Vitamin supplements during menopause: What should you take, and how much?

May 5, 2011 at 4:53 pm in Healthy Living by Holly Thacker, M.D.

Popping a pill that includes the nutrients of every woman-friendly food is far more convenient (and maybe more appealing) than filling up on spinach, salmon, antioxidant-rich berries, and other power foods.

But a colorful plate is the sign of a nutritious meal. If you fill your plate with food that is green, red (antioxidants), brown (grains), and blue (low-fat dairy), you’re well on your way.

We women need an extra boost in the calcium and iron departments. Meanwhile, avoiding trans fats becomes even more important to us at once we’re monitoring our cholesterol and taking preventive measures to reduce the risk of cancer and other diseases. And because our metabolic rate slows, portion control has never been so critical!

I recently posted about what B vitamins can do for a woman’s menopausal body – especially when it comes to easing early menopause symptoms. Here’s what you need to know about calcium, vitamin D3, vitamin C, and iron.

Eat or drink three to four servings of low-fat dairy products and calcium-rich foods a day. Find calcium in dairy, fish with bones (sardines and canned salmon), broccoli, and legumes like peas or beans. But don’t rely on foods to fulfill your daily calcium requirement. Most women simply do not get enough calcium from their diet. Others are lactose intolerant and avoid dairy products. Unless you drink a quart of skim milk daily (and I’m guessing you don’t), take a calcium supplement to reach the recommended daily amount of 1,200 mg. (Most women ingest only 600 mg daily—half the amount they need.) Women older than age 55 who are not on estrogen absorb less calcium from their diet, so they need to ingest 1,500 mg of calcium daily.

Calcium supplements come in two forms: calcium carbonate and calcium citrate. Calcium citrate is acid-based, and calcium carbonate is alkaline-based. Both types are effective.

I recommend calcium citrate. One reason is simple convenience. You can take it with or without food, whereas calcium carbonate should be taken with food to improve absorption. Also, calcium citrate absorbs into your system better than calcium carbonate does, and it has not been associated with a higher risk of kidney stones. However, calcium citrate costs more than calcium carbonate, so if budget is an issue, feel free to take calcium carbonate and know that it works well.

Vitamin D3 (Cholecalciferol)—the Supplement of the Century!
Calcium builds strong bones, but it isn’t absorbed well without vitamin D. All women need to get enough vitamin D; in northern climates with less sun exposure, this can be especially hard to do. If you follow the Reference Daily Intake (RDI) and take only 400 IU, you’re only getting enough vitamin D to prevent rickets. (RDI is the new term for RDA, Recommended Dietary Allowance.) Most bone experts recommend 1,000 IU of vitamin D daily. People who have been low in vitamin D need at least 2,000 IU of vitamin D3 daily.

Getting enough vitamin D has been associated with reduced risks for breast, colon, pancreas, and prostate cancer, as well as diabetes, arthritis, osteoporosis, multiple sclerosis, and falls. Far too many people are deficient in vitamin D. Your vitamin D level should be over 31 and closer to 50 and up to 100 is fine. Lifeguards in the summer have levels around 150! The results of 25-OH vitamin D levels for most of the women I test are well below these levels.

Iron and Vitamin C
Women lose 15 to 20 mg of iron each month during menstruation. Even if you are past having periods, iron is still vital. The RDI is 18 mg up to age 50 and 10 mg after that. Too much iron can cause problems with iron overload, and a small percentage of people absorb too much iron and have hemochromatosis (a buildup of iron in the liver that can lead to liver enlargement). Once menstruation ceases, the extra iron in “women’s formulation” vitamins is usually no longer needed. Most women absorb only 15 percent of the iron in their regular diet. If you eat some vitamin C with iron-bearing food, the amount you absorb will increase. Iron is abundant in such foods as lean red meat, potatoes, leafy green vegetables, iron-fortified cereals, and blackstrap molasses.

What vitamin supplements do you take now?

Dr. Holly Thacker is a menopause health specialist and the author of the Vibrant Nation health guide, Recognizing and Treating Menopause Symptoms: A 50+ woman’s guide to managing hot flashes, weight gain, mood swings, depression, vaginal dryness, night sweats and other menopause symptoms. Click to learn more about Holly’s book.

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