Finlay Haswell, Junior Physiologist at AXA PPP healthcare

Womens vitamins, minerals and supplements: who needs them, when and how much?

12 February 2020

This article was last reviewed by Raj Kundhi (ANutr), Associate Nutritionist and Senior Physiologist at AXA PPP healthcare.

According to Mintel, sales of vitamin, mineral and supplements (VMS) in the UK grew to £442 million in 2018, with this figure expected to rise to £447 million by 2023.

A greater interest in health across our wider society, our ageing population and the increasing trend towards plant-based diets are all driving factors in this continued growth, as consumers take a more proactive approach to managing their health and wellbeing, now and for the longer term.

Despite a rapidly growing male market for nutritional supplements in the UK (up 29% compared to a more modest increase in female users of 2.5%), women still spend the most on VMS products. However, only certain groups could actually benefit from taking them.

Finlay Haswell, AXA PPP Junior Physiologist tells us which vitamins and minerals women need for good health, and when and why certain supplements may be worth considering.

What vitamins and minerals do we need for good health?

“Vitamins and minerals are important to preserve health and to enable the body to function properly. However, we only need them in tiny amounts to reap the benefits,” says Finlay. ”The good news is that most of us can get all the vitamins and minerals we need from exposure to daylight (in the case of vitamin D) and a balanced diet.”

That means eating a variety of foods, including

  • Five or more portions of fruit and vegetables a day – try incorporating different coloured fruit and veg too, as this helps ensure you get a good balance of antioxidants and phytochemicals.
  • Starchy foods, such as potatoes, bread, rice, pasta and cereals, with these making up approximately a third of your overall intake – ideally go for wholegrain varieties and keep the skin on potatoes (and all fruit and vegetables where appropriate) – to get additional fibre into your diet.
  • A small amount of dairy or dairy alternatives, .e.g. milk, yoghurt, cheese.
  • Some protein – found in meat, fish, eggs, nuts and pulses, e.g. beans and lentils.
  • A small amount of healthier fats, such as olive, rapeseed and vegetable oils and spreads.
  • Drinking plenty of fluids (this doesn’t apply to caffeinated drinks or alcohol!).
  • Limiting foods high in fat, sugar and salt.

That said, there are instances in life when women could benefit from taking supplements. Finlay explains which they are and why.

1. Folic acid/folate (vitamin B9)

What is folic acid?

Folate and its man-made equivalent, folic acid, is a B vitamin - essential for the formation of red blood cells. It also plays an important role in the process of cell division, which enables us to grow and develop, and in creating and repairing our DNA. If you’re not pregnant or planning a baby, it can usually be found in sufficient quantities in a healthy, balanced diet as described above.

Who may need extra folic acid and how much?

It’s recommended that all women who are planning to get pregnant or are pregnant need to have 400–800mcg of folic acid each day, from naturally occurring dietary sources (folate) or a dietary supplement (most prenatal vitamins have this amount). There are no long term stores of folate in the body, so ensuring you keep your levels topped up, by whichever means you choose, is vital.

During pregnancy, folic acid helps prevent neural tube defects ((birth defects of the brain and spinal cord) in a developing foetus and the amount women need in their diet during this time – and throughout lactation – increases, making it particularly important to have a diet rich in folate and/or take a folic acid supplement. Because a baby’s neural tube develops during the first weeks of pregnancy (often before a woman becomes aware of the pregnancy), taking folic acid supplements (at least 5mg/d) before you start trying for a baby is recommended. If you’re suffering from morning sickness, try taking your supplement on a full stomach and at a time where you feel less sick (e.g. during the evening).

It’s particularly important to seek guidance from your GP before taking any folate supplements whilst pregnant if you:

  • have had a pregnancy previously affected by neural tube defects
  • are diabetic, or
  • take any anti-epilepsy medication.

Where can you get it?

Food sources of folate include leafy green vegetables, oranges, nuts, beans, chicken, lean beef, whole grains and fortified foods, such as cereals with added folic acid (always check the label).

Although present in food sources, if you're pregnant or trying for a baby, it’s advised that you take a 400-mcg folic acid supplement daily until you're 12 weeks pregnant and continue to include a diet rich in folate for the rest of pregnancy and during lactation.

2. Iron

Why do we need iron?

