Once you hit your 60s, you can’t absorb certain nutrients as efficiently, your estrogen levels are lower than they once were, your muscles may be decreasing, and your stomach acid has most likely decreased, so you can’t break down food as effectively as you could when you were younger.
While supplements can help with some of these changes, there’s only so much a vitamin can do, and unfortunately for you, the vitamin aisle is designed to capitalize on your confusion.
So we’re here to clear things up. Below you’ll find nine supplements (three of which aren’t technically vitamins!) that are backed by science for women in their 60s. We’ve ranked them in order of how much evidence there is behind each one, included the amount the government recommends women over 50 take, and given you the study/research we used to make this list (and who it doesn’t apply to).
A note before you hit the aisles: Some of these interact with medications, and the ideal dose of two of them depends on a blood test, so take this list to your doctor or pharmacist before you take it to the pharmacy.
Bonus reason to include fiber, protein, and creatine on the list: There’s more evidence behind them for your 60s than pretty much any vitamin, so any list that doesn’t include them was most likely created by the vitamin industry, not with your health in mind.
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1. Vitamin D3
Ask for a 25-hydroxyvitamin D test. If it’s low, ask your doctor about vitamin D supplements. Follow your doctor’s advice on dosing, but in general the NIH recommends 600 IU (international units) per day for adults up to age 70 and 800 IU a day for those over 70.
Don’t take more than 4,000 IU a day from all sources (supplements, fortified foods and natural sources) unless you’re working with your doctor to address a vitamin D deficiency. Although most vitamin D toxicity results from taking too many supplements, you can’t overdose on vitamin D from the sun, as your skin limits how much it makes.
Too much vitamin D can cause nausea, confusion, kidney stones and other health problems. Vitamin D helps the body absorb calcium, and taking the two together, according to the NIH, slightly increases bone strength in older adults. But it is not clear that the supplements reduce falls or fractures, according to the NIH fact sheet.
In the largest study of vitamin D and fractures, 25,871 people who weren’t chosen for low vitamin D or weak bones took 2,000 IU a day or a placebo for a median of 5.3 years. Those who took vitamin D weren’t less likely to suffer fractures (769 vitamin D supplement users broke a bone, compared with 782 placebo users). That held true even among study participants who initially had lower vitamin D levels.
2. Calcium, in Small Doses
After menopause the body can’t absorb as much calcium and hold on to it as efficiently, so the recommended amount of calcium increases. For women ages 51 to 70, the daily recommended amount of calcium is 1,200 milligrams (mg) versus 1,000 mg for men in the same age group.
No matter what form of calcium you take, don’t exceed 2,000 mg from all sources. It’s easy to hit that amount if you eat a diet full of calcium-rich foods and take a calcium pill. Read labels carefully.
Calcium is best absorbed in doses of 500 mg or less. Rather than take a single 1,200-mg calcium pill, it’s better to split that amount up over the course of the day with meals. There are different types of calcium.
Calcium carbonate is the least expensive type and is the kind found in many antacids. It has to be taken with food because it needs stomach acid for absorption. Calcium citrate can be taken with or without food. It’s best for people who have a hard time absorbing calcium because of low stomach acid, which is a condition that’s most common in older people, says the NIH.
Calcium can interfere with absorption of certain medications if they’re taken at the same time. Talk to your pharmacist about this problem and how to time your medications and supplements. In most cases, it’s recommended to space them out by a few hours.
Don’t automatically assume you need a calcium supplement. If you’re eating calcium-rich foods daily (say, a cup of yogurt, a glass of milk and some leafy greens), you may need only a few hundred milligrams from a supplement, or you may not need any at all.
3. Vitamin B12
If you’re on metformin (which can interfere with B12 absorption, potentially leading to deficiency) or a medication to control acid production in the stomach, such as omeprazole, lansoprazole, cimetidine or ranitidine (these can prevent the release of the stomach acid needed to separate B12 from the food it’s bound to), consider asking your doctor to include a B12 level in your next blood panel.
