Pregnancy is such a special time, but it is also a phase that can be extremely taxing on your body. It is not surprising since you are growing a whole other human on top of maintaining your own needs.
It is fairly commonplace that mamas can take supplements to help our growing babes (and ourselves) but deciding what the best prenatal multivitamin to take can be a minefield.
I have been getting questions asking what pregnancy multivitamin I used (and still use- since I am breastfeeding) however I am hesitant to answer.
If you were anything like me, during my first pregnancy my GP directed me to the pharmacy and told me to just pick one. Absolutely not helpful. Especially when you go to the pharmacy and are told by the sales rep, “well this one is popular.”
None the wiser, I took the advice and thought I was buying the best money could buy. But now I see this approach as problematic on multiple levels.
Firstly, the assistant had no idea who or what my needs were, generally yes but not specifically.
Secondly, just because a product has an enticing advertising campaign and an expensive price point doesn’t mean it was the best quality pregnancy/prenatal multivitamin I could have bought.
Thirdly, the pharmacy assistant had no idea of any contraindications I may have had.
For example, we all know the important role of folate (the naturally occurring form of vitamin B9) during pregnancy (and prior to conception) as a requirement for growth and development of a foetus particularly early on. However, did you know that most, including one of the most popular, over the counter pregnancy multivitamins on the Australian market provides folate in the form of folic acid?
Whilst folic acid is a supplemental form of folate, it is more accurate to say it is a synthetic form of vitamin B9 (folate) and it is not metabolically active. This means your body cannot utilise it until it converts it into a form that it can use.
Your body’s ability to convert folic acid into the active form of vitamin B9 is dependent on specific enzymes (which is controlled by your genetics) and the supply of other nutrients. More specifically, studies show that those who carry the methyltetrahydrofolate reductase (MTHFR) mutation, either have difficulty in or are unable to convert folic acid into methyl folate, the active form which your body can utilise.
The prevalence of MTHFR polymorphisms is said to be:
- 60% of the population have one variation of the two predominant MTFHR mutations (C677T and C1298A)
- 8.5% of the population carry homozygous alleles for one of the two predominant mutations
- 2.25% of the population are compound heterozygous and therefore carry alleles of both of the predominant mutated genes
Folinic acid on the other hand is couple steps closer to becoming metabolically active. But is it any better? Some practitioner only pregnancy supplements use folinic acid in their formulas instead of folic acid.
Going a step further, 5-methyltetrahydrofolate (5-MTHF) is the active form of folate and does not require the enzymes MTHFR. 5-MTHF is the predominant type of folate found in food (Prinz-Langenohl et al, 2009).
Double-blind, randomised, placebo controlled trials have demonstrated that methylfolate is more effective than folic acid at increasing red blood cell folate concentrations Greenberg et al, 2011).
Then there is the fact that certain pre-existing conditions could already be putting pressure on your methylation pathways and impacting the above.
Do you carry any of the MTHFR polymorphisms? Is your serum folate levels elevated? Should you be sourcing a prenatal with folinic acid or methylfolate?
It is a little more involved than going to your chemist and just picking one off the shelf you like the look of, hey? This is just one vitamin/ingredient too!
Needless to say, during my second pregnancy and a bit wiser, I didn’t just go to the pharmacy and pick one, I sought advice from my team of holistic health professionals.
So coming back to the question, what pregnancy multivitamin do I take? And which prenatal is right for you?
What I will say is, it is not an over the counter brand, it is a practitioner only formula that contains superior ingredients and was specifically picked by my naturopath for me because she knows more about my specific needs at this important time than my 15min in out appointment with my GP (whom I love but isn’t trained specifically in this area) and I highly recommend seeking the advice of a qualified naturopath whom which you have a rapport with to assist you in making that choice.
Before you go away and further search the “best prenatal multivitamins” I urge you to consider one last thing.
The internet has made great headways into how quickly we can access information, but it has also created the situation whereby anybody can post information regardless of their credentials. I understand that ‘All Natural Nancy’ who has overcome some debilitating health concern personally or with her child posts the script of what has helped her achieve her transformation, or maybe ‘Celebrity Sarah’ or ‘Influencer Evie’ is sponsored to endorse a particular brand however unless All Natural Nancy, Celebrity Sarah or Influencer Evie are formally qualified I wouldn’t be buying and taking what they are promoting without talking to my healthcare practitioner first.
So with all that in mind, whilst it isn’t because I am worried about the brand of multi I personally use, I love it but what I am cautious of is the fact that the best prenatal multivitamin for me may not be the best prenatal multivitamin that is right for you, alongside the fact that as a Building Biologist it is completely out of my realm of expertise and I dare not be so negligent.
Conclusion
- consider seeing an integrative doctor such as naturopathic doctor, alongside your mainstream medical practitioners, to support you with your pregnancy and lactation needs.
Want to know some of the healthcare professionals that assist my family and I in staying well and optimising our health, then head over to my Faves Wellness Providers page.
Want to find out how my chiropractor and naturopath supported me in optimising my wellbeing throughout my pregnancies, read my post here.
Xx Tammy
References
Boyd, A, 2017. Folate, Folinic Acid & Methyltetrahydrofolate (online) available: https://www.fxmedicine.com.au/blog-post/folate-folinic-acid-methyltetrahydrofolate (date accessed Sept 2020)
Greenberg, J.A., Bell, S.J., Guan, Y. and Yu, Y.H., 2011. Folic acid supplementation and pregnancy: more than just neural tube defect prevention. Reviews in Obstetrics and Gynecology, 4(2), p.52.
Long, S. and Goldblatt, J., 2016. MTHFR genetic testing: controversy and clinical implications. Australian family physician, 45(4), p.237.
Prinz‐Langenohl, R., Brämswig, S., Tobolski, O., Smulders, Y.M., Smith, D.E.C., Finglas, P.M. and Pietrzik, K., 2009. [6S]‐5‐methyltetrahydrofolate increases plasma folate more effectively than folic acid in women with the homozygous or wild‐type 677C→ T polymorphism of methylenetetrahydrofolate reductase. British journal of pharmacology, 158(8), pp.2014-2021.
