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How to Choose a Prenatal Vitamin

By Alexsia Priolo, Naturopathic Doctor

With so many options available online or at the health food store, choosing the right multivitamin can be difficult and overwhelming. Oftentimes price and convenience plays a big factor in decision-making, but when it comes to supplements you want to ensure that you’re choosing a product with quality ingredients and dosages, and no unnecessary ingredients.

Forms of Vitamins and Minerals

Active vs. Inactive

In most prenatal vitamins, the B vitamins (including folate) are often found in their inactive forms. Although the body can convert them into the active form, it can be difficult for some people. Choosing a prenatal with active B vitamins is preferable because they are often better absorbed and therefore better used by the body.

Be on the lookout for:

  • Vitamin B2 – choose riboflavin-5-phosphate
  • Vitamin B6 – choose pyridoxal-5-phosphate
  • Folic acid – choose methylfolate (more on that below)
  • Vitamin B12 – choose methylcobalamin

Folic acid vs. methylfolate

The most important part of a prenatal is folate, because it helps to prevent neural tube defects in baby. Methylfolate is the active form of folic acid, and although it does the same thing as folic acid, like the other B vitamins, the active form may be better absorbed and used. Ideally, folate levels should be around 600 mcg, although in some cases such as a neural tube defect in a prior pregnancy, a higher dose of folate is required.

Iron

Iron is often the reason why people stop taking a prenatal, as it can be hard on the digestive system and cause constipation, stomach pain, nausea and vomiting. However, it’s important to take iron because it declines in the second and third trimester. An iron deficiency may lead to symptoms such as fatigue, cold hands and feet, restless leg syndrome and even hair loss. Most companies use the form ferrous sulphate in their prenatal, which is poorly absorbed. Instead, look for a glycinate form which is easier on the digestive system.

Oxide vs. Citrate

Many vitamins and minerals in prenatal products are found in the oxide form. This form isn’t always well absorbed, so you may want to look for citrate forms instead.

Dosage

The amount of vitamins and minerals vary greatly between brands – and this makes it difficult to determine if you’re getting what you truly need.

In professional brands, you’ll likely see a larger amount of B vitamins (as well as active forms) – and this is important because the B vitamins are needed for energy, the developing brain and nervous system.

With respect to vitamin B6, research suggests that it can be helpful in managing morning sickness. Therefore you may want to look for a prenatal that contains more B6 instead of purchasing an additional product. It is possible to take too much vitamin B6, so be on the lookout for: rashes, peripheral neuropathy, change in sensations to fingers and toes, walking, reflexes, nervousness, insomnia, feeling ‘wired.’ Speak to your doctor before adding additional Vitamin B6 to your routine.

Higher levels of vitamin C can also help to improve iron absorption, and decrease your risk of iron deficiency.

Additional Ingredients

Additives may not matter to you, but sometimes they can pose harmful effects on the body for instance, BHT is a weak endocrine disruptor found in a popular prenatal. Moreover, you can skip the colours like: FD&C Red #40 Aluminum Lake, FD&C Blue #1 Aluminum Lake, FD&C Yellow #6 Aluminum Lake, D&C Red #27 Aluminum Lake, FD&C Blue #2 Aluminum Lake.

Sometimes products may also have proprietary herbal blends, which aren’t always necessary because you don’t know how much of a particular herb you’re getting.

Next Steps

Choosing the right prenatal is important to support your health during preconception, pregnancy and breastfeeding. If you have any questions about the right prenatal supplement for you, or any questions in general about vitamins and minerals during your pregnancy, feel free to reach out to our naturopathic doctors.

References

Kominiarek, M. and Rajan, P. (2016). Nutrition Recommendations in Pregnancy and Lactation. Medical Clinics of North America, 100(6), pp.1199-1215.

Sebastiani, G., Herranz Barbero, A., Borrás-Novell, C., Alsina Casanova, M., Aldecoa-Bilbao, V., Andreu-Fernández, V., Pascual Tutusaus, M., Ferrero Martínez, S., Gómez Roig, M. and García-Algar, O. (2019). The Effects of Vegetarian and Vegan Diet during Pregnancy on the Health of Mothers and Offspring. Nutrients, 11(3), p.557.

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