St. Augustine Woman's Journal - Educational Resource to the Women of St. Johns County Since 2009

By Dr. Larry Lake
BayView Healthcare 

Supplementing Vitamins and Minerals in Older Adults


June 1, 2017 | View PDF

In this FORUM, Erika Cook will discuss the importance of over the counter vitamin and mineral supplements. Erika is the Director of Dining and Nutrition Services at BayView Healthcare and holds a Master of Science Degree in Nutrition and a Registered Dietician.

Many people use dietary supplements to lower their risk of health problems. They come in many forms such as pills, capsules, powders, extracts and liquids. Supplements also may be added to foods and drink to enhance their values. Multivitamins are the most commonly used supplements and used by 40 percent of men and women in the United States. In women older than 60 years, the use of supplemental calcium has seen large increases, probably because of increased concerns of bone health. Along with Calcium, the use of vitamin D has increased in both men and women.

There are a few key terms that should be mentioned when talking about vitamins and minerals. Recommended Dietary Allowance (RDA) is determined by the Food and Nutrition Board of the Institute of Medicines and is the amount of each vitamin and mineral needed each day to meet the needs of healthy people. Adequate Intake (AI) is used when there isn't enough data to establish RDA. Daily Value (DV) is set by the Food and Drug Administration, this is used based on a 2,000 calorie each day diet and is used on food labels. Another term is Percent Daily Value which is the percent of the DV the supplement provides, helps a person to know how much more they need in a day.

What Are Vitamins and Minerals?

Vitamins are vital nutrients that your body needs in small amounts to keep a body healthy, grow properly and function normally. The amount you are required depends on the vitamin and mineral. Because your body can only make acute amounts of vitamins for itself, the rest requires a nutritious diet. Minerals are other nutrients that your body needs to perform. Examples of minerals include iron, calcium and zinc. It is best to get most essential nutrients from a balanced diet each day.

Using Vitamins and Minerals

Before starting any vitamin or mineral supplements, you should talk to your doctor to determine if it will work for your system. Some supplements may change the way prescription drugs work, as a precaution you should also tell your pharmacist if you begin taking them.

It is important to remember that supplements are not an alternative for a healthy diet of nutritious foods. As you get older, however, you can become low or deficient in certain vitamins and mineral, and the nutrients you get from diet alone may not be sufficient. In these cases, you should not treat yourself with over-the-counter supplements without first talking to your doctor.

Vitamin D

Due to its beneficial effects, vitamin D has seen more and more proactive use over the years. In the body, vitamin D helps your body consume calcium from the gut and is essential for strong, healthy bones and teeth. It can help decrease the risk of osteoporosis, a condition that makes your bones brittle and more susceptible to breaking. Taking the right amount of vitamin D may also reduce the risk of certain cancers and heart disease. The AI for vitamin D is 600 IU/day to 800 IU/day for older adults.

There are two forms of vitamin D: vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Because vitamin D3 is the form of vitamin D that is actively made by and used in your body, you should look for vitamin D3 if your doctor recommends it as a supplement. If you are a strict vegetarian or vegan, you can use vitamin D2 because it does not come from animal sources. After you take D2, it is converted to vitamin D3 by your body.

Normally, vitamin D is made when you go outside and your skin gets exposed to the sun. It is thought that five to 30 minutes of mid-day sun twice a week without sunscreen is enough to get the right amount of vitamin D. As you get older, you might not get enough sunlight, especially in the winter. Also, your skin and other organs that are responsible for making vitamin D might not work as well. Therefore, your doctor may supplement your vitamin D intake.


Almost all the calcium in your body is found in your bones. The mineral calcium is also needed for your heart, muscles and nerves to function. As you age, calcium tends to leave your bones, which can put you at risk for osteoporosis. Deficiency may also put you at risk for osteomalacia, which is a softening of the bones. To maintain strong bones as you age, you should do weight-bearing exercises, such as brisk walking, golf or dancing. Because vitamin D helps you absorb more calcium, your doctor may recommend supplementation with both of these nutrients at the same time. The RDA for calcium in older adults is 1,000 mg to 1,200mg. One cup of milk contains 300 mg of calcium. There are many foods other than dairy that provide calcium.

