Common Vitamin and Mineral Deficiencies in Perimenopausal and Menopausal Women

Key Vitamins & Minerals for Energy and Health in Midlife

As women enter their mid-30s to 50s, hormonal shifts around perimenopause can bring new fatigue, mood swings, brain fog, and sleep trouble. These symptoms are often compounded by nutrient gaps. Many midlife women are found to be low in iron, vitamin D, vitamin B12, and magnesium. Addressing these can help restore energy and well-being. The good news is that diet and targeted supplements can refill these gaps. Below we cover each nutrient, its role, and ways to replete it when diet isn’t enough.

Iron (for Energy and Red Blood Cells)

Iron deficiency is common in women of reproductive age, and perimenopause often means heavier or irregular periods, which can deplete iron stores. Heavy menstrual bleeding “can lead to iron-deficiency anemia, a well-known cause of fatigue.” Low iron may cause tiredness, lightheadedness, brain fog, brittle nails, or hair thinning.

• Supplements: If diet alone isn’t enough, iron pills (often ferrous sulfate/gluconate) can help. These are absorbed best on an empty stomach (or with a small vitamin C drink), but can be taken with food if stomach upset occurs. Always follow your doctor’s guidance on dosing.

By refilling iron, some women notice more stamina and mental clarity.

Vitamin B12 (for Energy and Nerves)

Vitamin B12 (cobalamin) is needed for red blood cell production and healthy nerves. Deficiency can cause fatigue, weakness, brain fog, numbness or tingling in hands/feet, and even mood changes or memory issues. B12 absorption requires stomach acid and an “intrinsic factor” protein; as women age, stomach acid often declines, so older midlife adults absorb B12 less efficiently. Vegan or very low-animal diets also risk low B12.

• Supplements: Many women benefit from a B12 supplement, especially if tests show low levels or if they have symptoms. If severe deficiency is suspected, your clinician may recommend higher doses or injections.

Vitamin D (for Bones, Mood & Immunity)

Vitamin D helps our bodies absorb calcium for bone health, and it may also influence mood and energy. In midlife, the risk of low D increases (less sun exposure and hormonal changes can reduce blood levels). Symptoms of vitamin D deficiency can include fatigue, bone/muscle aches or weakness, and mood changes (like feeling depressed). Importantly, low D leads to weaker bones over time.

• Sunlight: Aim for some safe sun exposure (arms/legs for ~10–20 minutes a few times a week) if possible.
• Supplements: Because it’s hard to get enough from food, most women take a vitamin D supplement. Choose vitamin D3 (cholecalciferol), as this form raises blood levels more effectively than D2.

Adequate vitamin D supports bone density and may help improve low energy or mood when it’s low.

Magnesium (for Sleep, Mood & Muscles)

Magnesium is a “power mineral” involved in hundreds of body processes, including muscle and nerve function, sleep regulation, and bone strength. In midlife, magnesium can help ease insomnia, anxiety or muscle cramps and support bone health. Many people don’t get enough from diet, which can worsen stress and poor sleep.

• Supplements: If you’re low or need extra support, a magnesium supplement may help. Look for forms like magnesium citrate or magnesium glycinate, which are well absorbed and gentle on digestion. (These “chelated” forms have high bioavailability.) Many women take a dose in the evening to aid relaxation and sleep. Start with a low dose to avoid loose stools, and increase gradually as tolerated.

Ensuring enough magnesium can help reduce muscle tension, improve sleep quality, and support mood during hormonal changes.

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