Menopause and the perimenopause transition is a truly unique experience. Whether you start to feel mind and mood changes in your late thirties or a multitude of symptoms in your fifties, the range and severity of which can be so broad, due to in part, our genetic make-up, health status, lifestyle habits, stress load, support network and of course dietary habits. There really isn’t one supplement to meet all needs of all women.

When you look at supplement complexes that claim to address a wide variety of symptoms, the likelihood is that they won’t…at least not in a significant way. The reason for this is that large amounts of herbals and some nutrients are required to tackle acute symptoms and quantities often just aren’t high enough in many supplement complexes.

However, if you are new to supplementation, need a general pick-me-up and your symptoms are mild, a complex might work well for you. Long standing or severe symptoms are best supported via nutrition consultations as they offer the best value by highlighting the core issues, targeting them directly through diet, supplements and lifestyles tweaks and in the long run, offering best value for money.

Speaking generally, with no underlying health conditions such as autoimmunity or blood clotting factors to consider, from late thirties onward women will benefit from daily supplementation of:

Ø  Omega 3 (EPA) – to support heart health and more

Ø  Strains of bacteria – to support gut health and more

Ø  Magnesium – for many biological processes

Ø  Vitamins D & K – for bone formation

Other helpful ingredients for perimenopause and beyond:

o   Vitamin B6 – to help support normal hormone balance

o   Vit B12 – supporting normal neurological and psychological functioning and more

o   Vit B9 (folate) – supporting normal psychological function, cell division and more

o   Isoflavones – to support the symptoms of menopause

o   Adaptogenic herbals such as Rhodiola & Ashwagandha

o   Ginkgo biloba – for microcirculation

o   Antioxidant compounds for overall health

NB herbals can interact with many prescribed medications. Seek approval of your GP or specialist before combining these.

Natural vs synthetic nutrients

Food sourced nutrients such as Vitamin D from mushrooms or Vitamin C from Acai berries are used in a number of supplement brands. Food sourced nutrients come with the natural co-factors of the vitamin or mineral attached – this means that they are more bioavailable, and our bodies are able to utilise them more effectively. However, these are more expensive than the lab made versions and so are used less often. Lab made nutrients are able to be absorbed and utilised by the body, albeit at a lower rate, but they are effective to a degree.

Vegan nutrients in supplements are often synthetic, lab made versions of nutrients.

Methylated vitamins

Methylation is essential for the production of certain bioactive vitamins (e.g., folate and

vitamin B12), amino acids, neurotransmitters, hormones, red blood cells, DNA, RNA, and

antioxidants. Symptoms of poor methylation can include low levels of neurotransmitters, histamine intolerances, fatigue, mood disorders, allergies and sensitivities, cognitive impairment, heart disease and stroke, various types of cancers, and neurological diseases, including Alzheimer’s disease, Parkinson’s, and multiple sclerosis.

A substantial portion of the population inherits mutations in the methylation gene (MTHFR). Two relatively common DNA sequence variants, known as single nucleotide polymorphisms (SNPs), can be examined: C677T and A1298C. Genetic variations in the MTHFR gene may lead to altered enzyme activity, resulting in reduced folate levels and elevated homocysteine levels in the body. Homocysteine is an amino acid that can be detrimental to health when present in high concentrations. The MTHFR enzyme also contributes to the production of an essential molecule called SAM, which is crucial for numerous biological processes, including the synthesis of neurotransmitters, which are chemicals that facilitate brain function.

Methylated vitamins fall into the category of more bioavailable for us to absorb. Healthy

adults can methylate non methylated vitamins to unlock their full potential but it means that we are not receiving the most available form from our supplement (or bang for our buck). A number of health conditions may mean we are unable to convert vitamins into their methylated forms and something as common as digestive issues that cause poor absorption may be an indicator of this. Older adults, neurological issues, pregnancy and inflammatory bowel disease (IBD) such as Crohn’s or Coeliac conditions will fair better using methylated versions of vitamins.

Food sources of methylated B vitamins include leafy greens, cruciferous vegetables, eggs, fish, and meat. Vegans may need to supplement for best health outcomes and deficiency prevention.

If you take supplements and would like the methylated versions of B vitamins, look

for the following:

Methylcobalamin – Vit B12

Methylfolate – Vit B9 or Folate

To support methylation in the body (1), look for the following in supplemental

ingredients listings:

B6 – Pyridoxal ‘5 – Phosphate

B2 – Riboflavin ‘5 – Phosphate

Magnesium

Vitamin D

Betaine

Co enzyme Q10

Choline or phosphatidyl choline

Chelated minerals

Just like B vitamins, there are more bioavailable sources of minerals available in some food supplements. Chelation is a process whereby a mineral is attached to an amino acid, allowing for improved absorption and utilisation by the body (2).