In the meantime, consider taking a daily B12 supplement. Of all the nutrients on this list, vitamin B12 is the clearest case for a supplement after 60. B12 in food is bound to protein and requires stomach acid to separate the B12 from the protein.
As we age, some of us don’t produce enough stomach acid to accomplish this task. The NIH reports that anywhere from 3 to 43 percent of older adults may be deficient in B12 (there’s such a wide range because different studies use different ways to measure B12 deficiency).
Their advice is uncharacteristically unequivocal: They suggest that people over 50 get most of their B12 from fortified foods or a supplement, because these forms are more readily absorbed.
The recommended amount of B12 is a mere 2.4 micrograms a day, but you’ll typically see supplements offering 500 or 1,000 micrograms. That’s because only a small percentage of large oral doses are absorbed, so this is the amount necessary to ensure that you get a few micrograms into your system.
Unlike other supplements, there’s little evidence that B12 can be harmful in high doses, making this one of the few supplements where it makes sense to err on the side of too much.
4. Magnesium
It helps regulate muscles and nerves, and plays a role in controlling blood pressure and blood sugar, but many Americans fall short of it. In a 2012 review of national intake data, 48 percent of the U.S. population was found to be getting less than the recommended amount of magnesium from food in 2005 and 2006. (Adult women should get 310 to 320 milligrams a day.)
There is no upper limit on how much magnesium you can get from food and water, and too much from those sources won’t hurt you. But for adults, there is an upper limit of 350 milligrams a day of magnesium from medications and supplements. Taking more than that can lead to nausea, diarrhea and cramping, and very high levels can affect your heart rhythm.
(Magnesium oxide, the least expensive version, is most likely to result in a trip to the bathroom, while most products containing citrate or glycinate targeted at improving sleep come in at or below that upper limit.) If you want to up your intake, here’s what to do: Eat more magnesium-rich foods (nuts, seeds, beans, whole grains and leafy green vegetables are good sources) and consider taking a supplement, but don’t megadose.
If you don’t eat a lot of the aforementioned foods, try taking a magnesium supplement of about 200 milligrams. (And talk to a pharmacist first, since magnesium can affect the way your body absorbs certain medications.)
5. Omega-3s, Mainly From Fish
Omega-3s made it onto our list of supplements for women over 60, but the actual evidence is more nuanced than you might expect. In the large VITAL trial, 25,871 men and women (all men were over 50 and all women over 55) took a daily supplement with one gram of marine omega-3 fats (or placebo) for a median of 5.3 years.
The trial’s main endpoint was major cardiovascular events, which occurred in 386 of the omega-3 users and 419 of those on placebo, a non-significant difference. Cancer rates didn’t change either. But here’s the rub: The number of heart attacks was 28 percent lower in the omega-3 group (that’s the statistic omega-3 marketers like to cite).
Overall, though, omega-3s were not shown to prevent major cardiovascular events, and that’s why the American Heart Association advises most people to just eat one to two servings of seafood per week. (The association does recommend about a gram of EPA and DHA per day, preferably from oily fish, for people who do have heart disease, but not for those who don’t have an increased risk for cardiovascular disease.)
Plant omega-3s in foods like walnuts and flaxseed can’t be substituted for the omega-3s in fish because your body only makes tiny amounts of EPA and DHA from plant omega-3s. If you don’t eat fish, an omega-3 supplement is the only way to boost your intake of EPA and DHA. It’s just important to know what it won’t do.
For example, in a large recent trial, people with dry eye who took 2,000 milligrams of EPA plus 1,000 of DHA daily for a year did no better than those on placebo. And know that omega-3s in high doses may increase your risk of bleeding if you take warfarin or other blood thinners.
For most women, the issue comes down to this: If you don’t mind eating fish twice a week, go ahead and enjoy those omega-3s. Otherwise, a supplement is your best bet.
