Have Google & your besties got you popping too many pills?

South Africans have enthusiastically joined the global rush to take health supplements, ranging from herbs and vitamins to gut bacteria, converts to the cause swear by them, but many health professionals have urged caution- and say 'natural' does not automatically equal 'safe'

03 June 2018 - 00:00 By SHANTHINI NAIDOO
South Africans now spend R5-billion a year on vitamins and supplements.
South Africans now spend R5-billion a year on vitamins and supplements.
Image: Keith Vlahakis

Every morning, a handful of pills goes down with my breakfast. A soft golden oval of evening primrose oil, a too-large vitamin C tablet, a bitter echinacea pill, then two capsules: magnesium and a probiotic. Once a month, there's a nuclear red and extremely painful shot of vitamin B12.

None of these is swallowed for medical reasons, but out of a belief in their prophylactic properties based on the recommendations of doctors and our trusty online friend Dr Google.

Am I superhuman at the end of all this?

Probably not, but along with millions of people around the world who are pill-popping for prevention, I do it to feel healthier and theoretically live longer.

A study this year showed that South Africans now spend R5-billion a year on vitamins and supplements, a figure that has grown about 13% a year since 2012.


Globally, the vitamin and dietary supplement market was valued at $132.8-billion in 2016, with at least 9% annual growth, says Yashvir Maharaj, research director of Insight Survey, the company that produced the local report.

He says South Africans are leaning increasingly towards natural alternatives to conventional drugs.

"Google seems to be our medical friend. People are also purchasing more online, going on ratings of how well vitamins and supplements work for others," says Maharaj.

His survey showed that in South Africa, the most popular dietary supplements include echinacea, ginkgo, evening primrose oil and garlic. Besides herbs we favour probiotics, calcium and fish oils with omega complexes, which are said to be good for cholesterol management and brain function.

Flu-fighter vitamin C is our most-consumed single vitamin, says Maharaj.

So I am not alone in believing that we can avoid colds and flu with the immune-boosting vitamin C and echinacea and keep my premenstrual symptoms at bay with magnesium and evening primrose oil.


Probiotics are an all-rounder; those who advocate them say good gut health is vital to fixing everything from depression to acne, and boosts the immune function. Vitamin B12 is for cell development and energising tired bodies, and who doesn't need that?

"If we look at the growth in spend every year from 2014 to 2017, it shows just how serious South Africans are about their health despite a strained economy," Maharaj says.

"It is stimulated by an ageing global population and increased focus on health, wellness and preventative healthcare. Interestingly, the global market has managed to appeal to all consumer segments with no discrimination in terms of dietary habits, culture, age or gender."


• Olive leaf extract and oregano oil are powerful natural antibiotics

• Echinacea is an immune booster

• High-dose vitamin C acts as a natural antihistamine, useful in treating allergies

• Magnesium is a muscle relaxant and lowers blood pressure

• Red yeast extract and niacin, a form of vitamin B3, lower cholesterol

Locally, it is middle-class consumers who seem to turn to preventative medicine, probably because of the expense.

But dietitian Lila Bruk says certain vitamin supplements are "quite ubiquitous" across income groups. "For example, folic acid is generally not expensive and is prescribed to all pregnant women to prevent neural tube defects."


But do they work?

This is the subject of fierce debate among medical professionals, many of whom believe a well-balanced diet will provide everything a person needs for good health.

And there is a danger of overdosing or mixing the wrong tinctures and tonics.

"There is definitely the misconception that because a supplement is 'natural' that it's safe," says Bruk.

"This is certainly not the case. St John's Wort, which is used as a form of 'natural antidepressant', can interfere with the contraceptive pill and blood-thinning medication," she says.

"There is the risk of toxicity with taking excessive amounts of certain vitamins and minerals. It is always important to choose vitamin and mineral supplements that are as close as possible to 100% of the recommended daily allowance, rather than taking mega doses of the nutrient. When it comes to supplements, more is not necessarily better."

Dr Ela Manga, an "integrated health" medical doctor, says, however, that "many of the supplements do work, and very powerfully", if you get it right.

"Our modern diets are so deficient in vitamins and minerals and full of processed food that supplements are often necessary to support the body to do what it has been designed to do," says Manga.


"However, not all supplements are of the same quality. How efficacious a supplement is is dependent on the quality of the ingredients, dosage and manufacturing process. They should also not be used indiscriminately."

Dr Noluthando Nematswerani, who heads the clinical policy unit at Discovery Health, says the medical aid provider does not encourage members to take vitamins and supplements that have not been clinically prescribed. "We know multivitamins are popular from our member data, and they are certainly marketed well. But look for clinical details before you take something. What are the trials saying? Have there been clinical trials?"

Manga agrees. She says the ideal is that supplements should be prescribed by a health professional who knows what works, and why.

The breakfast cocktail can then be personalised.


Vitamin supplementation may have originated as early as the 18th century when Scottish physician James Lind reportedly experimented with oranges and lemons as a cure for scurvy. The disease, which affected sailors on long journeys at sea, is caused by a deficiency of in ascorbic acid (Vitamin C) found in abundance in citrus fruit. 

In the 1940s, the first multivitamin in tablet form appeared in the US and they have featured in medicine cabinets since.

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