4000 iu vitamin a

Prenatal Vitamins

Nobody does nutrition better than nature. Not only does the body synthesize the nutrients naturally occurring in whole foods better than anything manufacturered in a lab, but nature’s time-honored recipes (for that carrot, those lentils, that peach, those walnuts) also probably contain a host of nutrients scientists haven’t even discovered yet. All of which goes double for expectant moms busily trying to fill the nutritional needs of two growing bodies — and all good reason to pick and choose a pregnancy diet that taps into nature’s wholesome bounty of whole foods.

In theory, that is. In real life, it’s easy to miss the nutritional mark anytime — but especially during pregnancy, when (in an ironic twist) Mother Nature throws mothers-to-be some serious curveballs that make eating well challenging….times two. The best of intentions are sometimes no competition, after all, for morning sickness (you dutifully ate your oatmeal, then promptly gave it the old heave-ho). Or indigestion (you were all fired up for that grilled chicken and broccoli…until the heartburn ignited your chest). Or even exhaustion (you totally intended to stop at the market for salad ingredients…but the sofa called, and you ended up dialing Dominos instead).

Enter: The prenatal vitamin. No substitute for nature’s nutritional finest (no pill can take the place of a balanced diet), but a pretty savvy supplement, one that’s scientifically designed to fill in the nutritional gaps when your real-life diet falls short. Think of it as a nutritional insurance policy (one you should consider taking out before you’re expecting, as well as while you’re breastfeeding). Notable among the nutrients they supply? Extra iron and folic acid, both vital to the health of your pregnancy and your baby. In fact, studies show that women who take prenatal vitamins before and during pregnancy dramatically lower their risks of having babies with spina bifida and cleft palate — and may also lower their risks of delivering prematurely. Not bad for a one-a-day.

Which Prenatal Vitamin Supplement Is Best?

Why can’t you just keep popping the vitamin-mineral supplement you’ve always taken — the one that’s done a good job of keeping you healthy up until now? Because pregnancy comes with a whole new set of nutritional requirements that prenatals are precisely designed to fill (but just as importantly, not overfill). For instance, prenatal vitamin supplements contain higher levels of those essential pregnancy nutrients (such as iron and folic acid) than regular one-a-days do.

Not sure which prenatal to start popping? Ask your practitioner for a recommendation (or for a prescription, if your health insurance plan will cover it). But also keep in mind that over-the-counter varieties can be just as good as (and a lot less expensive than) the prescription kind. Check the labels to compare.

Though dosages vary from brand to brand, your practitioner will probably recommend a supplement that contains the following vitamins and minerals, in these general amounts:

  • Vitamin A: No more than 4,000 IU (800 ug). Taking too much vitamin A can be dangerous. That’s why many manufacturers have reduced the amount of vitamin A in their vitamin supplements or have replaced it with beta-carotene, a much safer source of the vitamin.
  • Folic acid: At least 400 to 600 mcg. Folic acid is also known as folate.
  • Calcium: 250 mg. Keep in mind that the calcium requirement during pregnancy is 1,200 mg, so you’ll need to get enough additional calcium from your diet to keep your bones and your baby’s bones strong — or take an extra supplement.
  • Iron: 30 mg. Because your iron needs are so great during pregnancy, your practitioner may recommend an additional iron supplement after week 20 to protect against iron-deficiency anemia.
  • Vitamin C: 50 to 100 mg
  • Zinc: 15 mg
  • Copper: 2 mg
  • Vitamin B6: 2 mg
  • Vitamin D: 400 IU
  • Vitamin E: At least 15 mg (or 22 IU)
  • Thiamin: At least 1.4 mg
  • Riboflavin: At least 1.4 mg
  • Niacin: At least 18 mg
  • Vitamin B12: 4 mcg

Some prenatal vitamin supplements may also contain magnesium, fluoride, biotin, phosphorous, pantothenic acid, DHA (an essential fatty acid), or a combination of these.