6. A Protein Powder
If you have severe kidney disease (but are not on dialysis), ask your nephrologist how much protein is right for you, as for you, the goal may be to avoid too much, not too little. But for just about everyone else, this is the supplement most likely to make a difference in how well you move in ten years: a scoop of protein powder, preferably stirred into a breakfast food such as yogurt or oatmeal.
In 2013, an international panel of experts brought together by the European geriatrics society reviewed the data on protein in older adults and concluded that we need more protein than younger adults do, because our digestive tracts use up more of it and our muscles have less of a response to it meal by meal.
They recommended 1.0 to 1.2 grams of protein per kilogram of body weight for people over 65, and at least 1.2 if you’re working out regularly, versus the 0.8 that’s recommended for adults in general.
That’s more protein than most people over 65 are getting, particularly at breakfast. For a 150-pound woman, it means getting 68 to 82 grams of protein a day. A typical scoop of protein powder (whey or pea protein are common) contains somewhere in the neighborhood of 20 to 25 grams, according to the nutrition facts label.
(It varies by brand.) Muscle loss in later life predicts falls, disability and even mortality, so it pays to do what you can to prevent it. Protein powder, available in the sports section of your grocery store, is the easiest way to get more protein in your diet.
7. Creatine, If You Lift
There’s one supplement that has been shown to help older adults build muscle, and it’s not new. It’s been around for decades, and is most associated with young bodybuilders, but studies in older adults suggest it might be more of a geriatric supplement: creatine.
Creatine on its own won’t build muscle, but it can help an older woman who lifts weights gain a little more muscle than she would have without it. Here’s why that’s a big deal at a certain age: Every workout matters.
A 2017 meta-analysis of 22 randomized trials with a total of 721 participants (with average ages ranging from 57 to 70 years) found that when all the participants exercised with weights two or three days a week for anywhere from seven weeks to a year, and half of them took creatine while half took a placebo, those who took creatine built up an average of 1.37 kilograms (or three pounds) more lean tissue, and saw greater increases in strength on the leg press and chest press.
In an update on the evidence in 2021, researchers found the gains held whether people loaded creatine or just took a daily dose (five grams or less), and that taking creatine only on training days was still superior to placebo for gaining lean mass and strength. The best kind of creatine to buy, is plain old creatine monohydrate powder. It’s inexpensive and flavorless.
Take it mixed in a glass of water or your coffee, on a daily basis (or only on the days you train, if that will be easier for you to remember). Three to five grams a day is the usual dose. Creatine won’t work its muscle-building magic if you don’t lift weights, of course. If you’re not already strength training, start there, and save the creatine for month two.
8. Psyllium Fiber
Cholesterol control and regularity can both become a bit trickier to maintain after 60, which is why it’s a shame that only about 5 percent of Americans are consuming the amount of fiber recommended by the Dietary Guidelines for Americans.
Those guidelines suggest 14 grams of fiber for every 1,000 calories you eat, which works out to about 22 grams a day if you’re eating 1,600 calories, the number the guidelines suggest for women over 50 who aren’t very active.
The best-studied form of supplemental fiber is psyllium husk, which is the main ingredient in Metamucil and the store brands sitting next to it on the pharmacy shelf.
In a 2018 review of 28 randomized trials involving a total of 1,924 people, researchers found that a median dose of about 10 grams a day led to a modest improvement in LDL cholesterol (a decrease of 0.33 millimoles per liter, or about 13 milligrams per deciliter, to be precise) in people with and without high cholesterol.
They also saw improvements in apolipoprotein B and non-HDL cholesterol, two other measurements cardiologists are increasingly fond of. If you’re thinking of supplementing, start with just one 10-gram dose (two rounded teaspoons of powder mixed with a full glass of water, that’s not optional) a day for a week before working up to two.
