Supplements for the elderly

    The older people get, the more inefficient the metabolic processes become, and hence the greater the need for high-quality nutrition and supplementation.

    The elderly have their own specific health challenges because the body is in a constant process of ageing. Try to form an image of the ageing process, by imagining a factory that prints birthday cards using a template to make exact copies. Over time the template will slowly begin to wear away so that the birthday cards become imperfect copies. At first only an expert will detect these imperfections, but later anyone will begin to see the flaws. Ageing is something like that. Despite the fact that cells are dying and being replaced, the replacements are no longer a perfect copy of the original.

    While ageing is a natural inevitable process, a great deal can be done to make it as comfortable and even as joyful as possible. Is it possible for us to grow older without suffering from the diseases of ageing?

    Although ageing and degeneration may be inevitable as one grows older, a great deal of research has shown that there are many ways to slow ageing and improve function.

    For example, some good studies have shown that narrowing of blood vessels to the heart (arteriosclerosis) can be reversed.1,2 Other studies have shown that long-term meditators show biological age almost 12 years younger than their chronological age, and that hormonal changes usually associated with ageing can be slowed down or reversed through regular meditation.3,4


    There are a range of problems related to ageing, all of which should be considered:

    1. Nutritional deficiencies due to poor diet and inefficient physiological processes
    2. Thinning of bones
    3. Arteriosclerosis (narrowing of blood vessels to the heart)
    4. Increasing fragility
    5. Prescription drug use with possible side effects
    6. Loneliness and other psychological problems
    7. Sleep disorders
    8. Ageing skin, subcutaneous tissue and muscles
    9. Vision and hearing problems
    10. Cancer
    11. Neurological conditions such as dementia and Parkinson’s disease


    One of the problems I have with the anti-ageing movement is its strong emphasis on the use of hormones. While I am not against the use of hormones if the person has symptoms requiring hormone treatment, I am nevertheless very cautious about restoring hormone levels to what constitutes an ‘unnatural high’ for the individual. Many doctors believe that the ageing person should have their hormones returned to the level they had when they were young, healthy and full of energy.

    I personally believe that this is not natural and that many older people are well and healthy even with low hormones. Many women, for example, go through menopause without any symptoms despite the fall in hormone levels. Symptoms are often not the result of low hormones but the wrong balance and ratio of the hormones. Oestrogen dominance for example is a serious problem and could even be one of the primary causes of breast cancer. Many integrative doctors in general understand this and use low-dose bioidentical hormone creams rather than high-dose oral medication. Clearly this is an area requiring specialised treatment and your health practitioner should always be part of the decision making.


    People may be born with a strong constitution, and the genetic background may even be exceedingly good, yet poor lifestyle, indulgence in drugs, alcohol and smoking will lead over time to a much more rapid onset of the ageing process. The person may even live a long life, but the quality of that life may be very poor.

    What happens in the body when people start anti-ageing programmes is that physiological functions improve so that instead of operating at 60% efficiency one can push the functional integrity of the body up to 80% or even 90% efficiency. Even a 5% improvement is going to make a difference and could shift the whole process to another level. The body always functions as a whole so that even a small increase in efficiency can often make a big difference.


    In an extensive report entitled ‘The Benefits of Nutritional Supplements’ that reviewed more than a decade’s worth of the most significant studies measuring the health benefits of multivitamins and other nutritional supplements, benefit to the elderly was a consistent theme. The author of the report, Annette Dickinson, said that ‘In reviewing the available evidence, I was impressed by the powerful benefit that simple, daily intake of a multivitamin can have on overall immune function in the elderly.’

    Some of the highlights of the report include the following:

    • Many American diets are deficient in the intake of critical nutrients like calcium, B12, vitamin D and vitamin E. It is well known that deficiency of these nutrients is also especially common in the elderly. As many as 80% of subjects have inadequate intake and absorption of four or more key nutrients. There are many reasons for this, including poor quality of food, decreased stomach acid secretion, constipation or diarrhoea, malabsorption of nutrients, and a low level of digestive enzymes.
    • Elderly people living in nursing homes, flats or in long-stay care, and who are unable to do their own shopping, are at greater risk of developing nutrient deficiencies.
    • Bone density is an important area requiring supplementation. It has been estimated that proper supplementation with calcium, magnesium and vitamin D in the elderly could reduce the rate of hip fractures by at least 20%. This would mean about 40 000 to 50 000 fewer hip fractures each year in the USA.5

    The following nutrients should be included in the dietary intake of older persons (over the age of 60 years).

