Every entry whose writeup carries a note for over 65. The note is the entry’s own — follow it for the full context. See this in the planner →
Supplements
- Alpha-GPCThe stroke-risk association is most relevant here, where baseline cardiovascular risk is already higher.
- Alpha-Lipoic AcidMore likely to be on diabetes or thyroid medication, so the interactions above matter more.
- AshwagandhaPolypharmacy makes interactions more likely, and liver injury reports skew toward people taking several things at once.
- Bacopa MonnieriTake with food to limit the stomach effects, and mind the thyroid and cholinergic interactions if you are on several medications.
- Beta-CaroteneFor age-related macular degeneration, the updated AREDS2 formula replaced beta-carotene with lutein and zeaxanthin, precisely because of the smoker lung-cancer risk.
- Betaine HClLow stomach acid becomes a little more common with age, but it still needs proper diagnosis rather than assumption.
- Black Seed OilPolypharmacy makes the additive glucose- and blood-pressure-lowering effects more relevant.
- BromelainBleeding-risk interactions matter more if you are on anticoagulants, which is common with age.
- CaffeineClearance slows with age and sensitivity to sleep disruption increases, so the same afternoon coffee costs more than it used to.
- CalciumThe reference intake rises to 1,200 mg from 51 for women, and stomach acid falls with age — citrate is the more reliable form.
- Collagen PeptidesCollagen synthesis declines with age, which is the rationale. Resistance training does more for joint and bone health than any powder.
- CoQ10Natural production declines with age and absorption of the oxidised form falls, which is the main argument for ubiquinol in this group.
- Creatine MonohydrateIncreasingly studied for preserving muscle mass and strength in older adults alongside resistance training, with encouraging results.
- Devil’s ClawUlcer risk and polypharmacy both rise with age, making the acid and warfarin cautions more relevant.
- DHEAThe "declining with age therefore replace it" logic is exactly the reasoning that has failed for most hormones. Levels falling is not the same as a deficiency needing treatment.
- ElectrolytesMore likely to have raised blood pressure or reduced kidney function, so the sodium and potassium load deserves more caution.
- Folate (B9)High folic acid intake can mask B12-deficiency anaemia while nerve damage progresses quietly — and B12 deficiency is common in this age group. Check B12 too.
- HawthornCardiac disease and multiple medications are common, making supervision important.
- HMBMuscle loss during hospitalisation and immobility is the strongest use case, and this is the group it applies to.
- Huperzine AThe group most likely to be on interacting dementia or heart medication.
- Inulin (Prebiotic Fiber)May be of interest for mineral absorption and regularity, but titrate slowly to limit gas.
- IronNew iron deficiency in an older adult warrants investigation before supplementation, because gastrointestinal bleeding is a common underlying cause.
- L-ArginineMore likely to be on blood-pressure or nitrate medication, and the post-heart-attack caution applies.
- L-CarnitineSome research on the acetyl-L-carnitine form for fatigue and cognition, but the evidence is limited.
- L-GlutamineThe cirrhosis and hepatic-encephalopathy caution matters more with age-related liver conditions.
- Licorice RootSensitivity to glycyrrhizin rises with age, and polypharmacy makes the potassium and blood-pressure interactions more likely.
- Lutein & ZeaxanthinThe relevant population — this is one of the few supplements with a specific, trial-supported role in later life, but only for people who already have the condition.
- MagnesiumAbsorption falls and kidney excretion rises with age, and several common medications deplete it. Also the group most at risk if kidney function is impaired.
- ManganeseLiver function and manganese clearance decline with age, so avoid unnecessary high intakes.
- MelatoninNatural production declines with age, and this is the group where low-dose melatonin has the most support. Also the group most affected by next-day grogginess.
- Mucuna PruriensThe group most likely to have Parkinson's and to be on the interacting medications listed above.
- Multi-Strain ProbioticImmune function declines with age, which raises the (still small) infection risk from live organisms in frail individuals.
- Olive Leaf ExtractMore likely to be on antihypertensives, where the additive blood-pressure effect and interactions matter most.
- Omega-3 (Fish Oil)Intake is often low, and the triglyceride effect is unchanged with age.
- Panax GinsengPolypharmacy makes the warfarin and blood-pressure interactions more likely to matter.
- PhosphatidylserineThis is the population where benefit has actually been shown.
- PhosphorusKidney function declines with age, so the margin for handling extra phosphate narrows.
- PotassiumMore likely to be on ACE inhibitors, ARBs or diuretics and to have reduced kidney function, all of which raise hyperkalaemia risk.
- PregnenoloneMarketed for age-related memory and energy, but benefits in older adults are unproven.
- Saccharomyces BoulardiiInteraction risk is not the main concern here; older people are simply more likely to be the critically ill or catheterised patients in whom fungaemia has been reported.
- Sodium BicarbonateThe sodium load deserves more caution with age-related high blood pressure or reduced kidney function.
- Turmeric / CurcuminThe osteoarthritis use is most relevant here, but so is polypharmacy — the piperine interaction is the thing to raise with a pharmacist.
- UbiquinolEndogenous CoQ10 synthesis declines with age, which is part of the rationale for the reduced ubiquinol form, though clinical benefit in healthy older people is unproven.
- Vitamin AClearance slows with age, so the same intake produces higher blood levels — a reason to be more, not less, conservative.
- Vitamin B1 (Thiamine)Poor intake, diuretic use, and alcohol all cluster in later life, and deficiency can present as confusion that gets attributed to something else.
- Vitamin B12Absorption from food declines with age even when intake is fine, which is why supplemental or fortified B12 is often recommended from 50 onward.
- Vitamin B6Requirements rise slightly after 50, and status is often marginal — but the same overdose risk applies.
- Vitamin CRequirements do not change much with age, though appetite and intake often fall.
- Vitamin D3Skin makes far less from the same sun exposure, and the reference intake rises to 20 mcg from 71. One of the few supplements genuinely worth defaulting to in later life.
- Vitamin EClearance slows, and the same intake produces higher blood levels. Given the trial record, this is a group to be more conservative with, not less.
- Vitamin K2The bone and arterial claims target this group specifically, which is also the group most likely to be on warfarin. Check the medication list first.
- Whey ProteinGenuinely useful — protein needs rise with age while appetite tends to fall, and preserving muscle mass is one of the highest-value goals in later life.
- ZincIntake is often low and deficiency affects immune response and taste — but the same age group is most vulnerable to copper deficiency from over-supplementing.
Other situations