Is your Vitamin, magnesium supplement really the magic pill you think it is? Experts reveal truths behind India's new health obsession

Indian Express

a day ago

The Arora family in a plush condominium of Noida believes an apple is simply not enough to keep the doctor away. Ever since COVID-19 instilled the idea of immunity, they have built their safety dome to disperse every bug coming their way, with a wellness store in the premises addressing all their fears and concerns. Naveen Arora, 52, has been on shilajit supplement for reverse-ageing and energy. His mother Ashalata, 75, still swears by ashwagandha capsules post her Covid near-death scare, hoping her lungs can breathe better. Wife Prerna Sharma has been on Vitamin D supplements for bones and magnesium oil massage for insomnia. Teen daughter Aradhana takes biotin gummies for her thinning hair and collagen powder for shapely nails. And they all pop multivitamins.
The catch? None of them has ever consulted a doctor on whether they need these health boosters at all, relying instead on pharmacists, peer groups and social media-driven advisories. None of the benefits these supplements claim is supported by clinical trials. Most aren't even regulated. Worse, the Aroras still fall sick every season as before. Last week, Naveen was shocked to discover elevated liver enzymes despite not drinking alcohol or having fatty liver. 'That was the side effect of shilajit,' he says. Prerna ended up with more muscle cramps than ever. 'I kept taking the daily Vitamin D pills, thinking my pain was symptomatic of a deficiency. I didn't get tested or know I was supposed to stop in between,' she says. 'It's not that you won't need vitamins ever. But you need to get tested first and go to a doctor who is best placed to guide you on their usage,' says Dr Rommel Tickoo, Director, Internal Medicine, Max Healthcare, Delhi.
Preventive healthcare is being misinterpreted by Indians across age groups. It is seen as a magic pill that can eliminate the need for doctors and gives them agency over their bodies. That's the promise that beckons everyone as they walk into a pharmacy that has aisles glistening with Omega 3 globule jars, collagen creams and capsules, fat-burner and protein powders, the sugar-lowering lauki and jamun juice, magnesium gummies and vitamins, the many colours and letters of which you didn't know. Like you have uncorked the boring B complex syrup bottle to release hidden powers. In attractive packages and with reassuring claims, health supplements are redrawing the contours of new age consumerism, preying on your fear and anxiety of disease and fluffing up an illusion of security. On the pretext of developing health awareness, the supplement industry is building a culture of dependence instead of encouraging you to make actual changes in your lifestyle and diet. It bleeds you insidiously while letting you think that you are saving up on the doctor's fee and medical bills. That's tempting. And that's why the global supplement industry is projected to be a $200 billion juggernaut by 2025. The Indian health supplements market is projected to reach $16.42 billion by 2032, according to Market Research Future. The dietary supplement market is projected to reach $10,198.57 million by 2026, according to estimates by the Food Processing Industry
in India.
'The push for promoting and marketing supplements comes from the industry which seeks a shortcut from science to commerce, ignoring the fact that individual nutrients packed in a pill or pouch cannot replicate the goodness of multiple nutrients present in a food item. These balance, modify and modulate each other's actions. We need agriculture and food policies which provide wholesome foods rather than a hardsell of illusory quick fixes,' says public health expert and cardiologist Dr K Srinath Reddy, professor at the Public Health Foundation of India (PHFI).
Dr Reddy finds that dietary supplements, being marketed as nutraceuticals, are irrational or unnecessary with some being even harmful to health. 'A diverse, balanced diet will provide most of the nutrients we need while a healthy gut microbiome, which is nurtured by dietary fibre, manufactures some essential vitamins. A beneficial interaction between phytonutrients, present in natural fruit and vegetables, is usually absent in supplements,' he says. He even cites clinical trials of antioxidant supplements which showed no benefit for heart disease prevention (Vitamin E, Vitamin C) or even harm (beta carotene) while cohort studies with natural foods showed benefits. 'Protein supplements overload the kidneys if injudiciously consumed by body builders,' he says.
Dr Tickoo has seen too many cases of supplement overdose. He recounts how a 25-year-old patient was admitted with kidney failure after a Vitamin D overdose. 'Calcium levels spiked dangerously in his blood, which constricted the blood vessels of the kidneys. Excess calcium led to irregular heartbeats or arrhythmia. He needed dialysis, steroids and days at the ICU.' Another case involved a 68-year-old woman self-dosing on Vitamin D for joint pain, unaware she needed a blood test to assess levels. 'Sunlight suffices for most. Supplementation is advised only under certain health conditions or for the elderly with malabsorption issues, that too for a certain period. A serum level of more than 100 ng/ml (nanograms per millilitre) is toxic. A daily vitamin D intake of more than 100 micrograms (4,000 IU) is dangerous,' says Dr Tickoo.
Fertility specialist Dr Mannan Gupta of Elantis Healthcare, Delhi, recently had a 34-year-old man, who had self-medicated himself with shilajit as he had been trying to conceive with his partner for over two years. 'For nearly a year, he consumed unregulated doses. Not only did that fail to resolve his underlying condition, it affected his liver. What he needed was a minor surgery, lifestyle changes, hormonal support and antioxidants. Over the next six months, his semen parameters showed significant improvement. Within a year of guided treatment, the couple conceived naturally,' he says.
