Vitamins and Supplements for Seniors

by Richard O’Boyle, Publisher
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Anti-aging and alternative health products are extremely popular among people, especially senior citizens. One in ten seniors uses some type of dietary supplement on a daily basis, such as ginkgo biloba, St. John’s wort, glucosamine, melatonin, and other herbal and botanical preparations. Some of these supplements may indeed have beneficial medical uses, but may also increase risks for adverse reactions.

“Dietary supplements” refers any product intended for ingestion as a supplement to the diet. According to the U.S. Food and Drug Administration, this includes vitamins; minerals; herbs, botanicals, and other plant-derived substances; and amino acids (the individual building blocks of protein) and concentrates, metabolites, constituents and extracts of these substances.

“It's easy to spot a supplement because manufacturers [are required] to include the words ‘dietary supplement’ on product labels. Also, starting in March 1999, a "Supplement Facts" panel will be required on the labels of most dietary supplements,” says Paula Kurtzweil with the FDA. Dietary supplements come in many forms, including tablets, capsules, powders, softgels, gelcaps, and liquids. Though commonly associated with health food stores, dietary supplements also are sold in grocery, drug and national discount chain stores, as well as through mail-order catalogs, TV programs, the Internet, and direct sales.

Proper Nutrition and Supplementation

The role of vitamins and natural hormones has been studied for decades. Vitamins have effects throughout the human body – deficiencies in some vitamins may exhibit themselves as dementia, fatigue, vision problems, discolored skin, or a host of other conditions. It is unclear in may cases whether more than recommended amounts of vitamins leads to improved health.

The Food and Nutrition Board of the Institute of Medicine provides recommendations on the appropriate intake of vitamins and minerals. Over the years, the recommended levels have changed as research improves. Recommended dietary intake levels vary by sex and age group.

Recommended Dietary Intakes for Adults 50+

A 900 units (men) 700 units (women) (maximum upper level of 900 units for men and 700 units for women)

B1 1.2 mg/d (men) 1.1 mg/d (women) (no maximum upper limit set)

B2 1.3 mg/d (men) 1.1 mg/d (women) (no maximum upper limit set)

B6 1.7 mg/d (men) 1.5 mg/d (women) (maximum upper level of 100 mg/d men and women)

B12 2.4 units (men and women) (no maximum upper level limit set)

C 90 mg/d (men) 75 mg/d (women) (maximum upper level of 2,000 mg/d men and women)

D 10-15 units (men and women) (maximum upper level of 50 units men and women)

E 15 mg/d (men and women) (maximum upper level limit of 1,000 mg/d for men and women)

K 120 units (men) 90 units (women) (no maximum upper level limit set)

Roy Ulin, a certified personal trainer and founder of Westhampton Natural Foods in Westhampton, NY, recommends that seniors pursue a healthy lifestyle that in part includes intelligent supplementation. Nutritional supplements are only one piece of a lifestyle that includes avoiding self-destructive activities (such as excessive drinking and cigarette smoking), controlling your weight, getting regular and frequent exercise, and eating a healthy diet, says Mr. Ulin.

When choosing a supplement brand, Mr. Ulin recommends that consumers be skeptical. “Don’t be fooled by labels that say they have been ‘Independently Tested,’” he warns. The supplement industry is not well-regulated and “failing” tests are often ignored. He recommends purchasing products from companies that have their own manufacturing facilities, such as TwinLab, Solgar, Nature’s Bounty, and Country Life, rather than store-brands or private labeled products. Avoid products sold by multi-level marketers.

Some Popular Vitamins and Supplements

Increasingly herbal supplements are being promoted for their medicinal properties. Every day we see advertisements on television, in magazines and on the Internet touting easy-to-swallow pills that contains naturally derived compounds that may (or may not) helps with the numerous problems of aging. Promoters suggest that various pills will improve or maintain one’s health, vision, joint flexibility, mood, or mental state. It should be clear to consumers that this form of advertising is in a gray area and under constant scrutiny by drug regulators.

