Vitamins & Minerals for Seniors

Jeff Prescott, PharmD, RPh, and Brian Manalo, PharmD Candidate
Published Online: Friday, January 13, 2012

For additional perspectives relating to the topic, this article contains Clinical Commentaries from practicing pharmacists. To go directly to these commentaries, please click here or here.

When older patients are deficient in vitamins B and D, calcium, and iron, dietary supplementation can help them find nutritional balance.


Introduction

More than 40% of men and women in the United States use multivitamins. They are the most commonly used dietary supplements. In women older than 60 years, the use of supplemental calcium has seen large increases. The use of vitamin D has increased in both men and women.

Clinical Commentary
How do you to talk to a patient concerned about vitamin supplements?
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A recent study of older women suggests that multivitamins may not be as helpful as people think. In the study, researchers found an increased risk of death in older women taking several commonly used vitamin and mineral supplements. Although these findings may seem troubling, you should not stop taking vitamins that your doctor has prescribed unless told to do so. This article will discuss what vitamins and minerals are, give a few examples of ones that might be most useful for older patients, and explain how those products should be used.

What Are Vitamins and Minerals?
Vitamins are nutrients that your body needs in small amounts to stay healthy. The amount you need depends on the vitamin. Because your body can only make limited amounts of vitamins for itself, the rest must come from a nutritious diet. Minerals are other nutrients that your body needs to function properly. Examples of minerals include iron, calcium, and zinc.

Clinical Commentary
What are some considerations for recommending a vitamin supplement?
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Using Vitamins and Minerals
Before starting any vitamin or mineral supplements, you should talk to your doctor to determine if it is appropriate. Because these supplements may affect the way prescription drugs work, you should also tell your pharmacist if you begin taking them.

It is important to remember that supplements are not a substitute for a healthy diet of nutritious foods. As you get older, however, you can become deficient in certain vitamins and minerals, and the nutrients you get from diet alone may not be enough. 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 use over the years. In the body, vitamin D helps your body absorb calcium from the gut and is essential for strong, healthy bones. It can help reduce the risk of osteoporosis, which is a condition that makes your bones brittle and more prone to breaking. Taking the right amount of vitamin D may also reduce the risk of certain cancers and heart disease.

There are 2 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 5 to 30 minutes of midday 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 as work as well. Therefore, your doctor may supplement your vitamin D intake.

The Table lists the recommended daily allowances (RDAs) of certain vitamins and minerals. The RDA for a particular vitamin or mineral is the average amount that meets the daily dietary requirement for nearly all healthy people.

Calcium

Almost all the calcium in your body is found in your bones. 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.

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

Iron is a very important mineral found in red blood cells. Red blood cells are the oxygen-transporting cells of your body. 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. Because iron is found in red blood cells, bleeding caused by ulcers, injury, or even surgery may cause iron loss. As with all supplementation, you should not begin taking iron unless told to do so by your doctor.

Like calcium, there are many different forms of iron that you can buy over the counter, so make sure to talk to your pharmacist if you have any questions. After taking iron, you may experience an upset stomach. Your doctor may tell you to take it with food if this occurs. Like calcium, iron can cause constipation. Iron can also turn your stool black. Unless you have other stomach problems or medical conditions, this is not a cause for concern.

Vitamin B12

Vitamin B12, or cyanocobalamin, is used by all the cells in your body, especially the ones in your brain and spinal cord. If you become deficient, you may experience confusion, agitation, or hallucinations. As you get older, you may not absorb vitamin B12 as well. Because vitamin B12 is found mostly in animal protein, you can become deficient if you are a vegan or vegetarian. 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. PT


Dr. Prescott is vice president, clinical and scientific affairs, for Pharmacy Times. Mr. Manalo is a PharmD candidate at the Ernest Mario School of Pharmacy at Rutgers University in Piscataway, New Jersey.




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