It is common for women with menopause to be confused about the right vitamin routine for their symptoms. Vitamins are a confusing space – there are a litany of options and very little navigation in the crowded vitamin aisles. Given the overwhelming nature of buying vitamins, many women default to getting a women’s multivitamin or age-adjusted women’s multivitamin. However, it is fair to ask whether that is the optimal solution for menopausal symptoms.
The problem with many generic, mass market multivitamin formulas is that they fail to recognize the key differences between individuals and make no adjustments to the composition or dosing to reflect those differences. You are getting a least common denominator formula for your gender or age. These formulas are very watered-down, and the low dosing prevents many people from experiencing positive health benefits from their vitamin. If you look at the back of a multivitamin label, you will see a broad spectrum of nutrients, typically 30+ “A to Z” nutrients, with dosing levels that are fractions of the Recommended Daily Allowance (RDA) scale.
Is the RDA scale even the right scale to be using? Frequently, the best randomized clinical controlled trials show the need for dosing of nutrients far in excess of the RDA scale. The RDA scale was developed to show average nutrition intake needs for a healthy individual keeping a balanced diet. It is a way to fill gaps in minimum nutritional needs for a standard profile. But, who is a completely healthy individual that keeps a balanced diet anymore? We are living in a age of skewed diets. So, it is fair to ask whether an RDA scale, built for population average profiles, is the best way to calibrate your vitamin for your menopausal symptoms?
Enter Personalized Vitamins
In recent years, there has been the emergence of the personalized vitamin sector. Brands that play in this space will conduct an assessment to determine your vitamin needs. Often times, these assessments will ask about menopausal symptoms. In response to menopause, these brands may alter their formulas and dosing to directly addresses these needs. However, there is an array of models for manufacturing a custom solution, and consumers should be aware of the differences.
The main types of models include: 1) pill packs; 2) liquid mixes; or 3) customized all-in-one tablets. The pill packs are a supply chain innovation; they will repackage standard supplements in daily serving packets with unique recommendations for each individual. The upside of these models is they can provide a broad range of supplements. The downside, of course, is that these models can easily overprescribe supplements, and frequently recommend 10+ daily pills that cost in excess of $100 per month. For many consumers, this will be unsustainable, both from an adherence and cost standpoint.
Another model involves liquid mixes, which can be dispensed by a custom mixing machine (e.g., Keurig-like device) or pre-packaged smoothie pouches. These models are palatable to consumers that have a hard time swallowing pills. The disadvantage of these models is that it requires real hard habit changes to start swallowing a vitamin cocktail every morning. Many consumers balk at the taste and texture of these solutions. The solutions can also reach a high price point, and sometimes require an investment in counter top hardware.
The final area of innovation is customized all-in-one tablets. These companies manufacture a supplement that is more targeted to specific need states. The advantages of these models are that they mimic the “all-in-one” format of standard multivitamins. The price point is also realistic for many consumers, with many that cost $1/day or less. The drawback of these models is that they may not be able to encompass the same range of nutrients as a pill pack. Ultimately, a consumer needs to evaluate the different models and determine which personalized vitamin solution is right for their budget, pill tolerance, and habit building nature.
Finding the Right Nutrients for Menopause
Symptoms of fatigue, difficulty sleeping and hot flashes can drive even the most steady of women to the brink of insanity. Regular exercise can significantly help decrease hot flashes and improve a good night’s sleep. If you have low vitamin levels, such as vitamin D and iron levels, they can contribute to the exhaustion. Supplementing vitamin deficiency is a good place to start. Melatonin at bedtime, can also aid in catching some sleep.
There are a group of women who find relief from Black Cohosh. There is limited evidence at this time showing the effectiveness of Black Cohosh, but there are ongoing studies investigating its properties. It is important to look for a USP or GMP-certified supplement given that Black Cohosh is grown in the wild and is easy to misidentify. This supplement should also be avoided if you have any liver issues.
Flaxseed oil contains lignans which may help with menopausal symptoms including hot flashes. Studies are mixed. If you do want to try flaxseeds, it is easy to buy then at the grocery store and grind them up yourself in your coffee grinder to activate oils. Try sprinkling them on salads or adding them to granola or yogurt.
The properties in soy mimic estrogen, which in turn, may improve hot flashes. More specifically, Asian women have less symptoms of menopause and a high soy-based diet may be the missing link. Women with a history of breast cancer should avoid soy. Also, those ladies on thyroid medication should not take soy products within 3 hours of thyroxine.
While there are many articles on the internet suggesting DHEA supplements to help with mood and low libido, there is good reason to show caution with them. Since DHEA is a testosterone byproduct, it leads to unwanted hair in places you don’t want to see grow. We often see women in the office with thinning hair or increased hair loss because they are taking these supplements.
Another popular internet supplement is Dong Quai, a Chinese herb. This also may have long term risks including increased cancer risks. There is no solid evidence that it actually improves hot flashes.
Overall, it is important to consult your physician around your supplement routine. For those that choose a personalized vitamin brand, they are more likely to find supplements that are targeted to their needs. The industry is advancing rapidly and savvy consumers will keep pace with the changes by exploring a personalized vitamin as an alternative to a mass market selection.