Popular herbal supplements derived from plants are increasingly appearing in sports drinks, herbal teas, and food products. Read all product labels carefully and ask a salesperson about exotic ingredients that you may not recognize. Remember, supplements can have drug-like effects, which means that they can also interact with prescription drugs and even other supplements.

Vitamin E is a naturally occurring vitamin that is essential for human life. It is studied commonly used as a skin conditioner, antioxidant, heart protector, and memory enhancer. A survey in 2000 showed that more than 37 million Americans take Vitamin E supplements. Research is ongoing and inconclusive about the use of the vitamin for the treatment and prevention of Alzheimer’s Disease. One study has shown that overuse of Vitamin E in the elderly may lead to more severe lung infections.

“Natural Viagra” is a catch-all term for products claiming to enhance male (and sometimes female) potency and erections. The actual components of the supplements vary by product, but may contain herbs such as yohimbe (the bark of an African tree), ma huang (a Chinese stimulant), ginseng, or any other number of natural products including licorice and pumpkin. Caution should be used since these supplements have not been adequately tested for safety and efficacy. Stimulants such as ma huang have also been linked to stroke, heart attack, and death. Impotence is a serious medical condition and should be discussed with a doctor.

Coenzyme Q10 is a naturally occurring antioxidant that exists in all human cells. Ongoing research has shown that the use of coenzyme Q10 may slow the functional decline of patients with Parkinson’s Disease, a neurological disorder. The use of the supplement to improve heart and blood vessel is ongoing and inconclusive.

Calcium is a mineral found in bones and teeth. In older women, reduced absorption of calcium can lead to osteoporosis. Calcium supplements should be taken in small doses throughout the day along with food to ensure proper absorption.

DHEA is a hormone produced by the human adrenal glands. The body uses DHEA to produce other steroidal hormones, such as estrogen and testosterone. DHEA supplements are often touted as a way to reverse the effects of aging by boosting immunity, improving memory, and increasing muscle mass. While animal studies have been promising, there's little evidence that DHEA can do the same for humans. Nevertheless, research is being conducted to see if DHEA can help individuals with auto-immune diseases such as lupus, sexual dysfunction, depression, and chronic fatigue syndrome.

Saw Palmetto is the oily extract of the berries from the saw palmetto, a type of palm tree. It is primarily used to improve urinary flow associated with an enlarged prostate. Consumers should check with a healthcare professional for a proper diagnosis before using saw palmetto, particularly as the typical symptoms of enlarged prostate may signal other, more serious conditions that require prompt treatment.

Garlic is a pungent bulb used as a flavor enhancer. Use of garlic can help prevent hardening of the arteries since it appears to cause moderate, short-term reductions in cholesterol. However, garlic has not been shown to significantly improve HDL (good) cholesterol or serum glucose levels. There is evidence that regular use of garlic may help prevent colds and preliminary evidence that garlic as a food may help prevent cancer.

Melatonin is an amino acid produced by the pineal gland in the brain. It is promoted as a sleep aid, a remedy for jet lag and an anti-aging supplement. The hormone is known to play a role in regulating the body clock's natural wake-sleep cycle, triggering sleep. Use of melatonin appears to be effective in children and otherwise healthy adults (suffering from jet lag), but not the elderly.

Glucosamine is a natural component of joint cartilage. Researchers continue to study the use of glucosamine and condroitin with inconclusive results to date. Side effects may include increased intestinal bloating and softened stools. Since it is often made from shellfish products, people with allergies to shellfish should avoid these products.

Ginkgo Biloba is the powdered extract of the leaves of the Ginkgo tree. It is under heavy study as a possible memory enhancer and treatment for Alzehimer’s Disease. People should consult with their family doctors before using ginkgo biloba extracts. This is especially true for those with disorders in blood circulation or blood-clotting and those taking anti-coagulants such as aspirin. Because not enough research has been done, no specific daily amount of a ginkgo biloba extract can be recommended as safe or effective at this time.

Ginseng is a plant root that has been used in Asia for centuries to for vitality and well-being, among other numerous conditions. While it is generally considered safe, there is some concern that it may adversely affect blood sugar levels. If you or your loved one is diabetic, it is a good idea to consult with your physician.

