Vitamins in the elderly: Should your parent be taking supplements?

Reviewed by Dr Patrick Ruane

Should your parent or elder relative be taking any vitamins and supplements to support their health in old age? The best person to answer this question is your parent’s GP, but, in general, older people do often need to take certain supplements due to a number of factors.

The physiological effects and lifestyle changes that come with growing old, plus the side effects of some medications, mean that elder people can be deficient in certain vitamins and minerals, most commonly vitamin D.  

Here is a list of vitamins and minerals that can often be low or deficient in older people, supplements for which could support your parent to be healthier in their old age.  However, before introducing any new vitamins or supplements into their routine, it’s essential to consult with their GP first to ensure they align with their specific health needs and medical history. Taking supplements when they are not needed is not only an unnecessary cost, it can sometimes be harmful.

Note: When purchasing supplements, it’s worth noting that not all vitamins and supplements are made equal.  Always opt for reputable brands and quality products when choosing supplements, and make sure to read the label and check you’re not exceeding the recommended dose.

Vitamin D

Known as the ‘sunshine vitamin’, vitamin D deficiency is a common concern in old age. Not only is ageing skin less efficient at synthesising vitamin D from sunlight (which is where we primarily get it from), older people often spend less time outdoors due to mobility issues and other factors.

Vitamin D is essential for bone health, immune function, and overall well-being, and a deficiency in vitamin D can lead to conditions like osteoporosis, muscle weakness and an increased risk of fractures. Low vitamin D levels have also been linked to an increased risk of respiratory infection.

While there are some dietary sources of vitamin D, it can be challenging to obtain enough through food alone. The NHS suggests that everyone consider taking a daily supplement containing 10 micrograms, or 400 International Units (IU), of vitamin D during the autumn and winter. Elder people should take a vitamin D supplement all year round if they are frail or relatively housebound, and if your parent is in a nursing home, it is particularly important to check that they are getting a daily vitamin D supplement.

For maximum absorption, it is best to take vitamin D supplements with the heaviest meal of the day as it is fat-soluble, meaning it does not dissolve in water and is absorbed with fat.  

Good food sources of vitamin D: Few foods are naturally rich in vitamin D, but fatty fish (such as salmon, mackerel and sardines), eggs and mushrooms contain modest amounts.

Vitamin D Recommended Daily Allowance for over-50s (UK): 10 micrograms or 400 International Units (IU) per day.

Vitamin B12

Another vitamin deficiency of common concern in older people, vitamin B12 is critical for nerve function and the production of red blood cells. Ageing stomachs and medications often taken in old age can mean vitamin B12 is poorly absorbed from the diet, leading to a deficiency. Being deficient in vitamin B12 can increase the risk of anaemia and neurological problems such as memory loss.

Good food sources of vitamin B12:  Beef, liver, and other organ meats, chicken and turkey, fish and seafood, particularly shellfish. If your parent follows a vegan or vegetarian diet, it’s important to note that B12 is not naturally found in plant-based foods.

Vitamin B12 Recommended Daily Allowance for over-50s (UK): 1.5 micrograms/day

Calcium

Calcium plays a fundamental role in supporting bone health and overall bodily functions. As we grow older, our body’s ability to retain calcium from the diet decreases. Ensuring an elder person has plenty of calcium in the diet is important for maintaining strong bones and a number of other bodily functions. However, calcium supplements are usually only recommended for people who are at increased risk of fractures.

Good food sources of calcium: Milk, cheese, yogurt, and leafy greens such as kale and broccoli.

Calcium Recommended Daily Allowance for over-50s (UK): 700mg/day

Iron

While not as commonly discussed as vitamin D or B12 deficiencies in old age, iron is still important, especially for elder people who may have lower levels due to dietary restrictions, decreased gut absorption, or other health conditions.

Iron is essential for the production of red blood cells and plays a key role in maintaining energy levels and overall vitality.  Low levels of iron can lead to anaemia. However, iron supplements in older people should be used cautiously and under medical supervision due to the risk of iron overload. Too much iron can be toxic and can damage the liver, the heart, and the pancreas. Always speak to a doctor before starting iron supplements.

Good food sources of iron: Red meat,such as beef, lamb or pork, and shellfish are good sources of ‘haem’ iron, which is the form most easily absorbed by the body. Beans, lentils and dark leafy greens are good sources of ‘non-haem’ iron, which is less easily absorbed.  Eating foods rich in Vitamin C at the same time can help the body absorb non-haem iron better.  

Iron Recommended Daily Allowance for over-50s (UK): 8.7 mg/day

Magnesium

Magnesium is needed for more than 300 biochemical reactions in the body, important for muscle and nerve function, bone health, and regulating blood sugar levels. It also helps with sleep, which can be disrupted in older adults. As we get older, our bodies might not absorb magnesium from food or retain it in the kidneys as well as they used to. This, combined with not eating enough magnesium-rich foods, can lead to a small shortage of magnesium in the body. However, a small shortage of magnesium is not always easy to spot, as the symptoms are similar to common age-related issues like feeling weak, having trouble sleeping or having trouble with memory or cognition.

