8 Best Minerals, Supplements, & Vitamins for Menopause Fatigue

How tired do you feel right now? A-nap-would-be-nice tired? Or maybe I-could-sleep-until-dinner-tomorrow tired? 

The fact is, menopause fatigue can hit you hard—and it’s one of the most common symptoms of the hormonal changes that come in this phase of life. This kind of fatigue can be both physical and mental. You may drag because your body is tired or feel droopy because you’re mentally or emotionally tapped out. In menopause, it’s often a combination of the two.

Keep reading to learn more about fatigue during menopause, including how your diet might be affecting your energy levels, the menopause vitamins to consider, and the steps you can take to get your energy back.

Understanding Menopause-Related Fatigue

Fatigue during menopause can be a tough problem to solve. Why? There are so many reasons why you might be tired in the first place. Here’s a quick rundown of potential causes—see if any sound familiar to you.

• Symptoms of menopause like night sweats (hot flashes that occur at night) can interrupt your sleep multiple times a night. What’s more, changes in estrogen and progesterone levels during the menopausal transition can also lead to insomnia, sleep disturbances, and shorter sleep time.
• Your stage of life, because for many of us, it’s wild out there right now. You might be pushing hard career-wise, taking care of kids and/or parents, trying to maintain a romantic life, and so on. It’s busy, it’s stressful, and it can all make sleep more difficult.
• Underlying conditions: Certain health conditions, like sleep apnea (which commonly develops in menopause), can also cause exhaustion you just can’t shake, no matter how many hours you log between your sheets.
• Your lifestyle: Did we mention you’re busy? Well then, it may also be difficult to maintain a lifestyle that keeps energy high, incorporating a well-planned healthy diet, adequate sleep, regular exercise, and stress-management habits. 

Essential Vitamins and Nutrients to Combat Menopause Fatigue

Since menopause fatigue is so multifaceted, it’s unlikely that focusing on a single nutrient will be the answer to your energy woes. That said, filling certain gaps in your diet will help keep your engines revved. Here are a few nutrients credited with fighting fatigue:

Vitamin B Complex

There are eight B vitamins (B6, B12, and folate are a few of the ones you may hear about most often). As a group, they’re called B complex vitamins, and they have a wide range of functions in your body, including helping to break down food for use as energy. That’s why fatigue is one symptom that may indicate a deficiency in one or more B vitamins. All B complex vitamins are water soluble—meaning that any excess amount you take in will be excreted in your urine, not stored up—so you’ll need to regularly eat foods that contain them.

Best foods for this nutrient: That includes meats, vegetables, fruits, fortified foods, among many others.

Recommended daily intake: According to the NIH, adult women over age 51 should get 1.5mg of B6 a day and adult women (18 and up) should get 2.5mcg of B12. Since the kind of B supplement you may need depends on which specific one you’re falling short on, the best bet is to talk to a healthcare professional for dosing recommendations.

Vitamin D

Vitamin D (aka the sunshine vitamin) can be hard to come by, especially in winter months if you and the sun aren’t getting much time together. While vitamin D is known for keeping your skeleton strong—a real plus for menopause, when declining estrogen levels can deplete bone density—the nutrient also plays a key role in a robust immune system and has mood-regulating properties.

Vitamin D may affect our moods in a variety of ways. The nutrient helps regulate inflammation (an underlying factor in mood disorders) and there are vitamin D receptors in brain areas that aid in emotional processing, according to research in Frontiers in Physiology. People who have depression also tend to have lower vitamin D levels.

So what’s the connection with fatigue? Living with a low mood can make you feel tired and affect your motivation to do the things you love in life, resulting in a generally poor energy state.

Best foods for this nutrient: Along with sun exposure, we also get vitamin D from certain foods, such as fish (especially salmon) and certain mushrooms.

Recommended daily intake: Most adults need at least 600-800 IU of D per day although many doctors suggest doses of 1000IU per day and even up to 2000 in the winter, but that can depend on your baseline levels as well as where you live and the season, so it’s a good idea to consult with a clinician.

