Author: Dr Sarah Brewer Medical Nutritionist - (Nutr Med), MA (Cantab), MB, BChir, RNutr, MBANT, CNHC, FRSM Category: Health, Menopause, Supplements & Vitamins
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Dr Sarah Brewer explains the essential vitamins we need for midlife and the menopause

While diet should always come first, some vitamin supplements provide benefits in later life. Vitamin deficiencies are relatively common, especially if you are eating less to lose weight, have a reduced appetite or are avoiding certain foods due to intolerances. According to the National Diet and Nutrition Surveys, for example, average intakes of many key nutrients is below the nutrient reference value for women aged 19 to 65 years, including vitamins A, B2, C, D and E.

Vitamin A

Vitamin A is a collective term for a variety of powerful antioxidants, known as retinoids, which are mainly found in animal-based foods. Plant forms of vitamin A are pigments known as carotenoids, of which you can convert some (eg betacarotene) into retinoids if your levels are low.

Vitamin A helps to regulate the activation of genes and is vital for the production of numerous proteins, including enzymes, hormones and growth factors. This makes it particularly important for healthy skin, healing and sexual health as well as for vision.

Lack of vitamin A can affect your ability to see in dim light, and is associated with dry, scaly skin with raised, pimply hair follicles and dry, burning, itchy eyes as well as flaking scalp and brittle, dull hair.

Vitamin A derivatives are used medicinally, on prescription, to treat severe acne, psoriasis and sun damage (photoageing) including wrinkles.

B vitamins

The B group of vitamins are essential for energy production in cells, and are used to help reduce tiredness and fatigue, improve brain and nervous system function, aid memory, support immunity, maintain normal heart health and red blood cell formation.

There is some evidence that they reduce risk of heart attacks, stroke and dementia by lowering homocysteine levels.

Vitamin B1 plays a central role in metabolism and the way nerves and muscle cells conduct messages. It is essential for the production of energy from glucose and also helps to maintain feelings of calm, alertness and mental energy.

Vitamin B2 is also involved in the production of energy and the metabolism of proteins, fats and carbohydrate. It also acts as an antioxidant, is involved in immunity and the production of antibodies and in the formation of healthy hair, skin and nails.

Vitamin B3 is needed to release energy from muscle starch stores (glycogen) and to process fatty acids released from body fat stores. It also helps to maintain healthy skin, nerves, intestines and thought processes.

Vitamin B5 is vital for many energy producing reactions in the body involving carbohydrates, fats and protein. It is also needed by the adrenal glands and to maintain a healthy nervous system.

Vitamin B5 stimulates cell growth in healing tissues, helps to rejuvenate ageing skin and to reduce skin mottling. It is added to many hair care products as pantothenate to promote the growth of strong, healthy hair.

Vitamin B6 is needed for over 100 enzymes to work properly, and is involved in the synthesis of DNA, amino acids, proteins, brain chemicals and for metabolising carbohydrates and essential fatty acids.

Vitamin B7 – biotin – is involved in making and metabolising fatty acids, amino acids, genetic material, stress hormones and energy storage molecules. It is also essential for healthy hair, nails and skin.

Folate and the better absorbed synthetic form, folic acid, are especially needed by rapidly dividing cells such as those within hair follicles, the skin and bone marrow. When folic acid is in short supply, dividing cells become larger than usual and, when red blood cells are affected, a form of anaemia can result. Folic acid is also important during early pregnancy to help prevent certain birth defects such as spina bifida.

Vitamin B12 is essential for the synthesis of DNA during cell division, healthy nerve function, immunity and healing. To absorb vitamin B12 we need a special substance (intrinsic factor) whose production decreases with age. Vitamin B12 deficiency is relatively common, in the UK affecting around 6% of those under 60 years and up to 20% of those over 60 years. As B12 is mainly obtained from animal-based foods, people who follow a vegan or vegetarian diet are also at risk of deficiency. Lack of vitamin B12 can lead to pernicious anaemia.

Vitamin C

Vitamin C is an important antioxidant that is also needed for at least 300 metabolic reactions to proceed normally. It is essential for the production of collagen to maintain healthy skin and is also involved in the metabolism of stress hormones and the regulation of immune reactions. Other roles include supporting the nervous system and psychological health, boosting iron absorption and reducing tiredness and fatigue.