Good food sources of magnesium: Almonds, cashews, pumpkin seeds, and sunflower seeds are rich in magnesium, as are leafy greens like spinach and kale.

Magnesium Recommended Daily Allowance for over-50s (UK): 300mg/day for men and 270mg/day for women

Zinc

Zinc plays a significant role in the immune system’s response to infections, making it especially crucial as people age and their immune systems weaken. Mild zinc deficiency is common in older people, but can be hard to spot. Typical symptoms of zinc deficiency in older people include impaired taste, loss of appetite, hair loss, and increased susceptibility to infection.  If your parent has been recommended by their doctor to take Zinc supplements, be mindful that they should take them with food as the can make you feel nauseous if taken on an empty stomach.

Good food sources of zinc: Oysters contain more zinc per serving than any other food, but red meat and poultry are also good sources. Other foods like beans, nuts, whole grains, and dairy products also provide zinc, though in smaller amounts.

Zinc Recommended Daily Allowance for over-50s (UK): 9.5 mg/day for men and 7 mg/day for women.

Omega-3

Omega-3 fatty acids are vital nutrients that may be beneficial for older individuals due to their potential in supporting heart health, brain function, and reducing inflammation. As people age, their bodies may not efficiently convert plant-based omega-3 sources into the more bioavailable forms, such as EPA and DHA that are found in fish. These fatty acids are integral for brain health and reducing the risk of heart disease, which becomes increasingly important in later years. Studies suggest that omega-3 fatty acids might aid in cognitive function and potentially lower the risk of certain age-related cognitive decline, such as Alzheimer’s disease.

Good food sources of omega-3 fatty acids: Fatty fish, such as Salmon, mackerel, sardines, trout and herring are the best source of omega-3 fatty acids.

Omega-3 Recommended Daily Allowance for over-50s (UK): There is no set recommendation for omega-3. Heart UK recommends the average adult gets about 500mg of EPA and DHA combined each day (about the same as a 140g portion of oily fish per week).

In summary

If you’re worried your parent or elder loved one isn’t getting enough vitamins and minerals from their diet, speak to their doctor. Remember that individual needs vary, and consulting with a healthcare professional before starting an elderly parent or relative on any new supplement regimen is essential. The dosage and necessity of these supplements can differ based on a person’s health conditions, current medications, and dietary habits. With the exception of vitamin D, getting nutrients from a balanced diet should be a priority, and, where possible, supplements should complement a healthy lifestyle rather than replace a proper diet.

Common questions

  • Should older people take a daily multivitamin to cover the vitamins they need?

There is much debate amongst experts about the benefits of taking a daily multivitamin in people who have a normal, balanced diet. Recent research from the US, however, suggests that daily multivitamins in people over 65 may slow age-related cognitive decline, particularly in people with cardiovascular disease.  It’s best to talk to your parent’s doctor about whether they would benefit from taking a multivitamin, and which one would be best for them. For example, if your parent takes a medication that reduces blood clotting, then they may want to avoid a multivitamin that has vitamin K, which can lower the drug’s effectiveness.

  • Do GPs test the elderly for vitamin deficiencies in the UK?

Yes, if there is a medical reason for it but they don’t offer routine tests. On the NHS, if your GP suspects or is concerned you might have a vitamin deficiency, they will arrange for you to have the relevant blood tests to check your levels. If they have no reason to believe that you have a vitamin deficiency, they won’t arrange for tests.

  • Does vitamin D protect against COVID-19?

Vitamin D is involved in the body’s immune response, and there is some scientific evidence to suggest that taking Vitamin D supplements helps to protect against respiratory tract infections including COVID-19, particularly in people with low levels of vitamin D.

  • Can taking vitamin C supplements prevent the common cold?

In the UK, adults are recommended to consume 40mg of vitamin C daily. However, taking high dose supplements of vitamin C for the purpose of preventing or treating the common cold is unlikely to have much effect. Any surplus vitamin C that is not required by your body will just be excreted in your pee. Getting an adequate amount of vitamin C through a well-balanced diet is usually not too difficult. Good food sources of vitamin C include kiwi fruits, oranges, strawberries, broccoli and red peppers.

  • Which are the most reputable vitamin supplement brands in the UK?

The quality and purity of vitamin and mineral supplements can vary. Vitamin and mineral supplements are regulated as foods in the UK, which means they don’t have to meet the same strict requirements as medicines, in terms of proving their effectiveness and purity. Wild Nutrition and Solgar are two brands known for upholding high standards, providing accurate labelling, and using quality ingredients in their supplements. It’s always best to purchase vitamins and supplements from a reputable retailer, such as your local chemist.

  • Are at-home, self-tests for vitamin D worth it?

Everyone in the UK is recommended to take a daily 10 microgram (400 IU) supplement of vitamin D during the autumn and winter months. If you take a supplement but are still worried about low vitamin D levels, it’s best to get an appointment with a GP who can organise a blood test if they think it is required. However, if you are struggling to get an appointment, and really want to do a home test, you should consider using a test from a company run by doctors who can explain your results and prescribe the correct dose of vitamin D if you need it.

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