The perfect time to start a prenatal vitamin
One of the biggest questions women have when entering the fertility and prenatal community is: what prenatal should I take?
But even more importantly - when should I start taking it?
A good prenatal will have all the critical nutrients to support fertility, conception, and a growing baby. These ingredients should be delivered in the optimal dosage, and be present in the safest, most bioavailable, and easy-to-tolerate forms. Ideally this prenatal will also have undergone 3rd party testing to ensure the amounts of nutrients listed on the back of the bottle are indeed accurate, and also that the product is free from harmful contaminants. What I hope you take away from this blog today is when your ideal timeframe to start a prenatal is (and the best ones I recommend at the end of this blog), and why a personalized approach to health is so important.
Here is a decision tree I’ve created to help you figure out if you should start taking a prenatal vitamin:
If your results were *PERSONALIZED REGIMEN
Bloodwork is the best way to determine what nutrients you really need at this time. Some of the most important markers to test with your health care provider are vitamin D, folate, ferritin, and B12 (especially if you’re on a plant-based diet, as iron and vitamin B12 come mainly from animal sources). These are all nutrients that are easy to supplement with once you know your baseline levels. There are some nutrients that are relatively safe and advisable for young women to start taking. These include vitamin D (at levels of 2000-5000IU per day), and magnesium, which supports many aspects of fertility such as hormones, blood sugar, thyroid, nervous system, and sleep. My favorites are Live Conscious Vitamin D + K2, and Thorne Magnesium CitraMate, but other brands are well-regarded.
If you’re currently on hormonal birth control (namely the pill) or have been in the past, it may be contributing to certain nutrient deficiencies. The pill has been shown to deplete folate, vitamins B2, B6, B12, vitamins C and E, as well as magnesium, selenium, and zinc. All of these are essential nutrients for fertility and pregnancy. Getting your levels checked is the best way to know if you’re actually deficient, and prioritizing foods rich in these vitamins and minerals is a great place to start.
Is there a danger to taking a prenatal too early? 3 months before trying to conceive is the minimum time recommended for starting a prenatal, with 6 months to a year being even better to give your body time to use and store all these essential nutrients. Taking a prenatal more than a year before trying to conceive just may not be necessary, especially if you’re taking birth control and not planning to stop in the next 6 months. A balanced diet will usually cover all your nutritional needs at this stage.
If your results were *PRENATAL
Earlier than you expected? Our bodies need time to replenish, use, and store these nutrients. For example, folate is most needed in the first 25 days of conception when the fetal brain and spinal cord develop. But by the time the spinal cord is finished developing - most don’t even know they’re pregnant yet! The extra time (up to a year before trying) is important for many other nutrients besides folate as well. You also never know how your body will react to pregnancy, so stocking up on nutrients beforehand will only be a good thing if you’re very nauseous or not feeling like eating the way you usually do.
What the heck type of folate do I need? First to clarify: folate is what’s found in food, folic acid is the man-made version of folate found in supplements, but is still included under the umbrella term “folate” which is confusing, I know! There are a few reasons why it’s better to chose a prenatal with an active or “methylated” folate (L-methylfolate, L-5MTHF, Metafolin, or folinic acid). A very common gene mutation (in the MTHFR gene, 40-60% of us have it) makes us less able to convert folic acid into usable folate. There is still a bit of a scientific debate around if it’s better to supplement with folic acid vs. methylated folate, but our bodies actually prefer to use methylated folate: 95-98% of what’s in our bloodstream is this methylated form! Folic acid also binds more strongly to our folate receptors than active folate does. This means the folic acid can compete with natural folate and potentially cause a deficiency, as well as lead to a buildup of unmetabolized folic acid in the bloodstream. Ultimately you should be looking for a prenatal with these methylated folate forms, or those with a blend of methylated folate and folic acid.
Can’t I just eat healthy food? A quality diet is an absolutely necessary foundation for building a healthy baby! And prenatal vitamins provide a wonderful insurance policy at a time where a LOT of nutrients are needed. Many women are missing out on key nutrients in the required amounts due to factors in our modern food system, western eating habits, and what’s available or realistic for everyone’s budget. And if you have a history of birth control use, you will likely be starting from even lower levels of these nutrients at baseline.
PRENATAL RECOMMENDATIONS
Quality matters. Most inexpensive brands at the grocery store are unfortunately typically low-quality and not in the most easily absorbed or utilized forms, and most also do not use 3rd party testing to make sure the dosages on the bottle are actually what you’re getting, test for the presence of harmful contaminants, or test for purity. I’m a firm believer than anything is better than nothing - so I have included a few at different price points. However, I do recommend trying to make the investment, as the benefits go beyond just healthy conception. The environment a baby grows in affects many aspects of a child’s development and has effects lasting into adulthood!
FullWell Women’s Prenatal Multivitamin - $50/30 day supply
The best quality prenatal on the market that I have seen. The serving size is 8/day, because choline is a large molecule and takes up a bit of space. This formula does not contain iron, so I recommend testing to see if you are iron deficient, and supplementing with iron separately if you are (as the calcium in this prenatal can compete with iron absorption).
Since I love this brand so much, I have an ambassador discount code for 10% off the FullWell store: WTT10
Klaire Labs Prenatal & Nursing Formula - $39/30 day supply
A bit more affordable and serving size is 3/day. This does include iron, but has slightly lower levels of nutrients than FullWell.
Pure Encapsulations Prenatal - $28/60 day supply
Complete prenatal and most affordable option. Has 100% of recommended daily value of iron. It also has a blend of folic acid and methylated folate.
Written by Michelle Cawley, MS. 12/30/22
Updated 11/17/23
The information on this website is provided for educational purposes only and should not be treated as medical advice. WTT Nutrition makes no guarantees regarding the information provided or how products may work for any individual. If you suffer from a health condition, you should consult your health care practitioner for medical advice before introducing any new products into your health care regimen. For more information, please read our terms and conditions.
REFERENCES
Ferrazzi E, Tiso G, Di Martino D. Folic acid versus 5- methyl tetrahydrofolate supplementation in pregnancy. Eur J Obstet Gynecol Reprod Biol. 2020 Oct;253:312-319. doi: 10.1016/j.ejogrb.2020.06.012. Epub 2020 Jun 13. PMID: 32868164.
Greenberg JA, Bell SJ, Guan Y, Yu YH. Folic Acid supplementation and pregnancy: more than just neural tube defect prevention. Rev Obstet Gynecol. 2011 Summer;4(2):52-9. PMID: 22102928; PMCID: PMC3218540.
Palmery M, Saraceno A, Vaiarelli A, Carlomagno G. Oral contraceptives and changes in nutritional requirements. Eur Rev Med Pharmacol Sci. 2013 Jul;17(13):1804-13. PMID: 23852908.
US Preventive Services Task Force. Folic Acid Supplementation for the Prevention of Neural Tube Defects: US Preventive Services Task Force Recommendation Statement. JAMA. 2017;317(2):183–189. doi:10.1001/jama.2016.19438