Debunking Pregnancy Myths: Part One
December 28, 2016
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Real talk: even as a fertility and pregnancy nutritionist who knows the facts and REALLY tries to eat the most nutrient-dense, real food diet possible, the reality is it’s unlikely that currently at 5 months postpartum with my second child and breastfeeding on demand, I’m getting my full dietary requirements for me and my sweet little babe every day through food alone. And I definitely acknowledged this reality and made necessary adjustments while I was pregnant. Because the fact is the more nutrients babies get in utero, the better they’re set up for a healthy life ahead.
Which is why I’m a strong believer in the addition of high quality, therapeutic, research-backed supplements alongside a well-balanced diet*, and this is especially crucial while you are preparing for and being pregnant—you are literally BUILDING your baby cell by cell from your own tissues and nutrient reserves! You’re building a 3D printing of a human through food alone! It’s incredible. And it’s also incredibly important to be mindful that your nutrient intake is sufficient enough to keep both mama and baby healthy and thriving.
Taking supplements in the preconception stage and during pregnancy serves two main purposes—supporting your own health while making sure your nutrient reserves stay robust, and ensuring proper fetal growth for your babe. Your baby needs specific vitamins, minerals, and nutrients in order to develop properly and grow, and you are much more likely to become depleted in certain areas during pregnancy and postpartum if you’re not paying special attention to your diet and supplementation needs.
Knowing what supplements to take during pregnancy and which brands of pregnancy supplements are best can be incredibly overwhelming. That’s what I’m here for, and what this blog post will decode for you.
Below you’ll find the most important supplements to take before and during pregnancy. Because these are such high-quality supplements, made with research-backed, clean ingredients, you should be able to tolerate them even when you’re nauseous and battling morning sickness.
* here are a few of my favorite resources for the best fertility foods to be including in your diet when you’re trying to conceive, in addition to high-quality supplements: Fertility Diet: What To Eat When Trying To Get Pregnant, How to Build the Ultimate Fertility Smoothie, and Superfoods for Optimized Fertility.
DISCLAIMER: I am a nutritionist, but I’m not your nutritionist. It’s important to discuss all supplements with your health care provider prior to starting a supplement regime, especially when pregnant.
But FIRST – let’s talk preconception, ie – the critical time BEFORE you actually conceive. When preparing for pregnancy, you want to begin intentional preconception care at least three months—but ideally 6-12 months—prior to starting the *trying to conceive* process. Remember the life cycle of the egg and sperm is ~90 days, so everything you do (or don’t do!) in that window can affect the quality of the egg and sperm that will eventually meet .
Not only that, but intentional preconception care is where you are able to balance your reproductive hormones and optimize the health of your entire body in preparation to nourish and carry a little human to term.
AND, studies have shown that preconception care helps reduce the risk of miscarriage!
With pregnancy supplements, it’s also important to evaluate how the nutrients are processed (high heat, for example, can damage nutrients), and the additives. Avoid products that contain additives like sugar, artificial dyes, unnecessary preservatives, refined oils, and allergens like wheat, corn, or soy.
When it comes to taking supplements, you want to select the highest quality manufacturing standards possible. In addition, you have to look closely at the other ingredients. Many supplement brands use soy derivatives, corn, gluten, sugar, refined oils, aluminum, titanium dioxide, petroleum derivatives, and artificial colorings in their manufacturing. None of these are safe while pregnant, or while trying to get pregnant! There are very few brands that I use and trust. If you’re going to use supplements, invest in the best.
The recommended supplements for preconception and pregnancy that I list below have all been third-party tested and are guaranteed to be produced utilizing the highest standards of manufacturing. Each product is evaluated and monitored for quality throughout the manufacturing process. This means that every nutrition supplement I recommend in this article:
Here is a comprehensive list of labs to ask your primary care physician and/or Ob to run 90 days before you’re ready to start trying to conceive (or if you’re already actively trying, get these run now!), once you’re pregnant these labs should be drawn at least once every trimester:
– fasting insulin
– HbA1c
– Comprehensive Metabolic Panel
– TSH
– free T3
– free T4
– TPO antibodies
– antithyroglobulin antibodies
– vitamin D
– vitamin B12
– vitamin B6
– CoQ10
– OmegaCheck
– folate
– zinc
– iron
– ferritin
Let’s just address the elephant in the room really quickly—you’re definitely not going to find a folic acid supplement on this list, despite it being one of the first supplements that people think of when they are trying to conceive. Wanna know why? This blog post covers it all: Why You Shouldn’t Take Folic Acid. INSTEAD, make sure you are always supplementing with a methylated form of folate, like the form found in my favorite prenatal vitamin.
