Recommended Dose in Prenatal Vitamins

If you’re facing deficiency of some nutrition when you’re in pregnancy, you should be aware of choosing best prenatal vitamins in order to born a healthy baby.

You’d like to know the following dose recommended by authority, e.g. FDA, before you take any supplement. But some of the nutrients we don’t have the RDA values at this moment.
best prenatal vitamins
Vitamin A
Any excessive dose of vitamin A will cause a lot of trouble for pregnant women, for example, birth defects such as heart defects, cleft palate and hydrocephalus. The liver, bone, nervous system and skin will be damaged if intake a much higher dose of vitamin A.
To reduce the risk of above mentioned defects, pregnant women should avoid any prenatal vitamins which may contain more than 5,000 IU preformed vitamin A, suggested by the March of Dimes. It said that any separated vitamin A supplement exceeded this dosage should not be consumed by pregnant women and reduce the consumption of liver or other fortified foods which are enrich of preformed vitamin A. But vitamin A from fruits or vegetables existed as beta-carotene is not included.

Vitamin B-1 (Thiamin) supports human’s nervous system.
The RDA for pregnant/lactating women is 1.4 mg per day. UL value is not established at this moment.

Vitamin B-2 (Riboflavin) supports the skin and vision function.
RDA value for pregnant women is 1.4 mg, for lactating women is 1.6 mg per day. UL value is not established right now.

Vitamin B-3 (Niacin) helps the function of releasing energy from carbohydrates.
The RDA value is 18 mg for pregnant women, and 17 mg for lactating women.

Vitamin B-6 (Pyridoxine) plays important role in metabolism and immune/nervous system.
The RDA value is 1.9 mg and 2.0 mg for lactating women.

Vitamin B-9 (Folate) is very important for pregnant women, and if you plan to conceive.
The RDA value is 600 mcg for pregnant women, 500 mcg for lactating women.

Vitamin B-12 supports the function of building blood cells.
The RDA value is 2.6 mcg for pregnant women, 2.8 mcg for lactating women.
UL value is not established at this moment.

Vitamin C is an essential for blood vessel walls and bones.
The RDA value is 80 mg for pregnant women with eighteen years and younger, and 85 mg when nineteen years or older. For lactating women, 115 mg is suggested for eighteen years and younger, 120 mg for nineteen years or older.
The UL value is setup for adult only, 2,000 mg for 19 years and older.

Chromium supports the regulation of blood sugar in human’s body.
For pregnant women, it suggests to take 29 mcg for eighteen years or younger, 30 mcg for nineteen and older.
44 mcg is for lactating women when eighteen or younger, 45 mcg when nineteen or older.
No UL value is established at this moment. But if you take in excessive dose may increase the risk of damage to kidney or other organs.

Copper is one essential for skin pigment and connective tissue.
The RDA value for pregnant women is 1,000 mcg, 1,300 mcg for lactating women.
The UL value is established for adults only, 10,000 mcg for nineteen years and older.

Iodine controls the thyroid hormones producing, either the deficiency of it will cause low thyroid activity, or the intake in over dose will cause hypothyroidism. 3 cases of congenital hypothyroidism in infants reported due to high dose iodine supplement (11 times of UL value, and 57 times of RDA) taken by their mothers. Contrastly, if the mothers are deficient of iodine that will cause a brain development problem in their offspring. In U.S. it was reported in May 2014, that about one-third of pregnant women are marginally iodine deficient. And it was advised that pregnant women need to take a supplement containing 150 mcg iodine (from 197 mcg of potassium iodide) from a statement of the American Academy of Pediatrics.

Iron, it leads to anemia if deficient in pregnant women. The RDA value for pregnant women is 27mg.
The RDA is 10 mg for lactating women 18 years and younger. 9 mg when she is 19 and older.

Magnesium is an assistant of human’s nerve system and metabolism.
It suggested for pregnant women with 400 mg if they’re 18 years or younger, it’s 350 mg if 19 or older, 360 mg if 31 or older.
The RDA for lactating women, it’s 360 mg when they’re 18 years or younger, 310 mg when they’re 19 to 30, 320 mg when they’re equal or older than 31.

Manganese play roles in metabolism and bone formation.
The RDA for prenatal women is 2.0 mg daily;
For lactating women need 2.6 mg daily.
It will cause neurological side effects if intake too much.

