Dr. Anna’s Six Foundational Supplements in Perimenopause

Foundational Supplements for Perimenopause

Supplements for Hormonal Imbalance

Toxins, stress, and processed foods bombard us daily unless we make heroic efforts to avoid these things. I know this is a challenge for me and many of the people I know and coach. Unfortunately, all these “bad actors” lead to nutrient depletion and hormone imbalance, not to mention what they do to your gut health!

A whole universe of supplements and herbs exists out there. But the science is not always available to back their use, and opinions vary on whether or not supplementation is useful. However, some have data, and supplementation can be very helpful in the face of the environmental challenges we experience. 

And just as a caveat to keep in the back of your mind….a lack of data does not mean something does not work. It is more likely that the product has not been tested. Clinical trials are VERY expensive to conduct.

Today, I’ll focus on the foundational supplements I love in perimenopause. After you read about them, check out my supplement store for the quality brands I trust.

Here Are The Six Foundational Supplements: 

Vitamin C

Vitamin C can help raise progesterone levels. Low progesterone is one of the hallmark imbalances in perimenopause. It’s the only over-the-counter vitamin for low progesterone that’s proven to be effective. At doses of 750 mg/day, Vitamin C has been shown to raise progesterone in women with both low progesterone and luteal phase defect. In a randomized trial, women received either Vitamin C or a placebo. Within three menstrual cycles, the group receiving Vitamin C saw progesterone levels increase on average from 8 to 13 ng/mL. (Your goal is 10 to 25 ng/mL.) I generally recommend 1000 mg/day in divided doses.


If you’re a busy woman or you supplement with Vitamin D (or both), chances are you’re deficient in magnesium and don’t even know it. This multi-tasking mineral is needed for your body to complete around 300 processes, many of which impact hormone balance, and it can be hard to get from food sources because of mineral depletion in soil. Vitamin D supplementation also depletes magnesium.

Signs of Low Magnesium

  • Muscle spasms from foot cramps to chest pain (Always get chest pain checked out.)
  • Headaches
  • Feeling constantly fatigued or weak
  • Anxiety and edginess
  • Loss of appetite
  • Quick exhaustion during exercise – Research has found that women with low magnesium levels in their muscles are likely to use more energy and tire far more quickly during moderate activity.
  • Poor sleep

Magnesium can’t be manufactured as a single molecule; it needs to bind to something else to be stable. So, the biggest difference between magnesium products comes not from the magnesium itself (which is all the same) but from the molecule it’s bonded to. The most common bonding agents are oxide, citrate, glycinate, taurate, sulfate, and threonate. Glycinate, taurate, and threonate are all able to cross the blood-brain barrier and thus, may be more effective for sleep.


The B vitamins, which include riboflavin, thiamine, niacin, B12, and folic acid, are often referred to as the “stress” vitamins. There are many symptoms of B vitamin deficiency, and these include hair loss, tension, irritability, difficulty managing stress, poor concentration, and anxiety. 

B vitamins have a complex role in your body because stress and some medications like birth control pills and stomach acid suppressors deplete them from your body. Ensuring you have optimum levels during perimenopause can help in a number of ways to support stress management. I recommend the Nutrametrix brand because it comes as a powder and is easy to swallow (mix with water). Also, it has a form of folate that does not require any conversion in case an MTHFR genetic variant is present, and it doesn’t have that objectionable smell that many B’s have.

Vitex (AKA Chasteberry)

Chasteberry has been used for centuries to help with menstrual problems like PMS, irregular cycles, and low progesterone. Considerable research (mostly from Europe) suggests the effectiveness of chasteberry in treating the symptoms of PMS, breast tenderness, and infertility related to elevated prolactin or low progesterone.

The therapeutic dose of chasteberry depends on the brand and the formulation you choose. Chasteberry is available in liquid, capsules, and tablets. Taking chasteberry while using the oral contraceptive pill, the contraceptive patch, or Nuvaring for birth control increases the chance that you could get pregnant.  Allow several months for it to work. It may make cycles more irregular when you begin them.

Vitamin D with K2

Every cell in your body uses Vitamin D. Adequate Vitamin D intake is important to regulate calcium and phosphorus absorption, maintain healthy bones and teeth, and provide a protective effect against diseases such as cancer, type-1 diabetes, and multiple sclerosis.

The best way to get Vitamin D (which is actually a hormone) is by letting our skin convert sunlight to D3. Ten minutes of direct exposure without sunscreen is all you need daily. Even though it’s a short amount of time, it can be challenging to schedule, especially if you live in an area that is cloudy a lot or has short days in the winter. I supplement with a Vitamin D product that also contains Vitamin K2, which helps the D3 do its job. D3 and K2 work together to prevent calcium from depositing in the lining of the main arteries in your neck that feed blood to your brain. Calcification of these arteries can lead to heart disease and stroke. I generally recommend 5,000 IU of Vitamin D3 daily along with at least 45 mcg of Vitamin K2 to my clients, with a goal Vitamin D level of 50-70 ng/mL. I recommend the Nutrametrix brand of this product.

Adaptogenic herbs

Adaptogenic herbs are safe, non-toxic herbs that support the adrenal glands, helping you respond to stress. They help regulate cortisol whether it’s high or low and are one of my main go-to supplements for clients. Adaptogenic herbs are available as single herbs in tinctures or capsules. Many are also teas. Some of my favorites include Rhodiola, Panax ginseng, ashwagandha, Eleutherococcus, licorice root, tulsi (holy basil), maca, and reishi mushrooms. The choice of which herb to use depends on the symptoms you are experiencing, and I generally recommend blends of multiple adaptogens to my clients. Here’s one I like and use myself.

New Supplements for PerimenopauseFoundational Supplements Are Helpful

Perimenopause is a time when a little extra nutritional support can be helpful as you work on more foundational habit changes. Supplements can also counteract the effects of stress which lie at the root of many hormone imbalances. I suggest trying no more than 1 or 2 new supplements at a time so you can assess the effects and quickly pinpoint any problems with side effects.


Dr. Anna Garrett is a menopause expert and Doctor of Pharmacy. She helps women who are struggling with symptoms of perimenopause and menopause find natural hormone balancing solutions so they can rock their mojo through midlife and beyond. Dr. Anna is the author of Perimenopause: The Savvy Sister’s Guide to Hormone Harmony. Order your copy at www.perimenopausebook.com.

Dr. Anna is available for 1-1 consultation. Find out more at www.drannagarrett.com/lets-talk

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