Vitamin deficiency knows no age limit. People across all age groups find themselves susceptible to gaps in essential nutrients. As a result, the prevalence of supplement consumption has soared, with many individuals turning to multivitamins as a safety net against potential deficiencies. From Calcium to Vitamin B12, the allure of supplements is undeniable, offering the convenience of a pill to meet daily requirements. These broad-spectrum supplements may have certain advantages, but when taken carelessly or in excess, these supplements can pose significant risks, potentially wreaking havoc on the body’s delicate balance.
Micronutrient Malnutrition
In India, we see “micronutrient malnutrition,” which essentially means a large-scale deficiency of vitamins and minerals in our population, informs Dr D. Nageshwar Reddy, chairman of the Asian Institute of Gastroenterology (AIG). “Supplements should not be considered over-the-counter medications or used without medical supervision. Even simple vitamins, if taken in excess, can lead to severe medical consequences,” points out Dr Reddy. He says preventive medicine has evolved significantly in India and should be leveraged in the form of regular health checkups. “Vitamin and mineral supplementation can not only be advised but can also be customised by the experts as per individual needs,” he says.
Vitamin D Deficiency
For example, says Dr Reddy, more than 70% of Indians have a vitamin D deficiency. “For the elderly, this can lead to osteoporosis, cognitive decline, an increased risk of chronic diseases, and impaired immune function,” he warns. The main natural source of vitamin D is its production in the skin through sunlight exposure, and given our skin colour because the pigment (melanin) acts like a shade, it further reduces the production of vitamin D, explains Dr Reddy. Also, there are a limited number of food items, such as tuna fish, which contains vitamin D, and it is hard to eat enough to have adequate levels. “Therefore, supplementation becomes key in this context,” explains the renowned gastroenterologist.
VAD
Similarly, vitamin A deficiency (VAD) continues to be a major nutritional problem of public health concern in India, with one of the world's highest proportions of children with VAD. “This problem led to significant policy changes, resulting in the fortification of oil and milk with vitamin A.” The incidence of vitamin A toxicity, also known as hypervitaminosis A, resulting from excessive consumption is quite rare in our country, according to Dr. Reddy.
B12
Another key vitamin that Indians are deficient in is vitamin B12, with a prevalence of 47%, the majority of which is seen in adolescents. “This can cause anaemia along with fatigue and weakness, leading to a loss of productivity, be it for studies or work,” says Dr Reddy, adding that the natural sources for B12 are relatively convenient to consume, like dairy products, eggs, chicken, and fish. “It is important to understand that vitamins and minerals are responsible for the production of hormones, enzymes, and other substances that manage growth and development,” he adds.
Iron Matters
Iron, a vital mineral crucial for oxygen transport in the body, serves as a prime example of the delicate balance required in supplementation, says Dr Haroon H., Internal Medicine, KMC Hospital, Mangalore. “While iron deficiency can lead to anaemia and fatigue, excessive iron intake can result in toxicity, with detrimental effects on the liver and heart,” he points out. He advises people against the indiscriminate use of iron supplements without appropriate medical supervision since the hazards may exceed the benefits. Similarly, the overconsumption of fat-soluble vitamins such as Vitamin A presents a grave concern. “While essential for vision, immune function, and cellular growth, excessive intake of Vitamin A can lead to hypervitaminosis A — a condition characterised by symptoms ranging from nausea and dizziness to more severe consequences such as coma and death,” he explains.
Blurred Lines
Such dire outcomes underscore the importance of moderation and informed decision-making when it comes to supplement usage. “In the realm of B vitamins, particularly vitamins B6 and B12, the line between adequacy and excess is often blurred. While these vitamins play crucial roles in energy metabolism, nerve function, and red blood cell production, excessive intake can lead to neuropathy, nerve damage, and even masking underlying medical conditions,” says Dr Haroon. Calcium supplements are vital for bone strength, nerve transmission, and muscle function. “When used correctly, they help prevent osteoporosis and maintain overall health. However, misuse, such as excessive intake, can lead to kidney stones, constipation, and impaired absorption of other minerals.”
Consultation
Dr Haroon says consulting a healthcare provider ensures proper dosage and effectiveness. Vitamin D supplements play a crucial role in maintaining bone health, immune function, and overall well-being. “When used appropriately, they can address deficiencies, especially in regions with limited sunlight exposure.
