A report by Swachh Bharat Mission says that 74.5 per cent of public places are equipped with toilets. Another report by the Ministry of Jal Shakti states that there are 2.23 lakh Community Sanitary Complexes built across all States and UTs under the Swachh Bharat Mission (SBM) since October 2014. Over 92 lakh toilets have been constructed since the launch of SBM Gramin (SBM (G)) in April 2020.

While toilets are there, are they accessible? This is the question one should ask. The National Family Health Survey (NFHS) focuses on 131 health indicators, but not until the NFHS 5 survey did they include the question of accessibility of toilets in the survey. This happened after the inputs from the Department of Drinking Water and Sanitation (DDWS) and the Ministry of Health & Family Welfare questioned the accessibility.

One might ask, why is the question of accessibility so important? The answer is quite simple. Access to water, sanitation and hygiene is the most basic human need and is also included under the Sustainable Development Goals by the UN.

Are These Numbers Real?

This thought crossed my mind because back in 2021, I went on a solo trip, on a bus to Udaipur from Delhi. There, the bus made two stoppages. This was done so people could get a quick dinner and freshen up, relieve themselves and be prepared for the rest of the journey. This was a nightmare. The bus only stopped for 10 minutes. While some men used the washroom, others went to the bushes.

For the women, there were three cubicles. One of them was broken, and the other one did not have a light bulb, which meant only one was usable. There was a long queue for that cubicle, and time was short. There was no point in trying to find an isolated corner, because it was past midnight, in an unknown area.

I waited anxiously. When finally, my turn came, I saw an overused, dirty washroom. The toilet seat is in a horrible condition. I wanted to touch nothing there. But I had to pee. So, I used my mask to cover my nose from the odour, folded my pants so they did not touch the floor and squatted. It was quite a task to balance.

On my way back to Delhi, I made sure to not drink any water for over a 13-hour bus journey. I dehydrated myself so I did not have to use the washroom. When I did reach, I was severely dehydrated and was sick for three days.

I shared my experience with my friends only to realise that many women have faced the same. There are no washrooms for women.

A friend of mine told me that it is because these roads and dhabas are mainly designed to serve men. They are the ones who travel at night or are on the roads most of the time. As a result, the few women who do travel or are on the road suffer.

Health Risks Women Are Prone To

Well, it is true, but partially. While holding your pee for too long can lead to health risks, peeing on a dirty toilet seat cannot lead to infections unless your urethra is in contact with the bacteria present on that toilet seat. However, nobody wants to sit on a dirty toilet seat, even if you do not get an infection. A safe and hygienic toilet is a basic need.

One of the regular saleswomen, Usha, who visits my house shared her experience with me. “Being on the road constantly means I must use the dirty public washrooms. But I do not want to use them. So, sometimes I ask my regular customers to let me use their washrooms. Some say yes, and some say no. I understand they are also concerned about their safety and privacy,” she says. As a result, Usha spends most of her day not drinking enough water and holding her pee when she is at work. Due to this, she also suffered from a Urinary Tract Infection (UTI).

Her friend, Halima too faced similar problems and due to increased levels of uric acid in her body, she suffered from Hyperuricemia.

Other health risks are kidney stones and other kidney problems, headaches, dull skin, xerostomia or dry mouth, fatigue, and urinary incontinence, which means losing control over your pelvic floor muscles leading to uncontrolled leakage of urine, seizures and weakness.

What Can You Do?

Wear comfortable clothes and capris. Capri pants are comfortable and are short in length, which means this won’t touch the toilet floor when you squat or sit.

Carry Essentials

Even though you cannot get a UTI alone from sitting on a toilet seat, it is always safe to carry a toilet seat sanitiser. If nothing, it can help you get rid of the bad odour so you can use your stand and pee device inside the toilet. You can also use disposable toilet seat covers if your knees are weak, and you cannot squat. Always flush with your seat down.