Here are the most important supplements for getting pregnant and for a healthy pregnancy to ensure both you and your growing baby are getting all the nutrients you need.
The following list of supplements are for the preconception stage only. Once pregnant, they should be stopped.
NMN has been researched to significantly improve egg quality and decrease age-related fertility decline.
R-alpha Lipoic Acid has been shown to significantly improve egg quality, support IVF, and decrease age-related fertility decline. For men, lipoic acid has been shown to improve sperm count and concentration.
DHEA has been shown to significantly improve egg quality, support IVF, and decrease age-related fertility decline.
Carnitine is important for egg quality support. Acetyl-L-carnitine + L-carnitine are antioxidants that may protect against lipid peroxidation and membrane breakdown, which is vital to mitochondrial structure and egg cell health. L-carnitine specifically supports fat metabolism and energy supply throughout the body to support egg cell health and the formation of sperm cells. For men, carnitine has been shown to help normalize sperm motility (how well they swim) in men with low sperm quality. L-Carnitine stimulates the natural production of sperm, and the higher the sperm-cell count, the higher the chances for fertilization. Not only does L-Carnitine increase sperm levels, but it also enhances the sperm’s motility and improves the health of the sperm cells.
When choosing a prenatal, it’s important to look for one that contains a variety of high-quality nutrients, in the correct form that the body recognizes and can easily absorb and utilize. The prenatal that I recommend provides optimal supplementation for pregnant women, lactating women, and women planning and trying to become pregnant. The earlier supplementation begins the better because women need adequate nutrient stores to meet the greater nutrient demands for a growing baby.
These prenatals are some of the highest quality on the market using methylated folate, absorbable minerals, no added junk or fillers, and the correct form and dosage of all nutrients included so your body (and baby) is getting exactly what it needs to support optimal fertility health and pregnancy.
I love to recommend this prenatal because it gives you the best bang for your buck, and here’s why—it contains the recommended doses of each of the following:
Folate: Perhaps one of the best-known vitamins necessary for pregnancy, this vitamin helps prevent neural tube defects as well as congenital heart defects, cleft lip, limb defects, and urinary tract anomalies in developing fetuses. Deficiency in folate may increase the risk of preterm labor, fetal growth retardation, and low birth weight. Deficiency may also increase the homocysteine level in the blood, which can lead to spontaneous abortion and pregnancy complications, such as placental abruption and preeclampsia.
Vitamin A: Crucial for embryonic development and responsible for helping form the eyes, heart, arms, and legs.
Methylated B Vitamins including:
Thiamin (B1): is essential for nervous system and brain development—it’s involved in synthesizing a protective layer of fat around neurons called myelin, as well as several critical neurotransmitters. It’s also beneficial for language development and word retrieval.
Riboflavin (B2): A study of more than 100 pregnant women found that riboflavin deficiency increased preeclampsia risk by almost 5-fold.
Pantothenic Acid (B5): Necessary for one of the most critical enzymes in our body, coenzyme A, and required for fat synthesis and fat burning. These reactions become increasingly vital during the prenatal phase helping women store and burn energy based on the body’s changing demands.
Biotin (B7): Rapidly dividing cells require biotin to support enzymes during cell division, particularly critical throughout embryonic development.
Vitamin C: Known as the water-soluble antioxidant, it helps the body to fight damaging free radicals that wreak havoc on cells and membranes. It also helps make collagen and greatly boosts iron absorption when consumed as part of a meal. Vitamin C improves hormone levels, specifically progesterone, and increases fertility in women with luteal phase defect, according to a study published in Fertility and Sterility.
Iodine: Women need double the iodine during pregnancy; it plays a critical role in normal fetal brain development.
