How to Choose a Prenatal Vitamin for your Period, Fertility and Pregnancy
Originally Published January 26, 2018
Oh the world of prenatal vitamins…
It’s no secret that women who are pregnant or breastfeeding are advised to take a prenatal vitamin every day.
And because our eggs take 3 months to develop before they’re ovulated, ideally women are advised to start taking a prenatal vitamin 90 days before they start trying to conceive.
And as a fertility educator who works with period problems frequently, I always remind my clients that the same nutrients that give us healthy babies give us healthy periods. So if you’ve got a period and you want to support your body through it, prenatal vitamins are helpful for you too!
But with so many different options out there, women are often left wondering if they are taking the right vitamin.
I frequently get asked in my fertility classes what vitamin I recommend and to be honest, I used to feel like a deer in a headlight when I got that question. I, too, used to have three different bottles of prenatal vitamins in my own home and I would just take whichever one I felt like that day.
So one day I decided to do a little research to find the number one, ultimate, best, top of the line, comprehensive, but also affordable vitamin out there. I thought it probably wouldn’t be that hard but after two full work days of searching the Internet, I was ready to give up.
Here’s the thing. I searched the American College of Gynecology (ACOG) website and found the recommended daily values for the Big Four in the world of Prenatal Vitamins: Folic Acid, Calcium, Iron, and Vitamin D. And then I searched the FDA’s website and found this chart and this chart of recommended values for pregnant women BUT even they weren’t exactly the same and neither lined up perfectly with ACOG's page. I thought maybe one of them was more up-to-date than the other but then when I looked at current labels of vitamins, some of them seemed to line up with one chart, and some lined up with the other.
I was confused and stressed and wishing I would have majored in Nutrition because there must be something I’m not understanding about all of this.
So, after taking a break from my search, I took a deep breathe and decided that it’s ok to not get this perfectly on the dot. There is no ultimate vitamin out there. Nevertheless, there are plenty of really good vitamins.
So how do you decide what’s best for you? Here’s a few questions to ask yourself.
1) How much can you pay for your Vitamins?
Many Prenatal Vitamins will cost around 30-60 dollars a month but that number varies widely depending on where you shop. On the other hand, with a prescription from your care provider, many Prenatal Vitamins are free for pregnant women. Remember that any vitamin is better than no vitamin so if you don’t want to pay a whole lot, take the one your care provider prescribes!
On the other hand, remember that you get what you pay for. And sometimes, getting a low quality vitamin is like throwing money in your toilet… literally.
Furthermore, while a more comprehensive vitamin will naturally cost more money, there are many nutrients needed to support a healthy body. I have found over the years that buying a more comprehensive, higher priced vitamin will save you money and room in your pantry. If one vitamin takes the place of 4 supplements, it’s worth it!
So bottom line: if you’re going to pay for a vitamin, let’s help you put your money to its best use, shall we?
2) Can you stomach it?
If you’re struggling with nausea or vomiting throughout your pregnancy, swallowing pills can be really difficult.
And I’ve had plenty of fertility clients who don’t enjoy taking vitamins either.
So when picking a vitamin, pay attention to how many pills you’ll have to take a day. Some prenatal vitamins require you to take just one pill a day while others can be as many as five or six.
Or, you might be interested in looking for a powdered vitamin to mix into a beverage, a liquid vitamin, or a chewable vitamin. All are great options.
Seeking Health is one of my favorite brands and they recently released a prenatal vitamin with milk thistle and ginger to help combat pregnancy nausea which may be an option for you as well.
But let me just say that those delicious, sugary, fruit snacky gummy vitamins might not be the best choice (don’t hate me). Most of them have less nutrients packed into them and the last thing we need is for your vitamin to spike your blood sugar.
3) What sources do you want your vitamin to be made from?
Is it important to you that your vitamin is completely plant-based? Do you want to make sure there are no artificial additives in your vitamin? Would you like your vitamin to be from food sources as much as possible? There are plenty of options out there if you answered “yes” to any of these options but you may have to look at a health food store or online.
And while prenatal vitamins have long been a part of a pregnant woman’s ritual, some people find they align more with simply using food as medicine. If this is you, consider starting to consume beef liver and nettle tea as these have both been nicknamed “nature’s multivitamin.”
4) Does your care provider approve of it?
Here’s your friendly reminder that this blog post does not substitute for medical advice and you should always double check with your provider before starting any new supplements to make sure it’s right for you.
5) Does it have everything you want in it?
This is where things can get a little confusing again but remember, you don’t have to get it perfectly right.
Here’s the top nutrients I recommend everyone with a period or pregnancy try to include.
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Folate or Folic Acid?
All prenatal vitamins will have enough Folate/Folic Acid but it’s usually one or the other. Here’s the low down.
Folate is a natural substance found in food but Folic Acid is the synthetic form of it. Somewhere around 50% of the population cannot process folic acid well and will need methylfolate instead. Furthermore, if folic acid isn’t properly used, it can build up in the body and become quite problematic.
