Even if you are careful about eating a well-balanced diet, you can still be deficient in important vitamins and minerals that are crucial in helping to prevent illness. In fact, in a major article published in the Journal of the American Medical Association, researchers from Harvard Medical School reported that most adults have mild nutritional deficiencies and recommended a daily multivitamin/mineral supplement.

Every older adult should take a daily multivitamin/mineral supplement as well as additional supplements to support normal immune function and prevent chronic disease.

As valuable as many supplements are, use your common sense—don't overdo it. More isn't necessarily better. Always discuss dosage, safety and health value with your doctor first.


Look for a product that contains a broad base of vitamins and minerals. For each vitamin, the amount in the supplement should cover 100% of the DailyValue (DV), the daily amount you need as set by the FDA. In most brands, the amounts in a single capsule or tablet won't be 100% for every vitamin—otherwise, the pill would be so big that it would be hard to swallow. To get the right daily amounts, you'll probably need a formulation that requires more than one pill a day.

The right formulation will also provide 100% of many important minerals, such as zinc and selenium.

Important: Unless your doctor has diagnosed you with iron-deficiency anemia, choose a multi supplement that does not contain iron. Extra iron, beyond what you get from your food, can cause inflammation, liver damage, joint pain, fatigue and premature heart disease.

Note: Multi supplements sold in health-food stores and vitamin shops are generally better than those sold in pharmacies and grocery stores. In many cases, the formulations are more comprehensive and ingredients are higher quality and more potent.


The amounts of calcium and magnesium in a daily multi supplement are small—only about 10% of the DV. In addition to a daily multi, I strongly recommend that women and men add a sep rate product containing 500 milligrams (mg) of calcium, 250 mg of magnesium and 400 to 600 international units (IU) of vitamin D to maintain bone health.

Vitamin D is also important for immune system support, and solid research indicates it has a role in preventing cancer. Don't exceed 2,000 IU of vitamin D a day. Excessive amounts cause liver damage and possibly kidney damage. For best absorption, take this supplement at a different time of day than your multi.


Numerous studies have shown that 20% of Americans age 65 and older have very low blood levels of vitamin B-12. Others may have levels on the low side but don't yet show symptoms of deficiency. Vitamin B-12 is essential for making healthy red blood cells, maintaining mental acuity and protecting your heart, among other things. It is found in animal foods, such as eggs, dairy products and meat, but only in very small amounts that become increasingly hard to absorb as we age. I suggest a daily under-the-tongue supplement containing 1,000 micrograms (mcg).


While the amounts of vitamins and minerals in a daily multisupplement are unlikely to cause any drug interactions or toxicity, be cautious about adding extra supplements, especially…

  • Vitamin E and vitamin K. If you take a blood-thinning medication, such as warfarin (Coumadin), you need to avoid extra vitamin E and extra vitamin K. Vitamin E is in every multi supplement formulation and vitamin K is in some. The amounts in your daily supplement probably aren't enough to interfere with warfarin. Do not take additional doses of these vitamins unless your doctor recommends them.
  • Vitamin A. Avoid taking additional vitamin A-too much can be toxic. Up to 5,000 IU daily is safe for most people. Nursing mothers, pregnant women and anyone with liver disease should avoid these supplements.


  • Fish oil. I also strongly recommend a daily fish oil supplement for most people. Studies have shown that fish oil helps prevent stroke, heart disease and Alzheimer's and other memory problems. Fish oil also has an anti-inflammatory effect that's helpful in protecting your joints. Choose a steam-distilled product (check the label) that contains a total of 500 mg of both eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the active omega-3 fatty acids in fish oil.

Caution: Fish oil can thin your blood. Do not take fish oil supplements if you are on a blood-thinning medication.

  • Super greens. "Green products”—powdered supplements that contain super-green foods, such as chlorella, wheatgrass, spirulina and alfalfa—are a great way to get the nutritional benefits of green vegetables in a concentrated way, These green plants are very high in chlorophyll, minerals, fiber and plant nutrients, such as lutein, which helps protect your eyes against the sight-robbing disease called macular degeneration.

Super greens help with bowel regularity, have valuable antioxidant properties that protect against cell damage and help your body remove toxins and waste products. Many older adults don't get the recommended five or more servings of fresh vegetables every day.

Green products are available in powdered form (you can mix the powder into juice and other drinks) or capsules. I recommend Kyo-Green (www.kyolic.com) or Greens+ (www.greensplus.com), which are available at health-food stores. Follow the directions on the label. To avoid digestive upset, start with a small dose and gradually increase it to one tablespoon a day.

  • Joint supplements. Because osteoarthritis is common among older adults, I recommend taking 1,500 mg of glucosamine sulfate, 1,200 mg of chondroitin sulfate and 2,000 to 3,000 mg of methylsulfonylmethane (MSM) daily to support healthy cartilage in the joints and reduce pain and stiffness. These nutrients provide essential building blocks for repairing damaged cartilage. Numerous studies have shown their safety and effectiveness, and the results of the government- funded Glucosamine/Chondroitin Arthritis Intervention Trial showed that glucosamine and chondroitin were very effective for relieving moderate to severe arthritis pain.

Cautions: Because glucosamine supplements are derived from shellfish shells, avoid them if you're allergic to shellfish. Also, MSM has a mild blood-thinning effect, so check with your doctor if you're on a blood-thinning medication.

Liver supplements. The average older American takes at least one prescription drug, and many take three or more, daily. Many of these drugs stress of damage the liver. I recommend milk thistle, an herb that has been shown to protect the liver and kidneys, to anyone who regularly takes prescription medicine. Look for a product that contains 80% to 85% silymarin (the active ingredient in milk thistle) extract. Take 250 mg twice daily.

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