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Health


THE 3 SUPPLEMENTS YOU MIGHT ACTUALLY NEED AFTER 50


WHEN IT COMES TO VITAMINS AND MINERALS, MULTIPLE PILLS AREN’T NECESSARY

--------------------------------------------------------------------------------

By
Jeanette Beebe
 
AARP

367 Comments
En español
Published July 21, 2021
/ Updated April 26, 2024
d3sign/Getty Images
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Taking a dietary supplement or two (or five) every day isn’t exactly uncommon.
More than 74 percent of adults 60 and older reported taking at least one
supplement in the past month — be it a multivitamin or a chocolate-flavored
calcium chew, according to data from the National Health and Nutrition
Examination Survey. About 25 percent took at least four. 



Research from AARP found that share to be even higher: 78 percent of adults 50
and older who participated in a 2021 survey said they took vitamins or
supplements. Among adults 65 and older, the percentage shot up to 83.

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What supplements are really worth taking? And what should be left on the grocery
store shelf?

TRADE THAT PILL FOR FOOD

Or, if you must, have both.

One of the best ways to get all of your essential vitamins and minerals is the
old-fashioned way: through a healthy, balanced diet (proteins, veggies, fiber
and fluids).

Here’s where you can find calcium, vitamin D and vitamin B12:

 * Calcium: tofu, broccoli, collard greens, kale and various dairy products
 * Vitamin D: yogurt, milk, fatty fish, beef liver, mushrooms
 * Vitamin B12: poultry, meat, clams, dairy, eggs 

“In most cases, it is person-specific,” says Lingtak-Neander Chan, professor of
pharmacy at the University of Washington School of Pharmacy in Seattle. The
decision, he says, should be based on “underlying health conditions, diet,
access to food and other individual factors.”



The majority of older adults can get the nutrients they need from foods in a
varied, healthy diet. That said, if you’re worried you’re missing the
nutritional mark — your doctor can test you for a deficiency — calcium, vitamin
D and vitamin B12 are three supplements worth considering, Chan says.



That’s right, only three. But they’re mighty important.




CALCIUM



As we age, our bodies typically don’t absorb vitamins and minerals as well as
they used to. The poster child for this is calcium, and a deficiency can lead to
bone fractures and, eventually, falls. If you don’t get enough calcium from
dairy, leafy greens and other calcium-rich foods (women over 50 and men over 70
often don’t, according to the National Institutes of Health), your body sources
it from your bones, making them weaker. A lack of consistent, weight-bearing
exercise can make this worse.



Postmenopausal women are especially at risk for weak bones. According to the
National Osteoporosis Foundation, 1 in 2 women over 50 will break a bone due to
the bone-weakening disease osteoporosis; for men, it’s up to 1 in 4. A woman’s
chance of fracturing a hip is about the same as her risk of developing breast,
uterine and ovarian cancer combined. A hip fracture is more likely to be fatal
for men. So it’s not just women who should mind their calcium intake.



How much calcium do you need? Here’s what the NIH Office of Dietary Supplements
says:

 * 1,200 milligrams (mg) calcium per day for women 51 and older
 * 1,000 mg calcium per day for men ages 51 to 70
 * 1,200 mg calcium per day for men 71 and older



When it comes to supplements, calcium can be found in multivitamin pills and
chews; there are also supplements that contain only calcium or that pair it with
one other nutrient, such as vitamin D.



If you opt for calcium carbonate (which is more affordable than calcium citrate,
the other form found in supplements), you should probably take it with food. If
you also take a supplement that contains iron, you should take that at least
four hours apart from your calcium pill, Chan says. Make sure to check with your
doctor about whether any medications you’re on interact with calcium supplements
(for example, bisphosphonates to treat osteoporosis; the thyroid hormone
levothyroxine; and tetracycline-class antibiotics) or if there are any side
effects (constipation, for example) that are cause for concern.



This part is important: A bigger dose isn’t better. Taking more than what’s
recommended won’t make your bones stronger. In fact, “a mega amount” of calcium
can cause harm, Chan says.



Some studies suggest that taking a supplement with an excessive amount of
calcium can be dangerous for middle-aged and older adults, with negative effects
on the kidney, heart and prostate, though more research is needed to better
understand the potential links.



Because of this, you should try to get as much calcium as you can from foods —
dairy, broccoli, kale, salmon, sardines and various calcium-fortified grains —
and take a calcium supplement only if your doctor says you’re not getting enough
from your diet.




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VITAMIN D



Calcium works best when it’s taken alongside vitamin D, which assists in its
absorption from the gut. Vitamin D, like calcium, is crucial for bone health. It
supports the immune and nervous systems and may benefit the heart.



A vitamin D deficiency is often the result of two things that are becoming more
common among Americans: obesity and not enough exposure to sunlight. (Sorry,
sunlight through a window doesn’t count.) Safe sun exposure is key, of course,
because too much can cause skin cancer.

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Even if you’re getting enough sunshine, it might not do the trick, because the
aging process interferes with the skin’s ability to make vitamin D. Having
darker skin does too. People with Crohn’s disease and celiac disease are more
likely to have a vitamin D deficiency.



Here’s how much vitamin D you need, according to the NIH:

 * 15 micrograms (mcg) / 600 international units (IU) per day for adults 19 to
   70 years old
 * 20 mcg / 800 IU per day for those 71 and older



One word of advice: If you take a vitamin D supplement, take it with food for
optimal absorption, ideally with a meal or snack that contains a bit of fat.