Vitamin E

Vitamin E is a powerful antioxidant that may quell inflammation and help provide relief from menopause symptoms like hot flashes and night sweats, as well as supporting mood regulation which helps with fatigue, as we’ve discussed.

Best foods for this nutrient: You’ll find this vitamin in sunflower seeds, almonds, peanut butter, spinach, broccoli, kiwi, mango, and tomatoes. Deficiency in vitamin E is rare, but if you eat a low-fat diet, you may not be getting what you need unless you intentionally add E-rich foods in your diet. 

Recommended daily intake: According to the NIH, most adults need 15 mg of vitamin E per day.

Iron

Iron is a mineral that is a component of hemoglobin, a protein in red blood cells that ferries oxygen from the lungs into the tissues in your body to provide your cells with energy. Research in JAMA Network Open has found that as many as one in five women ages 25 to 54 have an iron deficiency. Being low in iron can cause anemia, and one of the key signs of anemia is fatigue. Iron deficiency anemia can result from heavy periods, one of the many symptoms women find themselves managing during perimenopause.

Best foods for this nutrient: Because of the changing iron needs with age, it’s important to talk with your clinician about recommended dietary changes, like eating more iron-rich foods like beef, fortified cereals, beans and lentils.

Recommended daily intake: Our iron needs decrease drastically after menopause. You go from a recommended intake of 18mg down to 8mg, after around age 51. A blood test can tell your provider if your iron levels are low and help determine if a supplement is needed.

Vitamin C

Vitamin C has many roles in the body, from supporting collagen production to keep your skin supple, to helping maintain a healthy immune system. Another key duty: Vitamin C is essential to your metabolism because it helps with energy production. It also helps your body absorb non heme iron (iron that comes from plant-based foods like beans).

Best foods for this nutrient: Most fruits and vegetables boast high levels of vitamin C, so you can go wrong if you eat a colorful diet of oranges, plums, green peppers and broccoli.

Recommended daily intake: Most people get enough C (the recommended amount is 75 mg for adult women) and deficiency is rare (not to mention it’s added to most multivitamins). However, if you have a very limited diet—one that severely limits or avoids fruits and vegetables—you may benefit from a supplement.

Magnesium

Magnesium is a mineral that’s widely known for its sleep-promoting effects, because it can relax muscles and buffer stress. Because of its potential positive effects on sleep, magnesium is a supplement you may want to consider if you’re dealing with menopause-related fatigue. 

Best foods for this nutrient: Magnesium-rich foods include spinach, avocados, bananas, black beans, and yes, dark chocolate.

Recommended daily intake: About half of people consume less-than-ideal magnesium from their diet. And while magnesium deficiency usually causes no symptoms, fatigue—along with weakness, appetite loss, and nausea and vomiting—can be an early warning sign. For sleep and relaxation, it’s best to choose magnesium glycinate, 200-300 mg at bedtime. (It doesn’t have the laxative effect of magnesium citrate or oxide.) 

**Learn more about better sleep in perimenopause and beyond: Sleep problems in midlife can have a range of causes—but there are solutions. Watch Midi's Webinar "Better Sleep for Perimenopause and Beyond" to get information and answers on how to manage your fatigue.

Omega-3 Fatty Acids

Omega-3s are polyunsaturated fats boasting with anti-inflammatory properties. Research is conflicting and limited, but they may also help improve hot flashes and night sweats, moodiness, and sleep quality in menopausal women, according to a review in the journal Nutrients.

Best foods for this nutrient: If you’re not eating many foods rich in Omega-3s (including oily fish like salmon and sardines and plant sources like flaxseeds, chia seeds, and walnuts) it’ll benefit you to add more. In addition to supplying your body with heart-healthy fat and energy, Omega-3 sources also support hormone function.

Recommended daily intake: If you choose to take a supplement, try 1000mg per day.

