Medical Contribution By Dr. Eric Levens
Claims that nutritional supplements will improve our health are gaining headlines in the media and in the popular press. While some supplements may provide some health benefits, including pregnancy-related outcomes, many nutritional supplements may not be as safe as they would seem.
“I frequently get asked about vitamins and supplements with respect to fertility,” said Annandalephysician Dr. Eric Levens. “Many patients are surprised to learn that excessive vitamin intake could create some medical complications for both the mother and baby. This is especially the case for fat-soluble vitamins (A, D, E and K).”
Another concern with nutritional supplements is that some have been found to contain contaminants such as toxic plant materials and prescription medications, to name a few.Dr. Levens echos a sentiment that all Shady Grove Fertility physicians feel – additional nutritional supplementation outside of a standard prenatal vitamin is not necessary. A typical prenatal vitamin will provide sufficient vitamins and minerals for a healthy early pregnancy. The amount of vitamin A, for example, in standard prenatal vitamins (4,000 to 5,000 IU) is considered the maximum recommended dose before and during pregnancy.
“Given lax oversight of dietary supplements, it’s not surprising to find that numerous contaminants have been identified in nutritional supplements including those with estrogen action resulting in adverse effects on reproductive function,” said Dr. Levens.
Prior to 1994, dietary supplements (vitamins, minerals, amino acids, and botanicals) were considered food additives and thus were required to demonstrate safety prior to product marketing. Since the passage of the Dietary Supplement Health and Education Act in 1994, supplements are now presumed to be safe until shown otherwise.
Relaxed federal regulation, largely unknown by consumers and physicians alike, has created an environment in which hazardous supplements may be produced with little product liability. To date, more than 140 contaminated products have been identified, but this likely represents only a small proportion of the total contaminated products available today.
With the exception of folic acid, there has been little conclusive research demonstrating a benefit of nutritional supplements for fertility or during pregnancy.
“Folic acid has been shown to reduce the incidence of a specific birth defect known as neural tube defects by as much as 36 percent,” said Dr. Levens. “As a result, the Centers for Disease Control and Prevention and the US Public Health Service recommend that women of reproductive age take 0.4 mg of folic acid daily before conception and during the first trimester.”
It is commonly recommended that women who have a prior history of a pregnancy affected by a neural tube defect or who are taking anti-seizure medications take 4 mg (10 times the amount) of folic acid in the months in which conception is attempted as well as for the first trimester. Studies have shown that this measure can help reduce the risk of neural tube defects by a remarkable 80 percent.
Still, Dr. Levens says that the most important thing a woman can do while preparing for and during pregnancy is make sure they get most of their nutrition through a well-balanced diet.
“Nutrition is an essential component of preconception care for all patients. The combination of a well-balanced, varied diet that is consistent with a woman’s food preferences and a standard prenatal vitamin should be sufficient to meet the dietary needs of a developing pregnancy.”