Those with digestive issues (3) , during pregnancy and the elderly population may benefit most from chelated minerals. And those who take some medications such as PPI (proton pump inhibitors like omeprazole) can interfere with magnesium absorption (4). But here’s some good news: chelated minerals which are bound to amino or organic acids don’t need as much stomach acid to be efficiently digested.

Examples of chelated magnesium include:

 Magnesium ascorbate

 Magnesium carbonate

 Magnesium citrate

 Magnesium fumarate

 Magnesium gluconate

 Magnesium lactate

 Magnesium malate

 Magnesium orotate

 Magnesium aspartate*

 Magnesium glycinate* (also known as magnesium bisglycinate or diglycinate)

 Magnesium taurate* (also known as magnesium ditaurate)

 Magnesium threonate* (also known as magnesium L-threonate)

*Other minerals are also widely available in their chelated forms in the supplement industry to improve bioavailability and absorption.

So, is methylation or chelation important when buying food supplements?

Investing in the most bioavailable forms of nutrients definitely has its advantages. If you are looking for high impact supplements, have absorption issues or fall into one of the health categories I have described, its worth paying more for methylated and chelated nutrients.

A note on binders and fillers

Numerous supplement brands incorporate artificial binders and fillers to maintain the volume and consistency of capsules and tablets. Over time, the inclusion of these substances in your daily regimen may adversely affect your overall health. Research findings are inconclusive regarding their long-term use, but it is important to note that many of these ingredients meet the regulatory standards for inclusion in food supplements within the EU. Below are some of the artificial ingredients commonly found in supplement ingredient lists:

o   Parabens (mixed research with minimal toxicity and not zero toxicity reported)

o   Sodium benzoate (restricted use due to toxicity issues)

o   Titanium dioxide (linked to many health concerns)

o   Magnesium silicate (synthetic form of talc)

o   GM soybean oil

o   Shellac (not artificial but mixed research on its safety)

o   GM corn starch

o   Citric acid – often derived from GM corn

o   Talc (not artificial but linked to some adverse health outcomes)

o   Potassium sorbate (possible changes to gut bacteria)

o   Maltodextrin (possible gut health issues)

Natural binders and fillers such as rice flour play a role in other supplement brands. When used in quantities of more than 2% of the overall volume they are legally required to declare the inclusion of these in the ingredients listing.

Do the benefits outweigh the risks?

The benefit of taking high dose supplements for a short time to address acute conditions may outweigh the risks of some inclusion of additives – only you can be the judge of this.

My view is that:

·       Synthetic fillers may be used short term if necessary to address specific symptom needs, providing they do not conflict with current health conditions

·       Natural Fillers are more appropriate for longer term supplement use

·       Filler free supplements are ideal but less widely available

If you have tried and tested a variety of supplements and are tired of counting calories, book a nutrition consultation or menopause coaching session with me today. I can guide you in the right direction to what may work for your unique menopause experience.

References

1 Bekdash RA. Methyl Donors, Epigenetic Alterations, and Brain Health: Understanding the Connection. Int J Mol Sci. 2023 Jan 25;24(3):2346. doi: 10.3390/ijms24032346. PMID:

36768667; PMCID: PMC9917111

2 Uysal N, Kizildag S, Yuce Z, Guvendi G, Kandis S, Koc B, Karakilic A, Camsari UM, Ates M. Timeline (Bioavailability) of Magnesium Compounds in Hours: Which Magnesium Compound Works Best? Biol Trace Elem Res. 2019 Jan;187(1):128-136. doi: 10.1007/s12011-018-1351-9. Epub 2018 Apr 21. PMID: 29679349.

3 Schuette SA, Lashner BA, Janghorbani M. Bioavailability of magnesium diglycinate vs magnesium oxide in patients with ileal resection. JPEN J Parenter Enteral Nutr. 1994 Sep- Oct;18(5):430-5. doi: 10.1177/0148607194018005430. PMID: 7815675.

4 William JH, Danziger J. Magnesium Deficiency and Proton-Pump Inhibitor Use: A Clinical Review. J Clin Pharmacol. 2016 Jun;56(6):660-8. doi: 10.1002/jcph.672. Epub 2015 Dec 30. PMID: 26582556.