A 60-year-old man came to me for a consultation about anorexia. Upon questioning, he showed me a list of 17 supplements (written on a scrap of frayed paper) he was taking. These ranged from vitamins, hormones and even steroids. He said he just wanted to live longer than others by consuming these “energy-giving supplements”. Investigations revealed a worn liver (high liver enzymes indicating liver damage) while urine showed too much protein (indicating kidney damage). I told him, “By taking this dangerous combination of supplements and hormones, you may live shorter than others.” I stopped taking all of his supplements and gradually his liver and kidneys healed.
Another patient came to me with very high levels of calcium, which caused kidney failure. When questioned, he said, “I heard that all of us are deficient in vitamin D, so I started taking it daily.” He bought it without a prescription and, without a doctor’s advice, took one sachet containing 60,000 units of vitamin D daily for three months (supposed to be taken once a week for a limited time for those with low vitamin D). It had to be accepted and we were able to gradually lower the calcium levels. His kidney function improved.
Do you really need vitamins and supplements?
Both cases were examples of types of vitamin and supplement abuse. The lesson is that you don’t need vitamins or minerals if you don’t have any disease. Regular exercise and a nutritious diet, including plenty of fruits and vegetables, should suffice. Adequate vitamins/minerals can be obtained from the following sources: Vitamin D from exposure to sunlight, calcium from milk, curds, cheese, etc., and B12 from liver and seafood, while protein can be obtained from non-vegetarian sources. , soybeans, milk, nuts, bengal gram, lentils and flax seeds.
Supplements are available in pure forms (such as vitamin B12, fish oil, vitamin D, whey protein, etc.) and mixed together (multivitamins have a few to 30 or more vitamins and minerals together). The latter is widely consumed.
When do you need supplements?
The patient should be guided by a doctor or nutritionist. When food absorption in the intestine is decreased (malabsorption, pancreatitis, or intestinal surgery), many vitamins are deficient. Patients who have lost a lot of weight (cancerliver disease, etc.) require vitamin and protein supplementation. Those who drink a large amount of alcohol for long periods of time develop vitamin deficiencies. Those with osteoporosis and lean muscles need vitamins, calcium, and protein supplements. Iron supplementation is needed in several cases: heavy menstrual cycles in women, peptic ulcer, worm infestation and so on.
Remember that multivitamin and protein deficiencies may occur after any acute infection (viral, bacterial) and have been observed in a severe manner in infected persons. COVID-19 infections. It is clear that pregnant women need vitamins to prevent birth defects in the offspring. Some vegetarians may have vitamin B12 deficiency and protein deficiency. For those going through the alcohol withdrawal process, thiamine supplementation becomes essential.
People with diabetes are often prescribed a multivitamin. Those taking the commonly prescribed medication, metformin, will need vitamin B12. Those with longstanding diabetes, the frail, and those with poor appetite or weak gut muscles (due to severe nerve damage) will need a vitamin and vitamin D supplement. Protein supplementation should be given with extreme caution in patients with impaired renal function. People with diabetes often have high blood fats (“triglycerides”) and can be treated with fish oil capsules (made from the oils of salmon and other fatty fish).
Young people who want to build muscle get protein supplements at the gym. This may help. However, the dose of total protein must be correctly calculated according to body weight. Other additives such as body building hormones (steroids) should be avoided. These supplements are given in many gyms by unqualified people.
Like excess vitamin D (see patient 2 above) and calcium, taking certain other vitamins can also cause harm. Avoid beta-carotene (from grains, but good from natural foods) if you’re a smoker/ex-smoker, and vitamin A if you’re pregnant. Excess vitamin E intake for long periods may increase the risk of prostate cancer.
Multivitamins won’t do the trick
Some people believe that if they take one multivitamin tablet, they will have enough of all the vitamins and minerals. this is not true. Vitamin/mineral deficiencies (vitamin B12, folic acid, calcium, iron, vitamin D, etc.) In case of severe deficiency, vitamins should be given by injection.
Finally, there is a misconception that taking a daily multivitamin/mineral will prevent heart disease or cancer. There is no evidence that this will happen in those who eat a variety of healthy diets, fruits and vegetables and get outside in the sunlight for aerobic exercise. Obviously, a multivitamin a day cannot replace a healthy diet and exercise.
(The author is a Padma Shree Award winner and author of “Diabetes with Delight”)