Conception update

Tasha Jennings, Naturopath,
Nutritionist, Natural Fertility Specialist

Prenatal supplements: the facts you need to know

So you want to have a baby!  You have probably been told by friends, family, GPs and the media about the importance of folate – or did they say folic acid? Aren’t they the same thing? Do I need more vitamins?

The barrage of information on do’s and don’ts can be overwhelming and confusing.  

Let’s remove some of that confusion around prenatal supplementation and provide clear information to help you achieve a healthy conception and pregnancy – and give your baby the best possible start in life.

Folate versus folic acid

Folate is used by the body to create DNA. It is well known for supporting the development and closure of the neural tube, which connects the brain and the spinal cord.  In fact, without adequate folate, you cannot sustain a pregnancy.

However, it is important to note that folic acid and folate are not the same thing.  

Folic acid is a synthetic supplemental form of natural folate. Unfortunately, 50% of people struggle to properly metabolize folic acid into useable folate and 40% of women are not getting enough to support a healthy pregnancy.

A common polymorphism (a condition occurring in several forms) of the MTHFR gene causes this metabolic issue. The MTHFR enzyme (standing for 5-methyl-tetrahydrofolate) is the enzyme which affects the conversion of folic acid to folate.  Different variants of this gene affect how much folate you are able to metabolise from folic acid. Those with certain variants are unable to properly metabolise folic acid into folate, which can leave them at risk of birth defects and miscarriage.

Supplemental folate in the form of Calcium folinate (folinic acid) is a more active form of folate, which can help overcome this metabolic issue. Some supplements now also provide methylfolate. Whilst methyl-folate can be very beneficial for those with a properly diagnosed variant of the MTHFR gene, it can have serious side effects including depression, irritability, severe anxiety, insomnia, achy joints, palpitations and migraines if wrongly prescribed.  

So unless you are under the guidance of a healthcare professional with a clear understanding of your MTHFR pathways, I recommend looking for a supplement which provides folinic acid combined with folic acid to help optimize folate absorption, alongside a healthy dietary intake.

The recommended daily intake for folate prior to conception is 400mcg increasing to 600 mcg during pregnancy. Most prenatal supplements will provide 500 mcg of supplemental folate in line with Australian supplemental guidelines.

Choline

Another vital yet lesser known prenatal nutrient is choline. It forms an important part of every cell in our body as a key component of our cell walls. It’s so essential to life that our body is able to manufacture limited amounts, which is one of the reasons it has flown under the radar of ‘essential’ nutrients.  

Research now shows that choline intake is critically important, especially during pregnancy and breastfeeding, yet the limited amounts our body produces are not sufficient and 90% of us are not getting enough.

Choline works alongside folate in the healthy development of the neural tube and supports healthy growth of the placenta as well as reducing risk of miscarriage. Choline also plays a key role in brain development with studies showing improvements in learning and memory.  The recommended adequate intake for choline prior to conception is 425 mg increasing to 440 mg during pregnancy.

Iron

In my opinion, iron is a nutrient which has received a little too much attention, with many claims that it is the answer to fatigue and tiredness and always much needed by women during pregnancy.  All of which may be true if you are deficient.

I always recommend getting your iron levels checked before taking high dose supplements, which are often routinely prescribed and can lead to constipation and can in fact be harmful.  

Iron is a heavy metal and is difficult for the body to absorb in high doses.

Our body also has no means to excrete excess iron, therefore high doses should not be consumed unless under the guidance of an informed Health Care Practitioner. If iron is required, it is best taken in smaller (5 – 25 mg) divided doses in the form of an iron amino acid chelate. If your iron supplement is causing constipation, it is likely not being properly metabolized and/or the dose is too high.

The recommended intake (RDI) for iron in the preconception period is 18mg increasing to 27 mg during pregnancy. The Upper Safe Limit (UL) is 45 mg/day.  Many over the counter iron supplement provide doses much greater than the upper safe limit. So I recommend getting your levels checked and getting advice from your healthcare professional.

Of course getting enough of these key nutrients is not the only factor to consider for a healthy pregnancy.  In the next instalment I will discuss important diet and lifestyle factors you need to be aware of during preconception and pregnancy. ________________________________________________________________  Tasha Jennings is a Naturopath, Nutritionist, Natural Fertility Specialist and Author of The Fertility Diet and The Vitamins Guide.  She has an information hub Conceive Baby, which provides expert information, articles, webinars and podcasts from leading fertility specialists from across the globe.  She also has a free ‘5 days to Improving your Fertility’ eCourse 5daystoimprovedfertility.com and a forthcoming ‘Your Fertile Pantry’ course. www.tashajennings.com.au.

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