Always keep disposable gloves, a portable bidet (fill it with water before use), a pocket liquid handwash, wet wipes, tissues and sanitiser handy. Do not forget to keep extra sanitary pads. It might sound a lot, but I promise that it all fits in one pouch. Use this travel-friendly pouch every time you are on the road, or using a public washroom.

What Can We Learn From Others?

However, in case we do not get these technologically advanced toilets here, you can always pack a travel-friendly toilet kit!

The NHS is urging millions of people across the UK to take vitamin D to support overall health, but experts say certain symptoms should not be ignored. In a post shared on X, an NHS spokesperson said: “From October to March we can’t make enough vitamin D from sunlight, so to keep bones and muscles healthy, it’s best to take a daily 10 microgram supplement of vitamin D. You can get vitamin D from most pharmacies and retailers.”

While health professionals agree that vitamin D supplementation is important for many people, especially during the colder months, they stress that it should be taken carefully.

Why Does Sunlight Matter For Vitamin D Production?

Sunlight plays a crucial role in how the body makes vitamin D. UVB rays trigger a reaction in the skin that converts a compound called 7-dehydrocholesterol into vitamin D3. This form of vitamin D is essential for absorbing calcium, maintaining strong bones, and supporting the immune system.

As sunlight in the UK is not strong enough between autumn and early spring, the government advises everyone to consider taking a daily supplement of 10 micrograms, or 400 IU. Relying on food alone is often not enough to meet daily needs during this period.

Expert Warns Too Much Vitamin D Can Backfire

Biomedical scientist Tobias Mapulanga, who co-founded Repose Healthcare, has warned that some people may be taking more vitamin D than their bodies can handle. He explained that as winter advice circulates, many people add tablets, sprays, or gummies without realising they are doubling up.

He said that symptoms such as constant thirst, needing the toilet more often, nausea, stomach discomfort or constipation, headaches, mental fog, and new aches or cramps can appear soon after increasing vitamin D intake. These signs are often mistaken for winter illnesses, when they may actually point to excess supplementation.

“The message is simple,” he added. “The right dose helps, but taking too much can leave you feeling worse, not better.”

High-Dose Supplements Raise Safety Concerns

Research shows that 42% of UK adults reported taking vitamin D supplements in the past year. However, an investigation by Which? found some vitamin D products on sale contained doses as high as 12.5 times the recommended safe upper limit.

NHS England also logged 42 incidents over a two-year period where high-strength vitamin D was given more often than intended. Some of these cases led to hospital treatment for hypercalcaemia, a condition caused by too much calcium in the blood, according to reports from Bristol Live.

Stop Taking Vitamin D If You Notice These Warning Signs

1. Ongoing thirst and frequent trips to the toilet

If you suddenly feel unusually thirsty or find yourself urinating more often after starting vitamin D, it may be a sign you’re overdoing it. Cut back to a single 10 microgram tablet and stop using any additional vitamin D products if this happens.

Too much vitamin D can disrupt fluid and salt balance in the body, leaving you dehydrated and running to the bathroom. Check labels carefully and remove multivitamins, sprays, gummies, and fortified foods or drinks that also contain vitamin D.

Keep water close by and sip regularly while your body settles. Stay well below the upper limit of 100 micrograms, keep just one product visible, and put the rest out of sight to avoid accidental doubling.

2. Nausea, excessive burping, or stomach discomfort

Feeling sick, bloated, or dealing with an upset stomach after taking vitamin D suggests it isn’t agreeing with you. Try taking your supplement with a full meal and switch from sprays or gummies to a plain D3 tablet if symptoms persist.

Food helps protect the stomach lining, while sprays and gummies often contain sweeteners or flavourings that can irritate digestion. Choose a simple cholecalciferol tablet with minimal ingredients and reduce the dose to 10 micrograms.

Avoid fortified shakes or energy drinks until your stomach feels normal again.

3. New muscle cramps or bone aches

If you notice more aches in your bones or frequent muscle cramps after starting vitamin D, take it as a signal to reassess. Lower your dose and focus on staying well hydrated while eating mineral-rich foods.

