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Iron Supplements in Pakistan: Status, Challenges &
Iron Supplements in Pakistan: Status, Challenges &
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D3D PRINTING
266 posts
Oct 07, 2025
5:14 AM
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Iron deficiency remains a major public health issue in Pakistan. Many people—especially women of reproductive age, children, and pregnant women—suffer from iron deficiency or iron deficiency anemia (IDA), which affects energy, immunity, cognitive development, and maternal health. In response, iron supplements are widely used. This article covers the scale of the issue, the supply and market of iron supplements, regulatory and quality concerns, usage practices, and recommendations for improvement.
The Scale of Iron Deficiency
A national survey in 2018 reported that over half of children under five in Pakistan are anemic, with about 28.6% of them being specifically iron-deficient.
In a study in rural Faisalabad, among 200 anemic patients, 85% had iron deficiency as the chief cause. The most affected groups were young women (21-32 years) and children under 14 years.
Among preschoolers in Central Punjab, a large proportion had both pica (a symptom associated with iron deficiency) and hemoglobin / serum ferritin levels confirming IDA.
These findings make clear that iron supplement access and correct usage are essential.
Market & Supply of Iron Supplements
Local & imported brands: Pakistan has several domestic manufacturers and distributors of iron supplements. There are also many imported options, including vegan chelated iron supplements, tablets, syrups, etc.
Distribution channels: Pharmacies, medical stores, online marketplaces (such as Daraz, Dawaai), Iron supplements in Pakistan and health shops carry a wide variety. Some products combine iron with vitamins like B12, folic acid, or vitamin C to improve absorption.
Prices: Prices vary widely depending on formulation (syrup vs tablet), strength, brand (local vs imported), and markups. For example, Good Health Fefer Iron Tablets (30 count) priced around Rs. 800-900.
Customs duties & import regulations: Recently, the Federal Board of Revenue (FBR) imposed a 20% customs duty on multivitamins, natural health products, and food supplements—this affects imported iron supplements, especially those bundled as multi-nutrient or “natural health product” formulations.
Regulatory Landscape & Prescription Practice
The Drug Regulatory Authority of Pakistan (DRAP) is responsible for licensing, quality control, and regulation of pharmaceuticals and some supplements. Safety, labeling, and manufacturing standards are supposed to be enforced.
In early 2024, a policy decision was made to prohibit medical and dental practitioners from writing prescriptions for vitamins, multivitamins, minerals, and food supplements (nutraceuticals) unless necessary. The purpose is to regulate overuse, reduce irrational prescribing, and control costs.
Some backlash from medical associations arguing that sometimes prescriptions are required, especially in cases of real deficiencies or medical conditions. The policy aims also to limit conflicts of interest and ensure consumers can purchase supplements OTC when needed.
Common Practices and Challenges
Usage Patterns
Iron supplementation is more common among pregnant women, children, and people with diagnosed anemia.
Many people take iron with vitamin C or in combination formulations to improve absorption. Liquid syrups are used in children, tablets/capsules in older children and adults.
Sometimes people take iron supplements without testing (i.e. guessing deficiency), which can lead to misuse or side effects.
Challenges
Quality & Authenticity
Concern among consumers about fakes, substandard products, or improper labeling. Some consumers report poor response from certain products.
Imported brands often seen as higher cost but perceived to be of better quality.
Cost & Access
Imported supplements are more expensive due to import duties, transportation, and markups. Local production helps but quality varies.
For poorer or remote regions, cost and supply chain issues limit access.
Regulatory Gaps
Although DRAP regulates many pharmaceuticals, oversight of some supplements / nutraceuticals has been weaker historically.
Recent policy changes to limit prescriptions may reduce misuse, but may also inadvertently reduce access for those who need medical supervision.
Awareness & Diagnosis
Many people do not get tested (for hemoglobin, ferritin) and self-medicate.
Underlying causes of iron deficiency (e.g. parasitic infections, poor diet, menstruation, celiac disease) may not be addressed. In a study, celiac disease was an underdiagnosed cause in some with iron deficiency anemia.
Side Effects & Tolerability
Iron supplements—especially some forms like ferrous sulfate—often cause gastrointestinal side effects (nausea, constipation, etc.), which leads many to discontinue or use lower doses.
Recommendations / Best Practices
Testing first: Before starting iron supplementation, get relevant blood tests (hemoglobin, ferritin, possibly TIBC) to confirm deficiency and help tailor dosage.
Choose the right form: For those with sensitive stomach, consider “gentle” iron formulations (e.g. ferrous bisglycinate, slow-release, chelated iron) or liquid/internal-absorption aids (iron + vitamin C).
Follow the correct dosage & duration: Iron deficiency treatment often requires several months of supplementation, even after hemoglobin recovers, to replenish body stores.
Address underlying causes: Poor diet, malabsorption (due to celiac disease or H. pylori infection), menstrual losses, or parasitic infections must be tackled alongside supplementation.
Ensure quality: Buy from reputable pharmacies or trusted online vendors. Check for DRAP approval, batch numbers, expiry date, and proper storage.
Regulatory oversight: Strengthening monitoring of supplements for authenticity and safety; clarity in regulations distinguishing prescription medicines vs over-the-counter nutraceuticals.
Public health programs: Government and NGOs should continue or expand iron-folate supplementation programs, fortification of staple foods (e.g. flour), and community screening, particularly in vulnerable populations.
Prospects
There is increasing local manufacturing interest, which could help reduce costs and improve access.
Recent regulatory changes—though controversial—signal the government’s intention to tighten control over the supplement/nutraceutical market.
Innovations in formulation (e.g. better tolerated iron forms, combined micronutrients) and distribution (online, low cost) provide hope for improved reach.
Conclusion
Iron supplements play a critical role in Pakistan’s efforts to combat iron deficiency and its serious health impacts. While usage is widespread, many challenges remain: ensuring quality, affordability, correct diagnosis, and sustainable, safe usage practices. Through improved regulation, better public awareness, and strong support from both healthcare providers and the public sector, iron supplementation can make a much larger positive impact on the health of millions in Pakistan.
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