3 Essential Supplements for a Healthy Pregnancy: Beyond The Prenatal
Supplements can be an important part of your fertility care plan, and trying to choose which supplement (and at what dose) can differ from person to person.
The running theme of supplementation for a healthy pregnancy is supplement early. Test and treat any nutrient deficiencies (some of which we will talk about here), and ensuring you’re getting the proper dose of each supplement you take. The risk of some of the complications that occur later in pregnancy can be done by supplementing pre-conception (ideally), and/or prior to 20 weeks gestation.
This article doesn’t include information on a pre-natal cause I thought it deserved a post of it’s own. So, if you’re looking for more information on pre-natal supplements, including when to use them, what to look for, and the benefits of taking a pre-natal, check out this article I wrote all about it!
For now, let’s go through common supplements most people will need to support an overall healthy pregnancy.
Vitamin D
Vitamin D deficiency is quite common in Canada due to our long, dark winters, and this can significantly impact fertility.
Research has shown that higher vitamin D status (at least 75 nmol/L) has been associated with:
improved pregnancy outcomes,
reduction in miscarriage rates (for every 1 point increase in 75nmol/L, there was a 1% decrease in miscarriage rates), and an
improvement in life birth rates. [1]
Remember to test and treat Vitamin D before 20 week gestation, and even better to screen for and correct a vitamin D deficiency before conception. Optimal vitamin D levels in early pregnancy will help prevent complications in the later stages of pregnancy.
It’s also recommended to measure serum vitamin D levels each trimester, and then adjust dose as needed.
Folic Acid
It’s currently recommended to start folic acid at least 5-6 months before conception and continue on until the end of early pregnancy. It takes time for folate to reach optimal red blood cell folate levels for reducing the risk of neural tube defects, as well as a risk reduction in offspring developing autism spectrum disorder (ASD). Women often don’t take folic acid before becoming pregnant, and NTD’s can occur very early in pregnancy. But remember, it is never too late to start folic acid supplementation!
And what about different forms of folate, such as methyltetrahydrofolate (MTHF)?
Most of the research on folic acid and even public health recommendation to reduce the risk of NTDs in offspring has been done on folic acid supplementation, not on methylated forms. Methylated forms do increase the levels of folate in the blood faster than folic acid supplementation. However, large scale trials showing that MTHF reduces NTDs are lacking, making it a difficult recommendation to replace folic acid at this time. Folic acid is more heat stable and less expensive than other forms, making it a more practical choice for widespread use in preventing birth defects and supporting reproductive health.
Most people with MTHFR variants can still process folic acid, just more slowly. Folic acid is the only form with strong, population level-evidence for preventing NTDs. If you prefer methylated folate or feel better on methylated forms that is also totally fine.
Iron
Iron supplementation is needed to make the extra blood you and your fetus will need during pregnancy. Normally, the recommended daily intake of iron is 18mg for adult women. When pregnant, the requirement of iron goes up to 27 mg per day, which most prenatal’s will contain.
Iron deficiency is common in Canada, and worldwide, especially among menstruating people of reproductive age. Also consider certain factors like age, race, and even socioeconomic status, place some people at a higher risk of iron deficiency. It could also be caused be poor diet, malabsorptive disorders, and other causes of blood loss, so if you’re experiencing signs of low iron deficiency or any other disorders that could cause low iron, speak to your health care team.
Signs of iron deficiency
Fatigue
Low mood
Dizziness
Shortness of breath
Cold hands and feet
Restless leg syndrome
Test for possible anemia and iron deficiency before conception and during pregnancy. Iron deficiency in pregnancy is often associated with increased risks of fetal and neonatal mortality, and low birth weight. And increasing iron stores throughout pregnancy may reduce the risk of preterm birth, perinatal depression, postpartum hemorrhage, and the need for blood transfusions.
Again, please get tested to check your iron status as some research does suggest iron supplementation when iron stores aren’t deficient could lead to adverse maternal and fetal outcomes. You’ll also want to check your ferritin levels alongside ESR or CRP (inflammatory markers), as ferritin can be elevated if there is any systemic inflammation occurring.
If you are ready to start conceiving or already pregnant, let’s work together.
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Disclaimer: this information is for educational purposes only and does not substitute for professional medical advice. Please consult your healthcare provider for personalized treatment recommendations.