St. John’s Wort has increasingly been touted as “herbal Prozac.” Some believe that it can help elevate mood and act as an anti-depressant. While it may alleviate mild to moderate depression, and related anxiety and insomnia, physicians worry that people taking the supplement will not get proper psychological counseling. There are widespread concerns that it reduces the effectiveness of some prescription drugs.

Echinacea may enhance the immune system by stimulating the production of white blood cells. However, the flower from which the supplement is derived is related to ragweed, so some people have experienced mild allergic reactions.

Kava is commonly used to relieve anxiety and has also been used as an anticonvulsant. It is dangerous in conjunction with alcohol, sedatives or antipsychotics because it may cause sleepiness and even coma.

As we age and our internal muscle tone decreases, many seniors experience trouble with constipation. One way to help ward off occasional constipation is to take in plenty of fiber. 

Preventing Frauds and Scams

Billions of consumer dollars are wasted on unproven, fraudulently marketed, and sometimes useless health care products and treatments. In addition to wasting their money, consumers with serious medical problems may be wasting valuable time before they seek proper treatment. Some products may cause serious harm and endanger lives.

Remember the first rule of thumb for evaluating health claims: If it sounds too good to be true, it probably is. The FDA and the Federal Trade Commission caution seniors to recognize the typical phrases and marketing techniques used to deceive consumers:
 - The product is advertised as a quick and effective cure-all for a wide range of ailments or for an undiagnosed pain;
 - The promoters use key words, such as scientific breakthrough, miraculous cure, exclusive product, secret ingredient or ancient remedy;
 - The promoter claims the medical profession or research scientists have conspired to suppress the product;
 - The advertisement includes undocumented case histories claiming amazing results;
 - The product is advertised as available from only one source, and payment in advance is required.
 - Don't rely on promises of a "money-back guarantee." Be aware that many fly-by-night operators will not be around to respond to a refund request.

Related Articles

- "Breakthrough? Understanding the Drug Development and Testing Process"
- "Too Good to be True: Preventing Health Frauds and Scams"
- "You and Your Doctor: It Takes Two to Tango"
- "Proper Nutrition 40+"

Online Resources

- U.S. Food and Drug Administration http://www.fda.gov
- National Center for Complementary and Alternative Medicine http://nccam.nih.gov/
- Federal Trade Commission http://www.ftc.gov

Sources

“An FDA Guide to Dietary Supplements” by Paula Kurtzweil, FDA Consumer Magazine Sept-Oct 1998 (Revised January 1999). http://www.cfsan.fda.gov/~dms/fdsupp.html

“A Caution on Vitamin E for the Elderly” by Adam Marcus, HealthScout News. August 13, 2002. http://www.healthscout.com

“Dietary Antioxidants and Related Compounds” Food and Nutrition Board, Institute of Medicine. http://www.iom.edu/iom/iomhome.nsf/pages/Fnb+Antioxidants?OpenDocument

“Dietary Reference Intakes: Vitamins” Food and Nutrition Board, Institute of Medicine. http://www.iom.edu/iom/iomhome.nsf/WFiles/webtablevitamins/$file/webtablevitamins.pdf

“Glucosamine and chondroitin for treatment of osteoarthritis: A systematic quality assessment and meta-analysis,” by T. E. McAlindon TE et al. Journal of the American Medical Association 283:1469-1475, 2000.

“Product Review: Glucosamine and Condroitin” ConsumerLab.com, January 2000. http://www.consumerlab.com/results/gluco.asp

“Product Review: Saw Palmetto,” ConsumerLab.com, December 1999. http://www.consumerlab.com/results/sawpalmetto_sam.asp?z=1

“Product Review: Melatonin Supplements,” ConsumerLab.com, 2002. http://www.consumerlab.com/results/melatonin.asp

“Product Review: Garlic Supplements,” ConsumerLab.com, 2002. http://www.consumerlab.com/results/garlic.asp

“Product Review: DHEA Supplements,” ConsumerLab.com, 2002 http://www.consumerlab.com/results/dhea.asp

 

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