Are Prenatal Vitamins Effective?

This article is a REPRINT, offered to newer readers of WellPostpartum Weblog.  Be sure and read to the bottom for an excellent product resource by Dr. Dean Raffelock of www.pregnancyrecovery.com.

Recommended Daily Allowances for Pregnant Women

Could we have a false sense of security because women use prenatal vitamins?  When I first realized that most commercially-available prenatal vitamins may not provide adequate nutrition for women, I was incredibly sad.  I knew that proper nutrition had the ability to impact mood reactions greatly- I had seen this happen for women repeatedly.  What I did not understand is how so many women could be nutritionally depleted if they were using prenatal vitamins.  I was surprised that most women I talked with were not told to continue using prenatals after they delivered their babies.

I realized many women were victims of circumstances that challenged their nutritional status.  Most women have one or more risk factors that cause them to ‘lose’ their nutrients, such as caffeine use, high sugar consumption, improper ratios of nutrients, stress, pH imbalance, the use of certain medications or birth control pills, toxicity in the body from environmental sources or food sources; etc.  I also realized that many women ate a poor diet.  Even those of us who feel our diet is pretty good probably do not eat like our ancestors did-even those who lived one generation before us ate completely differently than we do today.  

Today’s food is amazingly low in nutrients and stunningly high in pesticides, hormones and preservatives.  We seem to be starving for adequate nutrition, so we crave high calorie foods and carbohydrates to energize us. 

It is also true that many women have candida imbalance in the colon.  Candida can live in the human body like a parasite.  It craves to be fed and it thrives on sugar and carbohydrates.  Most women who have recurrent vaginal yeast infections, nipple infections during breastfeeding, or whose baby has cradle cap never realize they may have a systemic, internal yeast infection.  I will write more about each of these conditions in the future, but today the focus is on prenatal vitamins.  The use of high quality prenatal vitamins is paramount when taking into account all the nutritional challenges faced by pregnant women.

I averaged nutrient values for eight of the top-selling prenatal vitamins on Drugstore.com and compared the RDAs for major nutrients below.  The brands reviewed were Nature Made Prenatal, Rite Aid Prenatal with folic acid,  GNC Women’s Prenatal with iron, Rainbow Light Prenatal One Multi, Stuart Prenatal, New Chapter Organics, Pure Gels Multi Softgels and Nature’s Bounty.  A quick review of prenatal vitamins available in a health food store showed most of these brands are not much different than the brands above.

The Recommended Daily Allowances (RDAs) for pregnant women, established by the Food and Nutrition Board of the National Research Council, act as a baseline for determining vitamin and mineral requirements. These are suggested levels of vitamin and mineral intake intended to prevent nutrient deficiencies without risking overdoses and side effects.

Keep in mind, however, that RDAs are highly debateable.  Changing accepted RDAs is a very difficult process and takes a great deal of time and individual effort-many researchers are currently working for changes in the RDAs.  When it was finally found that folic acid helped to prevent spina bifida it took 7 years for The American College of Obstetricians and Gynecologists to officially endorse the use of more folic acid.  Also keep in mind that these recommendations are intended to prevent nutrient deficiencies (in otherwise healthy women) and not to enhance optimal nutrition.  This seems like a backward approach to perinatal wellness to me…

 
So, more from the Food and Nutrition Board of the National Research Council…

Calcium-Calcium is important for strong bones and teeth, as most people know, but it is also critical for proper development and function of the heart and other muscles, as well as for the blood clotting system. The fetus demands a huge supply of calcium during development and is thought to have a total body store of 25 grams of calcium at birth, all of which is received from the mother. Pregnant women need 1,000 milligram (mg) of calcium daily.  The average amount of calcium in prenatal vitamins was 236 mg.

Chromium-Chromium is important for your baby’s development. You should get 50micrograms (mcg) per day.  The average amount of chromium was about 41 mg.  Two brands had 50 mg, two had 120 mg, and the other four brands had no chromium.

Copper-Copper stimulates the growth of cells and tissues, hair growth, and general metabolism. It is a critical component of the baby’s major systems: the heart and circulatory system, the skeleton, and the nervous system. Two to three mg of copper daily is recommended and if you eat a healthy diet and take a multivitamin, you are certain to get enough. The average amount of copper per brand was 1.35 mg, with the exception of New Chapter Organics, which has .5 mg.

Folic acid-Folic acid is an important vitamin that stimulates red blood cell formation and the production of important chemical signals in the nervous system. It is also important in the process of making DNA. Perhaps more importantly, folic acid has been identified as a critical vitamin to prevent neural tube defects in your baby, such as spina bifida. Most doctors recommend that pregnant women get at least 400 mcg daily, while others recommend 600 to 800 mcg. Vitamins you take beyond your body’s needs are excreted in the urine, so don’t worry about taking too much. If you are at risk for Vitamin B12 deficiency, excess folate may mask this problem, so talk to your doctor.  The average amount of folic acid in the 8 reviewed brands was sufficient.

