Are Dietary Supplements Safe and Effective when Trying to Conceive?

Vitamins and supplements can be miraculous for those with diet deficiencies. In pregnancy, for example, research shows that having healthy levels of folate reduces babies being born with spinal cord abnormalities; healthy levels of zinc reduces chances of preterm birth; and healthy levels of iron can help to reduce the risk of low birth weight (source).


The effectiveness of taking dietary supplements in high concentrations, however,  is questionable. In fact, it can be dangerous.  When trying to conceive, how do you know which vitamins and supplements are essential to take versus harmful? In this post, we examine up-to- date scientific research and current recommendations. 


It is pretty amazing what happens if our diets are nutrient deficient. You may recall learning about scurvy in grade school. Scurvy symptoms include bleeding gums, loose teeth, hemorrhaging under skin and even death. The prevention and remedy to this problem is simply eating Vitamin C. Long before people understood vitamins, some sailors figured out that if they took along sauerkraut or lemons on their voyages, they entirely prevented death from scurvy.

baby with spina bifida.jpg

Even though today we live in a society with plenty of food and knowledge about nutrition, we rarely eat enough of the right foods. The most common disabling birth defect in the U.S. is spina bifida.  This is a disease in which spinal cord and nerves do not develop correctly during pregnancy and can lead to paralysis and brain damage (source). If you take folic acid supplements a month before getting pregnant and throughout the pregnancy, women can reduce their baby being born with spina bifida by 70% (source). 

Do you have to take supplements to avoid spina bifida? Perhaps if we didn't eat any processed food and our staples were vegetables, fish, fruit and liver, we wouldn't need to take folic acid. That isn't the case for the majority of us, and therefore, it's highly recommended to take prenatal supplements when trying to conceive and during pregnancy. Yet, the research on other supplements is not conclusive or consistent. Recently in July 2016, a study found that unless you have a specific dietary deficiency, folate acid and vitamin D are the only two supplements needed to take when pregnant.  The authors wrote, "we found no evidence to recommend that all pregnant women should take prenatal multinutrient supplements beyond the nationally advised folic acid and vitamin D supplements, generic versions of which can be purchased relatively inexpensively," in the journal Drug and Therapeutics Bulletin (source).

Should you toss your prenatal vitamins? Not so fast. Other studies show significant benefits from additional dietary supplements. Take EPA and DHA for instance. The APA says that women who consume an increased intake of EPA and DHA show reduced rates of pre-term labor and delivery, lower the risk of preeclampsia, and depression (source). 

 

 

What is Currently Recommended? 


Currently we know of 13 vitamins essential for health and to put to frankly, we die without them. These include vitamin A, C, D, E, K, and B vitamins (riboflavin, niacin, thiamine, folate, B12, B6, niacin, pantothenic acid and biotin). Then there are some 85, 000 dietary supplements such as antioxidants, herbs and minerals on the market.

Vitamins first were discovered in 1912 by Casimir Funk who coined the word (source).  From there, vitamins were isolated and better understood by a variety of scientists. For example, in 1930 Hungarian-born researcher, Albert Szent-Györgyi, identified and isolated vitamin C (source). Researchers continue to learn about vitamins and supplements and there are current efforts to figure out how they interact with the body in supplemental form. For example, supplements with too much iron can compete with zinc at the absorption site. In one study, women given trace minerals in a solution to help with iron deficiency were found to then have problems with zinc absorption.  However, when iron and zinc are given in a meal, this effect is not observed (source).  

 

Current recommendations by the American Pregnancy Association (APA) are to eat foods recommended for a healthy pregnancy and continue taking prenatal vitamins recommended by your doctor.  

 


Recommended Advice for a Healthy Pregnancy using Supplements: 

Start by eating foods that support a healthy pregnancy. Click here for a nutrition guide by the American College of Obstetricians and Gynecologists (ACOG). Since getting all the nutrition we need to support a healthy pregnancy is difficult, take a prenatal vitamin as well. Keep in mind that prenatal vitamins are never a replacement for a healthy diet, and you need to take them as part of a healthy diet. Second, take the prenatal vitamin that your doctor recommends, or prescribes.

 

Recommended Advice to Prevent Adverse Effects from Supplements: 

Stick to only taking your prenatal vitiamin unless otherwise prescribed by your doctoer. In other words, do not take any single vitamin or mineral supplements in higher-than-normal doses unless recommended by a health-care provider for a special condition. Higher-than-normal doses of the fat-soluble vitamins can be toxic. Fat-soluble vitamins include vitamins A, D, E, and K. Large doses of retinol (vitamin A) are known to cause birth defects in animals (source). 

 

What about Herbal Supplements when Trying to Conceive? 


If you have been trying to conceive for a long time, you may be  vulnerable to purchasing additional supplements that you may not need in effort to get pregnant. It’s true that herbs and supplements can be powerful and healing, however, they can be equally damaging. The APA shares that some herbs may even cause miscarriage or injury to the fetus. Natural herbs and vitamin supplements do not go through the same rigorous safety testing as medicine for safety, strength or quality. The potency and quality can even vary in each pill or powder. Do not trust online resources that are selling or promoting products as advice on whether you need the supplement or if it is safe.

 

If you are interested in herbal supplements, what should you do? The FDA advices women to consult a trained herbalist or healthcare provider to avoid hurting yourself or your pregnancy. Also, keep in mind that just because it is safe in to eat in your diet everyday, such as rosemary, in high and concentrated doses it may not be safe.

Here are a list of Unlikely Unsafe, Possibly Unsafe and Likely Safe herbs from the America Pregnancy Association

 

APA Herbs to Avoid: Unlikely Unsafe

  • Saw Palmetto
  • Goldenseal
  • Dong Qaui
  • Ephedra
  • Yohimbe
  • Pay D'ARco
  • Passion Flower
  • Black Cohosh
  • Blue Cohosh
  • Roman Chamomile
  • Pennyroyal

 

APA Listed Herbs as Possibly Unsafe:

  • Aloe
  • Ginseng
  • Evening Primrose
  • Kava Kava
  • Senna

 

APA Listed Herbs as Possibly Safe:

  • Red Raspberry Leaf
  • Peppermint Leaf
  • Ginger Root
  • Sloppery Elm Bark
  • Oats and Oat Straw

 

Check with your doctor about further about supplementing with iron, DHEA, CoQ10, antioxidants. Recent studies have shown positive outcomes for those struggling to conceive,  but should be discussed with a specialist first before consuming.  

 

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Resources

  • https://www.sciencedaily.com/releases/2010/07/100701145535.htm
  • . https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3988936/
  • https://www.livescience.com/55363-prenatal-multivitamins-dont-help-much.html
  • bid/206263/Medical-Monday-Herbs-to-Avoid-While-Trying-to-Conceive">http://fertility-news.rmact.com/Path-To-Fertility-Blog/bid/206263/Medical-Monday-Herbs-to-Avoid-While-Trying-to-Conceive
  • http://americanpregnancy.org/getting-pregnant/women-preconception-health/
  • http://ajcn.nutrition.org/content/72/1/280s.full
  • https://www.acog.org/Patients/FAQs/Reducing-Risks-of-Birth-Defects#pregnancy
  • http://americanpregnancy.org/pregnancy-health/vitamin-d-and-pregnancy/