I used to proudly avoid health supplements. Doctors always said that if you eat a healthy diet, you’re just wasting your money. Studies found that people who took multivitamins didn’t live any longer, and some even died a bit younger—one study last year showed a 4% higher risk of death. But now that I’m clearly past my youth, I’ve started taking four supplements a day: vitamin D (as recommended by the NHS), magnesium (for sleep, muscle relaxation, brain function, and stress—I think it’s helping), lion’s mane mushroom (for cognition—not sure if it’s working), and biotin (for hair health—also unsure). I’m even thinking about adding more if I can afford them. But am I being foolish? Do women really need to start taking supplements when they reach middle age?
“There are many reasons we might need supplements as we get older,” says Claire Pettitt, a women’s health dietitian working in the UK and Singapore. “It’s not a sudden, drastic change, like needing an IV drip,” she explains. “But as we age, our bodies don’t function as well, and we become less efficient at absorbing certain nutrients, like vitamin B12 and calcium.”
Hormonal changes are another good reason to take supplements, she adds, because declining estrogen “affects many parts of the body, including bone health, metabolism, cardiovascular disease risk, and muscle mass. Certain nutrients can help reduce these risks.” However, she cautions, “There’s no one-size-fits-all rule. Just because you’re entering perimenopause doesn’t mean you’ll be deficient in everything.”
Before turning to supplements, it’s important to honestly assess your eating habits. “We might have poor diets, especially in middle age when we’re busy caring for others and not prioritizing ourselves,” says Pettitt. Social pressures about body image and diet often lead to extreme measures, like replacing meals with trendy green smoothies or cutting out dairy. “Sometimes fad diets result in an unbalanced diet.”
Another key factor is getting enough protein, according to Nichola Ludlam-Raine, a specialist dietitian and author of How Not to Eat Ultra-Processed. She recommends “about 1.6 grams per kilogram of ideal body weight per day, spread throughout the day.” (Ideal body weight refers to a weight with a BMI between 18 and 25.) If you’re very active, up to 2 grams per kilogram is beneficial, she says, “along with resistance training two to three times a week to maintain bone health and muscle mass.”
Getting enough fiber is also essential, she notes, “because a healthy gut supports nearly every bodily function, from immunity to mood.” It also helps your gut microbes digest food and produce more nutrients—like having your own internal supplement factory.
How to spot deficiencies
Our bodies usually signal when something is missing. “I think we’ve lost the skill of listening to our bodies because we’re too busy,” says Pettitt. “Pay attention to changes, like fatigue, muscle weakness, or hair loss, which could indicate various micronutrient deficiencies.”
Your lifestyle, medications, and diet can also offer clues. “If you’re vegan, you might need a B12 supplement,” says Ludlam-Raine. “Or if you’re on a proton pump inhibitor [for reducing stomach acid] or metformin [for type 2 diabetes], these can affect nutrient absorption.”Switching to organic plant-based milks can unintentionally lower your calcium intake, as they are often not fortified with calcium and iodine. Calcium is vital for bone health, and iodine supports thyroid function. For menopausal women, it’s advisable to choose dairy products, fermented options like kefir, or fortified milk alternatives.
During perimenopause, heavier bleeding may lead to iron deficiency. It’s also important to consider digestive health issues, such as celiac disease, which can affect nutrient absorption. Serious deficiencies can typically be confirmed with a blood test, so consulting a dietitian or doctor for testing is recommended.
When it comes to supplements, vitamin D is commonly needed for bone health, immunity, muscles, and hormones. It’s generally advised to take it in autumn and winter, but if you have darker skin, use high SPF, or cover up outdoors, consider taking it year-round. A daily dose of at least 10mcg (400IU) of vitamin D3 is effective, and store brands are sufficient.
Magnesium is another supplement that’s gained attention for its role in muscle relaxation, nerve function, brain health, sleep, and stress relief. However, if your diet includes whole grains, nuts, avocado, and black beans, you may not need it. Assess your baseline lifestyle and make dietary changes first to see if they help. If you decide to try supplements, monitor your symptoms to gauge their effect.
It’s best to introduce supplements one at a time for four to six weeks, or even three months, to observe any changes, as improvements in areas like mental health won’t happen overnight.
If you don’t consume oily fish at least weekly, consider omega-3 supplements for their anti-inflammatory properties, which support cardiovascular, brain, and joint health. Look for brands that are third-party tested to ensure they contain adequate EPA and DHA.
Be cautious of terms like “food grown” or “micronised” on supplement labels, as they can be misleading without standardized definitions and may not guarantee better absorption.She explains that whole foods, as opposed to synthetic or isolated nutrients, may be better absorbed or more bioavailable because they include natural cofactors like enzymes and phytonutrients. However, she notes that this isn’t always the case, and some so-called “food grown” supplements are highly processed and not necessarily easier to absorb. Similarly, “micronised” is often more of a marketing term than a scientifically proven claim. The aim is to increase nutrient bioavailability, but whether it actually improves absorption or effectiveness is often unclear or not well-supported by evidence.
Ludlam-Raine agrees, stating that for most people, the focus should be on taking the right nutrient in the right dose for their individual needs. She advises prioritizing nutrients from food whenever possible and using supplements as a backup or safety net. Paying extra for “micronised” or “food-grown” versions is usually unnecessary.
