A lot of my clients who are going through perimenopause, menopause and post menopause ask me about supplements and which ones they should take. Every woman and their requirements are unique, which means supplementation requirements can be unique. So, I've compiled some evidence-based information with the most up-to-date thinking on the supplements.
Vitamin B12
This essential nutrient is involved in the formation of red blood cells, cell metabolism, nerve function, and DNA production. It's available in animal foods, yet as women get older, their bodies don’t absorb as much of this vitamin, which increases the risk of deficiency.
Potential Benefits
The health benefits of B12 are all related to preventing deficiency. Thanks to the crucial role of B12 in the brain, low vitamin B12 in older women might look much the same as neurodegeneration. This vitamin also plays a role in many critical physiological processes, including cardiovascular health.
General Recommendations
People older than age 60 are more likely to develop deficiency. Risk is even higher if they are also a plant-based eater, on certain medications (e.g., metformin), or have digestive issues (eg., gastritis). If you suspect you're deficient, check with your healthcare provider who can assess your Vitamin B12 status with a blood test.
Grab your B12 supplement here.
Vitamin D
Our bodies produce this hormone-like compound when our skin is exposed to sunlight. However, many people are deficient, especially if you have dark skin, are veiled, live in northern regions, or spend most of your time indoors.
Potential Benefits
Healthy vitamin D levels are associated with a wide range of benefits, including bone strength, increased cognition, immune health, and feelings of well-being. The vitamin may also reduce the risk of some forms of cancer, heart disease, and Type 2 diabetes. Because bones can become weaker as estrogen levels drop, this vitamin becomes even more important during and after the menopause transition.
General Recommendations
If you're concerned about a deficiency, speak to your healthcare provider about getting your vitamin D levels tested. While 600 IU per day is most commonly recommended, your physician may recommend high-dose D if you're severely deficient.
Grab your Vitamin D3 here.
Creatine Monohydrate
Creatine is an essential molecule that helps our bodies produce energy via the ATP-creatine phosphate system.
Potential Benefits
In addition to potentially boosting athletic performance, creatine may also help support bone, cardiovascular, and brain health in older adults.
While we don’t yet know the optimal dose, research suggests that creatine may improve cognitive processing. This is especially true when there’s a deficit in brain creatine, which can come from acute stressors (e.g., sleep deprivation) or chronic conditions (e.g., aging, Alzheimer’s disease, depression).
General Recommendations
While there are many potential benefits to taking creatine, be sure to speak with your physician or pharmacist to determine whether creatine is beneficial and safe given your health status. Creatine can cause water retention, which can potentially interfere with blood pressure and other medications.
More information on the benefits of creatine for women who strength train can be found here.
Grab your Creatine here.
Fiber
A type of carbohydrate, fiber is found in plant foods. Unlike other types of carbohydrates, however, fiber can’t be broken down or absorbed into the bloodstream. Instead, it passes through the GI tract relatively intact.
Potential Benefits
Women who struggle with constipation may benefit from adding a fiber supplement along with making dietary changes.
General Recommendations
As with all supplements, it’s a good idea to consult with your healthcare team before taking fiber. This is especially important for those with digestive disorders such as IBS, ulcerative colitis, or diverticulosis, as well as those with allergies or intolerances to specific carbohydrates.
Generally, however, you will:
Start with a small dose and increase gradually
Take the supplement with plenty of water
Experiment with a variety of fiber types to find what works best for you
Grab a Fiber supplement here.
Omega-3 Fatty Acid Supplement
A health-promoting fat, omega-3s are considered essential because the body can’t make them from other fats. There are three types: eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha-linolenic acid (ALA).
Potential Benefits
One of the greatest hits of healthy fats, omega-3s have wide-ranging benefits, including:
Lowering inflammation
Decreasing cardiovascular risk factors (e.g., the stiffness of arteries)
Lubricating tissues (e.g., eyes, vaginal tissues) that often get dry with aging
They may also help decrease hot flushes, mood issues, and cognitive symptoms, though evidence here is mixed. Plus, these fats can play a powerful role in overall health.
Grab your Omega 3's here.
General Recommendations
Before turning to supplements, dietary omega-3s are a great first option, especially if you're willing to consume fish—the richest food source of omega-3s—at least twice a week. On top of fatty fish like salmon, mackerel, and sardines, some plant-based foods, such as flax seeds and walnuts, contain alpha-linolenic acid (ALA), which our bodies can convert to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
If you don’t consume fish, supplements can be helpful. Most generally contain either fish oil, krill oil, or algae oil. This last option works great for plant-based eaters as well as those with fish or seafood allergies.
Omega-3s can decrease blood clotting. Because of this, check with your healthcare providers before taking them.
