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supplements for older adults with medical issues are not always a good thing

targeting how and why older adults with complex medical issues take vitamin and mineral supplements can prevent unwanted side effects.

by katherine j. ford., derek j. jorgenson, eric j.l. landry, and susan j. whiting
vitamin and mineral supplements have been available for decades, and they’re commonly used by people who feel they’re not getting enough nutrients from the food they eat. but sometimes we can overcorrect: over-supplementation is when people take more than their bodies can tolerate. this can cause harmful or unpleasant side effects — for example, taking too many calcium supplements can cause kidney stones. taking the improper amount of vitamin and mineral supplements is common with older adults who have complicated medical issues.

what the researchers studied and what they found

researchers looked at how adults who were 50 years of age and older, and who took a medication assessment at the university of saskatchewan medication assessment centre between 2014 and 2017, were taking vitamin and mineral supplements. more specifically, they looked at the amount of micronutrients these adults were taking in these supplements. micronutrients such as zinc, vitamin c, and calcium are important for a person’s growth and well-being, but only in safe amounts.
more than 200 men and women were included in this study. regardless of age or sex, 75 per cent of them reported taking one or more supplements every day. of those individuals using supplements, 39.8 per cent took more than their upper limit ― the highest safe level — of one or more micronutrients. over-supplementation generally resulted when people took more than one type of supplement per day. because of these adults’ complex medical profiles, taking more than the upper limit of any of the micronutrients could put them at a higher risk of unwanted health effects.
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canadian society for exercise physiology

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taking certain vitamin and mineral supplements might be the right course of action for people with complex medical issues. for example, adults older than 50 years of age or younger adults already at risk may take vitamin d to prevent osteoporosis. but high intakes of some nutrients can result in over-supplementation, with little evidence of any benefit if the individual taking them had no previously reported medical condition. for example, the study found that, while niacin is not a nutrient older adults need to worry about, 14.7 per cent of individuals took too high an amount as a supplement. this can trigger unwanted reactions, such as flushing.
another problem is not enough supplementation. although it is recommended that older adults take vitamin d supplements, only 64.6 per cent of older people in the study reported taking the right amount of vitamin d.

what it means

to avoid over-supplementation, an individual’s dietary intake and medical issues should be looked at when taking mineral and vitamin supplements. the findings highlight the importance of a multidisciplinary health care approach to supplements for older adults with complex medical conditions. health care providers in medicine and nutrition should collaborate to help decide which supplements older adults need. this could help ensure that older adults with complex medical conditions take the right supplements and in the right amounts, and prevent the harmful results of taking more than they need.

this article was written for the canadian society for exercise physiology by katherine l. ford, derek j. jorgensen, eric j.l. landry, and susan j. whiting. this article summarizes the study ford kl, jorgenson dj, landry ejl, whiting sj. vitamin and mineral supplement use in medically complex, community-living, older adults.  applied physiology, nutrition and metabolism. published on the web 10 january 2019, https://dx.doi.org/10.1139/apnm-2018-0515 . this summary was written for the canadian society for exercise physiology and has been reviewed by the csep knowledge translation committee.

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