Iodine-Iodine is critical for the development and functioning of the thyroid gland and regulation of metabolism. The RDA for pregnant women is 200mcg per day.  The average among the eight brands was only 50mcg.

Iron-Iron is a crucial element in many of the body’s processes. It is present in every molecule of hemoglobin, the protein that helps red blood cells carry oxygen to your body. Iron supplements are important for most women, as few women get enough iron through their diet. Often, women who lack iron become anemic. Iron-deficiency anemia, one of the most common forms of anemia, is regulated through iron supplements.  Iron levels were sufficient across the brands.

Magnesium-Magnesium is an important element for teeth and bones, regulation of blood-sugar levels, and for the proper functioning of body proteins. Magnesium is also important for tissue growth and repair. The RDA for magnesium for pregnant women is 300 mg. The average amount of magnesium for the 8 brands reviewed was only 60 mg.  Magnesium aids in calcium absorbtion so much that taking one without the other seems almost pointless.  Vitamin D also aids in this process.

Pantothenic acid-This vitamin is involved in many of the body’s regulatory and metabolic activities. The RDA for the average person is 4 to 7 mg. Only three of the 8 reviewed brands included this nutrient in adequate amounts.

Potassium-Potassium is a mineral that affects cellular function, fluid balance, and blood pressure regulation, as well as proper nerve and muscle function. While there is no RDA for nonpregnant adults, most doctors agree that pregnant women require at least 2,000 mg per day. Only two of the brands reviewed had any potassium, for each the amount was 10mg.

Phosphorus-This element is an important part of the development of the muscular, circulatory and skeletal systems. The RDA is 1,200 mg for pregnant women. The RDA for nonpregnant women is 800 mg for adult women and 1,200 mg for younger women. None of the brands I reviewed had any phosphorus.

Riboflavin (B2)-This vitamin is important for fetal development and growth. The RDA for pregnant women is 1.6 mg and 1.8 mg for nursing women.  B2 amounts were adequate in all 8 brands.

Thiamine (B1)-Thiamine is important for metabolism and development of the brain, nervous system, and heart. When you are pregnant you need increased amounts of many vitamins, including B1. The RDA for pregnant women is about 1.3 mg.  B1 amounts were adequate in all 8 brands.

Vitamin A-Vitamin A is critical for proper cell growth and the development of the eyes, skin, blood, and immunity and resistance to infection.  Vitamin A amounts were adequate in all 8 brands.

Vitamin B6 (pyridoxine)-Vitamin B6 is important for your body’s metabolism and for the development of the fetal brain and nervous systems. The RDA for pregnant women is 2.2 mg.  Amounts of B6 were adequate in all 8 brands.

Zinc-The RDA of zinc for pregnant women is 20 mg per day and 25 mg for nursing women.  Amounts of zinc were adequate in all 8 brands.

Vitamin B12-Because Vitamin B12 is found mainly in meats and dairy products, it can be a problem for vegans or strict vegetarians. If you have dietary restrictions, make sure that your vitamin supplement has adequate B12.   Amounts of B12 were adequate in all 8 brands.

Vitamin C (ascorbic acid)-Vitamin C is not stockpiled by the body, so you need regular sources to fulfill your daily requirement. Vitamin C is essential for wound healing and the production of the body’s connective tissue. Vitamin C also helps the body absorb iron. The RDA for pregnant women is 80 mg per day.  Amounts of vitamin C were adequate in all 8 brands.

Vitamin D-Humans produce vitamin D in their skin in response to sunlight. Vitamin D itself is found naturally only in some fish liver oils. Since exposure to sunlight is variable and this vitamin is so important for pregnant women and growing children, all milk is now fortified with 400 mcg vitamin D per quart as regulated by the U.S. government. Vitamin D in a supplement is especially important if you don’t drink milk.  A great deal of research has been coming out about vitamin D lately.  Some claim it is not even a vitamin, but a hormone.  Many researchers agree that we are sorely deficient in this nutrient.  Low vitamin D levels in breastmilk are linked with abnormal bone formation in children.  Click here for more articles on vitamin D.

In summary, levels of calcium, chromium, copper, iodine, magnesium, pantothenic acid, potassium and phosphorus were lower than the RDA for pregnant women in 8 top-selling brands of prenatal vitamins.  If you’ve read An Integrative Approach to the Prevention and Treatment of Postpartum Depressionhere on the blog, you realize how intracately these nutrients impact maternal mood.   

According to www.pregnancyrecovery.com, there are 7 major problems with prenatal vitamins. 

Poor Quality:

Most prenatal vitamins contain poor quality, synthetic forms of vitamins, minerals, and antioxidants like an inferior form of B12 called Cyancobalamin (that’s harder on your liver) and the cheap, hard to absorb, Calcium Carbonate.