Zinc: Critical in protein synthesis and cell division, both integral to the developing fetus. More than 80% of women worldwide are deficient in zinc during pregnancy; taken at recommended levels, it’s associated with a modest reduction in premature deliveries.
Selenium: Deficiencies have been associated with thyroid disorders, gestational complications, miscarriage, and low birth weight.
Copper: Requirements increase in pregnancy and lactation, largely to support the formation of red blood cells and connective tissue such as collagen. Low copper levels in pregnancy have been associated with premature rupture of membranes.
Chromium: Adequate chromium levels are important in enhancing insulin function, which is necessary to maintain blood sugar throughout pregnancy. At least one study found that chromium helped control blood glucose which can reduce the risk of gestational diabetes and other pregnancy-related complications.
Supplementing with a broad-spectrum mineral support in addition to a prenatal during pregnancy offers a synergistic blend of nutrients needed to support healthy bones (for both mama and baby). It offers the minerals calcium, magnesium, zinc, copper, manganese, potassium and boron, along with vitamins C, D and K – all in highly bioavailable and absorbable forms.
Calcium: This critical mineral is missing from most prenatals due to the sheer size being difficult to deliver in smaller pill and gummy formats. Yet, 20% of US women are deficient in calcium, which has been shown to reduce the risk of preterm labor and pregnancy-induced hypertension (PIH).
Manganese: A 2000 study from Johns Hopkins found that boosting manganese levels early in pregnancy potentially reduces preeclampsia risk. It also helps in the formation of fetal bones and cartilage.
Molybdenum: is mildly elevated in pregnancy and lactation, as this trace mineral’s most important role is serving as a cofactor for reactions that break down unwanted and potentially harmful compounds.
Taking a high potency omega-3 supplement has been shown to increase fertility by helping to regulate hormones in the body, increase cervical mucus, promote ovulation, and overall improve the quality of the uterus by increasing blood flow to the reproductive organs.
Omega-3 fats also contain two acids that are crucial to good health: DHA and EPA. These two acids have been shown to help many forms of disease. Low levels of DHA have been linked to depression and other mental health issues. During pregnancy, a lack of DHA may be associated with premature birth, low birth weight, and hyperactivity in children.
The omega-3 supplement that I recommend provides a potent 1600 mg of the omega-3 fatty acids EPA/DHA per serving (two softgels), and also includes lipase, a digestive aid to ensure maximum absorption.
Long-chain omega-3 fatty acids, particularly DHA, are required for healthy brain development. DHA is particularly crucial during the last trimester of pregnancy to support the fetal brain growth spurt. DHA concentrates in babies’ eyes and gray matter, protecting their brain from oxidative damage.
Omega-3s are critical for central nervous system development, brain development, inflammation, and optimal hormone production.
Studies show a significant correlation between vitamin D levels and fertility: low levels of vitamin D negatively impact fertility. A staggering 93% of women dealing with infertility are deficient in vitamin D3.
One study measured vitamin D levels in women undergoing IVF and found the odds of pregnancy were four times higher for women with high vitamin D levels compared to those with a vitamin D deficiency.
Another study found that in the group of women with the highest vitamin D levels, 47% became pregnant, while among women with low vitamin D levels, the pregnancy rate was only 20%.
Another more recent IVF study revealed a higher fertilization and implantation rate in a group of women with higher vitamin D levels.
Vitamin D also supports placental function, plays a role in fetal lung development, and also protects a newborn’s cardiovascular health, while vitamin K promotes healthy development of the face, skull, and nervous system.
In addition to supporting bone health, recent studies have shown that vitamin D at 4000IU reduces the risk of preeclampsia, gestational diabetes, preterm birth, and low birth weight. Even in the sunniest locales, nearly 50% of women are deficient in Vitamin D.
Vitamin K is critical in blood clot formation, where deficiencies can lead to excessive bleeding before, during, and after delivery.
While vitamin D is limited in food (egg yolks and liver are the best dietary sources), your body can synthesize vitamin D when exposed to the sun. Unfortunately, because most people spend their time indoors or covered up, especially during the winter months, many people are deficient in vitamin D.
