As you start thinking about adding to your family, you’ll want to prepare your body as much as possible for pregnancy. One way to improve your preconception health is to take pre-pregnancy vitamins. While you likely know about the importance of folate before pregnancy, you may not know several other critical nutrients. Along with folate, your pre-pregnancy vitamins should also contain the right amount of vitamin D, iodine, choline, and iron.
In this article, we share the five nutrients your pre-pregnancy vitamins should contain. Then we share how these nutrients can improve your fertility and help put your pregnancy on the right track.
At the very least, your pre-pregnancy vitamins should contain:
Folate is essential for many of the body’s normal processes. It is necessary for the proper formation of the neural tube in the earliest weeks of pregnancy. The Centers for Disease Control and Prevention, CDC, recommends that all childbearing age women consume at least 400 mcg of folic acid each day. You want to be sure that this nutrient is in good supply during the earliest weeks of pregnancy. Your baby needs folic acid most during the first few weeks (around 4 to 6 weeks) after conception.
The term “folate” refers to naturally occurring food folates, folic acid (the synthetic form found in many supplements and added to grains), and methylated folate (the activated form of folate found in some supplements).
Folate is naturally found in leafy green vegetables, fruit, dried beans, peas, and nuts. These are healthy foods, and you should eat them often. However, naturally occurring food folate is not as well absorbed as folic acid or methylated folate. It can also be difficult to rely solely on what you eat to supply enough folate for early pregnancy.
Folate needs during early pregnancy
You’ve probably heard that folate helps to prevent birth defects known as NTDs or neural tube defects. The most common NTD is spina bifida. Inside the embryo, the brain and spinal cord form from the neural tube, which starts out as a tube-like grouping of cells. It finishes forming 4 to 6 weeks after the first day of a woman’s last menstrual period. Studies show that taking a supplement with enough folate for at least one month before conception and continuing through pregnancy can significantly reduce the risk of NTDs.
How to get enough folate daily
In 1998, the United States Department of Agriculture (USDA) required food manufacturers to add folic acid to certain food products that do not naturally contain folate. These foods include enriched bread, flour, cornmeal, rice, pasta, and other grain products. However, the Harvard T.H. Chan School of Public Health recommends relying on a daily multivitamin containing folate instead of consuming a diet high in fortified foods.
One of the best ways to be confident you get enough is to take pre-pregnancy vitamins that contain, at the very minimum, 400 mcg of folate.
2. Vitamin D
Higher vitamin D levels in the blood may promote your fertility and are associated with having a healthy pregnancy. Many women have a low vitamin D level. Here’s why. First, there are not many vitamin D-rich foods in our diet. The UV rays from sunlight on our skin trigger vitamin D synthesis. However, many women stay out of the sun or wear sunscreen to reduce their risk of skin cancer. Also, women with darker skin have more melanin, which reduces the skin’s ability to produce vitamin D from sunlight. So it’s easy to see how many women can have low vitamin D levels when they start trying for a baby. It is worthwhile to get tested to determine your vitamin D level and take a supplement if needed.
The goal is to reach and maintain the normal vitamin D blood level of 30 ng/mL or greater. Women with vitamin D levels above 30 ng/mL during preconception tend to have healthier pregnancies.
Vitamin D during pregnancy
Most reproductive health professionals believe that maintaining a healthy vitamin D level during pregnancy is critical. In many cases, it can improve pregnancy outcomes. Research shows that daily doses of 2,000 to 4,000 IU of vitamin D3 during pregnancy will usually produce normal blood levels. Women with normal vitamin D blood levels have healthier pregnancies.
How to maintain vitamin D levels
Many people don’t know what their blood level of vitamin D is. Therefore, it is essential to ask your healthcare professional to test your level. If it is lower than 30 ng/mL, preconception vitamins with 2,000 to 4,000 IU of vitamin D each day can help restore you to a healthy level. The restoration process can take 60-90 days. Once your vitamin D level is healthy (greater than 30 ng/mL), you can take 2,000 IU of vitamin D each day to maintain this level.
One nutrient that we don’t hear a lot about is iodine. Both you and your baby need enough iodine for your thyroid to do its job and regulate several important body processes. You also need enough iodine to ensure that your baby’s brain develops to its fullest potential.
Iodine in foods
Elizabeth Ward, the author of Expect the Best, states: “Research suggests that women in their childbearing years in the US are probably at the greatest risk for insufficient iodine consumption. Adequate intake is important for a baby’s brain development during pregnancy and breastfeeding. Even a mild iodine deficiency can limit a baby’s physical and mental development. Certain foods are better sources of the mineral than others, but levels can vary. Seafood and sea vegetables, such as kelp and nori, are reliable iodine sources. Fruits and vegetables contain iodine, but the amount varies depending on the soil’s iodine content and other factors. Iodized salt is also a source, but it is not typically used in processed foods.”
How to get enough iodine daily
Elizabeth Ward recommends taking pre-pregnancy vitamins to get the iodine you need. She states: “It’s not always easy to fulfill your daily iodine quota with food, which is why the American Thyroid Association (ATA) recommends that pregnant and breastfeeding women, and those who are planning to become pregnant, consume at least 250 micrograms (mcg) of iodine daily. The ATA suggests that pregnant and breastfeeding women take 150 mcg of iodine as a dietary supplement every day to fill in possible iodine gaps. Choose a multivitamin with potassium iodide, as this form of iodine is well absorbed by the body.”
Another nutrient that you may not consider essential for preconception health is iron. Iron is necessary to support the growing placenta and to support your plasma volume and red cell mass. Healthy iron levels during pregnancy contribute to the health of your baby.
You actually need less iron during preconception than you need during pregnancy. Your pre-pregnancy vitamins should contain 18 mg of iron, and the dose should increase as your pregnancy goes on.
During the second and third trimester of pregnancy, your iron needs increase to 27 mg per day. You can find iron in fortified grain products, beans, lentils, and spinach. However, you will want to rely on prenatal vitamins to supply this increased need during pregnancy.
Choline is a vitamin-like compound that your body needs for cell membrane signaling, lipid transport, and many other body functions. Along with folate, choline is essential for neural tube formation. You need choline during pregnancy because it is critical for fetal and infant brain development.
Despite choline’s importance, few women get enough in their diet. The American Medical Association recently recommended that all prenatal vitamins contain adequate choline. Most prenatal vitamins do not contain any choline because it is difficult to put into a tablet or softgel.
It is very important to eat choline-rich foods (egg yolks, fish, chicken, broccoli, and brussels sprouts) while trying to conceive and during pregnancy, in addition to taking prenatal vitamins containing at least 100 mg of choline. The goal is to get at least 450 mg of choline from food and supplements each day.
When you’re thinking about getting pregnant, it’s essential to get enough of these nutrients. Many people are aware of the need for folic acid. However, there is not much attention to iodine, iron, choline, or vitamin D related to pregnancy. Consider taking pre-pregnancy vitamins to give you adequate levels of these critical nutrients.
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