Supplements your body needs in perimenopause

Mary Claire Haver emphasizes that fiber is her number one recommendation. She advises using a nutrition tracker to objectively measure intake because most people underestimate their consumption. She lists high-fiber foods: legumes (beans, peanuts), berries, seeds, nuts, and avocado. She personally uses avocado to meet her daily goal. The protocol is simple: track, identify the gap, then incorporate more fiber-rich foods consistently.

Haver explains that while magnesium glycinate and citrate are good for raising blood levels, they don't effectively reach the brain. Magnesium L-threonate, sold under brand names Magtein and Neuromag, has been studied in SSRI-resistant depression with positive results. She observes that her patients and followers report significant improvements in sleep and anxiety when taking it at night. This makes it a targeted intervention for the neurological symptoms common in perimenopause.

Haver lists omega-3s as her third vital recommendation. She notes that fatty fish are the richest source, but also mentions plant sources like flax, hemp, and chia seeds. She personally adds these seeds to yogurt for a combined fiber, antioxidant, and omega-3 boost. If dietary intake is low, she considers daily supplementation a reasonable and safe practice.

Haver tests vitamin D levels in every patient who consents. She finds that 80% are not just low but deficient. Reasons include reduced gut absorption, sun avoidance, and decreased skin synthesis with age. She stresses that vitamin D is a hormone, not just a vitamin, and that low levels mean the body isn't working as efficiently as it could. Her protocol is to test first, then supplement aggressively to bring levels into an optimal range.

Haver references a study showing that postmenopausal women with obesity and hypertension who took probiotics had lower blood pressure and visceral fat compared to placebo, with no change in weight. She acknowledges that gut health is hard to measure directly but points to subjective improvements like reduced bloating and regular bowel movements. She recommends making probiotic-rich foods a daily habit, and only supplementing if those foods aren't tolerated.

Mary Claire Haver explains that the brain has a protective membrane that selectively allows nutrients in. Magnesium L-threonate is one of the few forms that can cross this barrier. She cites a study where it was added to treatment for SSRI-resistant depression with positive results. In her own practice and among her followers, she observes significant improvements in sleep and anxiety when taken at night. This positions magnesium L-threonate not just as a general mineral supplement but as a targeted neurological support during perimenopause.

Haver describes a study where postmenopausal women with obesity and hypertension were given probiotics versus placebo. The probiotic group experienced significant reductions in blood pressure and visceral fat, while weight remained unchanged. She emphasizes that calories are still important but not the sole factor; the gut microbiome plays a key role in fat distribution. This finding supports her recommendation to consume probiotic-rich foods daily or supplement if necessary, as a strategy to mitigate menopause-related metabolic changes.

Haver explains that when women go through menopause and lose estrogen, the gut microbiome loses diversity regardless of probiotic intake. This shift changes the microbial composition to resemble that of a man, which is an independent risk factor for visceral fat deposition. She connects this to the phenomenon of belly fat, noting that visceral fat is metabolically dangerous. This insight reframes menopausal weight gain as partly a microbiome-driven process, justifying probiotic interventions.