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Supplements for the Menopause: what should you take?

There are many supplements on the market aimed at women going through menopause.

They include claims such as “Vitamin B6 helps to regulate and balance hormonal activity”, “Magnesium helps to support healthy psychological function”, and “Iron, Vitamin B2 and B12 contribute to reduction of tiredness to support normal energy levels”.

But how many of these claims are true and are these supplements necessary? Below are some of the common supplements for the menopause. 

Vitamin D

This vitamin is used to maintain bone, teeth, and muscle health, by regulating calcium and phosphate in the body.

It is one of the most common vitamin deficiencies in the UK, especially during winter months where sunlight is low.

People most at risk of vitamin D deficiency include those who are not outdoors often, wear clothes that cover up a lot of their skin when outdoors, and people who have dark skin. Vitamin D supports calcium absorption which is a key nutrient for menopausal women.

The vitamin is found in foods such as oily fish, red meat, liver, egg yolks, and fortified products. However, dietary intake is usually not sufficient in meeting the recommended daily intake of 10mcg per day. Therefore, a supplement of 10mcg per day is recommended for those at risk, or for everyone during months of low sunlight [1].

In terms of menopause, studies have linked vitamin D deficiency to low mood, meaning that it is important that menopausal women are meeting their daily requirements to prevent exacerbation of low mood symptoms that can be experienced by some women during perimenopause [2].

Vitamin B12

Vitamin B12 is used in the body to make red blood cells, release energy from food, and to maintain nervous system health.

Food sources of vitamin B12 include meat, fish, milk, cheese, eggs, and some fortified foods. The recommended daily intake of B12 is around 1.5mcg per day. You should be able to get the B12 that you need from your diet, however there are some considerations.

If you are vegan, or a vegetarian who does not eat eggs and/or dairy, you are more at risk of vitamin B12 deficiency as B12 does not occur naturally in fruit and vegetables. In this case you should aim to consume B12 fortified foods, such as breakfast cereals or soy milk, or take a daily vitamin B12 supplement containing around 1.5mcg [3].

Some studies show that low vitamin B12 concentration in menopausal women is associated with cognitive dysfunction and cognitive decline [4].

Vitamin B Complex

Vitamin B Complexes are a popular supplement made up of numerous vitamins:

  • Thiamine (vitamin B1) – to help the body break down and release energy from food and maintain nervous system health. Found in peas, bananas, oranges, nuts, wholegrain bread, and fortified foods
  • Riboflavin (vitamin B2) – to help the body to release energy from food and maintain skin, eye, and nervous system health. Found in milk, eggs, mushrooms, plain yoghurt, and fortified foods
  • Niacin (vitamin B3) – to help the body release energy from food and maintain skin and nervous system health. Found in meat, fish, wheat flour, and eggs 
  • Pantothenic acid (vitamin B5) – to help the body to release energy from food. Food sources include meat, eggs, mushroom, and avocado
  • Pyridoxine (vitamin B6) – to help the body to use and store energy from protein and carbohydrates, and the formation of haemoglobin. Found in meat, fish, peanuts, soya beans, oats, bananas, and milk
  • Biotin – to help the body make fatty acids. Sources include egg yolk, nuts, soya beans, cauliflower, wholegrains, and bananas
  • Folic acid – to help the body form red blood cells. Foods include broccoli, brussels sprouts, leafy green vegetables, peas, chickpeas, and liver
  • Vitamin B12 – to make red blood cells, maintain nervous system health, and release energy from food – found in meat, fish, milk, cheese, eggs, and fortified foods [5]

Low B-vitamin concentrations have been found to be associated with cognitive weakening and dementia in menopause and old age. Low folate, vitamin B12, and vitamin B6 concentrations were also associated with low bone mineral density, increasing fracture risk in menopause.

However, adequate intake of B-vitamins can be achieved through diet and introduction on B-vitamin foods in the diet should be considered before supplementation [6]

Vitamin C

Vitamin C is used to help protect cells, encourage wound healing and to maintain healthy skin, blood vessels, bones, and cartilage.

It is found in many foods including citrus fruit, peppers, strawberries, broccoli, brussels sprouts, and potatoes. The recommended intake for vitamin C is 40mg per day.

You can get the vitamin C you need from a balanced diet; however, it can’t be stored in the body, so it is important to consume vitamin C containing foods every day.

Taking too much vitamin C can cause stomach pain, diarrhoea, and flatulence so supplements are not recommended if you are getting enough vitamin C from your diet [7].

Magnesium

Magnesium is a mineral that helps to convert food into energy and to maintain parathyroid gland function, which releases hormones to promote bone health.

Low magnesium levels have been shown to be associated with low bone density both in pre and postmenopausal women [8].

Magnesium is found in foods such as spinach, nuts, and wholemeal bread, and the recommended daily intake is 270mg a day for women.

You should be able to meet your daily requirements by following a varied, balanced diet. It is important to note that taking high doses of magnesium supplements can cause diarrhoea [9].

Calcium

Calcium is used to help build healthy teeth and bones, regulate muscle contractions, and promote normal blood clotting. It is especially important in menopause as during menopause women are more at risk of developing osteoporosis [10].

Sources of dietary calcium include dairy products, green leafy vegetables, fortified plant-based milk substitutes, bread made with fortified flour, and sardines.

The recommended daily intake of calcium for post-menopausal women is 1200mg per day. You should be able to meet this recommendation by incorporating 3-4 calcium-rich foods into your diet each day.

Taking excessive calcium supplements can cause problems such as stomach pain and diarrhoea [11].

Zinc

Zinc is used for helping make cells and enzymes, processing macronutrients, and wound healing.

Sources of zinc include meat, shellfish, dairy foods, bread, and cereal products.

The recommended intake of zinc is 7mg per day. This recommendation should be able to be met by diet. Too much zinc can reduce the absorption of copper in the body, which can lead to anaemia and weakening of the bones [12].

Omega-3

Omega-3 fats are ‘essential’ fatty acids that can’t be made by the body in sufficient amounts. They help to prevent blood clots and promote heart health.

Heart health is important for menopausal women due to the increased risk of cardiovascular disease.

Foods containing omega-3 include oily fish, and plant foods like rapeseed, soya, flaxseed, linseed, and walnuts.

There is no specific recommendation for omega-3. However, you should aim to eat at least 2 portions of fish a week, including 1 oily fish, or ensure you are including plant-based omega-3 sources in your diet.

You may choose to take an omega-3 supplement, such as fish liver oil, however it is important to note that these supplements are often high in vitamin A, a vitamin that is stored in the liver and can cause liver damage if too much is ingested over time [13]

Learn more about specific vitamins and their role in menopause in our blogs:

Nutrition and Menopause

Nutrition and Menopause Symptoms

Bone Health and Menopause

Summary

Eating a healthy, well balanced varied diet should ensure you are meeting your vitamin and minerals during the menopausal. The only nutrient where needs increase post-menopause is calcium.

The use of supplements may not be necessary if you are eating a healthy, well balanced diet and varied diet. If you would like advice about whether you require dietary supplements, please book in for a FREE 15 MINUTE introductory call where we can discuss how I can help you.

Caroline Hill, Dietitian and owner of Caroline Hill Nutrition
Caroline Hill, Dietitian and owner of Caroline Hill Nutrition

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