Vitamin D in winter and creatine for your muscles have decent evidence behind them. Plenty of what’s on the pharmacy shelf doesn’t. Here’s how to spend your money sensibly.
Walk into any high street chemist and the supplement aisle will offer to fix your joints, your energy, your testosterone, your brain and probably your golf swing too. All you have to do is hand over a fair chunk of your weekly shop.
The good news is that a small number of supplements have solid evidence behind them for men in midlife. The less good news is that most of the rest are expensive urine. Here’s how to tell them apart, and where to be careful.
This is the easy one, because the advice comes straight from the government. Between October and early March the UK sun is too weak for your skin to make enough vitamin D, and it’s hard to get enough from food alone. So the advice is that everyone should consider a daily supplement of 10 micrograms (that’s 400 IU on some labels) during autumn and winter. The advice is the same in England, Scotland, Wales and Northern Ireland.
Vitamin D helps you keep your bones, teeth and muscles healthy. That matters more with every birthday, because muscle and bone density both start slipping in midlife.
Some people are advised to take it all year round, not just in winter. That includes anyone who rarely gets outdoors, people who cover most of their skin when outside and people with dark skin, including those of African, African-Caribbean or South Asian heritage.
You don’t need a blood test before taking the standard dose, and you don’t need anything fancy. A supermarket own-brand pack of 10 microgram tablets usually costs less than a pint, and works just as well as the premium tub with the mountain on the label.
Creatine used to belong to the gym lads with shaker bottles. These days it’s one of the most-researched supplements going, and the evidence is genuinely good.
Your body makes creatine and also gets it from meat and fish. It helps your muscles produce short bursts of energy. Taken alongside resistance training, creatine has been shown over and over to improve strength and lean muscle, including in older adults. It’s that combination that matters for you. From your 40s onwards you gradually lose muscle unless you work to keep it, and strength in later life is closely tied to staying independent.
The key word is alongside. Creatine on its own, with no lifting, does very little. Think of it as a small boost to effort you’re already making, not a replacement for it.
If you try it, plain creatine monohydrate is the form with the evidence behind it. The pricier versions with exotic names haven’t been shown to do anything better. A typical daily amount is 3 to 5 grams, and most people put on a little weight early on, mainly water held in the muscles. If you have kidney disease, or any kidney problem, talk to your GP before taking it. Research into possible benefits for the brain and mood is interesting but still early, so don’t buy it for that.
The supplements with the best evidence are often the cheapest on the shelf. The pricier the promise, the thinner the science tends to be.
Here’s where it gets awkward for the marketing departments.
Fish oil: eating oily fish such as salmon, mackerel or sardines is still recommended for heart health, and NHS advice is to aim for at least one portion a week. Taking omega-3 capsules isn’t the same thing. Large reviews have found little or no benefit from them for preventing heart attacks and strokes in the general population. If you hate fish, they’re not dangerous at normal doses, but they’re no shortcut to a healthy heart.
Multivitamins: if you eat a reasonably varied diet, the evidence that a daily multivitamin makes you live longer or avoid serious disease is weak. A basic one won’t hurt, but if it contains vitamin D you may not need a separate tablet. Check the label so you don’t double up.
Testosterone boosters: the herbal blends sold for energy and libido have no good evidence that they meaningfully raise testosterone or fix the symptoms men buy them for. Tiredness, low mood and a low sex drive have plenty of possible causes, from poor sleep to diabetes to depression. Some of those deserve a proper look from your GP, not a tub of fenugreek.
Collagen, turmeric, ashwagandha and the rest: some have small or early studies behind them, but nothing strong enough to recommend them to everyone. If one of them is the reason you’re sleeping better, fine. Just know the evidence is thin and keep an eye on what you’re spending.
Yes, and this is the part the bottles don’t shout about. Supplements in the UK are sold as food, not medicines. That means they don’t go through the testing medicines do before they reach the shelf, and more is not better.
Vitamin D: high-strength products of 25, 50 or even 100 micrograms are now everywhere. The NHS advises adults not to take more than 100 micrograms (4,000 IU) a day unless a doctor has told you to. Taking too much over a long period can raise calcium levels in the blood, which can harm your kidneys and heart. If your GP has prescribed a higher dose for a deficiency, follow their plan.
Vitamin A: too much over many years has been linked to weaker bones. Liver and fish liver oils are already high in it, so be careful about stacking a cod liver oil capsule on top of a multivitamin.
Vitamin B6: taking large amounts for a long time can damage the nerves in your hands and feet. Some energy and stress supplements are surprisingly high in it.
Iron: most men don’t need extra iron, and too much can cause problems. Don’t take it unless a blood test shows you need it.
Then there’s how supplements mix with medicines. St John’s wort can interfere with lots of medicines. High-dose vitamin K can affect warfarin. Some herbal products can affect blood pressure or blood sugar treatments. If you take any regular medicine, ask your pharmacist before you add a supplement. It takes two minutes and costs nothing.
For most men aged 45 to 64, the evidence-based list is short. Take vitamin D at 10 micrograms a day in autumn and winter, or all year if that applies to you. If you do resistance training, or are about to start, creatine monohydrate is a reasonable, well-researched addition.
After that, put the money into the things supplements are trying to copy: protein at each meal, oily fish, plenty of fruit and veg, decent sleep and two strength sessions a week. If you’re aged 40 to 74 and live in England, the free NHS Health Check checks your blood pressure, cholesterol and diabetes risk, which tells you far more than a capsule ever will. Scotland, Wales and Northern Ireland run things differently, so ask your GP practice what’s available where you live.
If you have symptoms that bother you, such as unusual tiredness, unexplained weight loss or bone pain, see your GP rather than treating yourself. Call NHS 111 for urgent advice, and 999 in an emergency.
After 45, the supplements with the best evidence are vitamin D, at 10 micrograms a day in autumn and winter as the government advises, and creatine monohydrate if you’re doing resistance training. Fish oil capsules, multivitamins and testosterone boosters promise far more than the research shows they deliver. Stick to sensible doses, and don’t go above 100 micrograms of vitamin D a day unless your doctor tells you to. If you take any regular medicine, check with your pharmacist first.
Dieting and cardio alone can strip away muscle as well as fat. Here is why lifting weights is the underrated part of losing weight in midlife, and how to start.
Muscle doesn’t stay put in midlife. If you don’t use it, you lose it. Here’s how much strength training you actually need after 45, and how to start safely.
Vitamin D through the winter is worth the pennies. Magnesium and omega-3 capsules are a harder sell for most men. Here’s what the evidence and the NHS actually say.
You lose muscle with age, but you can still build it at 50 and beyond. Here is what strength training does for you, how much you need and how to start.
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