The number of vitamin, mineral, and herb supplements crowding the shelves in drug, health food, and grocery stores can make it difficult to figure out which combination best serves our changing bodies.

Supplementation is important in the forties, because most of us don’t get every single nutrient we need, every day, from our food. You need at least 1500 mg of calcium daily to keep your bones strong, but other essential ingredients can complement your diet and increase your health and well-being.

Some women prefer to take vitamin, mineral, and herb supplements separately, using several products. This practice is fine, as long as you’re careful to take appropriate combinations and amounts. Overall, I favor a simple approach to supplementation: take one good multiple vitamin/mineral supplements each day, along with a calcium citrate supplement. This approach works for me personally for a number of reasons. One, I find it’s easy to remember to take my vitamin/mineral and calcium supplements each morning after breakfast. Second, I don’t have to spend a lot of time and money shopping for a variety of supplements. Third and most important, I’ve found a couple of vitamins that work well for me: ProCycle by Cyclin Pharmaceuticals in Madison, Wisconsin, and Optivite by Optimox in Torrance, California.

There is also a ProCycle Gold formula with extra calcium that is specially formulated for perimenopausal and menopausal women, but I’ve found that I feel best when I take ProCycle with a separate calcium supplement.

Choosing a vitamin and mineral supplement doesn’t necessarily have to be complicated or difficult. These are the guidelines I recommend to the perimenopausal women I see at my clinic:

- Look carefully at the ingredients, and the percentage of the U.S. Recommended Daily Allowance they provide. U.S. RDA amounts are based on guidelines developed by the FDA.

- Remember that RDAs are general guidelines meant to apply to healthy people¡ªtheir amounts do not vary according to age and gender. Individual requirements may vary, and at some times, such as during perimenopause or when recovering from illness, more than the RDA of certain nutrients, such as vitamin C or vitamin I6, may be beneficial. The vitamin/mineral supplement I take, for instance, has higher-than-RDA-levels of the B-complex vitamins: vitamins B1, B2, B6, and B12. I find these B-complex vitamins very helpful in minimizing water retention and depression.

- Vitamin E can also be helpful during perimenopause, regulating estrogen levels and relieving hot flashes, vaginal dryness, and breast soreness. An antioxidant, vitamin E can also provide heart disease protection. (Antioxidants prevent certain molecules from binding to cells and damaging them.) Some women use vitamin E oil as a lubricant directly in the vagina to help with tissue dryness. When taken orally, vitamin E dosages range from 100 to 600 I.U. per day. Vitamin E and iron don’t mix, however, so these supplements are not to be taken together.

- Nutrients such beta-carotene, selenium, chromium, potassium, and manganese also have health benefits, although no U.S. RDA has been established for them. I recommend choosing a supplement that includes them rather than taking them individually.

- As I’ve mentioned, you need at least 1500 mg of calcium per day, more than the U.S. RDA, to maintain strong bones. Calcium citrate is the form that is best absorbed as we grow older and our stomachs produce less of the acid needed to break down calcium.

- Some vitamins can have toxic effects when taken in too-large doses. And the ratio of the vitamins and minerals you take is important, too much of one can counteract the effects of another. That’s why I don’t suggest randomly mixing individual vitamins and minerals. It’s too easy to throw off the essential balance you need to make sure your body absorbs vitamins and minerals properly.

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