Think more is more? It definitely isn’t during pregnancy. Some vitamins and minerals are harmful in too-high doses, and some supplements contain herbs that aren’t pregnancy-safe. So don’t take any nutritional or vitamin supplements beyond that prenatal without your practitioner’s approval.

When is too much…too much? Get the scoop on why vitamin A can be both beneficial and harmful for pregnancy.

BY: KENDRA TOLBERT, MS, RDN, CDN, CLC

Pregnancy is a time of building, multiplying, and growth within a woman’s body. For cells to grow and multiply, your body and your baby require the support of vitamin A.

In addition to supporting growth, this vitamin serves as an antioxidant. As an antioxidant it helps protect your cells from damaging factors such as pollution, UV rays, and emotional stress.

If vitamin A is so important, why are women constantly warned about its dangers?

Because certain types, in high amounts really can be dangerous.

Vitamin A gets a bad rap during pregnancy because toxic levels may lead to birth defects. Yes, too much of it, especially from supplements, can be dangerous. But you still need it, your baby still needs it, and there’s a really good chance you’re not getting enough of it.

While too much vitamin A can have a negative health impact, so can having too little. Not getting enough vitamin A can weaken your immune system, causing hyperkeratosis (which you may know as chicken skin), and lead to night blindness.

26% of pregnant women don’t get enough vitamin A from their daily diet, and non-pregnant women aren’t doing any better. In fact, 48% of non-pregnant women aren’t meeting their needs.

So how much Vitamin A can you have during pregnancy?

The Recommended Dietary Allowance during pregnancy is 770 mcg per day, which you can get from both supplements or food sources.

Studies have shown that large doses of synthetic or preformed vitamin A in supplements can be dangerous and not only cause harm to you, but also your baby. As a teratogen, preformed vitamin A has been linked to birth defects and must be limited at any time, pregnant or not.

In supplements, vitamin A is usually reported in IU (international units) on its labels. If all the vitamin A is from beta carotene, up to 15,000 IU is allowed, though, not advised. You probably won’t find it that high anyway. If your vitamin contains retinyl palmitate or retinyl acetate, there shouldn’t be more than 2,500 IU from these two.

The safest way to obtain this vitamin is from food sources.

Beta-carotene, the type found in fruits and vegetables, is perfectly safe, even in high amounts. However, it is possible to get too much when it’s from animal sources, although you probably don’t need to worry too much about that. It’s highly unlikely for most people following the standard American diet to get too much vitamin A.

It’s also important to realize that most research about vitamin A toxicity isn’t about vitamin A from food sources. Most toxicity reports come from supplemental vitamin A, especially from preformed (retinol and retinyl) forms. That’s one more reason to focus on getting your nutrients from real food instead of supplements.

Here are 10 Vitamin A-rich food sources to consider in your diet:

  1. Liver (just make sure not to overdo it.)
  2. Sweet Potato
  3. Pumpkin
  4. Butternut Squash
  5. Carrots
  6. Spinach
  7. Collard Greens
  8. Kale
  9. Dried Apricots
  10. Mustard Greens

Here are some ways to squeeze more of this vitamin into your day:

  • Add ground liver to your ground meat used for hamburgers, tacos, or spaghetti sauce.
  • Opt for mashed sweet potatoes in place of mashed white potatoes as a side dish for dinner.
  • Grab a bowl of pumpkin soup for lunch.
  • Add butternut squash to your favorite pasta sauce recipe.
  • Sprinkle shredded carrots on a salad, on scrambled eggs, or on a sandwich.
  • Choose spinach instead of iceberg lettuce in salads or on sandwiches.
  • Use a collard green leaf in place of a tortilla or wrap when making wraps for lunch.
  • Rip up kale leaves and add them to an omelet.
  • Make your own tasty, healthy, and easy trail mix by combining dried apricots, coconut flakes, and dark chocolate.
  • Blend mustard greens into your favorite smoothie recipe.

Add these and other vitamin A-rich foods to your daily diet to meet your daily needs for a strong immune system, healthy skin, and a healthy pregnancy.

