This is a transcription of a portion of a Healthful Woman podcast.
Kara’s Question
“I’m planning to have a baby and was told to start taking a prenatal. The information out there is all different and confusing for what specific vitamins you should have included. What would you recommend focusing on? Are there specific brands? Also, what are your thoughts on CoQ10 to boost egg viability?”
Dr. Fox’s Response
“All right, Kara, so the short answer to your question is it doesn’t really matter what prenatal you take in terms of brands. The vitamins that we have data for that you want to be on early in pregnancy are really just folic acid or folate. So, what is typically recommended is if you’re trying to conceive, to start taking any prenatal vitamin with folic acid prior to conception, just so that it is pretty clear that you’re on it when you get pregnant. Not everyone knows when they get pregnant. Most likely, if you started it the second you got pregnant, that’d be fine too. But usually recommend just starting in advance.
Prenatal vitamins will typically have 400 micrograms, which is 0.4 milligrams or more of folic acid in them. You’ll have that. Sometimes they’ll have double, like 800, sometimes they’ll have 1,000. But that’s what’s typically in there. The rest of the vitamins that are in the prenatal are usually not markedly different from what’s in any standard multivitamin, and different prenatals market for different reasons. Some because they want to have smaller pills, some because they want to have more of this, more of that. But ultimately, in terms of health, it really shouldn’t matter which one you take prior to getting pregnant or early in pregnancy. And in fact, for a lot of women, the prenatal makes them nauseous. It’s usually a bigger pill because they put a lot of vitamins in there. And so for those women, usually we’ll tell them just, you know, stop taking the prenatal and just take the folic acid as well.
In terms of other vitamins, well, you know, it depends how you look at it. If you have a well-balanced diet with good, healthy foods, maybe you don’t need any other vitamins or supplements. But since we’re not always clear who’s eating what or able to eat what, usually we’ll recommend some form of prenatal early in pregnancy just to make sure you get them. In my practice, what I typically will tell people is take any prenatal that’s out there, you know, whether you want one that’s smaller, that’s bigger, that’s chewable, whatever it is, fine. If you can’t tolerate a prenatal, you don’t like the prenatal, just make sure to get the folic acid. Then, on top of that, I usually do recommend people take calcium as a supplement because most people don’t get enough calcium in their diet. The recommended daily amount is 1,000 milligrams a day. That’s like three to four servings of dairy. So, most people don’t get that in their diet. And so if someone does, that’s fine. But if they don’t, usually I’ll tell them to pick up calcium. And most prenatals will not put 1,000 milligrams of calcium in the prenatal because otherwise the prenatal will be the size of a golf ball. No one would have it.
So, either a prenatal or folic acid, number one. Number two, make sure, either through diet or through supplements, to get enough calcium. And then also similarly, whether it’s beneficial to take, like, a fish oil supplement or not. I ask people if they eat fish, if they eat it, you know, twice a week. For instance, I allow people to eat sushi during pregnancy. That’s sometimes the way people get fish. So, if people eat fish two to three times a week, that should be fine. If not, then usually I’ll tell them to either get a prenatal with fish oil or pick up a fish oil supplement.
Your question about CoQ10. So, CoQ10 is a supplement that a lot of people take. It has antioxidant properties. The thought is that maybe it will improve fertility, or maybe it’ll improve early pregnancy and lower the rate of losses. What I would say is a lot of people take it. A lot of people recommend it. The data on it is very unclear whether it actually does what it’s supposed to do. So, I think that a lot of the people who recommended it or people who take it, it’s sort of faith-based that like, “Hey, maybe this will help.” So, I don’t routinely tell people they need to take it, but I do have a lot of people who come into pregnancy taking it, and it is safe, and it’s fine. Maybe it’s helpful. Maybe it’s not. We’re just not really sure at this point.”
Learn More on the Healthful Woman Podcast
In this mailbag episode of the Healthful Woman Podcast, Dr. Fox answers several other questions about dietary and lifestyle changes during pregnancy. To learn more, check out the full podcast episode.
Carnegie Women’s Health blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!