Folate is so important to a baby’s development, particularly in the first few weeks. So this makes it even more important that you’re on a high-quality vitamin well BEFORE you get pregnant.
Because of all this, I highly recommend my clients find a vitamin with MethylFolate.
Magnesium
Magnesium is an important mineral that almost everyone is deficient in. So important for easy, pain-free periods it’s one of the first nutrients I recommend to my clients. In pregnancy, it’s especially important for managing stress, sleeping well, lowering high blood pressure, and preventing preeclampsia. Pregnant women could ideally get around 400 mg of magnesium but often there is much less in prenatal vitamins. Ask your care provider for guidance regarding this mineral.
Personally, I love a good powder magnesium so I can adjust from day to day how much I’m taking. If you’re stressed, if you’re working out, if you’re having cramps (those killer pregnancy Charlie-Horses, for example), if you’re struggling to sleep, or if you’re having annoying unproductive contractions in late pregnancy, you may need more Magnesium.
On the other hand, if your magnesium supplement makes you run immediately to the bathroom, you might be getting too much.
That’s why I’m also a huge fan of taking Epsom salt baths. Whether you’re trying to conceive or you’re already pregnant, a nice warm bath will help you relax and you will absorb the perfect amount of magnesium through your skin. No diarrhea necessary.
Vitamin D
Vitamin D is one of our most important nutrients for healthy periods and fertility and plays a role in preventing several different pregnancy complications. Pregnant women could ideally get between 2000 and 4000 IUs daily and a 2015 study found that a breastfeeding mother’s supplementation with 6400 IUs of Vitamin D is a safe and effective alternative to infant supplementation.
However, many prenatals only have around 400 IUs.
Ideally, if you’re on this page for period or fertility problems, test your Vitamin D levels first with a FEMM provider so you know exactly how much to supplement.
Be sure to get outside in the sun every day for your best source of vitamin D but know that it may be worth taking an extra supplement if your prenatal vitamin doesn’t cover your needs. Especially during the winter or if you live somewhere that isn’t sunny Florida (Hello, Indiana).
Vitamin D is especially close to my heart as it played quite a roll in helping me prevent preeclampsia in my second pregnancy. Read all about that here.
B Vitamins
Thiamine, Riboflacin, Niacin, B6, and B12 are all important and helpful in pregnancy and ovulation, especially if you are dealing with fatigue and morning sickness. Most prenatal vitamins have some B Vitamins in them but if you need extra energy and relief from nausea, talk to your care provider about taking more.
Omega 3s
DHA and EPA are omega-3 fatty acids that are vital in building your baby’s brain. Omega 3s are also important for reducing inflammation in the body which eases periods and aids fertility. Fatty fish are an excellent source but if you don’t eat fish a few times a week a supplement may be helpful. Many Prenatal Vitamins are starting to include DHA but most still do not, so consider supplementing if you don’t have one that does.
Zinc
To help support your thyroid, reduce period problems, and keep your immune system running well about, 30 mg of Zinc is helpful.
Choline
While the current recommendation is 450 mg a day of choline for fetal development, registered dietitian and expert in prenatal nutrition Lily Nichols reminds us that studies have shown that moving that number over 900 mg is optimal. Two eggs a day, one of our best food sources of choline, will get you about 300 mg so supplementing can be helpful.,
Selenium
Found abundantly in Brazil nuts, selenium is an important nutrient for thyroid health, fertility and pregnancy. This is often overlooked in our prenatals but can be very importnat to include so be sure to check your label for 50-200 mcg.
Probiotics
Finally, probiotics are important for your and your baby’s gut health and a prenatal probiotic can specifically help prevent GBS infection. Most vitamins don’t have probiotics but there are probiotics specific to pregnancy so consider taking one of those as well.
A few of my favorites
I’ve learned a lot since this post was originally published and today, I do have a few prenatal vitamins that I particularly love.
Exhibit A is the Seeking Health brand. They’ve got methylfolate, a nice amount of magnesium, and Vitamin D and they’ve got it in capsules, powder, or chewable form. The cons are that they are often out of stock, they’re expensive, and if you choose the capsules, you’ll have to swallow about 29,000 pills throughout your reproductive life (math=love). But I do find that it is one of the most complete vitamins on the market and I highly value that.
Exhibit B is the Thorne brand. They’ve also got methyl folate, they’re more affordable, and you’ve only got to swallow 3 a day. However, you may need to add in extra magnesium (yay for more Epsom salt baths) and extra Vitamin D (yay for more sunbathing).
And Exhibit C is the Needed Brand. I love that they check just about every box and they have a powder option. While they may be more expensive than some, this is where it’s important to remember that you’re saving money by not having to buy multiple supplements. And you can buy in bulk to save money as well!
So there ya have it, folks
Remember that most vitamins won’t check off every box so eating a balanced diet is crucial to ensuring that you and baby can grow healthy and strong. Because of that, you don’t have to stress too much about the exact vitamin you take.
While there is no one right answer for everyone when it comes to choosing prenatal vitamins, I hope this helps you decide which one might be best for you! May you have a safe, healthy, and enjoyable pregnancy ❤️