However, misuse, such as excessive intake, can lead to toxicity, resulting in adverse effects like nausea, vomiting, and kidney problems,” he says. So, what can individuals do to navigate the complexities of supplement usage responsibly? “Firstly, consultation with a healthcare professional is paramount to evaluating a person’s specific nutritional requirements, spot deficits, and adjust supplementation schedules as necessary,” says Dr Haroon. Secondly, the requirement for excessive supplementing can be reduced by adopting a holistic approach to health that places a high priority on a balanced diet full of whole foods. “In conclusion, excessive usage of vitamin and mineral supplements entails hazards, even if the promise of a quick fix may be alluring. By empowering individuals to make informed choices about their nutritional health, we can mitigate the potential harms of excessive supplementation and promote overall well-being,” says Dr Haroon.
Healthy Diet
Dr Babina NM, Chief Medical Officer, Jindal NatureCure Institute, says individuals who maintain a well-rounded diet typically obtain the necessary nutrients from food sources. “Depending solely on supplements could result in neglecting the significance of a diverse and nutritious diet, which offers a wide range of nutrients in addition to beneficial components like fibre and antioxidants,” she says. This behaviour of popping pills may be influenced by a variety of factors, including hectic schedules, eating habits, or health worries. “A diet that includes a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats provides the essential vitamins and minerals needed for good health. Consuming a diverse range of foods guarantees a broad spectrum of nutrients.” Choosing cooking methods that preserve the nutritional value of foods, such as steaming or lightly sautéing vegetables, can help retain vitamins and minerals, says Dr Babina. “Prolonged stress can also affect the body’s ability to absorb and utilise nutrients. Yoga practices, such as asanas (poses), pranayama (breathing techniques), and meditation, can aid in reducing stress levels, thereby promoting overall health and
nutrient absorption.” While supplements can be beneficial in addressing specific deficiencies or supporting particular health objectives, they should be considered supplements to a balanced diet rather than replacements for it, she says. “Multivitamins can be a convenient way to bridge potential gaps in one’s diet, but it is important to be cautious of the potential dangers associated with excessive intake of certain vitamins and minerals,” warns Dr Babina. Some vitamins and minerals, such as vitamin A, vitamin D, iron, and calcium, can be harmful when consumed excessively. “Over time, high levels of these nutrients can accumulate in the body and result in negative consequences,” she adds.
Functionality Nutritionist and lifestyle educator Karishma Chawla says choosing a vitamin individually or as a part of a multivitamin depends on its functionality. For example, the optimal dose of vitamin C is around 1-2 g, which helps to enhance immunity, prevent colds, enhance skin, and combat stress. “It is best taken individually rather than as a smaller dose in a multivitamin or a part of any other pill. We can look at a variety of vitamins available,” she says. A high-strength and good-quality multivitamin will have more than 20 mg of B vitamins and a good score of fat-soluble vitamins like A, D, E, and K, as well as other minerals and antioxidants. “The consumption depends on the function and form of the vitamin taken,” she says.
• Calcium Citrate is best taken on an empty stomach.
• Calcium Carbonate is taken with a meal to enhance absorption.
• Vitamin C and Vitamin E are anti-stress and anti-ageing and are best taken post-dinner to help combat stress and prevent cellular damage.
• Omega 3 helps to increase metabolism as well as overall well-being and can be had post-dinner.
• Digestive enzymes with meals for better digestion.
• Multivitamin (B complex) helps in metabolism and breaks down energy from food. It is best taken post-breakfast.
• Zinc and Magnesium help with better sleep and muscle recovery. It can be taken at bedtime.
• Ashvagandha, an adaptogen, can be taken first thing in the morning to cope with stress.
• Probiotics before meals to enhance gut health.
Doctor Clears Misconceptions
Diabetes specialist Dr V Mohan took to X to inform his followers that there is nothing called multivitamin deficiency. “Multivitamins do not provide enough of the deficient vitamin.” “There is nothing called multivitamin deficiency. Unless there is a deficiency of specific vitamins eg. Vit D or B12, giving multivitamins may not be beneficial and may even do harm. Multivitamins usually do not provide enough of the deficient vitamin," Dr Mohan wrote, rebuking the American multivitamin brand Centrum.
Supplements should not be considered over-the-counter medications or used without medical supervision.” — Dr D. Nageshwar Reddy, chairman, Asian Institute of Gastroenterology
While iron deficiency can lead to anaemia and fatigue, excessive iron intake can result in toxicity, with detrimental effects on the liver and heart.” — Dr Haroon H, Internal Medicine, KMC Hospital, Mangalore
Choosing a vitamin individually or as a part of a multivitamin depends on its functionality.” — Karishma Chawla, Functionality, Nutritionist and Lifestyle Educator
Individuals who maintain a well-rounded diet typically obtain the necessary nutrients from food sources.” — Dr Babina NM, CMO, Jindal NatureCure Institute