Otherwise, you’re likely to quit when you hit that bumpy third day, complete with bloating. And while taking psyllium with meals can help blunt cholesterol, take it a couple of hours before or after any of your other medications, as it can slow their absorption.
9. Lutein and Zeaxanthin, for Eyes That Already Show Changes
Lutein and zeaxanthin are yellow pigments that accumulate in the retina. The AREDS2 study looked at whether they slowed the progression of age-related macular degeneration, which is the leading cause of vision loss in people over age 60. Over five years in a study of 4,203 people aged 50 to 85 with early changes of macular degeneration, 29 percent of eyes given 10 milligrams of lutein plus 2 milligrams of zeaxanthin progressed to advanced disease, compared with 31 percent given a placebo, which was not a significant difference.
(All participants received the antioxidant formula from the original AREDS study.) In a ten-year follow-up analysis of 3,882 people, lutein plus zeaxanthin were associated with a 9 percent lower risk of late macular degeneration compared with not receiving them and a 15 percent lower risk compared with beta-carotene.
AREDS2 also studied whether fish oil supplements slowed the progression of macular degeneration. They didn’t.
(AREDS2 swapped in lutein and zeaxanthin for beta-carotene, which in AREDS2 was associated with higher rates of lung cancer, mostly in former smokers.) What does this mean for you? If your eye doctor has diagnosed you with intermediate macular degeneration, you can consider an AREDS2 formulation (with lutein and zeaxanthin, and without beta-carotene) because it is one of the few supplements with a clinical trial to back it up.
Otherwise, eat your kale, spinach and eggs rather than taking these as supplements. And get your eyes checked every year or two.
The Nine at a Glance
What About a Daily Multivitamin?
Multivitamins narrowly missed our list of nine, and for women over 60 they are a supplement you should probably continue if you already take one. The most compelling recent evidence comes from COSMOS-Mind, a three-year randomized trial in 2,262 older adults, which included an annual battery of cognitive tests by telephone.
Daily multivitamin use did not reduce the risk of developing dementia or mild cognitive impairment, although the study was underpowered to exclude some effect. However, among those who developed mild cognitive impairment, participants taking a multivitamin performed better on tests of cognition overall and in the domain of planning and had experienced less cognitive decline over the prior year.
Multivitamins also rarely contain enough calcium, vitamin D or magnesium to meet the recommended amounts above, so they’re no substitute for those recommendations. Think of a multivitamin as insurance for those days when your diet isn’t so great. If you’ve ever smoked, avoid supplements with beta-carotene.
Before You Buy Any of Them
Three of the nine supplements in question should be based on your blood levels. Vitamin D and B12 testing are so commonplace that you should just add them to your yearly blood panel. Many women should also get their magnesium level tested. Make sure your doctor gives you the actual level instead of simply interpreting it as high or low, because your needs may vary depending on your individual circumstances.
Some supplements interfere with the absorption of certain drugs (e.g., calcium inhibits the absorption of some drugs, psyllium fiber slows the absorption of others), and some have effects that overlap with certain medications (e.g., omega-3 fatty acids at high doses add to the bleeding risk of blood thinners like warfarin; metformin and acid-reducing drugs decrease B12 levels).
Rather than avoid supplementation in these cases, just ask your pharmacist (most will put this schedule together for you for free) to help you figure out a schedule that avoids drug-supplement interactions. Buy boring.
Buy psyllium husk fiber, calcium citrate, creatine monohydrate, cyanocobalamin or methylcobalamin forms of vitamin B12, and vitamin D3 (in a dose appropriate to your vitamin D level) from a reputable brand that’s been tested by a third-party organization and bears that organization’s seal of approval.
You’ll save money, and you’ll still get all of the benefits (the fancy products are the same boring compounds, just packaged to look nicer and cost more).
Kaelyn Johnson is a Registered Dietitian from Southern California who has worked as a clinical dietitian and is now a freelance writer.
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