Molybdenum is a part of multiple enzymes inside of the human’s body.
The recommended dose of molybdenum for pregnant women or lactating women is 50 mcg daily.

Selenium is needed for body’s antioxidant system.
The RDA for pregnant women is 60 mcg;
For nursing women it’s 70 mcg daily.

Zinc is working for sperm production, brain functionalities and wound healing.
The RDA for pregnant women, for 18 years or younger is 14 mg daily, and 11 mg when they’re 19 years and older.
The RDA for lactating women is 14 mg when they’re 18 years and younger, 12 mg when they’re 19 years and older.

For the nutrients of vitamin D, vitamin E, vitamin K, and the mineral of calcium, we currently don’t have the specific recommendation dose for prenatal women, only have the standard for adult.

Be careful when you’re in pregnancy, an eutrophy daily food will help both of the mother and fetus. If you cannot ensure your health dietary, you may need a selective prenatal vitamins instead.

The Importance of Essentials in Prenatal Vitamins

We already know how to find the best prenatal vitamins, but we may also need to learn what the benefit the prenatal vitamins can help us before we take it. Researcher had some evidences that supporting the prenatal vitamins brought about the healthy benefit for the pregnant women.

best prenatal vitamins

So here, we can collect some useful information as listed below:

For iodine

Due to concerns about inadequate iodine intake among pregnant and lactating women, in May 2014, the American Academy of Pediatrics issued a statement advising such women to take an iodine-containing supplement. Unfortunately most prenatal supplements currently do not contain the amount of iodine being recommended (150 mcg of elemental iodine from 197 mcg of potassium iodide). (Don’t worry about this, the prenatal vitamins we recommended here are with adequate iodine dosage)

Too much iodine intake during pregnancy can cause problems in infants, but so can too little. Three cases were reported of infants born with congenital hypothyroidism apparently due to their mothers having taken the high potency iodine supplement Iodoral (Optimox, Corp) which contains 12.5 mg of iodine/iodide per tablet more than 11 times the UL and nearly 57 times the RDA for iodine for pregnant women. Congenital hypothyroidism has also been reported in infants born to mothers taking an herbal supplement high in iodine-containing kelp.

For vitamin A

Do not take too much vitamin A. The most important risk involves pregnant women. Vitamin A given in modestly excessive doses can cause birth defects. Much higher doses of vitamin A can potentially damage the liver, central nervous system, bone and skin. The UL for daily intake should not exceed 2,000 IU for children 1 to 3 years old, 3,000 IU for those 4 to 8, 5,666 IU for those 9 to 13, 9,333 IU for those 14 to 18, and 10,000 IU for adults. To minimize the risk of birth defects such as cleft palate, heart defects, and hydrocephalus, the March of Dimes recommends that a pregnant women should not use a multivitamin or prenatal supplement that contains more than 5,000 IU of preformed vitamin A. It also advises that a pregnant woman should not take any vitamin A supplements beyond that amount and minimize consumption of liver, which contains preformed vitamin A. However, these ULs apply only vitamin A consumed from supplements, fortified foods, and animal sources, and does not include vitamin A as beta-carotene or intake from fruits and vegetables.

For folate

Folate is known to reduce the risk of certain birth defects. Supplements are generally recommended for women who are pregnant or may soon become pregnant.

In addition, folic acid supplementation at 1,000 mcg per day has been associated with a more than doubling of the risk of prostate cancer.

RDAs of folate for pregnant women, you may refer to here.

Best Time to Take Supplements

People always ask me when the best time to take supplements is. We can easily tell usage from the suggestion in product’s label. For example, you may find it here:

best time to take supplements

Recommendation: Take 1 tablet daily, preferably with food.

It is one multivitamins/multiminerals product, normally contains vitamin A, vitamin D, vitamin E, and other nutrients. To have a better absorption of these fat soluble vitamins or minerals, you’d better take it after a meal. For calcium, magnesium and iron, stomach acid helps them released from the supplement tablets and lead to a better absorption for zinc.

And if it has multiple pills in daily serving, you may divide them evenly to your three meals in morning, noon, and dinner, although some products may state as a time release caplets.

For some workout products, such as protein, glutamine, and here is the suggestion when you should take it:

  • 30 minutes before workout;
  • Right after you’ve done with a workout session;
  • Before your bedtime and just wake up in the morning;

But if the product label didn’t have any suggestion, when shall we to take it?

