Supplements Over 50: What Men and Women Actually Need

Once clients reach their fifties, one question comes up again and again: which supplements should I be taking? Walk into any pharmacy and you'll find shelves of pills promising more energy, stronger joints and a younger body.

Most people who eat reasonably well don't need a cupboard full of tablets. But our bodies do change after 50, and a handful of supplements have good evidence behind them. Here's what I tell my clients, split for men and women, with the reasons and the research.

Food comes first

Supplements are exactly that: a supplement to a good diet, not a replacement for one. Protein at every meal, plenty of vegetables, oily fish, dairy and olive oil will cover most of what your body needs. The supplements below are for filling specific gaps that become more common as we get older.

Supplements for men over 50

Vitamin D

Vitamin D helps your body absorb calcium and keeps your bones and muscles working properly. Living in Malta, you might assume the sunshine has this covered, but age works against you here. As we get older, the skin becomes less efficient at making vitamin D from sunlight, and many of us spend most of the day indoors at work.

The NHS advises adults to consider 10 micrograms (400 IU) a day, especially in autumn and winter, while the US National Institutes of Health (NIH) recommends 15 micrograms (600 IU) up to age 70 and 20 micrograms (800 IU) from 71. More isn't better, though. The NHS warns against taking more than 100 micrograms (4,000 IU) a day.

Vitamin B12

B12 keeps your nerves and blood cells healthy, and low levels can leave you tired, weak and foggy. The problem after 50 is absorption. Many older adults don't produce enough stomach acid to release the B12 from food, and the NIH estimates that between 3 and 43 percent of older adults are deficient.

For that reason, the NIH advises people over 50 to get most of their B12 from fortified foods or a supplement, which the body absorbs more easily. It's especially worth checking if you take metformin for diabetes or an acid-reducing medicine such as omeprazole, as both can lower B12 levels.

Protein

Protein isn't a vitamin, but it's the nutrient I see older clients fall short on most often. As we age, the body becomes less efficient at using protein to build muscle, so we need more of it, not less.

An international expert group, the PROT-AGE Study Group, recommends that older adults eat at least 1.0 to 1.2 grams of protein per kilogram of body weight a day, and 1.2 grams or more if they're active. For an 85 kg man, that's roughly 85 to 100 grams a day. If you struggle to reach that through meals, a scoop of whey or plant protein is a simple top-up.

Creatine

Creatine is one of the most researched supplements available, and it isn't just for young bodybuilders. Combined with strength training, it can help older adults build more muscle and strength than training alone.

A 2017 meta-analysis of 22 trials involving 721 adults with an average age of 57 to 70 found that those who took creatine while strength training gained around 1.4 kg more lean muscle than those on a placebo, along with greater gains in upper and lower body strength. Most studies use around 3 to 5 grams a day, and the International Society of Sports Nutrition considers it safe for healthy adults, including older people.

The key point is that creatine works alongside training. On its own, it won't do much.

Omega-3 (only if you don't eat oily fish)

Omega-3 fats are good for your heart, but the best source is food, not capsules. The NHS recommends at least two portions of fish a week, one of them oily, such as sardines, mackerel or salmon.

The evidence for supplements is less convincing. The large VITAL trial gave 25,871 men over 50 and women over 55 either 1 gram of omega-3 a day or a placebo for around five years. Overall, the supplement didn't reduce major heart events such as heart attacks, strokes and heart-related deaths combined, although there were fewer heart attacks on their own. If you rarely eat fish, a supplement is a reasonable option. If you eat sardines or mackerel every week, you probably don't need one.

What most men can skip

Unless a blood test shows you're low, there's usually no need for an iron supplement. Men need just 8 mg a day, which a normal diet easily provides, and too much iron can cause problems. The same goes for calcium: men aged 51 to 70 need around 1,000 mg a day, and most get that from dairy and other foods.