Adapted from the original article.
HEADER IMAGE: FREDDIE MARRIAGE

Kendra Tolbert, MS, RDN, CDN, CLC is a registered dietitian nutritionist, certified lactation counselor, and certified aromatherapist based in Alexandria, VA. Through her private practice, she helps women and couples prepare for pregnancy and enjoy healthier, happier pregnancies. Learn more about Kendra at Live Fertile.

Vitamin A supplementation during pregnancy

Guidance summary*

WHO recommendations

Vitamin A supplementation is only recommended for pregnant women in areas where vitamin A deficiency is a severe public health problem, to prevent night blindness.

Remarks

  • This recommendation supersedes the previous WHO recommendation found in the 2011 Guideline: vitamin A supplementation in pregnant women (1).
  • Vitamin A is not recommended to improve maternal and perinatal outcomes.
  • Vitamin A deficiency is a severe public health problem if 5% or more of women in a population have a history of night blindness in their most recent pregnancy in the previous 3–5 years that ended in a live birth, or if 20% or more of pregnant women have a serum retinol level below 0.70 µmol/L (2). Determination of vitamin A deficiency as a public health problem involves estimating the prevalence of deficiency in a population by using specific biochemical and clinical indicators of vitamin A status.
  • Pregnant women should be encouraged to receive adequate nutrition, which is best achieved through consumption of a healthy, balanced diet, and to refer to WHO guidance on healthy eating (3).
  • In areas where supplementation is indicated for vitamin A deficiency, it can be given daily or weekly. Existing WHO guidance suggests a dose of up to 10 000 IU vitamin A per day, or a weekly dose of up to 25 000 IU (1).
  • A single dose of a vitamin A supplement greater than 25 000 IU is not recommended as its safety is uncertain. Furthermore, a single dose of a vitamin A supplement greater than 25 000 IU might be teratogenic if consumed between day 15 and day 60 from conception (1).
  • There is no demonstrated benefit from taking vitamin A supplements in populations where habitual daily vitamin A intakes exceed 8000 IU or 2400 µg, and the potential risk of adverse events increases with higher intakes (above 10 000 IU) if supplements are routinely taken by people in these populations (3).

* This is an extract from the relevant guideline (4). Additional guidance information can be found in this document.

2. Sommer A, Davidson FR. Assessment and control of vitamin A deficiency: the Annecy Accords. J Nutr. 2002;132:2845S-50S.

3. Healthy diet. Fact sheet No. 394. Geneva: World Health Organization; 2015 (http://www.who.int/ mediacentre/factsheets/fs394/en/).

If you’re pregnant (or #TTC), you’re obviously eating all the kale, salmon, and whole grains you can…right?

LOL, right. Many moms-to-be eat whatever they can for the first few months (what up, saltine crackers and Swedish fish?) thanks to a little thing called morning sickness and a hyper-sensitive nose.

And that, kids, is exactly why prenatal vitamins were invented.

What exactly are prenatal vitamins?

Prenatal vitamins are there to fill in any nutritional gaps and make sure there is an abundance of all the vital nutrients your baby needs to grow—especially magnesium, zinc, calcium, vitamins B and C, and folate, says G. Thomas Ruiz, MD, ob-gyn at MemorialCare Orange Coast Medical Center in Fountain Valley, California.

Supplemental folate, in particular, is very important as it’s been shown to reduce neural tube defects in babies, and you need at least 400 micrograms a day, according to the World Health Organization (WHO).

Most of these vitamins are water soluble, meaning you’ll just pee out any excess, Dr. Ruiz says. (So, you don’t need to worry about OD’ing.) There is one exception to this rule, however: iron, which can be toxic in large doses.

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Pregnant women need 30 to 60 milligrams of iron each day, according to the guidelines from the WHO. Most prenatal vitamins come fortified with extra iron, so as long as you’re sticking to what’s in your daily prenatal (and not supplementing with even more iron), you’ll be fine, Dr. Ruiz says. (Caveat: If you’re anemic, you might need more, so Dr. Ruiz recommends discussing your individual needs with your doctor.)

Okay, so when do I need to start taking prenatal vitamins—and for how long?