A lack of iron can lead to iron-deficiency anaemia, which causes your heart to work harder to pump oxygenated blood around your body, and can leave you feeling tired, weak, dizzy and breathless. If your period is heavy or prolonged, you’re at a higher risk of developing this condition. Although supplementation may be necessary in some circumstances, always consult your GP before taking an iron supplement as too much can case stomach pain, constipation, vomiting and diarrhoea, and very high doses can be fatal.

Who may need an iron supplement and how much?

All women who menstruate lose iron during monthly bleeding and may need additional iron if they’re not getting enough from their diet. If your period is heavy, prolonged or if iron isn’t replenished during your cycle, you should consider talking to your GP about taking an iron supplement. During teenage years, iron requirements increase. This is particularly true in teen girls, especially heavily menstruating teen girls. The American Journal of Epidemiology (2013) showed that, in addition to heavy periods causing iron deficiency, premenstrual syndrome can also be a result of iron deficiency.

Women also need more iron during pregnancy to supply enough blood for their growing babies. Iron levels can be met through food sources, although if the iron level in your blood becomes low, a GP or your midwife will advise you to take iron supplements.

The recommended daily intakes of iron for women at different life stages are shown below:

  • 14.8mg a day for girls ages 14 to 18
  • 14.8mg a day for women aged 19 to 50
  • 8.7mg a day for women over 50.

Where can you get it?

Food sources of iron include lean meat, seafood, cereals/breads fortified with iron, nuts, beans, spinach and tofu. Consider combining different food sources of iron in your meals, particularly if you are a vegetarian. Liver is another rich source of iron but can be harmful to your unborn baby, so avoid eating it if you’re pregnant. You can find a detailed list of foods to avoid during pregnancy on the NHS website. If an iron supplement is appropriate for you, there are a plenty to choose from, in varying strengths and forms, including liquid, tablet, chewable and even spray versions.

3. Calcium

Why do we need calcium?

Calcium helps protect and build strong bones and reduce the risk of osteoporosis in later life. Your body stores calcium in your bones and teeth. If you aren’t getting enough calcium, your body will take it from your bones, making them weak and fragile and increase the risk of fractures and breaks.

The body also needs calcium to move muscles and for nerves to carry messages between the brain and body.

Vitamin D helps with the absorption of calcium from the foods that we eat so it’s important that there is a balance between the two. We mostly get vitamin D from sunlight throughout the year (we should spend at least 15 minutes, 3 times a week in the sun) and from foods such as oily fish, eggs and fortifies cereals and breads, however all adults and children over the age of one have been recommended to take a daily vitamin D supplement of 10mcg.

Who may need a calcium supplement and how much?

Calcium is essential for healthy bones, particularly in growing children, as their bones absorb calcium to strengthen them for adulthood. Calcium requirements for girls aged 7-10 are 550mg/day and increase to 800mg/day in 11-18-year-old girls. Adults should aim for 700mg/day, breastfeeding mums should have 1250mg/day and those suffering from coeliac disease or osteoporosis should have at least 1000mg/day.

Calcium is also important after the menopause, when you lose the bone-protective effects of oestrogen. Oestrogen is one of the main female sex hormones that’s needed in the female body for puberty, menstruation, pregnancy and bone strength. Because oestrogen helps with bone strength, post-menopausal women are more at risk of osteoporosis, a condition where bones become fragile and are more easily broken. After menopause, you need 1200mg of calcium each day to help slow the bone loss that comes with ageing. For more on how to improve bone strength, take a look at our article on how to boost your bone power.

Where can you get it?

Food sources of calcium include leafy green veg (such as, kale, spinach, cabbage), milk*, cheese, yoghurt, bony fish, seeds, as well as calcium fortified products, such as some breakfast cereal, oatmeal and orange juice (do check labels).

*It's important to note that most milk substitutes are fortified with calcium. A glass of cows’ milk contains around 300mg of calcium. Make sure you choose a milk substitute that contains at least 120mg of calcium per 100 ml. Our article on dairy free milk alternatives provides more information.

4. Vitamin B-12

Why do we need vitamin B12?

Vitamin B12 performs a similar role to B9 (or folate). It’s needed for the creation and multiplication of red blood cells and for making and repairing our DNA. It’s also important for brain function and for maintaining a healthy nervous system. Too little folate can cause folate deficiency anaemia, symtoms of which range from tiredness and a lack of energy, to muscle weakness, impaired vision and phycological issues, such as confusion and memory problems and depression.

Who may need extra vitamin B12 and how much?

