJ,  Singh  RJ,  Kumar  R.  Vitamin  D-mediated3.hypercalcemia: Mechanisms, diagnosis, and treatment.Endocr Rev 2016; 37(5):521-47.Galior K, Grebe S, Singh R. Development of vitamin D4.toxicity  from overcorrection  of  vitamin  D  deficiency:  Areview of case reports. Nutrients 2018; 10(8):953.Khan MN, Masood MQ, Siddiqui  MA, Naz S,  Islam N.5.Vitamin-D toxicity and other non-malignant causes ofhypercalcemia: A retrospective study at a tertiary carehospital in Pakistan. JAMC 2017; 29(3):436-40.Bhagwan  Das  and  Sarah  Nadeem..................................................................................The  Aga  Khan  University  Hospital,  Karachi,  Pakistan..................................................................................Correspondence  to:  Dr.  Bhagwan  Das,  Section  of  Endocri-nology,  Department  of  Medicine,  The  Aga  Khan  UniversityHospital,  Stadium  Road,  Karachi,  PakistanE-mail:  dr_bhagwandas@yahoo.com...................................................................Received: November 20, 2019;   Revised: January 27, 2020;Accepted:  January  27,  2020DOI:  https://doi.org/10.29271/jcpsp.2020.09.1002

Vitamin D usage among Pakistani population - Too much of a good thing

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Vitamin D usage among Pakistani population - Too much of a good thing

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