Vitamins for older people

Most of us can get all the vitamins and minerals we need by eating a healthy, balanced diet, but sometimes we need a little extra help. So when should we take extra tablets, and when shouldn't we bother?

Should you take vitamin supplements?

Many of us choose to take supplements, because we think we're not getting the right amount of vitamins in our body - but you might not realise that taking a high dosage, or taking them for too long, can do more harm than good, especially if you’re already taking prescription medication.

Not only that, vitamin supplements can be expensive - and unnecessary. Your kidneys will simply flush out what your body doesn’t need, which could mean that your expensive supplements end up going straight down the toilet.

GP Dr Liz Green says: 'It’s always good to ensure that you take supplements only in the recommended daily allowance (RDA) amounts and discuss with your GP why you're taking them and why they're needed.'

Nevertheless, vitamin supplements can be helpful for some people, so we asked the experts to help us identify the most common deficiencies to look out for in older people, along with some advice on how to prevent them.

Vitamin D

Our body makes most of our vitamin D in reaction to sunlight on our skin. It's also found in a small number of foods including oily fish, eggs, margarine, yoghurt and fortified breakfast cereals. However, people over the age of 65 are at risk of not getting enough vitamin D, especially when we’re not exposed to much sun.

The expert view

British Dietetic Association spokesperson Priya Tew says: 'It can be difficult in the UK to meet our vitamin D needs through sunlight and diet alone. For this reason, it's recommended that over-65s take a supplement of vitamin D of 10 micrograms per day. Try to get out in the sun for 10-15 minutes a day without sunscreen, too.'

You can buy vitamin D supplements at most pharmacies and supermarkets, but you shouldn't take more than 100mg a day as it can be harmful - in line with NHS guidance. 

However, if your doctor advises you to take a different amount, you should follow their advice as the amount you need to take can depend on a number of factors.

Iron

Iron is an essential mineral that has several important roles in the body, including helping to make red blood cells which carry oxygen around the body.

You should be able to get all the iron you need from your daily diet as it is found in red meat, pulses and beans, eggs, wholegrain products, nuts and seeds, green leafy vegetables, dried fruit and fortified cereals.

The expert view

Dr Liz Green says: 'Older patients should not routinely supplement with iron unless they have a known reason for any iron deficiency, for instance if they have just had an operation or suffered blood loss or are vegan.

'Also, iron deficiency in patients over 50 can be the first sign of an underlying health problem, so would we always want to investigate this fully.'

Fortunately, there are a couple of simple ways to improve iron absorption without taking a supplement. Priya Tew says: 'Drinking tea and coffee with a meal will reduce the amount of iron absorbed so keep these drinks to in-between meals.

'To boost iron absorption, have plenty of vitamin C in your diet and try having a glass or fruit juice with an iron-rich meal.'

Calcium

Calcium is an important mineral as it helps to build strong bones and teeth, regulates muscle contractions, including heartbeat, and helps blood to clot normally. Milk, cheese and yoghurt are all good sources of calcium, as well as green leafy vegetables, nuts and fish like sardines, where you eat the bones.

The expert view

Priya Tew says: 'Eating 3-4 portions of dairy products a day should provide all the calcium that is needed.'

If you’re concerned that you’re not getting enough, it’s best to consult your GP before taking a supplement as high doses of calcium can cause stomach pain and diarrhoea.

Dr Liz Green says: 'Most patients should only take calcium supplements if they have been advised by their GP as we need to be sure that there is a good reason to do so. Usually this is because there’s an increased risk of fracture, especially among very frail or housebound patients in residential care or nursing homes.'

B vitamins

There are several types of vitamin B and they all have different functions within the body, including helping to break down energy from food, keeping the skin, eyes and nervous system healthy, and helping to form red blood cells.

Provided that you eat a well-balanced diet, including wholegrains and cereals, you should be getting all that you need. However, as we get older it becomes harder to absorb vitamin B12, which is found in meat, cod, salmon, milk, cheese, eggs and some fortified cereals.

People who are deficient are at increased risk of anaemia and neurological problems such as memory loss.

The expert view

Priya Tew says: 'There's some evidence that older people can have B12 deficiency. Eating fortified breakfast cereals, yeast extract and meat can help with this.'

Alternatively, you could take a supplement: doses of 2mg or less per day are unlikely to cause any harm.

Vitamin C

High-dose vitamin C supplements have become a popular way to ward off colds, but are they really worth the money? While it’s true that vitamin C is an antioxidant that helps to fight disease and infections and aids healing, eating plenty of fruit and vegetables should help you to get all that you need.

The expert view

Priya Trew says: 'Aim for five or more portions of fruit and vegetables a day, with only one of these being fruit juice. Citrus fruit, strawberries and mango, as well as peppers and tomatoes are all good sources of vitamin C.'

Words: Ceri Roberts