Genesis Fertility Clinic Blog
searching: “folic acid”
October 19, 2009
DHA and pregnancy
Once we help a couple get pregnant one of the most common question I get asked is “what supplements should I take?” Seems there’s lots of advice given out at health food stores, pharmacies and by our friends about all sorts of things like raspberry tea, coenzyme Q10, fish oil, ginger, vitamin B6, etc.
What have large studies of women in the developed world shown that pregnant woman should be taking? A multivitamin containing folic acid (0.4mg to 1.0mg unless you are in a high risk group for a neural tube defect) and perhaps DHA. That’s it. We need iodine to prevent thyroid disease in the newborn but we get enough in our salt in Canada. So, if you have a reasonable diet and take a multivitamin with folic acid (the best studied are Materna and Pregvit) and perhaps some DHA you are doing everything right from a evidence-based nutrition perspective.
Sure, some people swear you should take extra B6 or a miriad of different herbs, but until a big studies suggests there is a benefit, and most importantly no harm, I’d stick with the basics. DHA is an interesting one…. there is some evidence that it helps with an infant’s gross motor control and visual acuity if taken in pregnancy. When to take it and how much isn’t clear. So, what do I take (I am 38 weeks pregnant now)? I take a DHA supplement daily that has been purified from fish oil (NOT fish oil as many preparations have too much vitamin A) that has 900mg of DHA and 180mg of EPA. The Institute of Medicine in the USA recommends 300mg/day while a similar European regulatory body suggests much more. So I take somewhere between the two. When to take it? Probably the last half of pregnancy – that’s when it’s been most widely studied.
I hope this helps… and if you are reading this I hope you have to decide on what supplements to take in pregnancy soon!
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility
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June 28, 2009How much folic acid?
How much folic acid should I be taking when I am trying to get pregnant or pregnant? This is a really common question and the answer is pretty straightforward.
MOST women should take a multivitamin with 0.4mg to 1.0mg of folic acid daily for 2-3 months before they conceive and throughout pregnancy. Taking folic acid alone is not enough – it should be folic acid in a multivitamin. Folic acid along reduces the risk of neural tube defects (NTDs), but folic acid and a multivitamin reduces other defects like heart defects, urinary tract abnormalities, limb defects and pyloric stenosis (a narrowing of a segment of the stomach).
SOME women should take more folic acid. These women are diabetics, epileptics, obese women (BMI >35 kg/m2), women with a family history of neural tube defect, and women belonging to a high-risk ethnic group (e.g., Sikh). These women should take 5mg of folic acid total. So if they are taking a multivitamin with 1mg of folic acid in it, they need to take an additional 4mg daily. To get your 5mg of folic acid you can buy a bottle of 1mg tablets of folic acid (and take 4 of them along with your multivitamin) or get a prescription for something called Pregvit Folic 5 – it’s a multivitamin with 5mg of folic acid in it.
What’s the harm in taking more? There is probably no harm. Excess folic acid in your body is removed in your urine. There’s lots of controversy about whether there is a risk or benefit of extra folic acid in people who don’t need extra. One day perhaps we’ll be advising all women to take 5mg of folic acid daily. Until then I’d just suggest following the guidelines above, which for most women means just taking a multivitamin that has 0.4mg to 5mg of folic acid in it daily. The most common vitamin women take is called Materna – you can buy it over the counter at any pharmacy.
Please don’t take too many vitamins in pregnancy – remember too much of a good thing can be bad. A great example is vitamin A – too much can cause blindness in a fetus. So, more isn’t always better. Just take a multivitamin like Materna daily and you are doing the best thing for your pregnancy.
For more info:
Society of Obstetrics & Gynecology Guidelines
Motherisk
Dr. Beth Taylor, MD, FRCSC
Reproductive Endocrinology & Infertility