“What medications are you taking? Nothing? What about any vitamins or supplements?” Because most vitamins and supplements are available over the counter, many women do not necessarily think to include them when discussing their medications with their physician.
A 2013 study published in JAMA found that 49% of adults report using a dietary supplement. The most common reasons for supplement usage were to improve or maintain health, and women reported using calcium for bone health. Of all of the supplements used, only 23% were based on recommendations of a health care provider. There are times in a woman’s life where certain vitamins or supplements are recommended.
For women of childbearing age or planning a pregnancy, a prenatal vitamin that has 0.4 mg of folic acid is recommended. Folic acid deficiency is linked to birth defects in the developing fetus. Some women depending on their medical history or current medications may require additional supplementation.
Women at risk for vitamin D deficiency include those over age 65, or those that are pregnant or breastfeeding. Vitamin D is important due to its role in calcium absorption. The Institute of Medicine recommends 600 IU daily for children and adults up to age 70, and 800 IU daily for people over age 71. Supplementation beyond this can cause increased calcium absorption and increased risk for kidney stones.
The role of calcium in preventing bone fractures has been called into question recently, and there does not appear to be any benefit beyond the recommended 1000 mg to 1200 mg of calcium per day, of which most can be consumed through diet. Too much calcium carries an increased risk of kidney stones, intestinal side effects, and heart attacks.
Other herbal supplements often have claims to potential benefits, but they may have harmful interactions with other medications prescribed by your health care provider. Most important is a healthy diet, exercise, and some sunlight exposure. If you aren’t sure what is right for you, talk with your health care provider.
Helen A. Dunnington, MD is the ACOG District XI Junior Fellow Chair. She is an Assistant Professor and Associate Clerkship Director in the Department of Obstetrics and Gynecology at Baylor College of Medicine, TCH Pavilion for Women.