Ideally you should start taking them as soon as you start trying to conceive, Dr. Ruiz says. (FYI: It’s a myth that they will increase your fertility, though.) Your baby will need those extra nutrients from the moment of conception, Dr. Ruiz explains.

Continue to take the vitamins throughout your pregnancy and afterward, for as long as you’re breastfeeding, he advises.

What do I really need in a prenatal vitamin?

Sifting through drugstore shelves or Amazon suggestions is super intimidating. And don’t worry, it’s not just you—all of those options don’t just start to sound alike, they really are very similar, says Wendy Goodall McDonald, MD, a Chicago-based ob-gyn.

The key, however, is making sure you start taking a vitamin with at least 400 micrograms of folic acid as early as possible (yes, even before conception if possible). You should also look for options that will help you meet the daily recommended amounts of 600 international units of vitamin D, 1,000 mg of calcium, and at least 27 mg of iron, according to the American College of Obstetricians and Gynecologists (ACOG).

As for the other ingredients listed? There’s no hard and fast rule as to how much, say, biotin you should take on the reg, as “biotin and many of the other minerals quantities aren’t backed by scientific evidence when it comes to the absolute required quantities in a prenatal,” Dr. McDonald explains.

So the question still remains: which prenatal vitamin is the right prenatal vitamin? While it’s different for everyone (for example, some people might have tummy troubles for one versus another), here are the top doctor-approved prenatal vitamins on the market, including the best-selling ones on Amazon to add to your cart, STAT. And to top it all off? Insight from the pros as to why you should add ’em to your cart.

1. One A Day Women’s Prenatal 1 Multivitamin

One A Day Women’s Prenatal 1 Multivitamin ONE A DAY amazon.com $40.46

This is the most popular brand of prenatal vitamins on the market, and it’s a solid choice, says Hillary Wright, MEd, RD, director of nutrition counseling at Boston IVF and an expert in prenatal nutrition.

It’s not necessarily fancy, but it gets the job done for a reasonable price and, best of all, it’s been verified by an independent lab so it actually contains what it says it contains, she adds. (Which isn’t always the case with supplements as they’re not monitored by the FDA.)

2. Nature Made Prenatal + DHA 200 mg Multivitamin

Prenatal + DHA 200 mg Multivitamin Nature Made amazon.com $29.99 $19.82 (34% off)

The best thing about this prenatal vitamin: a large dose of DHA, a fatty acid crucial to fetal brain development, Wright says.

“A lot of prenatals advertise they have this but they have a minuscule amount—you want a minimum of 200 mg of DHA per serving,” she says. You can also get DHA by taking a separate fish oil supplement.

3. Mama Bird Prenatal Multivitamin

Mama Bird Prenatal Multivitamin Best Nest Wellness amazon.com $32.99

These vitamins contain “methylated folate”—a pretty buzzy word in the prenatal vitamin world. Folate is one of the most important vitamins in prenatal pills, but some women have a genetic condition that makes it hard for their bodies to convert the folic acid in most prenatals to the active form the body can use, Wright explains.

But there’s a catch: You won’t know if you have the condition unless you have genetic testing done. So if you want to be super-safe and cover all your bases, then a methylated version of folate might be worth the money. Still, she emphasizes that for the majority of women, the regular (and more affordable) variety is just fine.

4. TheraNatal Complete Prenatal Vitamin & Mineral Supplement

TheraNatal Complete Theralogix amazon.com $75.00

This prenatal is Wright’s personal favorite and the one she recommends to her clients. It contains iodine and choline—two minerals vital to hormone regulation, fetal growth, and brain development—that are often missing from other prenatal vitamins.

Ideally, you want 150 micrograms of iodine and 450 milligrams of choline (which also is, btw, a key nutrient in eggs) every day, according to Wright, who also notes that this product in particular is also independently tested and has a high standard of quality.

There is one major downside: They don’t come cheap. These are by far the most expensive OTC option on the list, although you may be able to get them cheaper through your doctor or buying them directly from .

