Best Vitamins and Nutrients for Perimenopause Energy

Why Perimenopause Drains Your Energy

The fatigue that comes with perimenopause is not imaginary and it is not laziness. It comes from several overlapping causes: disrupted sleep from night sweats, hormonal fluctuation that affects neurotransmitter production, increasing demands on your adrenal system, and in many cases, nutritional shortfalls that have been building quietly for years.

The trap many women fall into is buying a general energy supplement without knowing which of these causes is actually driving their fatigue. Some nutrients address deficiencies that are genuinely common in midlife women. Others have evidence behind them for cellular energy production. And some are sold on promises with thin science behind them.

The guidance here is built around a key principle: test before you supplement when possible. Several of the nutrients below work well when levels are low but offer little benefit if you are already sufficient. Knowing where you stand saves money and prevents unnecessary high-dose supplementation.

Vitamin D: The One Most Women Are Short On

Vitamin D is the nutrient most likely to be genuinely low, and low vitamin D is consistently associated with fatigue, low mood, and muscle weakness. The reasons are straightforward: most people do not get enough sun exposure year-round, food sources are limited, and absorption decreases with age.

Vitamin D is not just a bone nutrient. It influences immune function, mood regulation, and muscle performance, all things that affect how energetic you feel day to day. Studies examining vitamin D supplementation in deficient adults find improvements in fatigue, mood, and physical function.

The critical step is testing. Serum 25-hydroxyvitamin D is the blood test to ask for. Most clinicians consider levels below 20 ng/mL deficient and levels below 30 ng/mL suboptimal. Supplementation doses depend on your baseline, so getting tested first is worth it. A general maintenance dose of 1,000 to 2,000 IU daily is commonly recommended for those in the adequate but not optimal range, while those who are deficient may need higher doses under clinical guidance.

Vitamin B12: Essential, Especially If You Eat Less Meat

B12 is required for red blood cell production, nerve function, and the conversion of food into usable energy. When B12 is low, fatigue is often profound and can come with brain fog, difficulty concentrating, and tingling in the hands and feet.

B12 is found almost exclusively in animal foods. If you eat little or no meat, fish, eggs, or dairy, the chance of being deficient or borderline is significant. But even meat eaters can have absorption issues, particularly as they get older, because stomach acid production decreases with age and B12 requires stomach acid to separate from food proteins.

A simple serum B12 test tells you where you stand. Levels below 300 pg/mL may be associated with symptoms even if they are technically within the lab's normal range. Methylcobalamin is generally considered a well-absorbed form. Sublingual B12 (dissolved under the tongue) bypasses some of the stomach acid absorption issue and is a good choice if you have any digestive concerns.

Iron: Get Tested Before You Supplement

Iron deficiency is a common and underdiagnosed cause of fatigue in perimenopausal women, particularly those who have heavier or more frequent periods, which is a common feature of perimenopause. Iron is required for making hemoglobin, which carries oxygen to your tissues. When iron is low, every cell in your body gets less oxygen, and energy production suffers accordingly.

Here is the important caveat: do not supplement iron without testing first. Iron overload is possible and is itself harmful. Ask your provider for a ferritin test, which measures stored iron, alongside a standard hemoglobin or CBC. Ferritin below 30 ng/mL is often associated with fatigue even when hemoglobin looks normal.

If your levels support supplementation, iron bisglycinate tends to be gentler on the digestive system than ferrous sulfate. Taking iron with vitamin C enhances absorption. Avoid taking iron at the same time as calcium supplements or calcium-rich foods, as they compete for absorption.

Magnesium: For Energy, Sleep, and More

Magnesium is involved in over 300 enzymatic reactions, including many that are central to energy production. It plays a direct role in ATP synthesis, which is the process your cells use to generate usable energy. It also supports quality sleep, and since poor sleep is one of the primary drivers of perimenopausal fatigue, the indirect energy benefit is significant too.

Magnesium deficiency is genuinely common. Processed food diets, high stress, and alcohol consumption all deplete magnesium. Studies examining magnesium supplementation in people with low dietary intake find improvements in energy, sleep quality, and mood.

Magnesium glycinate is the form best supported for sleep and mood, and it tends to be gentler on digestion than other forms. Studies have examined doses in the range of 200 to 400 mg of elemental magnesium daily. It is worth noting that serum magnesium tests often look normal even when intracellular magnesium is low, so clinical response is often more informative than the lab result alone.

B-Complex Vitamins: Supporting the Energy Machinery

The B vitamins, including B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6, folate, and B12, are all involved in converting the food you eat into energy your cells can actually use. They are cofactors in the metabolic pathways that produce ATP. Without adequate B vitamins, these pathways slow down.

B6 in particular matters during perimenopause because it is involved in the production of serotonin and dopamine. Low B6 is associated with mood changes and fatigue that can look very similar to depression. Stress and hormonal fluctuation both increase the body's demand for B vitamins.

A quality B-complex taken in the morning with food covers the bases without the risk of overdosing on any single B vitamin. Look for activated forms, such as methylcobalamin for B12 and methylfolate for folate, as they are better absorbed by people with certain common genetic variants in the MTHFR enzyme pathway.

CoQ10: Mitochondrial Support with Emerging Evidence

CoQ10 (coenzyme Q10) is produced naturally by your body and is essential for the mitochondria, the parts of your cells that generate energy. Production declines with age, and some research suggests that perimenopausal hormonal shifts may affect mitochondrial efficiency.

Studies examining CoQ10 supplementation in people with fatigue have found modest but consistent improvements in energy levels and exercise tolerance. The evidence is more robust in certain medical conditions than in healthy adults, but the safety profile is excellent and side effects are rare.

Ubiquinol, the reduced form of CoQ10, is better absorbed than ubiquinone, especially for adults over 40. Studies have examined doses in the range of 100 to 200 mg daily. If you take a statin medication, this is especially relevant: statins reduce CoQ10 production, and supplementation is often recommended alongside them.

How to Prioritize Without Overwhelming Yourself

If you are looking at this list and wondering where to start, the most evidence-backed move is to get your vitamin D, B12, ferritin, and magnesium levels checked at your next healthcare visit. Identify any genuine deficiencies first and address those before adding supplements with weaker evidence.

After that, a B-complex in the morning and magnesium glycinate at night covers two of the most practical bases for perimenopausal energy and sleep. CoQ10 is a reasonable addition if budget allows, particularly if you take statins or notice ongoing fatigue after addressing deficiencies.

Tracking how your energy changes over time gives you real information about what is working. Log your energy levels alongside sleep and symptoms in PeriPlan so you can spot which changes correspond to actual shifts in how you feel.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.