Q: Revital was prescribed to me as a general tonic and I have been taking it for the last 2 years. After reading about its side effects, should I discontinue it? If so, what other supplements can I take, without the side effects of Ginseng. I have osteoporosis for which I take one capsule of Goldcal and one tablet of Osteophos 70 once a week. I have relatively higher BP, 140/90, but do not take any medication for this so far.

A:Multi-vitamins and/or mineral supplements should be consumed only when there is proven, documented deficiency. Otherwise they can do more harm, apart from loss of money, than good. Recently, results of some major trials in the United States have thrown lot of light on such aggressively promoted supplements. It is not realised that regular multivitamin supplements intake doubles a mans risk of developing fatal prostate cancer. These findings come from a follow up study of 295,344 men who were free of cancer before they started taking multivitamin supplements. Over five years of follow up, 10,241 men were diagnosed with prostate cancer. Of these, 1,476 had advanced malignancy. Men who took multivitamins daily had a 98 per cent higher risk of developing fatal prostate cancer than those who never used the supplements. These positive associations were strongest in men who took micronutrient supplements that contained beta-carotene, selenium and zinc. Since you have already borderline high blood pressure, ginseng should, in any case be avoided since it can increase the blood pressure. With regard to osteoporosis, you have not given the result of bone mineral density (BMI), which will show the need or otherwise of taking medication. Unnecessary consumption of supplements leading to high levels of vitamin D and calcium in old age are associated with increased risk of large brain lesions. Such damage can result in cognitive impairment, dementia, depression and stroke. These adverse effects could be due to calcifications in the blood vessels. Goldcal does not appear on the national and international databank of quality formulations of reputed manufacturers. General statement on selection of brands: There are scores, sometimes hundreds, of brands of the same medicine. Against about 300 pharmaceutical manufacturers in western countries like Britain, there are over 20,000 producers in India that market more than 40,000 brands. Most manufacturers do not have quality testing laboratories. Hence selection of brands is important. Many companies give incentives to prescribers to patronise their products. Patients should check the reputation of manufacturers before consuming medicines.