When it comes to nutritional supplements such as multivitamins or fish oil etc., there are two extreme types of people in the world: one type is happy to pop whichever pill is touted as the wellness pill and the other scoffs at any suggestion even by doctors to take them, unless they see proof that they need them

But, the most rational approach obviously, is the middle path, where you do not pop the pills without any enquiry about their need and safety, but, are mindful that you may need them and want to get supplementation as per your needs

You will find guidance in taking this rational approach below and also a lot of data. Make your own decisions on the basis of these!

You may have to consider taking supplements if

  • If you have any symptoms of deficiency of nutrients (check table for symptoms of common deficiencies)
  • If your dietary intake is inadequate for a given nutrient and is unlikely to change (check out the ‘rich foods’ for common nutrients)
  • If you are an ‘at risk’ individual for deficiency of any nutrient (check table to know if you could be at risk)
  • If you have diseases of the gut (malabsorption syndrome, celiac sprue, crohn’s disease) or have had surgery for weight loss, in which case you must talk to your doctor regarding advice on supplements
  • If you have a health condition for which, a nutrient supplement has proven value and has been advised by specialist medical organizations (check table to know more)

Should you get tests done for any vitamin and mineral deficiency?

Taking supplement for the nutrient empirically would be the preferred approach for nutrients whose supplements are easily available, affordable and do not pose any health risks. In fact, most of the supplements are taken empirically (e.g. multivitamin supplements)

Getting tested for the suspected deficiency and getting supplementation in accordance with the test results would be preferred for nutrients whose supplemental doses and duration may differ on the basis of deficiency levels (mild or severe) or whose excess can pose some harm. The nutrients in this second category include Iron, vitamin B12 vitamin D for most people, to know more check out this table

 FHI recommendations on tests to detect for mineral and vitamin deficiency

Nutrient Test required Prophylactic (empirical) dose Therapeutic dose

(in established deficiency)

Iron Haemoglobin &haematocrit

+/_

Peripheral blood smear

For adults: 60 mg elemental iron For adults:120-180 mg elemental iron + 400 mcg folic acid orally, if iron-deficiency anaemia is present
Vitamin B12 Blood level of vitamin B12 6-25 mcg/day as a part of multivitamins If Vitamin B12 deficiency is detected on tests but no serious complaints exist,  supplementation at dose of 500-1000 mcg/day for at least two months, followed by maintenance with usual multivitamin supplements is recommended

(If there is Vitamin B12 deficiency with pernicious anaemia or as a result of malabsorption syndromes , get medical advice)

Vitamin D 25-OH Vitamin D2 blood test Typically 200-400 IU is found in calcium +vitamin D supplements If levels are severely low <10 ng/dl, your doctor may give high dose oral supplements (50,000 IU thrice weekly for one month) and then put you on maintenance dose of  supplements containing 800-2000 IU /day, For moderate to mild deficiency, where blood levels are  <25 ng/dL but more than 10ng/dL, lesser number of high dose supplements, followed by maintenance will be mostly needed

Make sure to take your supplements correctly

Vitamins  list

CHECK OUT: Our references for recommendations on supplements