    A multivitamin-mineral supplement

    Generally, the cheaper multivitamin-mineral supplements have lower-dose nutrients and tend to use synthetic ingredients while the more expensive products will use higher doses and nutrients that are more easily absorbed. These low doses may be quite adequate if the diet is nutrient-rich, organic and fresh.


    I generally recommend a broad-spectrum antioxidant rather than a single antioxidant unless there are very specific problems requiring a high intake of a particular antioxidant such as vitamin E for vascular problems. Antioxidants neutralise the free radicals that can cause serious damage to organs and tissues and are probably responsible for much of the ageing process including the oxidising of cholesterol. Antioxidants include zinc, selenium, copper, manganese, vitamins A, C, E, co-enzyme Q10, pine bark and grapeseed extract.

    Vitamin D

    I am highlighting this vitamin because the majority of people are deficient and this is especially so in the elderly. The body needs sunshine to manufacture vitamin D in the skin, and huge numbers of the elderly are just not getting enough sunshine, either because they have been warned of the dangers of sunshine (which has been overplayed) or because they spend too much time indoors. A study in the New England Journal of Medicine reported that blood levels of vitamin D were deficient in 57% of hospitalised patients, and 22% were severely deficient.6

    Vitamin B12

    Deficiency of this vitamin has been found in as many as 10% of people over the age of 60 years. It is an important vitamin and requires intrinsic factor (a glycoprotein) produced in the stomach for its absorption. Intrinsic factor decreases in the elderly together with stomach acid and probably accounts for the deficiency of B12. Deficiency of this vitamin could account for loss of balance, numbness and tingling of the arms and legs, confusion and even dementia. It also seems to function as a tonic stimulant.


    I have mentioned these two minerals together because a combination medicine is the most practical and best way to take them. Check to see if vitamins D and K are also present as this will facilitate the absorption of calcium.

    Essential fatty acids

    Another star of the nutritional market is omega-3, valuable for its anti-inflammatory action. These fats are called essential because the body cannot manufacture them and they must therefore be obtained from the diet. The brain is 60% fat, so these fatty acids may slow down the brain ageing process. There is also evidence that they reduce the incidence of heart disease and strokes.


    These are some of my very favourite supplements for ageing healthily. Adaptogens are products that help the body adjust to physical and emotional stress without over-stimulating or suppressing. They include ginseng, Ashwaghandi, Rhodiola, Eleutherococcus or Russian ginseng and Glycyrrhiza gabra (liquorice). Other products include Bacopa monnieri which is often used to treat anxiety in the elderly and prevent memory loss. Bacopa is a great tonic for stress relief and seems to regulate serotonin and dopamine.

    Other nutrients

    Other useful brain nutrients include phosphatidylserine, DMAE, acetyl L-carnitine and the herb Gingko biloba. A range of other nutrients can be added to the programme, but this constitutes the subject for another article. Briefly, these include MSM, alpha-lipoic acid, arginine and selenium.


    The elderly often complain of joint and muscle pain due both to inflammation and/or degeneration of the soft tissue and cartilage. For soft tissue and muscular problems, I like to use transdermal magnesium, which is rubbed over the area. This is especially great for people with serious lower leg cramps and restless legs at night. Curcumin taken internally is a good natural anti-inflammatory together with Boswellia, omega-3 and vitamin E.

    If degeneration is primary, then remember to exercise, and check diet and stress levels. Try MSM glucosamine and chondroitin sulphate. Bone broth is great also and contains the latter two products. Epsom salt soaks or baths are also a good idea and very helpful.


    Ageing is not for sissies, nevertheless there has been so much good research and there are so many good products on the market today that no one should go without making some effort to try and improve function. Choose wisely and check with your health practitioner to make sure you have the right balance.

    Remember also that nutrients are only part of the anti-ageing programme. Exercise, stress management, pollution control, a good sleep pattern and weight control are all essential for good health.


    1. Ornish D. Healing the heart, reversing the disease. Alternative Therapies. 1995;1(5):84-92.
    2. Lorgeril de M, Salen P. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction. Final report of the Lyon Diet Heart Study. Circulation. 1999; 99:779-785.
    3. Elson BD, et al. Physiological changes in yoga meditation. Psychophysiology. 1977; 14:52-57.
    4. Wallace RK, et al. The effects of the transcendental meditation and TM-Sidhi program on the ageing process. International Journal of Neuroscience. 1982; 16:53-58.
    5. Council for Responsible Nutrition.
    6. Melissa K, Thomas MD, et al Hypovitaminosis D in medical inpatients. N Engl J Med. 1998; 338(12):777-783.
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