Food first

When a pill is a tool

Whole-food patterns - vegetables, dals, millets, dairy or a B12 plan, nuts, seeds, fish or eggs, fruit in season - outperform isolated pills in almost every large trial for the diseases that actually kill. A supplement is a scalpel for a named gap, not a personality.

Decision tree

  1. 1. Are you fixing a lab-confirmed deficiency or a high-risk life stage (peri-conception folate, vegan B12, infant D, pregnancy iron after a haemoglobin/ferritin)? If no - you are shopping. Go to 2.
  2. 2. Is the plate already the pattern above? If no, fix breakfast protein, greens with fat, and tea-away-from-dal before you buy a bone blend.
  3. 3. If yes, skip collagen, antioxidant cocktails, mega-E, biotin gummies, and testosterone herbs. They do not deliver what the label implies.
  4. 4. If you are in a named case below, consider that one nutrient. One. Recheck. Stop when the lab or the life stage ends.

Vitamin D

Consider

Sun exposure is low (indoor work, covering clothing, northern winter), or 25-OH D is measured low, or a clinician is treating rickets/osteomalacia. Infants with limited sun: 400 IU as drops is standard guidance.

Skip

A 60,000 IU sachet every week because a friend does it. Already-sufficient adults mega-dosing through winter. Combining high D with high calcium without medical follow-up.

How

Test. Replete under advice. Maintain at DRI (600 IU, 800 IU if 70+) plus whatever sun you actually get. Take with a fat-containing meal.

Vitamin B12

Consider

Strict vegan or near-vegan with no fortified food. Adults over 50 with low stomach acid. Metformin or long-term PPIs. Documented low B12 or high MMA, or neuropathy being evaluated.

Skip

An omnivore with normal labs ‘for energy’. Sublingual sprays with theatrical pricing and no mcg on the label.

How

A cheap cyanocobalamin or methylcobalamin tablet in the 25-100 µg daily range (or as prescribed for deficiency, which is higher and sometimes injectable). Food still: dairy, eggs, fish, meat.

Iron

Consider

Confirmed iron-deficiency (ferritin/CBC) or a high-risk period already being managed: second/third-trimester pregnancy, heavy menses with documented anaemia, a 7-12-month infant who cannot hit 11 mg from food.

Skip

‘Just in case’ in a postmenopausal woman, a man, or anyone without labs. Iron in a person with high ferritin. Taking iron with chai, calcium, or thyroid tablets.

How

Only after the test. Then food plus the prescribed salt (often on an empty stomach or with vitamin C, away from tea). Recheck. Unexplained iron deficiency after menopause is a bleed until proven otherwise.

Folate / folic acid

Consider

Peri-conception: 400 µg folic acid daily, starting before pregnancy is visible, because the neural tube closes by week 4. Higher doses only if a clinician says so (prior NTD, some medications).

Skip

5 mg folic acid as a general tonic. Folate without knowing B12 when the smear is megaloblastic.

How

Tablet plus palak, methi, chana. The tablet is the peri-conception tool; the greens are the life-long one.

Omega-3 (EPA/DHA)

Consider

Fish intake near zero, pregnancy/lactation (200-300 mg DHA), or a clinician treating high triglycerides with a real EPA/DHA dose. Vegetarian: algae DHA, not flax as a pretend equivalent.

Skip

A rancid 1000 mg ‘fish oil’ of unknown EPA/DHA. Flax oil capsules billed as brain food. Mega-omega-3 if you have a bleeding disorder or are on anticoagulants without advice.

How

Fatty fish twice a week is the default. Algae oil labelled with DHA milligrams if the kitchen has no fish.

Megadoses and the ones that fail

High-dose vitamin E

Has not delivered the advertised heart or beauty benefit in large trials and can raise bleeding risk. Food (almonds, seeds, groundnut oil) is the form with a safety record.

Collagen powders

You already make collagen from amino acids plus vitamin C. The powder is a gelatin snack with better branding. If protein is low, eat dal, eggs, curd, fish - they come with leucine, which the powder often does not emphasise.

Random antioxidant blends

Isolated high-dose antioxidants have repeatedly failed to cut cancer or CVD in well-fed adults. Colourful plants work as a pattern. A red-green-blue pill is not a thali.

Biotin gummies

True biotin deficiency is rare. 5,000-10,000 µg doses interfere with TSH, troponin and vitamin D immunoassays - people have had missed heart attacks and wrong thyroid treatment. Food biotin is in eggs and dals.

Zinc lozenges for months

A short course in a cold is a maybe. Months of 40 mg+ induces copper deficiency, anaemia, and neuropathy. Food zinc does not.

Iron + calcium + tea at the same moment

They cancel. Iron away from tea and away from calcium tablets. This is an interaction, not a vibe.