After a mild case of viral fever, Rohan (6) developed frequent episodes of loose stools and mild abdominal discomfort. His proactive parents, influenced by social media and advertisements, started giving him multiple over-the-counter liquid probiotics daily without doctor’s advice. In the next two weeks, Rohan’s symptoms worsened. He was now experiencing excessive bloating and extreme constipation. When they consulted a paediatrician, the doctor told them that indiscriminate use of probiotics had disrupted Rohan’s gut microbial balance and worsened the problem.
In recent years, especially after the pandemic, anxiety about health has assumed worrisome proportions so much so that many parents especially come to me to seek solutions to make their children immune to ‘future pandemics’. A sizeable proportion are already partaking a variety of superfoods, immunity boosters, and other ‘magic’ remedies in their quest to attain better health, with many giving these to their kids as well.
A notable trend in recent decades is the widespread use of over-the-counter dietary supplements. Five popular supplements that urban Indians often take include multivitamins, vitamin D, fish oil/omega-3 fatty acids, probiotics and magnesium, readily available in pharmacies, supermarkets, and online platforms. They serve as convenient options for supplementing any gaps, genuine or perceived, in daily nutrition.
Many people consume multivitamins as they consider it a convenient way to cover dietary gaps. While multivitamins can support general health, energy levels, and immunity, these are typically unnecessary for most adults who consume a balanced diet rich in fruits, vegetables, grains, and protein. Their overuse carries risk of vitamin or mineral toxicity and negative interactions with regular medications for blood pressure, diabetes, cholesterol, etc. So, multivitamins should be used under medical advice.
Kashmir-based Shahbaz (55) was suffering from persistent vomiting, excessive thirst, frequent urination, confusion, and general weakness. Lab reports revealed very high calcium (hypercalcemia) and vitamin D levels. Shahbaz had been taking high-dose vitamin D oral supplements, influenced by media coverage emphasising vitamin D’s importance for immunity and bone health. His renal tests indicated acute kidney injury, while imaging showed high calcium deposits in the kidneys. He was diagnosed with vitamin D toxicity, being reported increasingly in many vitamin D-deficient region due to unsupervised supplementation.
Many urban Indians have low sun exposure, leading to widespread vitamin D deficiency, especially in winters or among those who work indoors. This sunshine vitamin is needed for better calcium absorption, supports bone strength, and immune system to help fight infections. However, high doses can cause toxicity, hypercalcemia and can damage the kidneys. Studies show mixed evidence about vitamin D’s impact on preventing chronic diseases like heart disease or cancer, especially in well-nourished populations. Supplementation is only required in case of deficiency, that too under medical supervision, and only for the period the doctor recommends.
Similarly, people are frequently popping fish oil and omega-3 fatty acids capsules nowadays. These are known for their anti-inflammatory properties and benefits to heart, brain, and joint health, and may help improve cardiovascular risk factors and cognitive function, though results vary among individuals. So, these should be taken under guidance, as high doses can increase the risk of bleeding.
Probiotics have become popular as awareness about having a healthy gut is increasing. These promote a balanced gut microbiome, crucial for digestion and immune function. Probiotics are beneficial in gastrointestinal issues such as irritable bowel syndrome and prevent antibiotic-associated diarrhoea. People eating a healthy diet that includes natural probiotic-rich foods like yogurt, curd, and fermented vegetables/pickles do not need additional probiotic supplements. Our traditional Indian diet provides sufficient support to maintain a healthy gut flora in most individuals.
For others, especially after taking a course of antibiotics or those having certain digestive conditions, probiotic supplementation can be beneficial but only under expert advice.
As anxiety and sleep issues become common, magnesium supplements have gained popularity because of their role in supporting better sleep quality and reducing anxiety symptoms. These also help with muscle and nerve function and muscle cramps. Various forms and combinations of magnesium offer different absorption rates, and large doses can cause diarrhoea/stomach upset. It is best to take these under medical consultation.
It is essential to understand that supplements should not replace a balanced diet but can help fill nutritional gaps when necessary. Over-supplementation can be harmful; hence, supplements are best used under your doctor’s supervision, tailored for individual needs and conditions.
India’s supplement market is growing rapidly, driven by greater health consciousness and prevalence of lifestyle diseases such as diabetes, hypertension, and heart disease. Urban consumers are increasingly using supplements as part of preventive health and self-care. But they should consume supplements carefully, balancing enthusiasm with evidence, to promote wellness safely and effectively.
While most supplements and multivitamins do offer useful benefits in certain situations, the key to lasting health lies in a healthy diet, regular exercise, stress management, and personalised medical advice when required.
— The writer is Head, Paediatrics and Neonatology, Cloudnine Group of Hospitals, Chandigarh
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If you eat healthy, you don’t need vitamins/mineral supplements
A majority of healthy adults in India, who eat a diverse, nutrient-rich diet, are unlikely to need supplementation. Additional supplements are only needed in case of specific deficiencies of any vitamin or mineral in the body:
— In deficiencies like vitamin D, vitamin B12, or iron
— In older adults/elderly with impaired nutrient absorption
— In pregnant or breastfeeding women who need additional folate or iron
— In vegetarians, vegans, or those with dietary restrictions
— In people with malabsorption issues or post-bariatric surgery
— In those with minimal sun exposure who may have low vitamin D levels
Factcheck: High doses of some vitamins and minerals when taken regularly for a long time can be toxic. These include vitamin A (liver), beta carotene (lung cancer), vitamins B6 & 12(sensory neuropathy, widening of blood vessels), C (diarrhoea), D (hypercalcemia), E (nausea, blurred vision); magnesium & phosphorus (diarrhoea), iron (constipation, reduced zinc uptake), zinc (immunosuppression and impaired copper uptake); selenium (brittle hair and nails, peripheral neuropathies and gastrointestinal upset).
Source: Canadian Medical Association Journal
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