Top 5 Essential Tips for Choosing Prenatal Supplements You Need to Know

“At no point in human nutrition is it more critical to ensure adequate nutrient intake than during the state of pregnancy” 

– Bruce Hollis, PhD 

Studies show 95 percent of pregnant women are nutritionally depleted.

Fertility, pregnancy, and postpartum are some of the most physically and mentally demanding times in a woman’s life. Unfortunately, the prenatal vitamin industry is failing women, leaving 95% depleted when nutrition for body and mind is needed most. 

Why? 

Because most supplement companies follow the current RDAs.  

RDAs are based on outdated research methods and studies conducted mainly on white men. In fact, pregnant and breastfeeding women were intentionally excluded from 83% of the studies chosen as the basis for the current perinatal RDAs. Including pregnant and breastfeeding women in clinical research was considered too risky and so these groups were excluded from clinical research under the guise of “protection”.

Ironically, their exclusion ultimately led to misinformed recommendations and a major gap in our collective understanding of women’s bodies, which had a devastating impact on millions of women and their families not set to support the mother in addition to the baby.

Over 630 nutrition studies support the finding that for many nutrients, the current nutritional guidelines for pregnancy and lactation are set well below optimal levels. Take choline as an example. More and more research is showing that the RDA for choline consumption should be much higher than it is to support a baby’s brain development.

Yet 90% or more women aren’t even reaching the current RDA level and most prenatals don’t even include choline in their formulation at all!

Why isn’t this research making its way into the official perinatal nutrition guidelines? On average it takes 17 years for new research to be incorporated. The lag between research and RDAs means women aren’t receiving the optimal support that they so desperately need.

So which 5 key components should you focus on when looking for a prenatal? 

1. Methylated B Vitamins
2. Activate form of vitamin A 
3. Vitamin D in adequate amounts 
4. Adequate amount of Choline 
5. Third-party testing 

Methylated Folate and B-Vitamins 

When it comes to prenatal supplements, one critical factor to keep in mind is the form of B vitamins they contain, particularly folate. While folic acid is the synthetic form commonly found in many supplements, methylated folate is often the preferred choice. This is because a significant percentage of people have a mutation in the MTHFR gene, which affects their ability to convert folic acid into its active form, folate, that the body can readily use. 

Having methylated B vitamins, including methylated folate, in your prenatal supplements ensures that your body gets the essential nutrients it needs without needing to convert them first. This can be incredibly important for preventing neural tube defects and supporting your baby’s growth and development. Moreover, B vitamins in their active, bioavailable forms are more easily absorbed and utilized by the body, providing better overall support during pregnancy. 

Therefore, opting for a prenatal vitamin that includes methylated folate rather than standard folic acid can be a game-changer, especially if you have concerns about the MTHFR gene mutation. Always consult with your healthcare provider to choose the prenatal supplement that best meets your individual needs.

Active Vitamin A 

When it comes to choosing the right form of Vitamin A in prenatal supplements, you might come across two common forms: retinyl palmitate and beta carotene. Retinyl palmitate is often considered more effective as it is a preformed version of Vitamin A, meaning it is readily usable by your body without the need for conversion. On the other hand, beta carotene, a pro-vitamin A, requires conversion by your body to be utilized. This conversion process can sometimes be less efficient, especially for individuals with certain genetic variations or dietary restrictions. Therefore, retinyl palmitate can offer more reliable and immediate benefits, ensuring that you and your baby receive the requisite amounts of this crucial nutrient.

Activated vitamin A: 

• boosts brain development
• enhances immune function
• supports bone formation

Vitamin D and Pregnancy 

Vitamin D is a fat-soluble vitamin and hormone. Its major functions include maintaining calcium and phosphorus in the body, regulating 3% of the genome, bone mineralization, blood pressure, mental health, cardiovascular health, neurodevelopment, immune health, and regulating cell growth and differentiation. 

How is it made? 

When UVB light in the sun interacts with 7-dehydrocholesterol, turning it into vitamin D3. You need adequate sun, and the time of day and year, latitude, sunscreen, clothing, and skin color can all affect vitamin D production. 

If you have pale skin, have moderate exposure to sun in a bathing suit can give you 10-25000 IU/day. 