Choline supports a baby’s neural tube formation and cognitive development, as well as mama’s healthy metabolism, blood pressure, and mood. 95%+ of mamas are not meeting their choline needs. The recommended daily amount (RDA) is 450mg-550mg while pregnant/nursing, though research suggests that upwards of 900mg in pregnancy supports optimal perinatal and infant health outcomes. Most prenatal vitamins contain 1/10th or less of the RDA.
There are many studies in both humans and animals that show the benefits of choline during pregnancy and the risks associated with deficiency. Choline prevents neural tube defects, benefits fetal brain development, supports placental function, and supports maternal liver function. It is extremely important to your baby’s brain development and learning capacity throughout life and is important to supplement while trying to conceive, during pregnancy and postpartum.
Choline is also an essential nutrient, meaning although your body can make small amounts of choline, it can’t make enough to meet your needs. Unfortunately I’ve yet to find a prenatal vitamin on the market that contains sufficient levels of choline, which is why I always recommend supplementing it additionally. The richest food sources of choline are egg yolks and liver, but even if you’re eating 3-4 eggs a day in pregnancy (which I highly recommend!), you still won’t be getting enough, making a choline supplement essential.
Probiotics are critical for optimizing the health of our microbiome, which is essential for healthy fertility. A strong and healthy microbiome (digestive tract, skin, and vagina) is needed for a healthy pregnancy—for you and baby. This particular probiotic is formulated to give you the targeted spore-based strains you need, and to seed your baby’s microbiome for optimal health. A healthy gut flora helps cultivate, preserve, and protect your baby’s microbiome. Take before, during, and after pregnancy—and even beyond.
N-Acetyl-L-Cysteine (NAC) is a potent compound used to reduce oxidative stress and improves the quality of cervical fluid, improves hormones and ovulation (especially in women with PCOS), and significantly improves egg quality because of its antioxidant nature.
NAC has also been shown to support women with recurrent miscarriage – “In a controlled study from 2008, 80 participants with a history of recurrent miscarriage took NAC and folate and another aged-matched group of 86 participants took folate alone. Results of the study showed that taking NAC along with folate “caused a significantly increased rate of continuation of a living pregnancy up to and beyond 20 weeks… and was associated with a significant increase in the take-home baby rate as compared with participants taking folate alone.”
Once digested, NAC is converted through a series of enzymatic reactions into glutathione, the body’s most powerful intracellular antioxidant. Excessive levels of oxidative stress impede normal ovarian function and new research suggest that women with polycystic ovarian syndrome (PCOS) have higher levels of oxidative stress which may exacerbate havoc wreaking symptoms on the ovaries. By replenishing glutathione stores and neutralizing the effects of oxidants, NAC has been proven to significantly reduce hirsutism, improve insulin sensitivity, balance hormonal parameters (hyperandrogenism) and improve ovulation rates. In a recent study, NAC was even found to improve the efficacy of clomiphene when used as an adjunctive therapy.
When compared to metformin, NAC proved equally efficacious at significantly reducing body mass index, hirsutism scores, fasting insulin, HOMA index, free testosterone and menstrual irregularity without the commonly associated gastrointestinal side effects of metformin.
N-Acetyl-LCysteine (NAC) is an amino acid that is a precursor to glutathione, the body’s most powerful antioxidant, and helps promote optimal detoxification. NAC has been heavily researched for its role in miscarriage prevention, especially for those with a history of unexplained recurrent pregnancy loss. A recent study showed that NAC and folate compared with taking folate alone caused a significantly increased rate of continuation of a living pregnancy up to and beyond 20 weeks.
NAC is also used for boosting immune system health which, during pregnancy, is very helpful as pregnant women are more susceptible to viruses, pathogens, and other bacterial infections.
Not only does magnesium allow the body to absorb calcium, it also regulates the pituitary gland, which in turn regulates hormone levels. The pituitary gland regulates the production of FSH (follicular stimulating) and LH (luteinizing) that in turn regulate the production of estrogen and progesterone. When you’re not getting enough magnesium, your body will produce less of the hormones that keep your reproductive system in optimal shape for a healthy pregnancy.
Magnesium is crucial for normal embryonic and fetal development—including DNA production—and just over half of US adults are not meeting magnesium requirements.
