Happy Fertile Friday everyone!! Today I want to do a recap of six important supplements for pre-conception and pregnancy. I know of some people who take a prenatal vitamin (of varying qualities), and that’s great, but there are a few extras that I think are so important during that time.
(1) Multivitamin and mineral
This one is quite obvious and well-known, but I do think it’s worth saying that there are varying qualities of multivitamin. Some of the cheaper brands add minerals that are not in a well-absorbed form. An example of this would be ascorbate and carbonate forms, which are cheaper to produce but not well absorbed. Citrate and malate forms of minerals are superior.
Vitamin A is a nutrient to watch out for – it can be found either as preformed vitamin A, or as beta-carotene, which we can convert to vitamin A within the body. Too much preformed vitamin A can contribute to birth defects- make sure you are not getting more than 10,000 IU daily from all your vitamin/ supplement sources.
Folic acid is an important nutrient to be aware of, in terms of dose and form, which brings me to #2:
(2) Methylated folate
Folic acid is considered one of the most important nutrients in pre-conception and during pregnancy. It is especially important to be taking it leading up to conception, since folic acid is given to prevent neural tube defects, most of which happen in the first six weeks of fetal development. However, approximately 50% of the population has what is called a methylation defect. It is a genetic issue, and while it can be quite complicated to understand all of it, the bottom line here is that many women can’t convert folic acid to its usable form. Therefore supplementing with folic acid is not the optimal way – it would be much better to take methylated folate, which is already in a more usable form. You may see this on labels as 5-methyl-tetrahydrafolate, or methyl-folate, or 5-MTHF. I take one tablet daily of Folapro by Metagenics which provides 800 mcg of 5-methyltetrahydrafolate, in addition to my prenatal multi.
(3) Calcium and magnesium
Calcium requirements increase during pregnancy, as obviously there are new bones and connective tissues being grown! Magnesium can also really help the leg cramps that are common in pregnancy. Calcium and magnesium should always be given together in a 2:1 ratio. The important consideration here is the form of calcium and magnesium – calcium citrate, malate and glycinate are all good forms that will be well absorbed. The same goes for magnesium – citrate, malate and glycinate forms are all good bets. I shoot for 1000mg calcium per day with 500mg magnesium, again, in addition to my multi which also contains some.
(4) Vitamin D
Vitamin D is so important for healthy bone development and immune function, amongst other things. Strangely, many of us are deficient in vitamin D and don’t even know it. Even here in sunny San Diego, most people I test are on the low end of normal. Most multis, even prenatals, contain 400-700 IU of vitamin D, which in my opinion is not enough for many people. Lab testing should be done to measure vitamin D levels (25- hydroxy D). While “normal” range is 30-100, optimal range is 60-80. I have many patients with a vitamin D level of 35 who’s doctor told them it was fine, within normal range. But I would argue that while in that range, 35 is still quite low and for optimal health they would be better in the mid to upper end of the normal range. D3 is the form of vitamin D that should be supplemented, typically in the range of 1000 IU to 5000 IU daily. I like Bio-D-Mulsion vitamin D drops made by Biotics. They’re so easy to take and they’re emulsified form for better absorption.
(5) EPA/ DHA
Essential fatty acids are so important for the neurological development of the baby. I talk here about the importance of DHA for children. Well that starts in utero. Having sufficient essential fatty acids are also really important for pregnant women to keep their nervous systems functioning well, and to reduce any inflammation in the body. Omega-3’s such as fish oil are usually dosed in 1 gram increments (such as 1 gram per gel cap) but the important thing is to check the actual levels of EPA and DHA. I use one that contains 430 mg and 290 mg of EPA and DHA respectively, which are good levels (I take 2 daily of those). Some go even higher than that. Metagenics has great fish oils that are screened for purity, and digest well without fishy aftertastes!
I’ve talked a lot recently about the importance of probiotics, and the importance of the microbiome (the colonies of bacteria that live on and within us, in particular in our gut). The mother’s microbiome is crucial for starting her baby out with a good microbiome. One of the ways women can help is by taking probiotics themselves, and trying to avoid excessive sugars, antibiotics, high carb diets, and other things that would foster imbalance in their own gut flora. I recommend 50 billion live organisms of a high-quality probiotic per day. There are a number of probiotics that I like, and I’ll often rotate. I have Klaire Labs capsules in my fridge that I’ll take in the morning, but I also have a Xymogen one by my bed that does not need refrigeration, and I’ll take one of those at night.
How to Get All These Nutrients
One product that I’ve liked a lot and use myself is Metagenics Wellness Essentials for Pregnancy. It has pouches that contain a multivitamin, calcium/ magnesium, essential fatty acids and extra choline (for healthy neurological development of the growing baby). I like that it comes in ready-to-go-packets, I just take one packet daily with breakfast and that covers a lot of the bases I’ve outlined above. It also contains 1 mg of 5-methyltetrahydrafolate which very few prenatals do.
Daily routine to get all the nutrients listed above:-
1 pack Metagenics Wellness Essentials for Pregnancy
2-3 drops Bio-D-Mulsion Forte
2 capsules Ther-Biotic Complete
It’s a pretty manageable routine, but can go such a long way to really optimizing the health of both mama and her growing baby!