Supplementing during pregnancy

You are at your first appointment at the OBGYN after discovering you are expecting a little baby in your belly. The first thing you receive is a whole list of supplements you must take without questioning previous blood work to show any deficiencies. But of course, you wouldn’t question your doctor, and I am not saying you should. But I would like to shine some light on the phenomenon of the obedience to the white coat, and how we do anything they tell us without even researching anything whatsoever.

One of the best tricks of this capitalistic patriarchy we live in is to make us think our bodies are faulty. We must have an external input to have our organic machine working properly. Oh, if it were that simple… Let’s begin by saying that you should always, in general, do a blood checkup to see if you actually have any deficiencies. Secondly, if you do have any deficiency and no one even mentions nutrition, run. We get our nutrients from our food first, and supplements are a last resort. You need to learn how and what to eat, and this should be emphasized during pregnancy.

Now let’s dig into this list of supplements you will have to take “or else your baby won’t grow properly”. This is one of the many infantilizing threats recommendations you will most definitely receive.

Folic Acid. This is the most important one and definitely my favorite to explain. It is a vitamin B complex mostly found in leafy greens. Something most adults don’t consume on a daily or even weekly basis. Deficiency during pregnancy increases the risk of neural tube defects. So there are 2 main problems with the recommendation of supplementing.

1; No one ever mentions the foods you should consume, that you should in fact check your folate levels, or that you can in fact consume too much which brings second effects such as upset stomach, nausea, diarrhea, irritability, confusion, behavior changes, skin reactions and even seizures.

2; Everyone recommends Folic acid, when in fact Folate is much more bioavailable. Maybe only 1 out of 10 doctors will recommend the correct version of this.

Folic acid (FA) is a synthetic compound. It is manufactured by humans in the laboratory. It is not found in nature. We find it added to fortified foods and as a supplement.

Folates (plural) is the term we use to refer to vitamin B9. There are more than 150 forms of folates in foods. Much of them are found in the form of tetrahydrofolate or THF and 5-methyltetrahydrofolate or 5-MTHF.

Iron. Iron deficiency anemia is the most common nutritional deficiency among pregnant women. There is a decrease in hemoglobin and serum iron levels, while the total iron transport capacity increases. There are few data to make statements about the impact of prophylaxis on obstetric and perinatal outcomes. The addition of folates to iron prophylaxis does not appear to improve hematologic outcomes. I believe we shouldn’t just take supplements prophylactically without previously having done a blood test to see if there is an iron deficiency, and having spoken to a specialized perinatal nutritionist to start with dietary changes.

“In most of the studies reviewed, iron supplementation, with or without folic acid, increases Hb levels at term, although this has not been shown to translate into better perinatal outcomes.”

Iodine. An essential micronutrient that is necessary for optimal brain development. We only need a small amount in our diet, but it is very important as it intervenes in the function of our thyroid gland by regulating the production or not of thyroid hormones. In most countries, people suffer from iodine deficiency, and sometimes programs to implement iodized salt have been launched to alleviate this deficiency. Iodine deficiency occurs when the soil is poor in iodine, causing a low concentration in food products and insufficient iodine intake in the population. Years ago, in Spain, iodine was added to regular table salt or milk as a prevention strategy. In Spain, iodine supplementation is recommended for pregnant people and its use is advised for the general population.

The origin of iodine is marine and therefore it is found in fish, shellfish, and also in algae. Supplementation is necessary when these lack chronically from your diet. You must take care though, as most fish and algae are full of heavy metals, microplastics, and forever chemicals. Try to buy these always from an organic (Bio) source (in your nutrition as in your supplementation).

Excessive iodine consumption has been associated with a higher risk of autoimmune thyroiditis or hyperthyroidism in the mother and neonatal hypothyroidism.

These 3 are the most important, and only critical ones during your pregnancy. The message I want to send to everyone is that taking supplements prophylactically is not useful, and sometimes even damaging to you and your baby. Always check for deficiencies, adapt your diet to every stage of your life, and try to get as many nutrients from there. Don’t over supplement, it is a whole business and many try to take advantage of emotional moments in people’s lives. In the best case scenario, you end up with very expensive pee. But do look always first at your diet. Eat your fruit, veggies, leafy greens, legumes, seeds, nuts, and good protein sources. From now on you are taking care of not only yourself but also of another little being. Give them the best possible start, and give them a dietary example. They learn to nurture themselves through you. Make it as healthy and happy as possible. A healthy mom = a healthy baby. Don’t outsource your health.