Protein Powder
Protein powder is a dry powder that is mainly protein and made from foods such as:
Whey or casein (for those who can tolerate dairy)
Egg or egg white
Beef isolate
Soy, hemp, pea, rice, pumpkin seed, or another plant-based source or blend
Potential Benefits
Getting enough protein is key to healthy aging. However, some women struggle to consume enough high-protein foods. That’s where a protein powder supplement can help.
General Recommendations
Find options that you like, can digest well, and enjoy consuming. You may need to experiment with different options to see what works for you. For instance:
Dairy-intolerant people often need to avoid whey (the most popular type of protein powder) and casein.
Plant-based eaters may prefer a soy, pea-protein, or other type of plant-derived formula.
Thickeners such as xanthan gum and guar gum can cause digestive discomfort in some women. Many protein powders add digestive enzymes to the formulation to ease this, which may or may not work for you.
Many protein powders are sweetened with artificial sweeteners, so aim to select one with a natural sweetener such as stevia. Artificial sweeteners can cause inflammation in the body, which is already high when reaching the menopause transition phase of life.
Choose a protein powder here.
Soy and Isoflavones
Isoflavones are bioflavonoid compounds found in foods like soybeans, red clover, and alfalfa.
Potential Benefits
Isoflavones may have estrogen-like effects, which may help relieve menopausal symptoms. They do this by binding to estrogen receptors, the sites on a cell where estrogens would normally bind to do their work.
There are two types of estrogen receptors:
ERα (or alpha), the most common form in the breast and uterus.
ERβ (or beta), found mostly in the cardiovascular system, urogenital tract, and bone.
Isoflavones bind weakly to ERα but more strongly to ERβ, which means that the beneficial effects of isoflavones may be most obvious in menopausal symptoms like hot flushes or bone density.
However, importantly, there are likely individual differences in how women respond to isoflavone supplementation. For example, women of Asian descent are, on average, more able than women of European descent to effectively convert some isoflavones into estrogen-like compounds. In part, this is due to variations in gut microbiota, which help metabolize these substances.
This—along with differences in the concentration of isoflavones in various soy foods—may explain why soy consumption seems to help some women more than others. In regions with relatively high consumption of soy, the average daily intake is about 15–60 milligrams per day from soy foods.
General Recommendations
Include more soy foods—especially fermented soy, such as miso or tempeh—at meals. Also track your soy consumption as well as your menopausal symptoms in a food journal. That way, you'll be able to see if soy is helping.
If you are interested in taking isoflavone supplements, consult with your doctor. These can act like hormones in the body, especially at higher doses.
Iron
Iron is a mineral that contributes to hemoglobin production, which helps deliver oxygen from the lungs to the tissues of the body.
Potential Benefits
Some women are at a higher risk for iron-deficiency anemia. That includes women who:
Do a lot of physical activity (particularly endurance training)
Follow plant-based diets
Have digestive health issues
Have very heavy periods during perimenopause
Don’t eat a lot of iron-rich foods
Supplementation may help supply this additional necessary iron.
General Recommendations
If you suspect you're low in iron, see your healthcare provider to get her levels assessed by a blood test.
Because iron supplements often upset the stomach, clients may prefer to use a Lucky Iron Fish. These small fish-shaped pieces of iron can be dropped into cooking water to add iron to foods.
Probiotics
Probiotics are supplements that contain microorganisms (particularly bacteria and yeasts) thought to be helpful in maintaining a healthy balance of gut flora.
Potential Benefits
These supplements may help:
Maintain healthy levels of friendly bacteria in the gut
Prevent harmful pathogens from getting a foothold
Positively impact digestion and immune system function
A healthy gut microbiome has also been linked to good mental health.
General Recommendations
If you choose to supplement, you'll benefit the most from a brand that has a high CFU (colony-forming units) and several bacteria strains rather than just one.
To help the supplement work effectively, consume minimally processed foods and fruits and vegetables that are higher in fiber, which nourishes healthy gut bacteria.
Greens Supplements and Vegetable Powders
These include dehydrated and powdered fruits, vegetables, and other plants (such as spirulina) or plant extracts (such as inulin).
Potential Benefits
Eating an array of healthy vegetables each day is always the most nutritious option. But some days, it can be easy to fall short. Greens supplements are portable, non-perishable, convenient sources of nutrient-rich plant foods that are easy to consume in a protein shake or smoothie.
General Recommendations
Be aware that some greens supplements may cause digestive problems, especially if they contain inulin or other highly-fermentable fibers. If you're considering a greens supplement, try different brands and formulations to see what you prefers.
Choose a yummy greens powder here.