Excess vitamin D can interfere with mineral balance, which muscles rely on, and dehydration can make cramping worse. Drink water with meals and include yoghurt, leafy greens, beans, and bananas in your diet.

Gentle stretching and short walks can ease stiffness. Stick to one 10 microgram supplement and avoid adding anything else until symptoms improve.

4. Brain fog or headaches

Trouble concentrating or recurring headaches can be signs that your vitamin D intake is too high. Replace multivitamins or high-strength products with a single 10 microgram D3 tablet.

High doses can raise calcium levels, and extra additives found in combined supplements may affect clarity of thought. Choose a product that contains only cholecalciferol and basic fillers.

Take it with food at the same time each day for consistency and better digestion. Avoid combined vitamin A and D products and focus on one simple supplement.

To prevent accidental overuse, review everything you take that contains vitamin D. Spread out all tablets, sprays, gummies, and fortified foods, and read each label carefully. Convert IU to micrograms by dividing by 40 to make totals easier to track.

Discard any extras and stick to one daily 10 microgram source. Keep a note of symptoms such as thirst, frequent urination, stomach upset, cramps, or mental fog to see how they relate to your intake.

For decades, iodine deficiency was a serious public health concern in India. Conditions like goitre and other iodine-related disorders were widespread until the nationwide introduction of iodised salt changed the picture. The move is widely seen as a major health success, preventing thyroid problems on a large scale.

Due to this, iodine has come to be almost inseparable from conversations around thyroid health. While its role is vital, doctors now caution that focusing on iodine alone can give a false sense of security.

“The thyroid is often misunderstood as a simple gland that switches on with iodine,” says Dr. Narendra BS, Lead Consultant – Endocrinology and Diabetology at Aster Whitefield. “In reality, it is a complex hormone-producing system that depends on several nutrients and physiological processes working together.”

Thyroid Does Not Run On Iodine Alone

The thyroid gland produces hormones that regulate metabolism, energy levels, body temperature, and even mood. Iodine is required to make these hormones, but it is only one step in a longer chain.

According to Dr. Narendra, problems can still arise even when iodine intake is adequate. “Hormone production and activation involve multiple stages. If other nutrients are lacking or the body is under stress, thyroid function can suffer despite normal iodine consumption,” he explains.

Nutrients That Quietly Support Thyroid Function

Several nutrients play supporting roles in keeping the thyroid healthy. Selenium is needed to activate thyroid hormones into their usable form. Iron is essential for hormone production itself, which is why thyroid disorders and anaemia often occur together. Zinc contributes to hormone synthesis, while adequate protein levels help transport thyroid hormones through the bloodstream.

“When these nutrients are missing, patients may continue to experience symptoms even though they are using iodised salt regularly,” Dr. Narendra notes.

Diet Patterns Matter More

Modern eating habits can also place strain on the thyroid. Very restrictive diets, frequent meal skipping, or cutting out entire food groups can disrupt hormonal balance. Diets heavy in ultra-processed foods may increase inflammation and worsen overall metabolic health, indirectly affecting thyroid function.

“A varied, balanced diet supports not just the thyroid, but the entire endocrine system,” says Dr. Narendra. “Nutrition should be looked at as a whole, not reduced to a single nutrient.”

Lifestyle factors often overlooked in thyroid care include stress and sleep. Chronic stress and poor sleep quality can interfere with how thyroid hormones are converted and used in the body.

“This is why some people feel unwell despite having ‘normal’ thyroid blood test results,” Dr. Narendra explains. “Stress hormones can mask or worsen symptoms, making the problem harder to identify if we focus only on iodine levels.”

When Salt Alone Is Not The Solution

Many people turn to iodised salt hoping it will ease fatigue, weight gain, or hair loss. While correcting iodine deficiency is important, these symptoms are frequently linked to broader thyroid disorders, including autoimmune conditions, which require medical evaluation and proper treatment.