Vitamin D3 is metabolized in the liver and converted to 25 (OH)D which is then converted to 1,25 OHD = calcitriol, which is the active form of vitamin D 

• 25OH D has a half-life of 2-3 weeks and is an indicator of vitamin D status
  
• 1,25 OH D has a half-life of 4-16 hours
  

In pregnancy, the production of calcitriol increases dramatically. The placenta converts vitamin D to its active form (1,25OHD). By 12 weeks, 1,25 OHD serum levels are 2x the level before pregnancy, and it continues to rise reaching 700+ pmol/L (non-pregnant range is 48-120 pmol/L). These levels would be toxic (due to hypercalcemia) normally, but essential during pregnancy. 

Over 30 tissues express the vitamin D receptor and are able to respond to 1,25OH D. Adequate 25 OH D directly affects 1,25 OH D levels in pregnancy. 

Role of vitamin D in pregnancy:

• Aids in implantation
  
• Supports fetal growth through the delivery of calcium
  
• Regulates placental function and placental hormone levels
  
• Limits production of proinflammatory cytokines (which can impact preeclampsia)
  
• Involved in the maturation of fetal lungs
  
• Maintains endothelial integrity/membrane stability
  

Vitamin D Requirements (highly debated): 

IOM: 600 IU /day 

RDA: 600 IU/ day

UL: 4000 IU/ day 

Endocrine Society: 1500-200 IU/day and UL 10,000 IU 

It’s estimated that 20-85% of pregnant women are deficient in vitamin D worldwide. Women of color are at greatest risk because of the melanin – black women 6x more deficient/at risk than white women. 

Vitamin D Deficiency:

• Deficiency is even common at latitudes where year-round UVB exposure is expected to be adequate
  
• Dark skin women in northern latitudes are at higher risk because you need even more time in the sun
  
• Study of 40 healthy moms in Michigan (42 latitude) took 600 IU daily + 2 cups milk (100 IU/cup)
  
• Found that at birth 76% of mothers were deficient (>20 ng/ml) and 81% of newborns were deficient
  
• 600 IU is not enough!
  

What happens when you’re deficient? 

1. Increases odds for gestational diabetes, preeclampsia, and preterm birth
   
2. Associated with periodontal disease, postpartum depression, prolonged obstructive labor, recurrent pregnancy loss, C-section
   

*Always optimal to get levels high before pregnancy! 

• Stores of vitamin D in the infant is dependent on maternal vitamin D status.
  
• 25 OH D passes from the placenta to the fetus
  
• Maternal 1,25 OH D does NOT cross the placenta, however, the placenta can synthesize 1,25 OHD directly from 25 OHD
  
• Mother typically maintains higher vitamin D than the baby
  

Choline 

 Most women do not consume enough choline in their daily diets and supplementation is high beneficial. Most prenatal vitamins contain too little to be supportive (55mg of Choline or less) as it’s a bulky nutrient that can be difficult to formulate with. Our dose is optimally supportive and safe.

How it supports baby:

• Normal neural tube development
• Optimal brain development, including cognitive performance
• Proper DNA synthesis
• Help mitigate some of the adverse effects of prenatal stress
• Transporting Omega-3 DHA from mom
 to baby

Third Party Testing 

In addition to the forms and amounts of nutrients, we recommend seeking out a prenatal that has third-party testing and is medical grade. When a product is third-party tested, it means it undergoes independent testing by accredited laboratories to verify its purity, potency, and overall quality. 

This additional layer of scrutiny provides peace of mind, knowing that your products meet the highest standards of safety and efficacy. Third-party testing is not only important to confirm that what you would expect from the label is actually in your supplement, but also to ensure that there is nothing you would not expect.

Testing for microcontaminants and heavy metals ensures that the product is safe and of the highest quality. We recommend looking for reputable independent third-party certifications such as Clean Label Project, NSF, or USP to help verify product quality. 

Additionally, when choosing prenatal supplements, it’s crucial to scrutinize the ingredient list. Opt for products that are free of common allergens like gluten, dairy, and soy, to minimize the risk of adverse reactions. Checking the expiration date on the bottle ensures you’re not consuming a product past its prime, which could compromise its effectiveness. 

What’s more, some supplements include herbal ingredients designed to alleviate pregnancy-related ailments. While these can be beneficial, they should be used with caution. Always consult your healthcare provider before adding any herbal supplements to your routine to ensure they are safe for you and your baby. 

Remember, a well-rounded prenatal supplement should contain essential nutrients like folate, B12, and chelated minerals in their active, bioavailable forms. These nutrients are crucial for fertility and pregnancy health. For instance, an iron-free formula offers customizability and may be easier on your digestive system, as iron needs can vary among pregnant individuals. 

Finally, always keep your doctor informed about any changes to your diet or supplements. This will help them give you the best advice tailored to your specific needs, ensuring a healthy pregnancy journey.