For example:

best time to take supplements

This is a kind of herbal supplement, in order to have a best effectiveness you’d take it in each morning before your breakfast or before each of your meal.

For the following herbal products below, you should be aware of above suggestion for best practice:

  • Grape seed extract
  • Milk thistle
  • Bilberry extract
  • Ginkgo biloba
  • St. John’s wort
  • Turmeric/Curcumin
  • Maca
  • Saw palmetto
  • Echinacea
  • Garlic
  • Cinnamon
  • Ginger root
  • Black cohosh

Some nutrition supplements have an enteric coating, one protective layer applied to a softgel, capsule and caplet. Normally made of materials, such as starch and plasticizers. This coating prevents the ingredient from being released in the stomach and destroyed by acid in the stomach, e.g. some digest enzymes. So the ingredient can keep intact in stomach acid and reach the small intestine for a better absorption. Sometimes, supplements like fish oil or garlic are designed with enteric coating, not just for the maximum absorption in small intestine, also to avoid the unpleasant aftertastes or burps after taking the pills.

So for these supplements with strong smell you shall follow the recommendation in the label, possibly take them after a meal.

Somehow, you may find probiotics supplements are suggested to take in an empty stomach, or may also be taken with food. You can take as suggested in the label, but you may need to know some tips when you take probiotics:

1, some strains can survive from stomach acid, such as:

Lactobacillus, Bifidobacterium and Streptococcus species

So probiotics included above strains are not necessary using enteric coating, but according to a study, only 10-20% of strains are able to survive from stomach acid if took without food. But it has more times of survival rate if the probiotics supplement has enterically coating. So normally the probiotics supplement with coating effects better than the one without coating, of course, the price will be costly also.

best time to take supplements

EnteroGuard® Coating is one kind of enteric coat technology.

2, some products are with enteric coating technology, but some are not. If the pill doesn’t have an enteric coat, you’d better take it just before you have a meal or during a meal.

Here is a few recommendation of the best probiotics for infant.

We can find whole food source supplements become popular on the market. Although most of these food base supplements are more expensive than others, we still can get benefits from the ingredients from natural food.

best time to take supplements

For example, the above mentioned prenatal vitamins is the best prenatal vitamins, gentle organic formula and can be taken with or without food.

As it contains vitamin B6 and ginger root, that will help soothe the stomach from upset in the morning when a pregnant woman in her first trimester.

best time to take supplements

And some supplements are prescribed from your physician, you have to follow the instruction from a professional. Be careful, some supplements may interact with medicine, such as natural vitamin E will thin your blood, if you’re taking warfarin or aspirin, don’t take them at the same time in a high dose until you have a suggestion from a pharmacist!

Folate – An Essential in Prenatal Vitamins

Folate, also known as folic acid, vitamin B9, plays a key role in cell division in human body. It is an important essential in prenatal vitamins. In some researches, we found it reduce the risk of heart disease, and it is helpful lessen the incidence rate of some cancers.

folate-prenatal vitaminsYou can find the folate from dark green leafy vegetables, and oranges. These are natural good source of folate, but the synthetic source of folic acid seems has a twice absorption and a more bioavailability as well as the natural source folate.

There are two new synthetic source of folate products, Metafolin and Quatrefolic were accepted by FDA individually in 2001 and 2010. With stabilized form in Metafolin (calcium salt, Metafolin® is a registered trademark of Merck KGaA, Darmstadt, Germany) and Quatrefolic (glucosamine salt, Quatrefolic® is a registered trademark of Gnosis S.p.A. Corporation), they have an active compound, called L-5-methylfolate, which is same created in the body as folate and folic acid does. People with common genetic mutations were suggested to take these new forms, as it was proved to have more effectiveness than folic acid in a short term.

Benefits for pregnant women
It is helpful to reduce the risk of spina bifida in fetus if folate consumed in prenatal vitamins by pregnant women. Folate is also proved to lessen the occurrence of leukemia and some other defects among infants.

A research from the Norwegian Institute of Public Health in Oslo announced that, the women took folic acid (400 mcg per day) from 4 weeks before to 8 weeks after their pregnancy had a 39% lower risk of autistic disorder in children, compared to the children whose mothers didn’t have any folic acid supplement.

