Just a month after the Ozempic-famed weight-loss and diabetes medicine semaglutide entered the market as a generic, there has been a sudden surge in the demand for nutraceuticals like multivitamin supplements. As patients on GLP-1 receptor agonists, a new class of anti-obesity medicines, face the risk of micronutritional loss, these supplements are being prescribed by clinicians to make up for the deficit.
According to Pharmarack, which tracks major Indian pharmaceuticals, the sales of vitamin supplements increased by 11.6% in April (Rs 871.85 crore) compared to March (Rs 780.57 crore). The overall vitamin-mineral-nutrition market increased by 10% in the same period.
The pharma tracker attributed the growth to the arrival of generic versions of semaglutide. On the clinical side, doctors have a straightforward explanation: as appetite is suppressed and food intake is lowered, there is a direct impact on various aspects of health.
Muscle Loss and Protein Supplements
“Muscle loss is one known drawback, which is why doctors have been asking patients to take GLP-1 medications along with exercise and protein supplements,” said Dr Tushar Bandgar, head of endocrinology department at KEM Hospital. He added that the role of vitamin supplements is now coming into the picture as daily diets are proving insufficient. “The daily recommended dietary allowance needs to be maintained, otherwise there is a chance one will face severe deficiencies,” Dr Bandgar said.
Patient Experience
A Grant Road resident, who started on another kind of GLP-1 medication in April, said that he had blood tests done a few weeks prior to find out his pre-existing deficiencies. “I was short on vitamins D and B12, and iron, and rectified it with supplements,” he said.
Clinical Studies and Findings
An analysis published in February this year in the Clinical Obesity journal took into account six studies involving 4,80,825 middle-aged and older adults (56% women) with diabetes, obesity, or both, who were taking GLP-1 medicines. Vitamin D deficiency was the most common problem, affecting 13.6% of participants after 12 months of treatment. Anaemia due to nutritional deficiency affected 4%. Other problems included iron deficiency (3.2%) and vitamin B deficiency (2.6%).
Indian Context and Guidelines
Endocrinologist Dr Shashank Joshi said that in the Indian context, there is still insufficient data to fully understand the extent of micronutrient loss caused by GLP-1 medications. He advises his patients to consume adequate fibre, ensure proper hydration, and address protein deficits through diet and exercise, while prescribing vitamin supplements only after thorough tests.
“We need to strictly screen patients for deficiencies. Currently, we are attempting to frame guidelines for clinicians on this front. A qualified nutritionist needs to be involved along with a doctor,” he said.
