How to Evaluate Vitamins for Older Adults

Vitamins, supplements, and alternative therapies are a big topic in aging. With so many options — and opinions — out there, it can be a difficult to navigate area of care.

In this article, we’ll talk about how to assess for yourself whether or not an alternative treatment is worth trying. We won't recommend specific options but instead provide a framework for how to evaluate whether or not to add a treatment you’re considering to your regimen.

Defining Vitamins, Supplements, and Alternative Therapies

Vitamins, supplements, and alternative therapies are naturally occurring substances or activities — behavioral or physical — that don’t require a prescription and may have a proven benefit preventing or treating certain conditions. Alternative therapies are also sometimes referred to as integrative or complementary medicine, though there is a small difference between the three.

One important note is that alternative therapies are not limited to the things you ingest or use topically on your skin – some of the strongest evidence for alternative medicine involves mind-body interventions, like meditation, yoga, or tai chi. Be sure to consider a wide range of potential treatments when investigating your options.

How to Be Your Own Advocate

Choosing therapies of any kind — alternative or not — is complicated at every age, but it can get even more complex as we get older.

No matter how limited your medical background may be, being able to do your own research when it comes to alternative therapies equips you to better understand if a potential solution might be right for you. The key to this is learning to leverage expert-led, credible sources amidst the plethora of bad and misleading information out there.

Why Should You Do Your Own Research?

Alternative therapies are not standardized the way that western medicine is. For example, two preparations of the sleep aid melatonin coming from different manufacturers can have different amounts of the hormone. Similarly, while an FDA-approved antibiotic will be the same even if it's administered in two different cities, a treatment like acupuncture might not be, and will be largely dependent on the experience and technique of the practitioner.

Many considerations — the particular diseases or diagnoses you may have, costs, the ability to adhere to a treatment regimen, and the quality of the studies — go into making the decision about what’s right for you. And while a doctor can and should be a critical voice in making the decision, with the hundreds of new journals and studies that come out each month, it’s possible that your physician may not be up to date on the latest information around any given potential alternative treatment, no matter how current they are.

Approaches to Research: Finding a Trusted Source vs. DIY

There are two different ways to approach research: finding a reliable source that can serve as an independent aggregator to distill it for you in lay terms, or the DIY approach of reading a medical paper yourself.

Where to Find Your Trusted Sources

For those looking for a distilled version of research, these are our favorite trusted sources:

• The National Center for Complementary Medicine and Alternative Health: NCCIH is an arm of the National Institutes of Health. It has a wealth of consumer-friendly information about vitamins and supplements, a list of ongoing clinical trials involving alternative treatments, and good advice on how to evaluate these therapies. Sections like Health Topics A-Z and Herbs at a Glance help you find information on exactly what you’re looking for.
• Medical journals: While they used to be geared towards the medical community only, medical journals now include lay interpretations of research for physicians to give to patients. These are useful resources that summarize the current status of many alternative medicine therapies. Some of our favorites are Annals of Internal Medicine, JAMA, and The New England Journal of Medicine.
• Your doctor: It’s critical to keep your doctor in the loop and get their thoughts as you evaluate. While they might not always have exact, up-to-date knowledge of a particular alternative therapy you’re considering (though many do), your physician should have a role in the decision — not only as a trusted source of information, but also to make sure what you’re considering does not interfere with any of your current traditional treatments.

If You’d Like to Opt for DIY Research

The other research path is to dive into full articles or studies on the alternative therapy you’re considering. The two best places to do this are Google Scholar or PubMed.

Many find Google Scholar more accessible to navigate, but you’ll be searching through a database that has scholarly research on all topics — not just health-related ones — which can feel more overwhelming.

Google Scholar’s Help Section breaks down how to search, their metrics and methodologies, and more. For easy-to-access tutorials on PubMed, the NIH has a full online training with short videos to help you get acquainted.

Tips to Keep In Mind

Once you’ve started to explore the research, the difficult part will be figuring out if what you’ve found has any relevant guidance for you. Here are some tips that might help you reach the right conclusion:

• Make sure what’s being studied is actually what you’re interested in: While it sounds obvious, make sure that the study you’re reviewing is testing the alternative treatment you’re considering in the same way you’ll actually be receiving it. For example, if you’re thinking about taking a vitamin or supplement, you need to be clear that the study you’ve found has the same ingredient, dose, and frequency. Be sure that other accompanying interventions aren’t complicating the picture (such as other supplements being given alongside the one you care about, or additional interventions like physical therapy). If the study is of a physical intervention, like yoga, meditation, or an exercise program, make sure it’s clearly articulated how the technique was performed. How long was the session and how many times per week? What exactly were the components? Dig into the details and ensure they align with your case.
• Make sure the person you’re considering the intervention for is similar to those in the studies, to the greatest extent possible: While you’re never going to find a study where every participant is exactly like you or your loved one, they should at least be of a similar age, gender, and general health state or you could be comparing apples and oranges. Historically, some of the most egregious age-related errors in clinical trials have occurred in the drug industry, wherein studies of a new medication are conducted on adults in their 20s and 30s but are then used predominantly by older adults, resulting in a variety of unanticipated side effects.
• Assess the quality of the work by seeing how many elements of a randomized trial are in the study: The gold standard of clinical research is the randomized trial, where half the patients are randomly assigned the treatment and the other half placebo; called blinding, neither the patients nor the people evaluating them know who got what. Poorly done studies have no control or comparison group. Other things to look out for are no formal assessments of the outcome and/or no reports of side effects, dropouts, or adherence to the supplement or therapy in the treatment and control group.
• Look for self-effacing scientists: At the end of their papers, the best scientists usually spend very little time “selling” the brilliance of their findings. Instead, they discuss the potential problems with their research — anticipated and unanticipated — and how that might impact the findings. When you find a discussion section that feels self-congratulatory as opposed to self-reflective, be weary; good scientists are skeptics, especially of their own work.
• Involve your physician: Ask your doctor about studies you’ve read and see if they’ll opine. This tactic is especially useful in getting your physician to consider alternative treatments that he or she may not be aware of.  Providing medical evidence can be a great way to engage them around a specific topic.