“Iodised salt prevents iodine deficiency, but it cannot correct poor diet, chronic stress, sleep deprivation, or undiagnosed thyroid disease,” Dr. Narendra cautions.

Iodised salt is a starting point, not a complete solution. It plays a crucial role in preventing iodine deficiency, but true thyroid health depends on balanced nutrition, healthy habits, and timely medical care. The thyroid needs more than what comes from the saltshaker to function well.

A pharmacist has warned that people taking certain long-term medications should stay alert to subtle symptoms such as numbness, tingling, and an unusually red or sore tongue. According to Superdrug Pharmacy Superintendent Niamh McMillan, as per Mirror, the signs are often easy to dismiss and may quietly develop over time in people with low vitamin B12 levels.

Pharmacist Warns Certain Medicines May Trigger Overlooked Vitamin B12 Symptoms

McMillan explained that vitamin B12 plays a vital role in keeping nerves and blood cells healthy. A shortage can build up slowly, which means early symptoms are often brushed aside or mistaken for everyday fatigue.

She said common warning signs include persistent tiredness or weakness, breathlessness, headaches, dizziness, pale skin, and a sore or red tongue. Some people may also notice pins and needles or numbness in their hands or feet, memory lapses, trouble focusing, or changes in mood such as feeling low or unusually irritable.

Who Is Most At Risk Of Low B12 Levels?

Vitamin B12 deficiency occurs when the body either does not get enough of the vitamin from food or struggles to absorb it properly. McMillan noted that people following vegetarian or vegan diets are at higher risk, as B12 is naturally found mainly in animal products.

Older adults are also more vulnerable, as are people with digestive conditions such as coeliac disease or Crohn’s disease. In addition, those taking certain medications may be affected, particularly long-term acid-reducing drugs such as proton pump inhibitors or diabetes medication like metformin.

Dietary Sources That Help Maintain B12 Levels

To reduce the risk of deficiency, McMillan advised including reliable dietary sources of vitamin B12 wherever possible. Foods naturally rich in the vitamin include meat, fish, eggs, milk, cheese, and yoghurt.

For people who avoid animal products, fortified foods such as some breakfast cereals and plant-based milks can help support intake. In some cases, supplements may also be useful, especially when diet alone is not enough or absorption is impaired.

When To Seek Medical Advice?

McMillan stressed that anyone experiencing symptoms or falling into a higher-risk group should speak to a healthcare professional. A simple blood test can measure B12 levels, and early treatment can help prevent lasting nerve damage or other complications.

She added that Superdrug Health Clinics offer a Vitamin B12 Injection Service at selected UK locations, following clinical assessment or confirmation of deficiency.

How Medications Can Interfere With Vitamin B12?

Several commonly prescribed medications can affect how the body absorbs or uses vitamin B12. This often happens because the drugs alter conditions in the stomach or gut, making it harder for B12 to be released from food or absorbed into the bloodstream.

Medications Linked to Vitamin B12 Deficiency

The most frequently associated medications include:

• Proton Pump Inhibitors (PPIs): such as omeprazole, esomeprazole, and lansoprazole
• H2 Blockers: including famotidine and cimetidine
• Metformin
• Oral contraceptives, although experts continue to debate whether these cause a true deficiency
• Colchicine, used to treat gout and known to damage the intestinal lining
• Anticonvulsants, including drugs like phenytoin and phenobarbital, which can affect B-vitamin metabolism
• Nitrous oxide, commonly known as laughing gas, which can rapidly inactivate existing B12 in the body
• Antibiotics, particularly long-term use of chloramphenicol or neomycin, which can disrupt gut bacteria involved in B12 processing

What To Do If You Take These Medications Long Term?

Experts advise people on these medicines not to stop treatment without medical guidance. Instead, they recommend staying alert for symptoms such as fatigue, tingling or numbness in the hands or feet, brain fog, or a sore, red tongue.

Getting tested is also key. A straightforward blood test can confirm B12 levels, and many doctors now suggest regular screening for patients who take metformin or proton pump inhibitors over extended periods.