If your doctor recommends a calcium supplement, it is important that you buy the right one. Several different forms of calcium are available in stores. They are known as calcium salts. Each salt has varying amounts of calcium in it. For example, calcium carbonate has more calcium in it than calcium citrate. Talk to your pharmacist if you are not sure whether you are purchasing the right product or how much you should be taking.

When taking calcium supplements, you might experience constipation. You can lessen these side effects by drinking plenty of fluids, eating lots of fiber (or using a fiber supplement) and exercising.


Iron is an important mineral found in red blood cells and is an essential component of hemoglobin. Red blood cells are the oxygen-transporting cells of your body, transporting oxygen from the lungs to tissue. Iron deficiency may lead to anemia, which is a condition that develops when your body does not have enough healthy red blood cells. A common symptom of anemia is fatigue.

When people get older, they may not consume enough iron in their diets, or their bodies absorb less iron. According to NIH, the RDA for Iron >50 is 8mg, RDA for vegetarians are 1.8 times higher because the iron available from meat in easier for the body to absorb. Iron is available in many supplements, including a MVI with iron. As with all supplementation, you should not begin taking iron unless told to do so by your doctor.

Vitamin B12

Vitamin B12, or cyanocobalamin, is used by all the cells in your body, especially the ones in your brain and spinal cord, it plays essential roles in red blood cell formation, cell metabolism and nerve function. As you get older, you may not absorb vitamin B12 as well from animal foods. Also, because vitamin B12 is found mostly in animal protein, it is more likely to become deficient if you are a vegan or vegetarian. The RDA for adults 2.4 mcg. Like iron deficiency, lacking too much vitamin B12 may lead to anemia.

Staying Proactive

As you age, vitamin and mineral supplements can keep you healthy. However, it is important that you use them appropriately and in conjunction with healthy diet and exercise. By talking to your doctor and pharmacist about your supplement use, you can reap the benefits of supplementation while avoiding unwanted side effects.

What Are Antioxidants?

You may have heard about the possible benefits of antioxidants such as vitamin C, vitamin E and carotenoids, natural substances found in food. Right now, there is no proof that large doses of antioxidants will prevent chronic diseases such as heart disease, diabetes, or cataracts. Eating fruits and vegetables (at least five servings a day) rather than taking a supplement is the best way for you to get antioxidants. Vegetable oil and nuts are also good sources of some antioxidants.

If you are thinking about using dietary supplements for your senior parent, remember:

• Talk to the doctor or a registered dietitian first. Just because something worked for your neighbor's elderly parent, doesn't mean the same will be true for your senior mom or dad.

• Use only the supplement the doctor or dietitian decided on-don't buy combinations with unnecessary added supplements.

• If the doctor does not suggest a dietary supplement, but your senior parent has decided to use one anyway, tell the doctor. Then he or she can keep an eye on your aging parent's health and adjust their other medications if needed.

• Learn as much as you can about the supplement your senior mom or dad is thinking about, but be aware of the source of the information. Could the writer or group profit from the sale of a particular supplement?

• Buy brands you know from companies you, your doctor, your dietitian, or your pharmacist know are reputable.

• If you have questions about a supplement, contact the firm or a doctor and ask if it has information on the safety and/or effectiveness of the ingredients in its product.

Dr. Larry Lake is the Executive Director/CEO of BayView Health-care. "As a local nonprofit healthcare provider, we are excited about how this FORUM can help share the knowledge and expertise of more than 250 healthcare professionals at BayView and across our continuum of care. In each issue we will address an area of interest to help consumers be even more informed about their health and wellness."

Health & Wellness Forum 161 Marine Street, St. Augustine, FL (904) 829-3475

BayView Healthcare is a private, not-for-profit comprehensive continuum of healthcare provider founded in 1920. Our superior level of services includes short-term inpatient and outpatient rehabilitation, skilled nursing at BayView Rehab at the Samantha R. Wilson Care Center, BayView Home Health and BayView Assisted Living at The Pavilion and Buckingham Smith, an Emergency Charitable Assistance Program and BayView Wellness. Caring Hands-Caring Community is a separate 501(c)3 charitable organization founded in 2004 by our parent organization. It was formed to support the exceptional services and continuum of care provided to people in need of healthcare services and financial assistance. For further information about any of the programs offered through the BayView Healthcare continuum please call (904) 829-3475.


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