Uses and Misuses of Vitamins and Minerals

By Akhtar, Mahmud Ahmad; Mirza, Zafar | Economic Review, September 1994 | Go to article overview

Uses and Misuses of Vitamins and Minerals


Akhtar, Mahmud Ahmad, Mirza, Zafar, Economic Review


"Food is the best source of vitamins and minerals. A balanced diet contains far more vitamins and minerals than the daily need of an individual. Intake of too much of vitamins is not only useless but can be harmful". It is better to have a balanced diet which provides vitamins and minerals in adequate quantities and in natural forms. Amongst the fruits guava is the richest source of vitamin C followed by mangos and citrus fruits and bers. Amongst the vegetables, turnip tops, mustard green and gram leaves are richest in vitamin C. Watermelon is the richest source of carotene (vit. A) and carrots also contain it in large quantities.

Different vitamin and mineral preparations are widely prescribed and used. It is common to see prescriptions from qualified doctors containing one or more than one such preparations. As a result of aggressive and unethical promotion by the pharmaceutical companies and common prescriptions by the doctors, people use these preparations to improve their general state of health, to treat general weakness and body aches and pains. Another very common practice is to use vitamin and mineral preparations concomitantly with antibiotics. Strangely enough, this belief is promoted and reinforced by the doctors through their prescriptions.

One indication of the wide use of these "tonics" is that in public sector a huge share from the National Drug Bills is consumed on purchase of vitamins. The national pharmaceutical statistics of Pakistan show that vitamins are the second largest group of drugs consumed. In the year 1977, ninety million rupees and in 1986 over 400 million rupees were spent on their purchase. In private sector there is even more waste. This is despite of the fact that a clinician in this country rarely comes across cases of primary vitamin deficiencies like rickets, scurvy, hypo-prothrombinaemia and megaloblastic anaemia etc. Secondary deficiencies are also rare.

What is the rationale behind manufacturing, registering, prescribing and using all these preparations? One way of answering this question is to review and appreciate the specific indications for the use of different vitamins and minerals and their recommended doses in these indications vis a vis their normal daily requirement.

Vitamin deficiency diseases are quite rare in Pakistan as is evident from the hospital sickness returns, so the large scale use of vitamins is generally a misuse. In order to rectify this situation, there is a need to rationalize the vitamin formulations so that the waste could be minimized. The formulations based on the daily requirements, as mentioned in Table-I are thus recommended. Market is littered with very expensive, useless and harmful preparations of vitamins and minerals in the form of tablets, capsules, syrups and injections. Some even contain hormones which may cause dangerous consequences. Many of these are even imported e.g. a calcium preparation "Ossopan" costing Rs. 4.50 per tab is imported. Isn't it an absolute waste of national resources?

"Food is the best source of vitamins and minerals. A balanced diet contains far more vitamins and minerals than the daily need of an individual. Intake of too much of vitamins is not only useless but can be harmful". It is better to have a balanced diet which provides vitamins and minerals in adequate quantities and in natural forms. Amongst the fruits guava is the richest source of vitamin C followed by mangos and citrus fruits and bers. Amongst the vegetables, turnip tops, mustard green and gram leaves are richest in vitamin C. Watermelon is the richest source of carotene (vit. A) and carrots also contain it in large quantities.

The human body has vitamin reserves e.g. folic acid is stored for six months and vit B12 for two or three years. Primary deficiencies of vitamins are rare, however, secondary deficiencies occur in conditions like malabsorption syndrome. It is reasonable to prescribe vitamin supplements based on the estimated daily requirements (which are very small), when a patient is unable to take enough food because of gastro-intestinal disturbances. …

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