From daily calcium tablets to biotin gummies, nutritional supplements are now part of everyday conversation in India, often consumed without medical advice or testing. The trend has grown with changing lifestyles and easy online availability, but doctors warn that self-prescribing vitamins or minerals can do more harm than good. The central message from experts: don’t guess, test.
The hidden dangers of supplement overuse
Dr Arti Bhalerao, Chief Dietitian and Clinical Nutritionist at Sahyadri Hospitals MomStory, Pune, highlighted that many of the “more is better” mindsets when it comes to downing supplements can quietly lay the groundwork for serious health problems.
Calcium, thought of as universally safe, can build up in the kidneys, causing stones, or in arteries, raising the risk of heart disease if taken unnecessarily. Vitamin D, widely used today, can dangerously elevate calcium levels, leading to nausea, kidney damage, and irregular heartbeat. Overconsumption of fat-soluble vitamins such as A, D, E, and K carries the risk of hypervitaminosis, while protein excess can strain the kidneys and liver.
Zinc misuse is equally problematic, as it interferes with copper absorption, resulting in low immunity and anaemia over time. Even biotin, commonly taken for hair and skin health, can skew blood test results, sometimes masking thyroid or cardiac issues. Bhalerao emphasised that unexplained fatigue or hair fall may hint at deeper issues such as stress, thyroid disorder, or hormonal changes, which go undiagnosed when people rely on supplements alone.
She advised that supplements can support health effectively when prescribed for the right reasons, but self-prescription carries hidden costs: “Think of it as maintaining your car. You don’t randomly add oils and fluids without the opinion of a mechanic; you first diagnose the problem. Your body deserves the same care.”
The skin and hair supplement trap
Dr Raina Nahar, Consultant in Dermatology at P.D. Hinduja Hospital and MRC, Khar, Mumbai, said that over-the-counter beauty supplements for skin and hair are often purchased without regulation. She explained that biotin, collagen, and vitamin E may have benefits, but should never be used indiscriminately.
In her practice, she has observed patients consuming biotin gummies for hair fall, when the real cause could be iron or vitamin B12 deficiency, which may worsen with unchecked supplementation. Similarly, overdosing on fat-soluble vitamins like vitamin A and E may damage skin and hair health instead of improving it.
She stressed that diagnosing the root cause is critical. For example, supplements can certainly help with age-related changes in skin quality, but only when introduced under medical guidance and in the right dosage. “The wrong combination, wrong brand, or needless duplication of nutrients can impair your skin’s barrier or even cause excessive dryness and hair fall,” she cautioned.
Gut health, absorption, and drug interactions
Dr Jaydeep Palep, Senior Consultant Gastro-Intestinal & Bariatric Surgeon (Robotic & Laparoscopic) at P.D. Hinduja Hospitals and MRC, Khar, pointed out that nutrient absorption depends heavily on gut integrity. Magnesium and B-complex vitamins, for instance, are absorbed in specific segments of the intestines. Any disease or surgery affecting these areas can lead to malabsorption and deficiencies.
He also highlighted how supplements can interact with medications. Patients with gastroesophageal reflux disease (GERD) often rely on PPI drugs (that reduce the acid in the stomach), but calcium carbonate supplements are poorly absorbed in this population. Instead, calcium citrate may be recommended. Similarly, iron absorption drops with excessive acidity but improves with vitamin C or, in severe cases, intravenous administration.
According to Palep, the timing of supplement intake, knowledge of drug formulations, and awareness of drug–nutrient interactions are key: “One should take any nutritional supplements only on the advice of their physician, not by hearsay.”
Diagnostics must come first
Dr Sujay Prasad, Chief Medical Director at Neuberg Diagnostics, underscored the importance of diagnostic testing before supplementation. He cited an illustrative case of a 35-year-old who, assuming fatigue was due to vitamin D deficiency, self-prescribed extremely high doses for months. This led to vitamin D toxicity, kidney strain, and hospitalisation.
To prevent such risks, Prasad recommended essential tests such as Complete Blood Count (CBC), Vitamin D levels, Vitamin B12 and folate assessments, iron panels, calcium and magnesium tests, and zinc levels. These diagnostics, he explained, help detect deficiencies, ensure correct dosing, and prevent over-supplementation, especially in the case of fat-soluble vitamins, which are stored in fat and accumulate to toxic levels if unchecked.
In India, where vitamin D deficiency affects up to 100% of some populations, calcium inadequacy remains widespread, and zinc deficiency is common due to vegetarian diets, supplementation may indeed be necessary. However, data-driven management in which supplementation is targeted based on diagnostic results is critical to preventing long-term harm.
Experts concur that supplements are not as harmless as they appear. The risks of kidney stones, liver damage, anaemia, diagnostic errors, and drug interactions highlight the need for a diagnostic-first approach.
The take-home message: Supplements should never replace a balanced diet, and they should not be self-prescribed. A simple blood test and consultation with a qualified doctor can ensure that supplements serve as precise, effective tools for health, rather than silent risks to it.
