5 Supplements to Think Twice About as an Older Adult

Vitamins, botanicals and other supplements aren’t without risks and considerations

Michelle Crouch,

AARP

Comments

Published May 06, 2026

Many older adults turn to supplements to boost energy, ease pain or fill nutritional gaps as they get older. About 4 out of 5 adults age 50 and older take at least one supplement or vitamin, according to a 2022 study.

Although supplements can be helpful, doctors say it’s wise to approach them with caution as you get older. “Just because something is sold over the counter doesn’t mean it’s safe to take,” says Dr. Kathleen Hager, an internal medicine geriatrician at OhioHealth.

As we age, our bodies process medications and supplements differently, making us more vulnerable to side effects, she says. Some supplements can raise blood pressure, irritate the stomach or cause dizziness, while others may affect how prescription drugs are absorbed or metabolized.

Older adults are also more likely to be taking multiple medications, increasing the chances of interactions.

Hager says one of her biggest concerns when it comes to older adults and supplements is polypharmacy — defined as taking more than five medications a day.

“Polypharmacy is a huge contributor to bad outcomes in older adults,” she says, noting research that links it to falls, confusion and medication-related reactions. People often think of polypharmacy as “just prescriptions,” she adds, “but it also includes supplements.”

Health experts say it’s important to check with a doctor or pharmacist to make sure every supplement you’re taking is safe, necessary and will not interact with your other medications.

Here are five common vitamins and supplements that experts say older adults should generally avoid, or at least approach with caution.

1. Saint-John’s-wort

This herbal remedy can be effective for mild depression, but doctors say most older adults should steer clear because it interacts with a wide range of other medications, making them less effective.

Saint-John’s-wort revs up certain liver enzymes that your body uses to break down medications, so drugs clear out of your system too quickly, says Dr. Victoria Maizes, executive director of the Andrew Weil Center for Integrative Medicine at the University of Arizona. That makes your prescriptions ineffective, even if you take them as directed.

“Say you needed a medicine at a dose of 200 milligrams. Because you’re also on Saint-John’s-wort, you only got 100 milligrams because it was broken down faster and it got out of your system faster,” says Maizes, the author of a new book with AARP called Heal Faster: Unlock Your Body’s Rapid Recovery Reflex.

Saint-John’s-wort is known to have significant interactions with blood thinners, transplant rejection drugs, antiretrovirals, digoxin and many psychiatric medicines. If you still want to take it, it’s essential to have a doctor review every medication you take before you start.

2. Vitamin E

Most people get plenty of vitamin E from food, but some older adults also take a vitamin E supplement for its anti-inflammatory and brain health benefits.

The problem, Hager says, is that high doses can increase your risk of bleeding — including dangerous brain bleeds. Too much vitamin E can also cause fatigue, headache, diarrhea, cramps and other abdominal symptoms.

Vitamin E can be especially risky if you’re on a blood thinner, have cardiovascular disease or have had a heart attack or stroke.

Hager says she often sees patients who are taking blood thinners as well as vitamin E, without realizing the combination is raising their risk for bleeding and cardiovascular complications.

“Just because it may be an anti-inflammatory doesn’t mean it’s the best thing for you,” she says. “That is one I often counsel my patients to come off of.”

The National Institutes of Health sets the upper limit for vitamin E at 1,000 mg per day (about 1,500 IU), but many experts recommend staying well below that.

3. Iron or a multivitamin with iron (if you’re menopausal)

Many women take iron during their childbearing years, but it’s rarely needed after menopause and can be harmful if you take too much of it, Maizes says.

“Excess iron can increase the risk of heart disease, diabetes and various kinds of organ damage,” she says.

Older men and women don’t need extra iron unless they’ve had a blood test that shows a deficiency, she says. In fact, she suggests that women check after menopause to ensure the multivitamin they’re taking does not include extra iron (sometimes abbreviated as FE), or switch to one for older adults.

Iron pills can also be tough to swallow and sometimes cause choking, Maizes says.

4. Licorice root

Another supplement to be cautious of is licorice, which is sold as a supplement on its own and added to many herbal blends because of its natural sweetness, Maizes says. It often shows up in products marketed for gut health, stress relief or an energy boost.

The concern comes from glycyrrhizin, a compound found in natural licorice root. In higher amounts or taken regularly, it can cause the body to retain sodium and lose potassium, which can lead to dangerously high blood pressure, swelling or heart rhythm problems.

Licorice is especially risky for people who already have high blood pressure or heart or kidney problems, Maizes says.

Instead of products made with whole licorice root, Maizes recommends choosing formulas with deglycyrrhizinated licorice (DGL), which removes the risky compound.

5. Weight loss or energy-boosting supplements

Weight loss and energy supplements can be risky because they often rely on stimulant ingredients to rev up your metabolism or suppress appetite, says Richard Bloomer, dean of the College of Health Sciences at the University of Memphis. Common stimulants include guarana, green coffee extract, Garcinia cambogia, Panax ginseng and caffeine — all of which can make your heart work harder than it should.

Stimulant products can raise blood pressure, increase your heart rate, interfere with heart medicines and aggravate underlying heart failure. They can also trigger sleeplessness, jitteriness and anxiety.

Stimulants are especially dangerous if you already have heart problems or high blood pressure, Bloomer says. One landmark study found that weight-loss or energy supplements were responsible for about 72 percent of supplement-related ER visits.

Maizes says older adults looking for an energy lift should consider gentler adaptogens instead, such as schisandra, holy basil or ashwagandha.

%{postComment}%

Michelle Crouch is a North Carolina-based writer who has covered health issues for Reader’s Digest, The Washington Post and other publications. She has written for the Bulletin for more than a decade.