Magnesium is considered the “anti-stress” mineral, and Magnesium Glycinate is a highly absorbable and bioavailable form of magnesium.
Magnesium is one of my favorite supplements to use in pregnancy, and can be used for SO MANY THINGS. It helps with bowel regularity (no more constipation!), promotes high quality sleep, decreases leg cramps, and is one of the few safe adrenal support agents (highly useful as pregnancy can be just a tad bit stressful).
In studies, magnesium supplements were found to improve sleep by decreasing the release of cortisol, a known cause of sleep disruption. Stress depletes magnesium and magnesium relieves stress. When your magnesium levels are low, your nervous system gets out of balance. Studies also suggest that magnesium deficiency may also be one of the causes of insomnia.
If you have an MTHFR gene mutation, have a vitamin B12 deficiency (as seen on your lab results), or you suspect you are deficient in folate, I recommend supplementing with additional vitamin B12 and folate, in addition to what’s found in your prenatal.
To find out more about the MTHFR gene and how it affects your fertility, check out MTHFR and your fertility.
This vitamin B12 + folate product combines vitamin B12 with methylated folate. We know that both folate and Vitamin B12 are critically important for preventing spina bifida and other spinal and central nervous system birth defects in your baby.
Vitamin B12 is a critical cofactor for DNA replication and cell growth. Inadequate intake of B12 in pregnancy is common and is associated with a wide range of adverse outcomes including premature delivery, low birth weight, and neural tube defects.
While vitamin B12 does help power our cells, in pregnancy, it does even more than that. Vitamin B12 is critical for making new cells, which as you can imagine, you make quite a lot of during pregnancy.
In America, 23.3% of pregnant women have insufficient B12 levels, while 6.6% are overtly deficient. People who eat no or few animal foods in their diet (such as vegans and vegetarians) are particularly at risk for a vitamin B12 deficiency in pregnancy. One of the most important steps you can take to ensure your baby’s brain develops properly is to optimize your intake of vitamin B12.
Coenzyme Q10 (CoQ10) is an antioxidant found in every cell of the body. It is needed in the preconception phase to support egg and sperm quality. CoQ10 also supports energy production, protects cells from damage, and supports metabolism.
Levels of CoQ10 in the body decline with age, starting around the age of 30. Supplementation is often needed to maintain optimal levels. A study demonstrated that women receiving CoQ10 pre-treatment for 60+ days had enhanced egg health and higher fertilization rates. Furthermore, research indicates CoQ10 treatment improves sperm motility and concentration, potentially protecting against free radicals that hinder sperm function and motility.
CoQ10 is also essential for healthy mitochondrial function, and here’s a cool fact: the ovaries are one of the most mitochondria-rich sites in the body, helping to ensure not only healthy ovum formation and ovulation, but a genetically healthier fetus.
Numerous studies have found CoQ10 to be beneficial for women with fertility challenges, and two studies found that lower CoQ10, whether blood levels or in the cervical cells themselves, is associated with a higher risk of cervical cancer. The CoQ10 I recommend is in the active, antioxidant form Ubiquinol, which accounts for over 90% of the CoQ10 in the body.
Ferrochel Iron is a potent iron supplement that is extremely well tolerated by the gastrointestinal system. And, unlike most iron preparations, it will not result in constipation or gastric upset.
Anemia is a common problem during pregnancy because blood volume increases by almost 50% to support the development of the placenta and your baby. 40% of women are iron-deficient in the third trimester, so we combine iron, which is notoriously poorly absorbed, with Vitamin C, to enhance iron absorption 2-3 fold.
Sensitol is a unique formulation comprised of two naturally occurring isomers of inositol: myo-inositol (MI) and D-chiro-inositol (DCI) – along with alpha lipoic acid, designed to support healthy ovulation, egg quality, normal insulin function and cellular metabolism.
Inositol, an integral member of the vitamin B family is supported by several studies to alleviate symptoms associated with PCOS by improving insulin resistance. As an insulin mediator directly involved in the glucose signaling cascade, myo-inositol has been shown to significantly reduce insulin resistance, improve ovarian follicle maturation, restore spontaneous menses, increase ovulation frequency, improve egg quality and most markedly impact metabolic factors.
