New Delhi: Dr Tejal Lathia, a consulting endocrinologist at the Mumbai-based Apollo and Fortis Hospitals, said she was recently left wondering why a Type 2 diabetes mellitus patient had vitamin D toxicity.
Further investigation revealed the culprits — a fear of contracting Covid-19 and a social media barrage on the unproven claim that vitamin D pills boost immunity.
“The patient had seen messages on social media on how vitamin D may help in building immunity against Covid-19. But instead of the recommended dose of one pill a week, she consumed one a day,” Dr Lathia told ThePrint.
High vitamin D levels can spike blood and urine calcium levels which, in turn, can cause nausea, vomiting, dehydration, dizziness, confusion, and drowsiness among other changes.
“Vitamin D in blood levels greater than 150 ng/ml can cause all these symptoms reflecting toxicity. My patient had a level of 348 ng/ml but luckily did not suffer any consequences,” she said.
The Mumbai doctor added that almost all of her patients are taking immunity boosters in one form or another. “I have been hearing about the immunity boosting measures from all my patients,” she said. “The most-used products are homemade kadhas, zinc, vitamin C and vitamin D and medicines like the homeopathic Arsenicum album.”
And Dr Lathia isn’t alone.
Doctors across the country are fighting new-age medical emergencies that involve the over-consumption of turmeric, fenugreek seeds, aloe vera juice, Vitamin D pills — all driven by unproven social media messages that they boost immunity against Covid-19.
“My colleagues and I are seeing a lot of patients who are self-medicating with so-called immune boosting agents,” said Dr Cyriac Abby Philips, a specialist in hepatology and liver transplant medicine at the Cochin Gastroenterology Group in Kerala.
“The major factor for this sudden interest among patients is the fear of contracting Covid-19, especially those who are immune compromised,” Philips said. “The relentless social media posts, promotion by the government on immunity boosting practices using herbs is leading consumers to adopt such unhealthy practices. In turn, quacks are also cashing in on the opportunity.”
Medical practitioners pointed towards the central government advice of using alternative medicine systems such as homoeopathy and ayurveda to ward off the coronavirus.
Prime Minister Narendra Modi has repeatedly asked people to follow an advisory issued by the Ministry of Ayush (Ayurveda, Yoga & Naturopathy, Unani, Siddha, Sowa Rigpa and Homoeopathy), which suggests a range of home remedies to boost immunity, including consumption of turmeric, honey, ginger and some concoctions.
The central government has also recommended a course of ‘Arsenicum album 30’ — a homeopathic medicine.
“While using these products in moderation or recommended quantity may not cause any harm, people have started consuming these products without knowing their proper dosage, way of preparation and consumption and their interaction with their ongoing medications. The trend is dangerous,” said Dr Manoj Goel, director, pulmonology at Fortis Memorial Research Institute, Gurugram.
Side-effects of over consuming natural products
Doctors are seeing a spike in the number of patients complaining of side-effects that are then traced back to their diets.
Dr Philips said he has seen “patients who have consumed decoctions of Fenugreek (methi seeds) and landed in trouble”. According to the Kerala-based doctor, fenugreek seeds in large doses lead to thinning of blood and “can dangerously cause bleeding events in patients with or without liver disease”.
He cited the example of a patient who took to a fenugreek decoction to boost immunity. “After use of fenugreek decoction for a whole week (two glasses of fenugreek boiled water a day), his test ratio (to check for blood thinning) was above 3 (which normally is usually 1 or less),” Dr Philips said. “After stopping Fenugreek decoction, the test value was restored to normal levels but he had a few bleeding spots on the skin.”
“Another big issue I have faced is high consumption of special juice diets, especially aloe vera juice which is very dangerous. It induces liver injury,” Dr Philips added.
Dr M. Shafi Kuchay, senior consultant, endocrinology and diabetes at Medanta Hospital in Delhi, tweeted that he had seen a patient who had consumed excessive amounts of turmeric to ward off Covid-19.
“Yesterday, (I) saw a patient for diabetes. Bilirubin was normal. He had yellow eyes but no symptoms of any liver disease. Reason: He had consumed 2 tablespoons of turmeric with water, three times per day, for the last two-three months. This was for prevention of Covid19.”
Yesterday saw a patient for diabetes. He had yellow eyes but no symptoms of any liver disease. Bilirubin was normal. Reason: He had consumed 2 tablespoons of turmeric with water, three times per day, for last 2-3 months. This was for prevention of #COVID-19. 😄😄
— M Shafi Kuchay (@drshafikuchay) September 2, 2020
“We have seen several patients taking mostly local herbal-based preparations for boosting immunity,” he told ThePrint.
According to Dr Gaurav Jain, consultant, internal medicine, at the Delhi-based Dharamshila Narayana Superspeciality Hospital, four to five patients a day are reporting side effects after consuming “immunity boosters”.
“It is unfortunate to see people putting themselves at the other health risks in the name of consuming immunity boosters,” Dr Jain said. “Overconsumption of products such as ashwagandha, kaadha (concoctions) and chyawanprash among others is leading to digestion problems and other health issues.”
Survey finds high sale of immunity boosters
Numbers also bear out the trend of high consumption of products labelled as immunity boosters.
According to a survey by Pronto Consult, a health research firm, immunity boosters are now an increasing trend across categories not only in medicines, but also in food-related products.
“Out of every 100 medicine bills, 92 were for immunity-boosting products,” the survey found, adding “products containing honey, chyawanprash, ginger, moringa oleifera, probiotics, green tea, amla (gooseberry), tulsi (basil), haldi (turmeric), lemongrass, karela (bitter gourd), jamun (berry), saffron seen a trend upwards, including detox brands.”
Medical practitioners, however, warn that they should be consulted for proper dosage of immunity boosting products, especially among those suffering from medical conditions.
“Don’t consume any immunity booster without proper consultation, especially if one is already suffering from another disease. Consult your concerned specialist first,” Dr Jain advised.
The doctors say that the risk and benefits of supplements has been assessed on a case-to-case basis.
“It is my practice to assess risk versus benefit. These boosters (such as vitamin C or D or Zinc) may not cause any harm if taken in appropriate doses,” Dr Lathia said. “I usually advise simple steam inhalation or gargles because most people want to do something to satisfy their fear of catching Covid-19.”
“I strongly discourage the use of unknown store-bought products without appropriate labelling or substances that can cause harm,” she said while adding that “weight management, good control of blood sugars and blood pressure with appropriate medications, use of mask and hand washing are the best immunity measures.”
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