Zinc

This mineral has a hand in hundreds (hundreds!) of enzyme reactions in the body. When it comes to energy or fatigue, low zinc intake has been associated with depression, so this may be one reason why you’re dragging. 

Best foods for this nutrient: Beef, pork, turkey, fortified cereal, pumpkin seeds, sardines and shrimp are all high in zinc.

Recommended daily intake: According to the NIH, adult women should get 8mg of zinc per day.

Incorporating These Nutrients Into Your Diet

You don’t need to follow a specific diet to get all of these menopause-friendly nutrients into your eating routine. What’s most important is choosing a varied diet that focuses on mostly whole foods and limits ultra processed foods (such as fast food, packaged desserts, soda, chips) since these are often lower in nutrients and higher in saturated fat, sodium, and added sugars. 

Foods to focus on include fruits and vegetables, whole grains, lean proteins like poultry, tofu, and fish, nuts and seeds, olive oil, and dairy or plant-based dairy substitutes. There’s no one perfect diet for everyone–but you can find the perfect diet for you. Your preferences and restrictions can always be taken into account when choosing nutrient-rich foods to eat. 

Other supplements and botanicals that can help fight menopause fatigue:

• Melatonin levels drop in midlife, so supplementation can reduce the time it takes to fall asleep, and increase sleep duration and quality. 
• Valerian, a flowering herb native to Asia and Europe, also has proven benefits for postmenopausal women. 
• To help fall asleep a bit faster, Midi also suggests trying L-tryptophan, L-theanine, tart cherry juice, and glycine.
• Other supplements that help relax the body, quiet the mind, and enhance sleep include lavender, passionflower, chamomile. 

Lifestyle Modifications to Enhance Energy Levels

What you eat affects your energy—in positive and negative ways—but there are other lifestyle modifications that put more pep in your step during the menopausal years:

• Set yourself up for sleep success: Setting the stage for good sleep is key to getting the rest you need. Sleep hygiene habits, such as doing something relaxing before bed, staying off your phone and computer an hour prior to sleep, and creating a room that’s cool, dark, and quiet will support a good snooze.
• Don’t forget to simmer down: Stress is a drain on your physical and mental energy. No one’s asking you to get rid of it completely (impossible!) but you can take small steps to begin to manage daily tension. What helps you relax? Is it a walk in the morning before your day starts? Tuning into a meditation app? Sitting back into child’s pose? Taking an extra long shower? Whatever it, make time for it in your schedule as a non-negotiable.
• Stay hydrated: Even mild dehydration triggers fatigue and brain fog. Make sure you’re sipping water (and eating water-rich foods like fruits and vegetables) throughout the day.
• Exercise regularly: It may seem counterintuitive that moving your body when you’re so tired can give you the energy boost you’re looking for, but regular physical activity is a bonafide fatigue fighter. For the biggest energy benefit, incorporate both cardio and resistance exercise into your routine, research suggests. Among other mechanisms, exercise decreases inflammation (a drag on your entire body) and releases feel-good neurotransmitters that give you a physical and mental pick-me-up.
• Limit (or eliminate) caffeine, alcohol, and nicotine: When your eyelids droop to half-mast, it’s understandable to reach for caffeinated coffee or energy drinks. But over-relying on caffeine for a jolt can backfire by making it difficult to fall asleep later that night, creating a cycle where you feel extra-needy of caffeine the next day. Your best bet is to have your last caffeinated beverage by or before 3 o’clock in the afternoon. Now let’s talk about alcohol and nicotine. While a nightcap may make it easier to fall asleep initially, alcohol intake is also associated with sleep problems. And nicotine use (unhealthy in a whole host of ways) contributes to worsening menopause symptoms, which in turn mess with your sleep. If you're having difficulty cutting back on any of these substances, reach out to a clinician, who can guide you toward resources to help you reduce or quit these entirely.