5. Ritual Prenatal Vitamins

Essential Prenatal Ritual ritual.com $35.00

These vitamins are great because of what they don’t have: calcium. “Calcium and iron compete with each other for absorption,” says Alyssa Dweck, MD, an ob-gyn in Westchester County, New York, and co-author of V Is for Vagina. “I recommend getting iron from a vitamin and calcium from your diet,” she says, since it’s much easier to get calcium from foods (think: dairy, greens) than iron.

These vitamins’ minty favor is a nice bonus for women experiencing morning sickness, as mint is known to control nausea, Dr. Dweck explains.

6. Thorne Basic Prenatal

Thorne Basic Prenatal amazon.com $27.00

This one’s another great choice, according to Felice Gersh, MD, a board-certified ob-gyn and director of Integrative Medical Group of Irvine in Irvine, California, because it also contains the methylated forms of folate and B12. Plus it also has more even more folate (a full milligram more, in fact) than most vitamins out there, which makes it ideal for women who don’t get enough green leafy vegetables into their diet.

Another plus? “This vitamin is also high in vitamin D and provides a healthy blend of calcium citrate and malate, though it does take three capsules daily though to get these amounts,” she says, which differs from the usual one-pill regiment for most prenatal vitamins.

7. Garden of Life Vitamin Code Raw Prenatal

Vitamin Code Raw Prenatal Garden of Life amazon.com $29.99

In addition to being a good source of vitamin D, it also offers a blend of vitamin A, which is known for being beneficial for your (and your fetus’) eyes per WHO, and contains ginger to soothe nausea, probiotics that support your immune system, and an organic vegetable blend.

“This is a great option for women looking for a very affordable option without any unhealthy binders and fillers,” Dr. Gersh adds.

8. Vitapearl

Prenatal Multivitamin With DHA VitaPearl goodrx.com $126.18

Unlike the others on the list thus far, this small, easy-to-tolerate (read: less risk of GI distress) pill is only available through an Rx from your doc. So now you’re probably wondering: is a prescription prenatal better than an OTC? Not necessarily, according to Dr. McDonald, who says she doesn’t having a preference for one over the other.

What draws people to an Rx option rather than the more “trendy” OTC products is that your health insurance might cover the cost if the specific prenatal is fits your plan, Dr. Dweck explains. If that sounds like something you’d be interested in, consult your insurance plan to see what, if any prenatal vitamins, are covered and then chat about it further with your doc.

9. OB Complete One (+ Petite)

OB Complete One goodrx.com $185.62

This prescription option recommended by Dr. McDonald stands outs for being loaded with iron—40 mg to be exact—which is particularly great because, per ACOG, during pregnancy your body needs extra iron to help make more blood to carry all that oxygen to the fetus. Just be sure to avoid eating or drinking dairy within 30 minutes of taking this vitamin, as the calcium can interfere with iron absorption, she explains.

10. Prenate Mini

Prenate Mini goodrx.com $236.08

If even the word “vitamin” freaks out out (hi, huge horse pills), Dr. McDonald recommends Prenate Mini, the micro vitamin that still provides you with the essential nutrients needed for a healthy pregnancy. Of particular note is its large amount of DHA—350 mg—which should free you from potentially having to take an added DHA supplement.

Quick reminder: DHA is a type of omega-3 fatty acid (you know, the brain-boosting fat that you can frequently find in fish). Omega-3 fatty acids are believed to play in an important role in the fetus’ brain development before and after birth, according to ACOG, which is why extra DHA is super important.

Charlotte Hilton Andersen Charlotte Hilton Andersen has been a health and fitness writer for 12 years and is the author of The Great Fitness Experiment. Elizabeth Bacharach Elizabeth Bacharach is the Assistant Editor at Women’s Health where she writes and edits content about mental and physical health, food and nutrition, sexual health, and lifestyle trends across WomensHealthMag.com and the print magazine. Kristin Canning Kristin Canning is the health editor at Women’s Health, where she assigns, edits and reports on emerging health research and technology, women’s health conditions, psychology, mental health, wellness entrepreneurs, and the intersection of health and culture for both print and digital.

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