Lack of vitamin C can lead to dry, rough, scaly skin with broken thread veins, easy bruising, dry lips, muscle and joint pain as well as weakness and fatigue.

As an antioxidant, vitamin C helps to reduce the ultraviolet-induced skin damage that can cause ageing skin to become increasingly thickened, yellow, scaly, mottled and wrinkled with a coarse, leathery texture. Vitamin C is now added to many cosmetic creams designed to slow the visible signs of skin ageing.

Vitamin D

While vitamin D is best known for its role in calcium absorption to maintain strong bones, it is also vital for immunity and for regulating mood. Deficiency can cause headache, loss of appetite, mental fatigue, low mood and irritability.

Vitamin D is now known to be essential for good immunity. For example, research involving 5,660 people showed that taking a vitamin D supplement can reduce the risk of experiencing a respiratory tract infection (including the common cold, influenza and pneumonia) by a third compared with placebo. The average vitamin D dose used was 40 mcg per day. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3686844

Older people need higher doses of vitamin D because it is absorbed less effectively from our food and because we make up to four-fold less in our skin on exposure to sunlight. I usually suggest a dose of 25mcg vitamin D per day for those under the age of 50, and 50mcg vitamin D per day for those over the age of 50.

In light of the recent COVID19 pandemic, a recent article in the Irish Medical Journal suggested that adults take 20mcg to 50mcg supplements per day to help reduce the severity of infection. https://tilda.tcd.ie/publications/reports/Covid19VitaminD/index.php and quoted in https://www.nutraingredients.com/Article/2020/04/07/Could-vitamin-D-play-a-role-in-coronavirus-resistance

Look for supplements supplying vitamin D3 which is more effective in maintaining vitamin D status than the plant form, vitamin D2.

Vitamin E

Vitamin E is a powerful antioxidant that protects body fats (including cell membranes) from going rancid, and helps to reduce premature ageing of nerves, arteries and skin.

Vitamin E is also important for immunity and antibody production. Vitamin E also has a strengthening effect on muscle fibres and is traditionally used to relieve muscle cramps.

Vitamin K2

Most vitamin K obtained from food is the plant version, vitamin K1, which is found in cauliflower, broccoli, lettuce and other dark green leaves. Less than 10% obtained from a typical diet is in the form of vitamin K2, which is found in liver, egg yolk, meats and fermented foods such as live yoghurt, cheese and natto.

While your liver uses vitamin K1 to make clotting proteins, other tissues such as your bones and arteries need the vitamin K2 form. Vitamin K2 activates proteins that transport calcium away from the arteries, so it is deposited in bones instead. So, as well as protecting against osteoporosis, vitamin K2 helps to guard against calcification of artery walls. While your tissues can convert some vitamin K1 to vitamin K2, your liver hoards vitamin K1 when it is short supply, so a supplement is a great idea for people in later life. I’ve certainly started taking it.

Ubiquinol

While not classed as a vitamin, the ubiquinol form of coenzyme Q10 is a vitamin-like substance that is often in short supply in later life. Ubiquinol is needed to process oxygen and generate energy in cells – especially heart cells. Ubiquinol is especially helpful if you feel lacking in energy, and if you are taking a statin drug which blocks the production of both cholesterol and coenzyme Q10 in the body. Cells that are lacking in coenzyme Q10 function less well, and deficiency has been linked with heart failure and with statin-related muscle aches and pains.

Healthspan MenoSerene

Specifically developed for women, MenoSerene is a vitamin and mineral supplement that also includes natural plant oestrogens with flax, sage and soy extracts to support hormone balance and help reduce hot flushes and night sweats.

The results from 19 randomised controlled trials show that taking soy isoflavone extracts significantly reduced hot flushes by 39% compared with placebo. https://www.ncbi.nlm.nih.gov/pubmed/20464785

MenoSerene includes vitamins A, B1, B2, B3, B5, B6, B12, Biotin, C, D3, E, Folic acid plus minerals (calcium, chromium, copper, iodine, magnesium, manganese, selenium, zinc) and soy isoflavones, flax seed and sage extracts.

*MenoSerene 60 day supply £17.95 available from Healthspan

NB Before taking supplements, check with a doctor or pharmacist if you are taking any prescribed medications.

Dr Sarah Brewer is Medical Director of Healthspan and author of *CBD: The Essential Guide to Health and Wellness. Available now from Amazon

*Affiliate link

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