Proper blood sugar regulation is key to healthy eggs. Alpha Lipoic Acid is a versatile antioxidant that supports energy production, both of which are key to normal egg cell health.
While the value of myo-inositol outside PCOS is still uncertain, it may be helpful if you have insulin resistance or a high fasting insulin level, which can cause a lower percentage of mature eggs in IVF and a low fertilization rate, as well as recurrent miscarriage. Myo-inositol also appears to help ovarian follicles respond to FSH. New studies indicate that in women with a very high FSH level and poor follicle growth in IVF, supplementing with myo-inositol may help ovarian cells respond better to FSH, resulting in eggs that are more likely to fertilize. (Unless the low fertilization rate is caused by poor sperm quality – a common culprit).
Digestzymes contain a perfect blend of digestive enzymes along with betaine HCL to support the optimal digestion of proteins, fats, and carbohydrates. This product contains the special protease dipeptidyl peptidase IV (IVDPP), which aids in the breakdown of the peptides gluteomorphin (from gluten) and casomorphin (from casein), which many women struggle to properly break down. Digestzymes also includes the enzyme lactase, which helps break down the dairy sugar, lactose. The use of Digestzymes before meals may be helpful for reducing gas and bloating after eating, constipation, or a feeling of fullness after eating only a small quantity of food.
For a lot of pregnant mamas, digestion SUCKS during pregnancy. I love using digestive enzymes for this reason. They just help give the body a little support in digesting your foods, because pregnancy is miraculous in that it actually causes your digestion to slow wayyyyyy down so you can absorb every last crumb of the food that you’re eating so baby gets NOURISHED. The only issue here is that this usually leaves you feeling like a bloated, gassy, constipated mess. Digestive enzymes to the rescue. Promise.
Collagen powder is an excellent source of protein during pregnancy. Protein requirements increase significantly during pregnancy to support fetal growth. Further, protein enhances vitamin and mineral bioavailability and causes the gut to further upregulate nutrient absorption.
A lot of pregnant mamas don’t consume adequate protein (especially in the first trimester when your diet might be, ummm, lacking in a few areas to say the least). Especially during pregnancy, women need protein for blood sugar management, minimizing nausea, placenta development, and supporting a growing baby’s cells. Collagen is in an optimal form to support all of these needs. It also supports joints, pelvic floor tissue, skin elasticity, as well as skin, hair and nail health – for both mama and baby.
Even among pregnant mamas with a higher protein intake, the richest sources of collagen—animal skins, bone broth, and tendons—are not typically part of the modern Western diet.
Since collagen powder can be incorporated into smoothies, tea, soups, stews and other foods and beverages, collagen is a convenient way to ensure adequate intake of these unique amino acids.
This whole body collagen product contains a unique blend of three patented collagen peptides supported by clinical research showing their efficacy for supporting collagen production, bone strength, joint health and integrity, skin elasticity, and more. This collagen powder is ethically sourced from the hides of grass-fed, pasture-raised, hormone-free bovines from New Zealand.
Lastly, collagen supports the integrity of the connective tissue during pregnancy providing a barrier of protection against diastasis and hernias. The stronger the integrity of this tissue, the healthier it will remain throughout pregnancy. AND it’s also extremely helpful on a cellular level in regenerating the tissue postpartum.
The Fertility Code is the best-kept secret of women who want to take the guesswork out of conceiving, and give themselves every possible chance of getting, and staying, pregnant successfully.
Bringing together a personalized & custom approach, evidence-based information, science-backed protocols, and nurturing practices, this course is for anyone who is struggling to get pregnant, or thinking about getting pregnant soon. The course is a one-stop-shop for getting your body, mind and soul prepared for conception.
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Sarah Jane Sandy is a certified nutrition therapist, and a fertility and women’s health expert. She has helped hundreds of women increase their fertility naturally and go on to have healthy full-term pregnancies. She has been working with women and couples trying to get pregnant for over 16 years and over 90% of the women who work with her get pregnant and have healthy babies.
She also works with women trying to fix their hormone imbalances, as well as supporting women through pregnancy and the postpartum period. Learn more about her own fertility and hormone journey here. To send Sarah a message, complete her Contact Form.
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