The four supplements actually worth your money in midlife

These are the evidence-backed options. None of them are a magic pill and none are a substitute for nutrition. Think food first, then supplement if you have a genuine gap to fill. I am focusing on the unglamorous basics because they have the most research behind them and the biggest potential payoff for bone, muscle and cardiometabolic health.

1. Vitamin D

Vitamin D helps your body absorb calcium, which is essential for building and maintaining bone, and it supports muscle and immune function. The biggest gains come from correcting a deficiency, not mega-dosing when your levels are already adequate, which is why it is worth getting tested and speaking to your provider rather than guessing.

Getting enough is hard. There are few vitamin D rich foods, and sunlight exposure is limited by indoor life, winter, covering up, sunscreen and darker skin tones. Most importantly for us, skin becomes less efficient at making vitamin D as we age. If you are deficient you may notice nothing at all, or fatigue, low mood, frequent niggly illnesses, muscle aches or weakness, and bone and joint aches.

Low vitamin D has been associated with higher insulin resistance, and deficiency is commonly reported in people with PCOS. Association is not cause, but it is another reason to get tested.

2. Omega-3 (EPA and DHA)

EPA and DHA are the fats in oily fish and algae that support heart health, help keep inflammation in check, and may help with insulin sensitivity and muscle function as we age. A low intake can show up as dry skin, brittle nails, dry eyes and achy joints.

• —If you are not eating oily fish regularly, aim for at least 1,000mg per day of combined EPA plus DHA
• —Label tip: ignore '1000mg fish oil' on the front. Turn the bottle around, add the EPA and DHA figures together, and look for 1,000mg or more
• —Food sources: salmon, mackerel, sardines, herring, anchovies, trout, tuna, shellfish and algae. Aim for two portions of fish a week, at least one oily
• —Flax, chia and walnuts contain ALA, which converts to EPA and DHA only in small amounts. If you do not eat fish, algae oil is the closest swap

3. Creatine monohydrate

Creatine helps your muscles make ATP, the quick energy currency for short hard efforts like lifting and sprinting. In midlife, when you are trying to protect strength, power and muscle, it can help you train harder and get more out of your sessions. It is not the holy grail social media makes it out to be. It works as part of a healthy lifestyle, not as a substitute for one.

• —3 to 5g per day, every day, and give it 8 to 12 weeks before you judge it
• —Supports strength and power gains, repeated high-intensity efforts and training quality over time
• —Cognitive benefits exist in some studies but the hype is overblown. Treat any brain benefit as a bonus
• —Choose cheap, plain creatine monohydrate. Be wary of pricey versions marketed specifically at women or pushed by menopause doctors
• —Talk to your doctor first if you have kidney disease. If you are prone to tummy upset, start at 3g and build up

Creatine pulls water into the muscle, so the scale may go up slightly. That is not fat gain. Think of it as your muscles being better hydrated.

4. Calcium

Calcium is a key building block for bones and teeth, and your body needs it for muscle contraction and nerve signaling. If intake is low long term, your body prioritizes keeping blood levels stable, which can mean pulling calcium from bone. Vitamin D matters here too, because low D means you absorb less calcium.

• —Aim for 1,000mg a day total from food and supplements up to age 50, then 1,200mg
• —Food first. Supplement only to top up a genuine shortfall, and keep to 500mg or less at a time because absorption is better in smaller hits
• —Calcium carbonate absorbs better with food. Calcium citrate can be taken with or without, and is often better tolerated with reflux medication
• —Label tip: look for elemental calcium per serving. More is not better
• —Food sources: milk, yogurt, cheese, fortified cereals and plant milks, tofu set with calcium, tinned fish with bones, some leafy greens
• —Get guidance first with kidney disease or kidney stones. Calcium can block absorption of thyroid medication, some antibiotics, bisphosphonates and iron, so separate the timing

So what should you do now?

Start with your nutrition. Before you buy anything, look honestly at what you are getting day to day: protein, calcium-rich foods, oily fish, fiber. Then ask what your actual goal is, whether that is bone, muscle, heart markers, energy or sleep. Once you know that, you can decide whether you need a supplement at all, and choose the one that fills the gap. And always check the label properly.