Fibre powders and probiotics have gained popularity as health advice shifts toward gut health, but Pettitt believes we should aim to include these in our diets through food. She points out that fiber-rich foods offer additional benefits, such as micronutrients, antioxidants, anti-inflammatories, and phytochemicals. Most people should simply eat more fruits and vegetables.
Ludlam-Raine takes a probiotic when she remembers, in addition to consuming naturally probiotic fermented foods. She predicts that the UK may one day recommend daily servings of fermented foods, similar to the “five-a-day” guideline. Examples include kimchi, sauerkraut, miso, and natural yogurts, with kefir being particularly versatile for meals or snacks.
Pettitt notes that collagen is currently trendy, with most evidence supporting its benefits for joint and bone health, especially during perimenopause and aging. It’s also being promoted for brain health, though she says there’s less evidence for that. She suggests trying it to see if it helps. Ludlam-Raine, approaching 40, takes it for skin health and considers it safe with a slight protein boost.
Ludlam-Raine often works with bariatric surgery patients who experience hair thinning, which can also result from dropping estrogen levels in perimenopause. Biotin is a popular supplement for this, but she only recommends it if a deficiency is confirmed by a blood test. She encourages a food-first approach with sources like eggs, salmon, nuts, seeds, sweet potatoes, legumes, mushrooms, and avocados. Since biotin is water-soluble and not stored in the body, she doesn’t oppose trying the supplement, but advises stopping it three days before blood tests to avoid skewed results.
Regarding lion’s mane mushroom capsules, Ludlam-Raine mentions that while animal trials show potential for improved cognition and nerve regeneration, large-scale human studies are lacking. She says it’s harmless if you have a good diet and if it makes you feel good, but it shouldn’t replace recommended treatments like HRT for brain fog.
Ludlam-Raine adds that creatine is gaining popularity beyond the gym, where it’s known for fueling muscles, and it’s one of the most researched supplements.The benefits of creatine for brain health and cognitive function are attracting increasing attention. Unless you have kidney issues—in which case you should consult your doctor—taking three to five grams daily is considered safe. One expert suggests trying it for four weeks to see if it helps, even if you aren’t technically deficient. She explains that our bodies use up creatine stores, particularly during exercise, and research indicates that supplementation can offer additional benefits, even for those with a balanced diet.
Many vitamins and micronutrients are now available in tasty gummy forms, which may encourage regular use. However, as Ludlam-Raine points out, the sugar content in these chewables can accumulate. It’s important to check the ingredients and serving size, as consuming several gummies might be comparable to eating half a pack of fruit candies.
When it comes to supplements, it’s tempting to think that more is better, but this isn’t always the case. Despite the availability of high-dose products, it’s possible to overconsume certain supplements like iron, vitamin A, vitamin D, and magnesium. Always stick to the recommended amounts.
Ludlam-Raine emphasizes that pharmacists are an underused resource. If you have existing health conditions or take other medications or supplements, consult a pharmacist to check for potential interactions.
Pettitt warns against viewing supplements as a quick fix. Making significant lifestyle changes—like reducing job stress or addressing relationship issues—takes time and effort, whereas buying a supplement can feel like an immediate solution for problems like poor sleep or stress.
Ludlam-Raine adds that people who feel consistently unwell may be swayed by marketing rather than evidence. She advises focusing on the fundamental pillars of health: diet, physical activity, stress management, sleep, and social connections. Getting these basics right should come before considering supplements.
Frequently Asked Questions
Of course Here is a list of helpful and clear FAQs about vitamin supplements for women in midlife
Beginner Foundational Questions
1 Why is midlife a time when women might need to think about supplements
During perimenopause and menopause hormonal changes can affect how your body absorbs and uses nutrients Your needs for certain vitamins and minerals can increase making supplements a helpful way to fill nutritional gaps
2 What are the most common nutrient deficiencies for women in midlife
The most common deficiencies are in Calcium Vitamin D Vitamin B12 Iron and Magnesium
3 Cant I get everything I need from a healthy diet
A balanced diet is the best foundation However factors like decreased absorption dietary restrictions or specific health concerns can make it difficult to get optimal levels of certain nutrients from food alone
4 Whats the most important supplement to start with
For most women Vitamin D is a top priority Its crucial for bone health mood and immune function and its very hard to get enough from food alone
Questions About Specific Supplements
5 Why is Calcium so important and how much do I need
Calcium is vital for maintaining strong bones and preventing osteoporosis as estrogen levels decline Women over 50 generally need about 1200 mg per day Its best to get it from food and supplement only if you fall short
6 Ive heard about Vitamin D and Calcium together Why is that
Your body needs Vitamin D to properly absorb Calcium Taking them together ensures you get the full bonestrengthening benefit Many calcium supplements already include Vitamin D
7 What does Magnesium do for women in midlife
Magnesium is a multitasker It can help with common issues like improving sleep quality reducing muscle cramps relieving headaches and supporting bone health
8 Should I be taking Iron
It depends If you are still having regular periods you may need an iron supplement to replace what is lost monthly After menopause iron needs drop significantly and you should not supplement unless a blood test confirms a deficiency
9 What about B Vitamins especially B12
B12 is essential for energy and brain function As we age our