Be sure to talk to your doctor about whether vitamin D2 or D3 is more
appropriate for you. (D2 is plant-based and more often prescribed by health care
providers; D3 is animal-derived and more common over the counter, experts from
the Cleveland Clinic explain.) Don’t forget to ask whether vitamin D might
affect medications you’re taking. Some cholesterol-lowering statins such as
atorvastatin (brand name Lipitor) may not work as well if you take vitamin D
supplements. Similarly, the weight loss drug orlistat (Alli) can reduce the
amount of vitamin D your body absorbs from food and supplements, according to
the NIH.



Your health care provider can advise you on how much vitamin D to take. Some
reports published in the past 10 years advocated supplementing with up to 2,000
IU of vitamin D daily. “But more recent clinical trials suggested that amount of
intake does not show benefits (no harms either), so it may not be the best
generic approach for everybody,” Chan says.



Still, excessive doses — the daily upper limit for adults is 100 mcg / 4,000 IU
— can do terrible things to the body: vomiting, confusion, dehydration, muscle
weakness and more. Extremely high levels of vitamin D can lead to kidney failure
and death.




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VITAMIN B12



Remember how aging makes it harder for the body to use calcium? And to make
vitamin D?



When it comes to vitamin B12, older adults are again at a disadvantage. That’s
because aging impacts the body’s ability to absorb this essential nutrient,
which plays an important role in regulating blood, nerve and genetic health,
according to the NIH.



Older adults who are vegetarian or vegan, who take the antidiabetic medication
metformin or who take gastric acid inhibitors to treat certain digestion
problems are even more likely to be B12-deficient. Just like with vitamin D,
people with Crohn’s or celiac disease are more likely to have a B12 deficiency.



If you do have a vitamin B12 deficiency — and it’s estimated that 3 to 43
percent of older adults do — you will be more likely to develop anemia. A B12
deficiency can also lead to neuropathy or nerve damage (which may feel like
tingling or numbness in your hands or feet), balance issues, depression,
confusion, poor memory and dementia-like symptoms.



How much do you need? The NIH recommends that adults get, on average, 2.4 mcg
per day of vitamin B12. When it comes to food, you can get what you need from
fish, meat, poultry, eggs, milk, clams and beef liver, as well as from some
fortified cereals. Many multivitamin supplements contain this key nutrient, or
you can take it on its own.



There’s no need to worry if your supplement contains a higher dose than what’s
recommended. Unlike calcium and vitamin D, “vitamin B12 has not been shown to
cause any harm, even at high doses,” the NIH maintains. Just be sure to talk to
your doctor about any medications you are on that could interact with a vitamin
B12 supplement.




OVERHYPED SUPPLEMENTS



Calcium, vitamin D and vitamin B12 — that’s the very short list of vitamins and
minerals older adults may want to consider taking. Many other dietary
supplements lack robust data to support their regular use, and you might want to
steer clear of a few altogether.

 * Vitamin E: A vitamin E deficiency is rare in most healthy people, according
   to the NIH, even if your diet is short on the recommended daily amount (15 mg
   for adults). Although vitamin E that is naturally present in food causes no
   harm and does not need to be limited, getting too much from a supplement can
   be dangerous. For example, high doses of vitamin E in supplement form can
   increase bleeding risks, especially in adults on blood thinners. Research has
   also linked vitamin E supplementation to an increased risk of prostate cancer
   in men. For these reasons, “routine supplementation of vitamin E should be
   avoided,” Chan advises. 

 * Vitamin C: Despite popular belief, there’s no solid data to show that loading
   up on vitamin C will prevent or cure the common cold. It’s a myth. Taking too
   much vitamin C can cause diarrhea, nausea and stomach cramps. Instead, opt
   for citrus fruits and vegetables to get the recommended amount needed to
   support your overall health.

 * Folic acid: For most people, there is no need to take this B vitamin, since
   many foods, such as cereals, are fortified with folate. “Folic acid
   deficiency is rare in the United States ... its routine use in aging has not
   been supported by research,” Chan says. (One exception is during pregnancy.)

 * Beta-carotene: If you’re taking beta-carotene in hopes that it will ward off
   cancer or cardiovascular disease, experts say it’s best to stop. In an update
   to its recommendations, the U.S. Preventive Services Task Force advises
   against taking the supplement to prevent these two leading causes of death,
   citing no known benefit and a possible increased risk for lung cancer in some
   populations, including smokers and people who have been exposed to asbestos.
   Experts say if you’re interested in reaping the benefits of beta-carotene,
   switch up your diet instead. You can find it in yellow, orange and leafy
   green fruits and vegetables (think carrots, sweet potatoes, spinach and
   broccoli). 

MULTIVITAMINS MAY COME WITH BRAIN BENEFITS

Accumulating research suggests that a daily multivitamin could be beneficial for
your brain. A series of three randomized clinical trials — considered the gold
standard in research — found that older adults who took a multivitamin had
slower declines in reasoning and memory, compared with adults who took a
placebo.

Experts caution that swallowing your vitamins and minerals in pill form will not
prevent or treat dementia. But taking a multivitamin along with getting plenty
of exercise, eating a healthy diet and socializing could help support brain
health as you age. Read more about the studies and what you need to know before
taking a multivitamin on AARP.org.

Editor’s Note: This story, originally published July 21, 2021, has been updated
to include new information. 


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