What supplements are effective for increasing telomere length in a middle-aged or older adult?

Supplements for Increasing Telomere Length

Based on current evidence, omega-3 fatty acids and Astragalus-based supplements show the most promise for lengthening telomeres, while routine multivitamin supplementation in vitamin-replete older adults is unlikely to provide benefit.

Evidence-Based Supplement Recommendations

Omega-3 Fatty Acids

• Meta-analysis of clinical trials demonstrates a statistically significant beneficial effect on telomere length (mean difference = 0.16; 95% CI, 0.02,0.30; p = 0.02) 1
• The mechanism likely involves antioxidant and anti-inflammatory properties that reduce oxidative stress and chronic inflammation, both of which accelerate telomere attrition 1
• This represents the most robust evidence from pooled clinical trial data available

Astragalus-Based Supplements

• A 2024 randomized, double-blind, placebo-controlled trial showed significant telomere lengthening in middle-aged adults (mean age 56.1 years) over six months 2
• Subjects taking the Astragalus supplement exhibited significantly longer median telomere length (p = 0.01) and short telomere length (p = 0.004) compared to placebo 2
• The supplement works by increasing telomerase activity and reducing the percentage of critically short telomeres (<3 Kbp) 2
• TA-65, a telomerase activator derived from Astragalus, showed that low-dose supplementation (250 U) significantly increased telomere length by 530 ± 180 bp over 12 months (p = 0.005), while placebo subjects lost 290 ± 100 bp (p = 0.01) 3
• No adverse effects were reported in either study 3, 2

Multivitamins and Individual Micronutrients

Important caveat: The evidence for multivitamins is mixed and context-dependent:

• In vitamin-replete older adults, routine vitamin D supplementation does not influence telomere length 4

• A large randomized trial of monthly vitamin D in Australians aged 60-84 years showed no effect on telomere length (adjusted mean difference -0.001; 95% CI -0.02 to 0.02) 4

• However, in younger women with potential micronutrient deficiencies, multivitamin use was associated with 5.1% longer telomeres compared to non-users (p = 0.002) 5

• Higher dietary intakes of vitamins C and E from foods were each independently associated with longer telomeres, even after adjusting for multivitamin use 5

Critical Considerations and Pitfalls

Measurement Variability

• Telomere length measurements are hampered by significant noise and wide longitudinal variations that cannot be explained by health events 6
• Different measurement methods (restriction fragment analysis, fluorescence in situ hybridization) have produced contrasting results in observational studies 6
• This measurement error makes telomere length currently not useful as a biomarker of biological age in clinical practice 6

Population-Specific Effects

• The benefit of supplementation appears to depend on baseline nutritional status 4, 5
• Supplementing already vitamin-replete individuals is unlikely to provide benefit, while those with deficiencies may see improvements 4, 5

Theoretical Concerns About Telomerase Activation

• While telomerase can replenish telomeric DNA, this mechanism plays a fundamental role in cancer growth 6
• However, the clinical trials of telomerase activators have not shown increased cancer risk to date 3, 2
• Short telomeres are associated with increased mortality, cardiovascular events, and multiple adverse health outcomes 6

Safety Considerations for High-Dose Vitamins

• Vitamin E supplementation at 200 IU/day appears safe and may reduce mortality in older adults, but doses should remain well below the tolerable upper limit of 1,600 IU/day 6
• The U.S. Preventive Services Task Force found no evidence of benefit from single or paired vitamin/mineral supplements for cardiovascular disease, cancer, or all-cause mortality prevention in the general population 6
• Some supplements may interact unfavorably with cancer treatments or promote progression of pre-malignant lesions 6

Practical Algorithm for Supplementation

For middle-aged and older adults seeking to optimize telomere length:

1. First-line recommendation: Omega-3 fatty acids, given the strongest meta-analytic evidence 1

2. Second-line consideration: Astragalus-based supplements (such as TA-65 at 250 U daily), based on two positive randomized controlled trials 3, 2

3. Assess nutritional status before recommending multivitamins: Only consider if dietary intake of vitamins C and E is inadequate 5

4. Do not routinely supplement vitamin D solely for telomere length in vitamin-replete older adults 4

5. Avoid using telomere length testing as a screening tool due to poor sensitivity, specificity, and high measurement variability 6