Protein supplements continue to be misused the most. Dr Deepak Kumar Chithralli, nephrologist at Manipal Hospital, Bengaluru, hospitalised a 30-year-old man who had consumed 250 grams of protein daily to build muscle on the advice of his trainer. 'A healthy adult needs only 55-60 grams unless they are athletes. He had body ache, so he took OTC painkillers. This cocktail caused kidney damage. He required dialysis and IV hydration.' He sees many gym enthusiasts, who take steroids on the advice of their trainers and end up in the emergency. 'Get this: you can get your required protein in two portions of either animal and plant proteins. That portion has to be a palmful or a quarter of your plate,' he says. Turmeric capsules — concentrated with 95 per cent curcumin compared to three per cent in natural turmeric — have also triggered liver problems.
If stores in Delhi are a microcosm of popular choice, then the top-selling supplements are immunity boosters, vitamins, protein powders, creatine (for muscle building), ashwagandha, shilajit and biotin. But magnesium is the new king as supplements fly off the shelves rapidly. 'Yet magnesium is not needed at all because you can get it from a balanced diet. Only those with diabetes, Irritable Bowel Disease (IBS), heart arrhythmia, osteoarthritis, absorption issues and the elderly may need it. When taken in very large amounts (greater than 350 mg daily), magnesium is unsafe, triggering irregular heartbeats, low blood pressure, confusion and slowed breathing. Most important, extra magnesium interferes with the absorption of certain drugs like antibiotics and those recommended for diabetes,' warns Dr Tickoo.
People often end up having a cocktail of supplements without realising that they could be working at cross purposes with each other. 'Calcium blocks the absorption of iron, zinc blocks copper. So taking high doses of one nutrient can actually cause a deficiency in another if you don't ask a doctor,' says Dr Tickoo.
Such is the hype around magnesium for sleep that most people, as Dr Rakesh Gupta, internal medicine specialist at Indraprastha Apollo Hospitals, Delhi, found out, take the wrong compound. 'Magnesium oxide is one of the most commonly available forms. Unfortunately, it's poorly absorbed and acts like a laxative. So people land up in the OPD with diarrhoea,' he says. He even lists the compounds and their uses. Magnesium glycinate relaxes the nervous system and improves sleep quality. Magnesium threonate eases brain fog, magnesium malate is for chronic fatigue, citrate supports digestion and helps with constipation. Meanwhile, magnesium taurate supports normal blood pressure.
'Many people make the mistake of focusing only on magnesium, forgetting that certain nutrients help it work better. You need Vitamin B6 and Vitamin D3 for better absorption. Taking zinc or calcium supplements along with magnesium at the same time can interfere with its absorption. It's best to stagger them by a few hours,' adds Dr Gupta.
Dr Tickoo crosses out biotin and detox teas altogether as he does vitamin C and multi-vitamin infusions. 'IV drips are the worst aberration of supplement use as high levels damage organs, trigger infections and blood clots at the injection site,' he warns. Extra vitamin C and E, particularly through supplementation, can lead to gastrointestinal issues like diarrhoea and nausea. While both are antioxidants, taking very high doses do not offer additional benefits and could interfere with the body's natural antioxidants.
Chennai-based Krishna Ganpathy, 38, says she relied on peer chatter to try out magnesium. 'Everyone around me swore by it, especially in office and walking groups. I even checked advice online, including AI tools. But my doctor later clarified most studies were small, unverified and inconclusive,' she says. Dr Tickoo blames misinformation on social media and gym culture. 'Online testimonials may have been the result of paid partnerships. Inexperienced trainers recommend muscle-building creatine without blood work or fitness tests. It leads to bloating,' he says.
The surge in supplement use is directly linked to a post-COVID health consciousness and rising lifestyle diseases like diabetes, high cholesterol, fatty liver and cancer. 'Supplements feel like a quick fix, a shield. Online platforms make them easily accessible and you get them delivered at your doorstep. That ease matters, ' says Dr Sanjeev Sharma, clinical pharmacologist and medical advisor at Apollo Research and Innovations. The elderly fuel the demand for bone, heart and cognitive health products. 'The emphasis on plant-based diets is driving demand for plant-derived proteins, vitamins, minerals and herbal products,' he explains. That's why even organised players like Apollo, Sun Pharma, Zydus and Dr Reddy's now command 30–40 per cent of the nutraceutical market, with smaller brands and international entrants following suit.
Major brands claim scientific backing for their products. But regulation is thin. In India, dietary supplements fall under the Food Safety and Standards Authority of India (FSSAI), with guidance from the Indian Council of Medical Research (ICMR). 'There are recommended permissible limits of ingredients to be used. The manufacturing units must have a GMP (Good Manufacturing Practices) certificate and adhere to licensing and labelling norms. The FSSAI even monitors standards and ad campaigns of the products, ensuring they do not make dramatic claims like a cure. Even the smallest of claims should be backed by big data sets. You can't say we saw results in five or 10 per cent of subjects,' says Dr Sharma.
Yet, reports of contamination with heavy metals and poor ingredient control — especially in herbal products — persist. That's why Dr Sharma suggests a risk categorisation for supplements at the policy level. 'High-risk items should be prescription-only. This will curb misuse,' he says. India may be mimicking the supplement boom in the West but that happened because of expensive healthcare and limited accessibility to doctors at the primary level. 'In India, doctors are more available, even at the primary care level. That's why we must base choices on medical advice,' reasons Dr Sharma.
Supplements can never lessen the disease burden. Clinical researchers are working around the world on thousands of molecules and compounds that can have therapeutic uses. Only a few make it to clinical trials and fewer to an acceptable, viable medicine. Supplements are even lower on the pecking order. 'Is it worth waiting for such a miracle?', asks Dr Tickoo.