But many pregnancies are unplanned, it is difficult to recommend a folic acid supplement before conception. Most of time the neural tube defects may have already occurred, because the average of first antenatal visit normally is 9 weeks.

Since 1998, folic acid were fortificated in cereal grains mandatorily and as a result, there is less than 1% of people in Americans have folate deficiency. Then over 50 countries around the world have followed this mandatory fortification with folic acid.

Recommended dose
As a result, the RDAs doses are based on the regular food sources, if you are taking folic acid in prenatal vitamins or fortificated food, which are twice absorbs in the body, you have to take 1/2 following RDAs:

For Children 1 – 3 years old: 150 mcg
Children 4 – 8 years old: 200 mcg
Children 9 – 13 years old: 300 mcg
Over 14 years old: 400 mcg
Pregnant women: 600 mcg
Lactating women: 500 mcg

The ULs of folate (total amount from fortified food and supplements):
For Children 1 – 3 years old: 300 mcg
Children 4 – 8 years old: 400 mcg
Children 9 – 13 years old: 600 mcg
Children 14 – 18 years old: 800 mcg
Individual over 19 years old: 1,000 mcg

Concerns
There are increasing concerns for the folic acid intake 1000 mcg per day from supplement, associated with a more than doubling risk of prostate cancer. Meanwhile, the folate from natural sources was not found any risk raised.

Although folate may reduce the incidence rate of cancer, e.g. the notably colorectal cancer, there are some concerns about the exceed folic acid from supplements and fortificated foods may increase the risk of cancerous tumors or pre-cancerous. For example, it was observed that the risk of colorectal cancer was increased after the country began to fortify the wheat flour with folic acid in Chile and other countries in 2009.

But according to a recent study in U.S. (2011), there was no significant association found between the colorectal cancer and folic acid serving. In contrast, this study found a 19% reducing in the risk of colon cancer comparing the people took the highest dose of folic acid (including both of the natural folate and folic acid) to those with the lowest dose intake.

Iodine: One-third of U.S. pregnant women are in iodine deficiency minimally

According to a report from American Academy of Pediatrics published May 24, 2014 said that, a lot of women in the United States are with iodine deficiency when they’re in reproductive age. It may because the salt in their daily dietary is not iodized.

iodine deficiencyIodine is one of the essential nutrient for thyroid hormones. Any iodine deficiency will cause a hypothyroidism, with the symptom of over weighted, energy deficiency or goiter. You may eat some foods with iodine rich, like seafood, seaweed and kelp. Also some table salt is iodized, you can choose it from market.

On the other hand, too much iodine intake in your dietary will also cause hypothyroidism. A research initialed in Journal of Pediatrics, announced that excess intake of 12.5 mg iodine when the mothers were pregnant or breastfeeding, caused three infants were developed thyroid hormone deficiency. The researcher agreed that it was important for taking supplement contains iodine, but they also stressed that it will cause a negative effect of exceeding the safe threshold of iodine. There are 10 times iodine levels in the infants’ blood than the healthy babies. The study stated that most of the congenital hypothyroidism occurred in infant is resulting from an iodine deficiency instead of an over intake of iodine supplement. In the developed country, the iodized salt plays an important and helpful role to reduce the iodine deficiency commonly, nevertheless, the salt in processed foods is not iodized in a general speaking.

So what’s the RDAs (Recommended Dietary Allowances) and ULs(Upper Tolerable intake levels) for iodine? From the recommendation of the American Academy of Pediatrics, the expectant women requires a dosage of 150 mcg iodine nutrient from 197 mcg potassium iodine.

Here is the RDAs dosage for different ages:

Age 1 – 8: 90 mcg

Age 9 – 13: 120 mcg

Age 14 and older: 150 mcg

Pregnant women: 220 mcg

Lactating women: 290 mcg

ULs for different ages:

Age 1 – 3: 220 mcg

Age 4 – 8: 300 mcg

Age 9 – 13: 600 mcg

Age 14 – 18: 900 mcg

Age 19 and above: 1,100 mcg

In the United States, most of the prenatal and lactating women are taking nutrient supplement, but only 15% – 20% of the supplement contains the essential of iodine! Many of prenatal vitamins don’t have any iodine. Even it contains, the dosage is less than 150 mcg. You can learn to how to choose the best prenatal vitamins from here.