You may need a vitamin B12 supplement if you:

  • are pregnant: vitamin B12 is very important for your unborn baby’s development.
  • follow a vegetarian or vegan diet: vitamin B12 comes mostly from animal products. It can also be found in fortified products, such as cereals, yeast extract, bread and plant-based milk alternatives, but you may need to take a supplement to make sure you get enough.
    Find out more about eating well on a plant-based diet in our articles What can a vegan eat? And Dairy free milk alternatives. Additionally, talk to your GP or a midwife if you are breastfeeding, because your baby may need to take a supplement too.
  • are aged 50 or older: as we age, our bodies can’t absorb vitamin B12 as well, so we may need to get more of it from supplements or fortified foods.

The recommended intake of B12 is 1.5 micrograms a day for adults aged 19-64. It’s important to get your folate levels checked by the GP too if your vitamin B12 levels are low. Treatment for low folate levels can help to improve your symptoms but can hide vitamin B12 deficiency.

How to find it?

Food sources of vitamin B12 include meat, salmon, cod, milk, cheese, eggs and some fortified breakfast cereals. If your diet contains meat, fish or dairy foods, you should be getting enough vitamin B12 from diet alone; however, as vitamin B12 is not found naturally in foods such as fruit, vegetables and grains, vegans may not get enough of it and may have to supplement. As before, if you’re pregnant there are certain foods to avoid or be careful with. These include some cheeses, fish, meat and eggs. You can find full details on the NHS website.

Summary

Vitamin and mineral supplements are usually only appropriate if you have a clinical need or are otherwise unable to meet the recommended daily amounts, for your age and particular circumstances, naturally.

Supplements shouldn’t be used as a substitute for a balanced diet and healthy lifestyle. If you do take them, make sure you don’t exceed your daily requirement as this can be harmful to your health. Be particularly careful if you take multiple supplements that haven’t been prescribed by a doctor, dietician or other suitably qualified practitioner. For example, someone taking a daily multivitamin in combination with a ‘skin, hair and nails’ supplement, or one or more individual vitamins or minerals, is likely to be taking too much of one or more component, which, as well as being potentially damaging, is a waste of money! Please talk to your GP or dietitian for more information on supplementation.

Further information

If you have a question about nutritional supplements, pregnancy or any other aspect of your health and wellbeing, our Health at Hand team are available to support you, at any time of the day and night. Simply post your question online using our Ask the expert service and one of our team of nurses, midwives and pharmacists will get to you with an answer as soon as they are able to .You’ll usually hear back within a couple of hours but it could take up to 24 hours to respond, depending on the nature of your enquiry and availability of appropriately qualified experts.

Alternatively you can find lots more expert-led information on diet and nutrition plus recipes that pack a healthy punch in our diet and nutrition hub, or check out our women’s health hub for more like this.

Additional resources

Pregnancy hub – AXA PPP healthcare
Thinking of going vegan? Here’s what you need to know – AXA PPP healthcare
Dairy free milk alternatives - AXA PPP healthcare
Boost your bone power! - AXA PPP healthcare

References

D outshines C to become the UK's favourite single vitamin supplement. Mintel. 18 Jan 2019. Accessed 11 Feb 2020
Five emerging trends in vitamins, minerals and supplements. Grant Thornton. 3 Feb 2017. Accessed 11 February 2020
Vegan trend propelling growth of UK dietary supplements market. Pharma Intelligence, Informa. Accessed 11 February 2020
Vitamin D - NHS website
Iron deficiency anaemia - NHS factsheet
Menopause and your bone health - NHS website
Calcium Food Fact Sheet - British Dietetics Association
Why do I need folic acid in pregnancy? NHS website
B vitamins and folic acid - NHS website
Patricia O. Chocano-Bedoya, JoAnn E. Manson, Susan E. Hankinson, Susan R. Johnson, Lisa Chasan-Taber, Alayne G. Ronnenberg, Carol Bigelow, Elizabeth R. Bertone-Johnson, Intake of Selected Minerals and Risk of Premenstrual Syndrome, American Journal of Epidemiology, Volume 177, Issue 10, 15 May 2013, Pages 1118–1127
John L. Beard, Iron Requirements in Adolescent Females, The Journal of Nutrition, Volume 130, Issue 2, February 2000, Pages 440S–442S
Foods to avoid in pregnancy – NHS website

Ask the Expert

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