Supplements for women over 50

Most of the advice for men applies to women too. The big difference is menopause, which changes what your body needs, particularly for your bones.

Vitamin D and calcium

After menopause, the body absorbs and keeps less calcium, and bone loss speeds up. Over time, this can lead to fragile bones and osteoporosis. Vitamin D and calcium work as a team: you need vitamin D to absorb the calcium you eat.

The NIH recommends 1,200 mg of calcium a day for women over 50, compared with 1,000 mg for men aged 51 to 70. The UK's Royal Osteoporosis Society suggests 700 mg, rising to 1,000 mg for women taking osteoporosis medication. Aim to get it from food first: milk, yoghurt, cheese, tinned sardines with their bones, almonds and leafy greens are all good sources.

Only take a calcium supplement if your diet falls short, ideally after speaking to your doctor. The European Menopause and Andropause Society notes that calcium supplements have been linked to a higher risk of kidney stones, so more isn't better. If you do take one, your body absorbs calcium best in doses of 500 mg or less at a time. For vitamin D, the same amounts apply as for men.

Vitamin B12

The same drop in stomach acid affects women too, so the same advice applies: fortified foods or a supplement, and a blood test if you feel unusually tired, take metformin or use acid-reducing medication.

Protein and creatine

Women lose muscle with age just as men do, and the years after menopause are when many notice it most. Aim for the same 1.0 to 1.2 grams of protein per kilogram of body weight. For a 65 kg woman, that's about 65 to 80 grams a day, spread across your meals.

If you're strength training, creatine is worth considering too. More muscle means better balance, stronger bones and a lower risk of falls, which matters more with every year.

Iron: you probably need less now

This one surprises a lot of women. Before menopause, women need 18 mg of iron a day because of monthly blood loss. From 51, that drops to just 8 mg, the same as men. Some multivitamins are designed for younger women and contain the higher amount, so check the label and ask your doctor whether you still need it. Don't take iron supplements unless a blood test shows you're low.

Check with your doctor first

Supplements can interact with medication. For example, high doses of omega-3 can increase the risk of bleeding if you take blood thinners such as warfarin, and people with serious kidney problems may need to limit protein. Before starting anything new, especially if you take regular medication or have a medical condition, speak to your doctor or pharmacist. A simple blood test can show whether you're actually low in vitamin D, B12 or iron, so you're not guessing.

Supplements won't replace training

No pill will do what regular exercise does. Strength training two or three times a week, enough protein and good sleep will do more for your health after 50 than anything in the supplement aisle. Think of supplements as a small top-up to a good routine, not a shortcut.

Over 50 and want to get stronger? Book a free 30-minute consultation through the Book Online page. We'll check your blood pressure, blood sugar and body composition, and plan training that suits your body and your goals.

Mark

Sources

• NHS. Vitamin D. nhs.uk.

• NHS. Fish and shellfish. nhs.uk.

• National Institutes of Health, Office of Dietary Supplements. Vitamin D fact sheet for consumers.

• National Institutes of Health, Office of Dietary Supplements. Vitamin B12 fact sheet for consumers.

• National Institutes of Health, Office of Dietary Supplements. Calcium fact sheet for consumers.

• National Institutes of Health, Office of Dietary Supplements. Iron fact sheet for consumers.

• National Institutes of Health, Office of Dietary Supplements. Omega-3 fatty acids fact sheet for consumers.

• Bauer J et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. Journal of the American Medical Directors Association, 2013.

• Chilibeck PD et al. Effect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysis. Open Access Journal of Sports Medicine, 2017.

• Kreider RB et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. Journal of the International Society of Sports Nutrition, 2017.

• Manson JE et al. Marine n-3 fatty acids and prevention of cardiovascular disease and cancer (VITAL trial). New England Journal of Medicine, 2019.

• European Menopause and Andropause Society. Calcium and postmenopausal osteoporosis. Menopause Essentials, 2026.

• Photos: Unsplash.