Inadequate Potency:

Most have inadequate potency (not enough for baby and mom, based on current research). An example is: folic acid. Most prenatals contain 400 mcg of folic acid, but new research indicates that you and your baby really need 800 mcg.

Tablet Form:

Most are hard to digest due to being highly compressed and covered with waxes, such as carnauba wax. Use capsule forms instead.

No Omega-3s:

Most prenatal vitamins DO NOT contain optimal Omega-3 fatty acids, in the form of high quality fish oils, that build your baby’s nervous system, eyes, skin, and cells. If they are included, they probably don’t contain a high enough dosage of DHA and EPA oils or are certified free of dangerous heavy metals such as mercury, lead (ever heard of lead poisoning?) cadmium, aluminum and PCBs (environmental toxins). Flaxseed oil does not easily convert into DHA which is essential for baby and mom. They also may not be in the needed amounts.

Calcium & Iron Together:

Iron and Calcium should be taken at separate times of the day. Why? Calcium binds to iron, interfering with the absorption of both they cancel each other out.

Missing Nutrients:

Most prenatal vitamins don’t contain key nutrients (like C0Q10 and alpha lipoic acid) that truly help the body produce an abundance of natural energy, something all pregnant moms need. These powerhouse nutrients are expensive and rarely included in prenatal vitamins.
No Concern for Your Situation:

Most prenatals also don’t address specific problems most pregnant women experience, such as sleeplessness and “morning queasyness” with natural solutions like Papain enzyme (from Papaya) and Ginger Root Extract. 

 

Thanks to Dean and Stephanie Raffelock, I have become aware of a very different type of pre- and postnatal supplement. Before Baby Boost and After Baby Boost are available at http://www.soundformulas.com/bbb.html.

It will be interesting to learn what other integrative health professionals and mothers recommend.  I know there are many health systems out there and, thankfully, many professionals are encouraging pregnant women to enhance their health using exceptional brands.  To comment on this article, just scroll down and write in the white box below.

 

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Comments
4 Responses to “Are Prenatal Vitamins Effective?”
  1. cheryljazzar says:

    To post your question online, simply type it in the white box below the post.

    Here is a question sent to me via email from Anne Marie in Alaska:

    Why do my prenatal vitamins make me nauseous?

  2. There are a number of reasons that prenatal vitamins can cause nausea during some pregnancies. One is that the extremely poor quality prescription prenatal vitamins manufactured by pharmaceutical companies are very hard to digest and many of these are coated with carnuba wax which is more suitable to protecting the nose of jet fighter planes than human consumption. Two, there is far too much constipating, non-digestible iron in these pharmaceutical prenatals and this causes the iron to oxidize…upsetting digestion. The cheapest, least absorbable forms of vitamins are contained in these prescription drugs masking as prenatal vitamins. Hormonal fluctuations can contribute to overall nausea but this is greatly exacerbated by ingesting poor quality vitamins.

    There is no normal physiologic process more draining of nutrients than pregnancy and it is essential for the physical and emotional well-being of mother and developing baby that only high quality, high potency nutrients in the most assimilable form be used for this purpose.

    I am continually appalled by the mis and dysinformation put out by the pharmaceutical companies and bought hook, line, and sinker by uninformed physicians. I do not believe that obstetricians should be able to give any vitamin advice unless they have completed a board certification in nutrition by a qualified board not aligned with or funded by a drug company.

    According to JAMA (Vol 284 July 26th, 2000) each year over 106,000 U.S. citizens die from “non-adverse” effects of prescribed drugs. However, in a 24 year review of vitamin intake by the U.S. Center for Poison Control, a total of 11 deaths in the entire United States were attributed to taking vitamins in that entire 24 year period. In 16 of those 24 years not one person in the U.S. died from ingesting vitamins. More people die each year from eating soup than taking vitamins!

    The 3 bottle prenatal vitamin “system” called Before Baby Boost that I formulated based upon many years of extensive vitamin blood lab testing in pregnant and postpartum women, manufactured by Sound Formulas, contains papain enzyme and a standardized extract of ginger root to help digest the high quality, high potency vitamins, minerals, antioxidants and fish oils contained in Before Baby Boost prenatal vitamins. These nutrients are necessary to form a new baby’s body and help keep mother nourished during pregnancy.

    If we are going to try to stop the tide of PPD and other pregnancy and postpartum health problems, we need to stop taking nutritional advice from doctors who are unqualified to give this advice and become educated and encourage those we care for to become educated.

    Sincerely,

    Dr. Dean Raffelock

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  1. […] publishing Monday’s post on prenatal vitamins I became curious about copper. In the past I had supported a mother experiencing obsessive thoughts […]

  2. […] As reported earlier in my post on the effectiveness of prenatal vitamins, the RDA for zinc in pregnant women is 20 mg per day, and 25 mg per day for women who are nursing. […]



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