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Can supplements make up for my diet?
No. A supplement can correct a specific deficiency, and for that it is valuable. It cannot provide what a varied diet provides: fibre, thousands of plant compounds and the food that gut bacteria live on. Nor can it undo the effects of poor sleep or inactivity. I prescribe supplements when a test shows a need, for a defined period.
In short
- Supplements treat deficiencies. Food builds health.
- Fibre and plant variety feed gut bacteria. No capsule replaces them.
- Common deficiencies in India that do need treatment: vitamin B12, vitamin D and iron.
- More is not better. Some supplements cause harm in excess, and some herbal products injure the liver.
- Test first, treat for a defined period, then review.
What can a supplement do well?
A supplement works when it replaces something the body is measurably short of:
- Vitamin B12 in vegetarians, and in people on long-term acid-blockers or certain diabetes medicines
- Vitamin D when blood levels are low
- Iron in iron-deficiency anaemia, once the cause of the loss has been looked for
- Folic acid before and during pregnancy
- Specific probiotics in a few specific situations. See what probiotics are
In each case there is a clear reason, a dose and an end point.
What can a supplement not do?
Replace fibre
Large studies link higher fibre intake with lower rates of heart disease, diabetes and bowel cancer. The benefit is greatest at 25 to 29 grams a day or more, from whole foods. See why your gut needs fibre.
Replace variety
Different plants feed different gut bacteria. A varied plate does what no single product can.
Replace fermented foods
In one trial, a diet rich in fermented foods increased the diversity of gut bacteria and lowered markers of inflammation. Curd, buttermilk and traditionally fermented batters are part of this.
Replace sleep and movement
Both affect digestion, appetite and blood sugar directly.
What does a gut-friendly plate look like?
It can be built from ordinary Indian food:
- Half the plate vegetables, cooked and raw
- A dal, pulse or other protein at every meal
- Whole grains and millets in place of refined flour, most days
- Curd or buttermilk daily, if you tolerate dairy
- A fruit or two, and a handful of nuts or seeds
- Less of what comes in packets
Can supplements cause harm?
Yes. Vitamin A, vitamin D, iron and vitamin B6 are harmful in excess. Many supplements interact with prescribed medicines. Some herbal and bodybuilding products are a recognised cause of liver injury, and the contents of a bottle do not always match its label.
Bring every supplement you take to your consultation, including herbal and protein products.
How do I decide when to prescribe one?
A reason
A symptom, a diet or a medicine that makes a deficiency likely.
A test
A blood level that confirms it.
A plan
Food first where food can do it; a supplement where it cannot; a dose and a duration.
A review
A repeat test, and the supplement is stopped or reduced when the level is corrected.
Questions patients ask me
Should everyone take a daily multivitamin?
For a healthy adult eating a varied diet there is little evidence of benefit. Specific groups, such as pregnant women, strict vegetarians and older adults, have specific needs that are better met by targeted supplements.
Do I need a probiotic every day?
Most healthy people do not. Probiotics have a place in a few defined conditions. Fermented foods and fibre do more for the gut’s own bacteria.
Are protein powders necessary?
Most people can meet their protein needs from dal, pulses, dairy, eggs, fish or meat. A powder is a convenience for those who cannot, such as during recovery from surgery or with a poor appetite.
How do I know if I am deficient?
Tiredness, hair fall, tingling in the hands and feet, mouth ulcers and frequent infections are common pointers. A blood test confirms it. Do not treat on a guess, because several of these symptoms have other causes.
Sources
This page is written for patients and is based on the guidelines and studies below. It is for education and does not replace a consultation.
- Systematic reviews of carbohydrate quality and human health. Reynolds A et al. Lancet. 2019. PubMed 30638909
- Trial of high-fibre and fermented-food diets and immune status. Wastyk HC et al. Cell. 2021. PubMed 34256014
- International consensus statement on the term probiotic. Hill C et al. Nat Rev Gastroenterol Hepatol. 2014. PubMed 24912386
- American Gastroenterological Association guideline on probiotics in digestive disorders. Su GL et al. Gastroenterology. 2020. PubMed 32531291