When to Supplement

A knowledgeable clinician, like the ones at Midi Health, can draw up a Care Plan for you that includes nutrient supplementation, if needed. It’s important to do this in partnership with a healthcare professional who will take your existing diet, lifestyle, other health concerns, conditions, and medications into account when advising you on what menopause or perimenopause supplements could be right for you. When purchasing supplements for menopause, always make sure the ones you’re buying are third-party tested to ensure that they’re labeled accurately, free of contaminants, and safe.

How Hormone Replacement Therapy (HRT) Can Help You Manage Symptoms of Menopause Fatigue

Ready for some additional news that’ll perk you up? Hormone replacement therapy (HRT) can be a powerful tool to support quality sleep and combat menopause fatigue in addition to vitamins and supplements.

First, some background: The name HRT is a little misleading—you’re not replacing any hormones but supplementing decreased estrogen, and in patients who still have a uterus, adding back progesterone or progestin, to minimize the risk of uterine cancer. HRT works by releasing bioidentical hormones (which means they have the same chemical and molecular structure as hormones that are produced in the human body) into the bloodstream. It is available in many forms and FYI, some experts now prefer the term Menopausal Hormone Therapy (MHT).  

How HRT Helps:

• Effective at treating insomnia: At Midi, we’ve heard from thousands of women that HRT helped them finally get good rest, and plenty of research backs them up. HRT can be extremely effective in treating insomnia, reducing symptoms by 90%. That’s major, since difficulty sleeping affects 61% of menopausal women.
• Fights hot flashes and night sweats: For those who experience hot flashes, nearly 44% suffer from chronic insomnia (night sweats are a major culprit there). Since HRT is the single most effective treatment for vasomotor symptoms (hot flashes and night sweats), it follows that it’s been shown to improve sleep quality. 
• Regulates your circadian rhythm: Estrogen regulates body chemicals that influence the sleep-wake cycle and mood, so adding back some of the estrogen your body loses in the menopause transition can also help address insomnia, sleep apnea, and sleep-wrecking mood problems. 

As part of HRT, most women are also prescribed progesterone or progestin (again, the exception may be those who’ve had a hysterectomy). This hormone has calming effects that may translate into improved sleep, which is why Midi clinicians recommend taking progesterone before bed, as part of a regular HRT regimen. Progesterone also affects respiration, protecting against breathing issues such as sleep apnea. 

Keep in mind that HRT is not right for every woman, so it’s important to discuss your options with a Midi clinician or another menopause specialist who can give you individualized recommendations.

The Takeaway

• If fatigue is an issue for you, think closely about the various factors that may be influencing your energy drain and sleepiness. 
• Look at your diet and assess if you’re getting enough of the 8 key vitamins and nutrients that can impact fatigue. 
• To support your energy levels, work on sleep hygiene, adding in exercise, controlling stress levels, and even staying hydrated.
• Work with a qualified clinician who can help you look at your diet and lifestyle to find out what might best address your issues, especially as they relate to any symptoms of menopause you're also experiencing.

Frequently Asked Questions (FAQs)

What supplements are good for menopause fatigue?

There is no one supplement that will fix fatigue in menopause. However, if you have a deficiency in a specific nutrient, such as iron, B12, or vitamin D, you may benefit from supplementing if recommended by a clinician.

How can I overcome menopause fatigue?

Making dietary changes to eat more minimally processed foods, exercising regularly, getting at least seven hours of sleep per night, and managing stress will help manage fatigue in menopause. If you have night sweats or other symptoms of hormonal change that interfere with your sleep, other treatments like hormone replacement therapy (HRT) may be right for you.

What are the symptoms of low B12 in menopause?

Symptoms of low B12 include fatigue and weakness, pale skin, heart palpitations, and weight loss. A blood test can check your B12 levels.

What are the most important vitamins after menopause?

During the menopause transition, many women fall short of their vitamin D and fiber needs, but there are a number of other vitamins and minerals that may benefit from supplementation. Talk to a clinician for personalized recommendations.