Falls and Supplements in Older Adults: Understanding Which Supplements Increase Fall Risk Through Dizziness and Hypotension
Falls are a leading cause of injury and disability in older adults, with fractures, head injuries, and loss of independence often resulting from a single fall. While environmental factors (loose rugs, poor lighting, uneven surfaces) and intrinsic factors (muscle weakness, balance problems, vision changes) are well-recognized fall risk factors, the role of supplements in increasing fall risk is often overlooked. Many supplements can cause dizziness, hypotension (low blood pressure), sedation, and impaired balance—all direct fall hazards. For caregivers, understanding which supplements increase fall risk is essential for safety.
How Supplements Increase Fall Risk
Supplements can increase fall risk through multiple mechanisms: orthostatic hypotension (dizziness upon standing due to sudden blood pressure drop), sustained hypotension (chronically low blood pressure), sedation or confusion, impaired balance or coordination, electrolyte disturbances (low sodium, potassium, or magnesium), and interactions with medications that compound fall risk. In older adults with already-compromised balance, vision, or strength, even modest increases in dizziness or blood pressure changes translate to substantially increased fall risk.
Supplements That Lower Blood Pressure
Garlic supplements, often used for cardiovascular health, can lower blood pressure, particularly at high doses. This can cause dizziness or lightheadedness, especially upon standing quickly. Older adults on blood pressure medications taking garlic supplements may experience excessive hypotension and fall risk.
Hawthorn berry supplements, promoted for heart health, can lower blood pressure and may cause dizziness or weakness. The combination with blood pressure medications increases risk.
Hibiscus tea, consumed for antioxidant and blood pressure-lowering effects, can cause significant hypotension in some individuals, particularly when combined with blood pressure medications. Dizziness and weakness may result.
CoQ10 supplements, while generally safe, can lower blood pressure in some individuals. This is particularly relevant in those already on blood pressure medications. Monitoring for dizziness is appropriate.
Omega-3 (fish oil) supplements at high doses may lower blood pressure mildly. While moderate doses are generally safe, very high doses (>3 grams daily) combined with blood pressure medications may cause excessive hypotension.
Supplements With Sedating Effects
Valerian root and passionflower, used for anxiety and sleep, have sedating properties. Sedation increases fall risk by impairing alertness, balance, and reaction time. Older adults taking these supplements should avoid engaging in activities requiring coordination (like walking on uneven surfaces) particularly in the hours after taking the supplement.
Kava kava, used for anxiety, has sedating properties and has been associated with liver toxicity and should generally be avoided in older adults.
Ashwagandha, an adaptogenic herb promoted for stress reduction, can cause sedation and dizziness in some individuals, increasing fall risk. Combined with sedating medications, the effect is compounded.
Chamomile and other relaxation herbs in concentrated supplement form can cause drowsiness. While a cup of chamomile tea is unlikely to cause significant sedation, high-dose supplements may.
Supplements Affecting Balance and Coordination
Ginkgo biloba, promoted for cognitive function, can cause dizziness and impaired balance in some individuals. Additionally, ginkgo may increase bleeding risk when combined with blood thinners, which could result in intracranial hemorrhage (particularly dangerous in the context of falls).
Ginger supplements, while generally safe in food amounts, can cause dizziness at high doses. This is particularly concerning in older adults already struggling with balance.
Turmeric/curcumin supplements can lower blood pressure and cause dizziness in some individuals, particularly at high doses.
Supplements Causing Electrolyte Disturbances
High-dose diuretic herbs (like herbal teas marketed for “detox” or weight loss) can cause excessive urinary losses of sodium, potassium, and other electrolytes. This leads to weakness, dizziness, and increased fall risk. Additionally, electrolyte disturbances can cause arrhythmias.
Licorice supplements can cause sodium retention and potassium depletion, leading to hypertension (though paradoxically, electrolyte disturbances also cause weakness and dizziness). This can increase fall risk.
Medication-Supplement Interactions Increasing Fall Risk
Some supplements don't directly cause falls but compound the effects of medications that do. For example: sedating supplements combined with sedating medications increase drowsiness; blood pressure-lowering supplements combined with antihypertensive medications increase hypotension; and anticoagulant supplements combined with blood thinners increase bleeding risk (dangerous in falls that cause head injury).
Assessment and Prevention
For caregivers, fall risk assessment should include review of all supplements. Questions to ask about each supplement: Does it lower blood pressure? Does it cause dizziness or sedation? Does it affect balance or coordination? Does it interact with medications? For those taking supplements with known fall risk, several approaches reduce harm: keeping blood pressure medications appropriately dosed (not too low, which increases dizziness); avoiding standing too quickly; ensuring safe environments (good lighting, clear walkways, assistive devices as needed); monitoring for dizziness or weakness; educating the older adult about fall risk; and considering discontinuation of unnecessary supplements with fall risk.
Safe Supplement Practices for Fall Prevention
For older adults taking supplements: discuss all supplements with healthcare providers, particularly those on blood pressure medications or other fall-risk medications; report any new dizziness, weakness, or balance changes; avoid high-dose blood pressure-lowering or sedating supplements; maintain adequate hydration (which helps maintain blood pressure); stand slowly and use assistive devices as needed; and have vision and balance assessed periodically by healthcare providers (optimizing these reduces fall risk regardless of supplements).
This article is for informational purposes and should not replace professional medical advice. Any dizziness, weakness, or balance changes should be reported to a healthcare provider. Fall risk should be assessed by a healthcare professional. MercyAssistedCare.org Wellness Team | July 2026