Bill's retired and lives alone. Often he's just not hungry or is too tired to fix a whole meal. Does he need a multi-vitamin or one of those dietary supplements he sees in ads everywhere? He wonders if they work—will one help his arthritis, or another give him more energy? And, are they safe?

"Dietary supplements" used to make you think only of vitamins and minerals. But, today this big business makes and sells many different types of dietary supplements that have vitamins, minerals, fiber, amino acids, herbs, or hormones in them. Supplements come in the form of pills, capsules, powders, gel tabs, extracts, or liquids. Sometimes you find them added to drinks or energy bars. They might be used to add nutrients to your diet or to prevent health problems. You don't even need a prescription from your doctor to buy dietary supplements.

Who Needs a Dietary Supplement?

Ads for supplements seem to promise to make you feel better, keep you from getting sick, or even help you live longer. Often there is little, if any, scientific support for these claims. In fact, some supplements can hurt you. Others are a waste of money because they don't give you any health benefits.

So, should you or your elderly parents take a supplement? You might want to talk to a doctor or a registered dietitian to answer that question. A friend, neighbor, or someone on a commercial shouldn't be suggesting a supplement for you or an elderly relative.

Are Supplements Safe?

If you or your senior parent is thinking about taking a supplement, you should remember that these "over-the-counter" substances are not like the penicillin or blood pressure medicine a doctor might prescribe. The U.S. Food and Drug Administration (FDA) has to check prescription drugs to make sure they are safe and do what they promise before they are sold. The same is true for "over-the-counter drugs" like cold and pain medicines. It is not the FDA's job to check dietary supplements in the same way. That means that they are not reviewed by the FDA before being sold. However, it is the FDA's job to take action against unsafe products on the market. Only if enough people report problems with a dietary supplement, can the FDA study these possible problems and take action.

Vitamins and minerals are nutrients found naturally in food. We all need them to stay healthy. The benefits and side effects of many vitamins and minerals have been studied. The best way to get vitamins and minerals is through food consumed, not through any supplements taken. You and your senior mom or dad should try to eat the number of servings of food recommended by the U.S. Department of Agriculture's Food Guide Pyramid each day. Pick foods that are lower in fat and added sugars. If you or your senior parent can't eat enough, then ask a doctor if taking a multivitamin and mineral supplement is necessary.

Remember, the supplement doesn't need to be a "senior" formula, it shouldn't have large or "mega-doses" of vitamins and minerals, and generally store or generic brands are fine.

So how much should be taken? The National Academy of Sciences (NAS) has developed recommendations for vitamins and minerals. Check the label on the supplement bottle. It shows the level of vitamins and minerals in a serving compared with the suggested daily intake.

For example, a vitamin A intake of 100% DV (Daily Value) means the supplement is giving you the full amount of vitamin A you need each day. This is in addition to what you are getting from your food.

Some people might think that if a little is good, a lot must be better, but that doesn't necessarily apply to vitamins and minerals. Depending on the supplement, the age of the person taking it, and their health, taking more than 100% DV could be harmful to overall health. Also, if the body cannot use the entire supplement taken, you or your elderly parent has wasted money. Finally, large doses of some vitamins and minerals can also keep prescription medications from working as they should. People over the age of 50 might need certain supplements, so talk to your senior parents' doctor before starting supplements.

Vitamin and Mineral Intake Guidelines for Seniors

  • Vitamin B12 — 2.4 mcg (micrograms) of B12 each day. Some foods, such as cereals, are fortified with this vitamin. But, up to one-third of older people can no longer absorb natural vitamin B12 from their food. They need this vitamin to keep their blood and nerves healthy.
  • Calcium — 1200 mg (milligrams), but not more than 2500 mg a day. As people age, they need more of this and vitamin D to keep bones strong. Bone loss can lead to fractures, mainly of the hip, spine, or wrist, in both older women and men.
  • Vitamin D — 400 IU (international units) for people age 51 to 70 and 600 IU for those over 70, but not more than 2000 IU each day.
  • Iron — Men and postmenopausal women need 8 mg of iron a day. Extra iron may be necessary for women past menopause who are using hormone replacement therapy. Iron helps keep red blood cells healthy. Postmenopausal women who use hormone replacement therapy may still experience a monthly period and they need extra iron to make up for this loss of blood.
  • Vitamin B6 — 1.7 mg for men and 1.5 mg for women daily. This vitamin is needed for forming red blood cells and to keep overall health.

What Are Antioxidants?

You may have heard about the possible benefits of antioxidants, natural substances found in food. Right now, there is no proof that large doses of antioxidants will prevent chronic diseases such as heart disease, diabetes, or cataracts. Eating fruits and vegetables (at least five servings a day) rather than taking a supplement is the best way for both you and your senior parent to get antioxidants. Vegetable oil and nuts are also good sources of some antioxidants. Non-dairy calcium sources are especially good for people who cannot use dairy products.

What About Herbal Supplements?

You may have heard of ginkgo biloba, ginseng, Echinacea, or black cohosh. These are examples of herbal supplements. They are dietary supplements that come from certain plants, and since they come from plants, it's easy to think they are safe. Furthermore, although herbal supplements are not approved as drugs, some are being studied as possible treatments for illness. However, it's still too soon to tell. Remember some strong poisons (like hemlock) and some prescription medicines like cancer drugs come from plants as well, so care should be taken.

When you or your elderly parent use any dietary supplement including herbals for a health problem, you are using that supplement as a drug. Because the ingredients may have an effect on the body, they can interfere with medications already being taken. Some herbal supplements can also cause serious side effects such as high blood pressure, nausea, diarrhea, constipation, fainting, headaches, seizures, heart attack, or stroke.

If you are thinking about using dietary supplements for your senior parent, remember:

  • Talk to the doctor or a registered dietitian first. Just because something worked for your neighbor's elderly parent, doesn't mean the same will be true for your senior mom or dad.
  • Use only the supplement the doctor or dietitian decided on—don't buy combinations with unnecessary added supplements.
  • If the doctor does not suggest a dietary supplement, but your senior parent has decided to use one anyway, tell the doctor. Then he or she can keep an eye on your aging parent's health and adjust their other medications if needed.
  • Learn as much as you can about the supplement your senior mom or dad is thinking about, but be aware of the source of the information. Could the writer or group profit from the sale of a particular supplement?
  • Buy brands you know from companies you, your doctor, your dietitian, or your pharmacist know are reputable.
  • Remember that many of the claims made about supplements are not based on enough scientific proof. If you have questions about a supplement, contact the firm or a doctor and ask if it has information on the safety and/or effectiveness of the ingredients in its product.

Here's what one active older person does: When Pearl was nearing 60, she was concerned about remaining healthy and active as she aged. She began to exercise. Now she takes a long, brisk walk 3 or 4 times a week. In bad weather, she joins the mall walkers. In good weather, she also works in her garden. She had long since stopped smoking. Pearl tries to follow a healthy diet. She reads the newspaper daily. She's even learning how to use a computer and keeps in touch with her family by email, as well as phone calls. She always wears a seatbelt when in a car. Last month, she danced at her granddaughter's wedding. Pearl is now 84 years old.

Have your elderly parents try following Pearl's example—sticking to a healthy diet, exercising, keeping their minds active, not smoking, and seeing their doctors regularly.

The National Institute on Aging (NIA), one of the 27 Institutes and Centers of the National Institute of Health (NIH) leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people.