What Supplements Should Women Take?

By: Sandra Cooper, CNP, CNM • Posted on August 29, 2024

In the United States, the dietary supplement industry's overall economic impact in 2023 was $159 billion and it continues to grow. Much of this growth has been driven by an increase in consumer demand for health and wellness products.

So, how do women know what is right for them? The simple answer is - what they need. The details around this are more complex. It is best to know what blood values are for vitamins and nutrients. Although blood testing is not flawless, it does provide some parameters for low and excess levels of vitamins and nutrient levels.

Ideally, all nutrients can be obtained through food but that is frequently not the case for most people. Even when consuming a whole foods diet, a person can have deficits due to low intake of diverse whole foods and/or poor absorption. A diet that is high in processed foods and high sugar contributes to disruption of the gut microbiome leading to inflammation in the gut and impaired absorption of nutrients.

When starting or continuing supplements, certain considerations like optimal blood levels, food sources, dosing, benefits and risks should be discussed with your healthcare clinician.

Multivitamin

There is little evidence that multivitamins are necessary
Multivitamins may be useful when a nutrient dense diet is not consumed
Caution: Read the label and only take as directed to avoid excess intake of some nutrients

Vitamin D

Optimal vitamin D blood level: 50 nmol/L
Foods sources: fatty fish, egg yolks, mushrooms and sunlight is an optimal source
Typical supplement dose: 2000 international units
Promotes: bone health, immune health and mood
Risks: a blood level over 150 ng/mL can lead to hypercalcemia, renal failure and cardiac arrhythmias

Calcium

Optimal blood level: ionized calcium 4.6-5.3 mg/dL
Food sources: sardines, salmon with bones, spinach, kale, broccoli, bok choy, tofu and dairy
Typical supplement dose: for women age 19-70 is 1000 mg daily. Calcium citrate is well absorbed compared to calcium carbonate.
Promotes: bone health. Maintains: heart, muscle and nerve health
Risks: hypercalcemia can cause digestive issues, bone pain, muscle cramps and possible calcium deposits on coronary arteries

Omega 3 fatty acids

Optimal blood level: omega 3 index >5.5. Some consider >8 ideal
Food sources: cold water fish, flax seeds, walnuts, green leafy vegetables, nuts and seeds
Typical supplement dose: fish oil or algae omega (EPA+DHA) 1000-3000 mg per day depending on your blood level
Promotes: health of heart, brain, eyes and reduces inflammation
Risks: may cause bleeding at higher levels

Magnesium

Optimal blood level: magnesium RBC 4.8-6.2 mg/dL. Some consider >6 ideal
Magnesium food sources: almonds, bananas, black beans, broccoli, brown rice, cashews, flaxseed, green vegetables (spinach), nuts, oatmeal, seeds (pumpkin, sesame, sunflowers) soybeans, sweet corn, tofu, and whole grains
Typical supplement dose: magnesium glycinate, magnesium threonate and magnesium malate are all well absorbed, 300-400 mg/day
Promotes: cellular, bone and muscle health, supports mitochondria
Risks: diarrhea may be a side effect, less so with topical magnesium. Hypermagnesemia is uncommon but may cause bradycardia and muscle weakness

Iron

Optimal blood level for iron: ferritin > 40 ng/ml, may be symptomatic <100ng/ml
Food sources: meat, pork, poultry, salmon, beans, nuts, green leafy vegetables
Typical supplement dose: 80-200 mg of elemental iron per day. Ferrous fumarate, ferrous gluconate, ferrous sulfate, ferrous bisglycinate are all bioavailable preparations. Should be taken an hour before meals. Vitamin C enhances absorption
Promotes: oxygenation of red blood cells, treats anemia
Risks: epigastric pain, nausea, constipation. Taken every other day can reduce side effects. Iron can also be corrosive to gastrointestinal lining

Vitamin B12

Optimal blood levels: 500-1300 pg/ml
Food sources: meat, seafoods, egg yolks, milk
Typical dose: 50-250 mg daily for prevention. 500-1500 mg daily to treat deficiency. Methylcobalamin may be better absorbed than cyanocobalamin
Vitamin B12 promotes: functioning of brain and nervous system, acts as an antioxidant
Risks: Higher vitamin B12 ranges have been associated with headaches, fatigue, gastrointestinal issues, tingling in hands and feet

Probiotic

Optimal level: commensal or “good” bacteria can be assessed with a specialty stool test. Probiotics can be beneficial after illness or antibiotics that disrupt the gut microbiome
Food sources: fermented foods like yogurt, kombucha, kimchi, sauerkraut, pickles
Typical supplement dose: benefits in 10-20 million CFU, higher doses may be needed if treating dysbiosis (gut microbiome imbalance)
Promotes: balanced microbiome which reduces systemic inflammation, improves gastrointestinal disturbances, improves allergies, nutrient absorption and possibly regulating weight and mood
Risks: probiotics can lead to an overgrowth of certain bacteria that can cause gas, bloating, nausea, constipation and diarrhea

Be Strong, Be Healthy, Be in Charge!

Sandra Cooper, APRN/CNP
Center for Functional Medicine
Wellness & Preventive Medicine Department

References

About Sandra Cooper, APRN/CNPP

Sandra Cooper, APRN/CNP works in the Cleveland Clinic Center for Functional Medicine Department. She earned her undergraduate degree in Nursing from Indiana University and then went on to earn a graduate degree in Nurse-Midwifery from Georgetown University. Sandra also has a post graduate certificate in Women's Health Nurse Practitioner from Frontier Nursing University. And she is a Certified Functional Medicine Provider from the Institute of Functional Medicine.

supplements, vitamins, vitamin D, calcium, magnesium, omega 3, probiotics, iron, multivitamins, women's health, wellness

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