TTC and vitamins

Discussion in 'Fitness & Pregnancy' started by fit'n'healthy, Aug 17, 2006.

  1. fit'n'healthy

    fit'n'healthy Senior Member

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    So...I had my annual checkup yesterday, and mentioned to the doctor that my husband and I are planning on TTC next May. She told me to get on a prenatal vitamin right away, even though its almost a year off. She gave me a prescription for one, that has twice the amount of folic acid of the kind you can find over the counter (I can't remember the name). I think that it is too early to start taking them, but I talked to my sister who is a nurse and she said to go ahead and take them. The folic acid prevents spina bifida which occurs about 3 weeks into a pregnancy before most people even know, so in case you accidentaly get pregnant it is a good thing to be taking regardless.

    I thought my husband would freak out, but he didn't and was fine with it. I'm wondering how early those that are TTC or have children started taking a prenatal. I noticed that the prenatal doensn't have some of the other vitamins in my multi. Would it be ok to alternate my multi w/ the prenatal? (every other day?)

    Thanks!!
     
  2. colo1278

    colo1278 I'm growing a person!

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    I went off the pill in Feb and on a prenatal right away, hoping to get pregnant starting in April. My gyno reccomended at least three months on the prenatals, and from what i have read on the internet, that's the reccomended MINIMUM.

    Do what you feel is right, but think about your baby's health too. Like yu said, you might be a month or so along before you even realize you are pregnant and that first month is critical to the baby's development.

    Maybe try to find another prenatal that matches your regular daily better, or take the prenatal and supplement (with single ingredient pills or diet) with the ones you are missing.

    IMO, it's best to always do what your doc says and also err on the safe side.
     
  3. Ana

    Ana Think back...Move forward

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    Prenatal is all you need really ;)
     
  4. strongchick

    strongchick Well-Known Member

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    Yup, best to start early.
     
  5. homeschoolmom

    homeschoolmom Well-Known Member

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    I started mine early as well, but the extra iron in the prenatals totally messed with my stomach. So I ended up taking a regular vitamin plus an extra folic acid vitamin. Then when I finally got pregnant, I ended up taking Flintsones because they were the only ones I didn't throw up. Just do your best to get that folic acid in.
     
  6. smiles:)

    smiles:) Member

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    Iron wrecks havoc for a lot of people. Read: constipation. I'm not sure why you couldn't just add and extra folic to your regular supplementation. I bet it would be a lot cheaper, too. Then as you get closer take the prenatals.
     
  7. colo1278

    colo1278 I'm growing a person!

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    yeah that would prob be fine- the folic acid is what helps prevent the neural tube defects like spina bifida.

    This article says you only need the iron when you are actually preg to help prevent iron-deficient anemia.
    http://www.babycenter.com/refcap/pregnancy/pregnancynutrition/287.html

    edit to add: I didn't notice any bad effects of taking the prenatals, except nausea once, so I started taking them at night.
     
  8. Aaron_F

    Aaron_F A Grade Asshat

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    Neural tube defects like anencephaly, encephalocele, and spina bifida occur during organogenesis, and normal neural tube closure occurs ~30 days following conception. Folic acid supplementation (and in reality B12 should be in there as well) should occur prior to the pregnancy to be effective, as it takes time for the levels to reach the level to required to provide the lowest risk of NTD's.

    Folic acid reduces the risk of NTDs it does NOT prevent NTDs.
     
  9. colo1278

    colo1278 I'm growing a person!

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    Right. I read it reduces the chance though by nearly 70%. Pretty good odds! :)
     
  10. homeschoolmom

    homeschoolmom Well-Known Member

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    I noticed you stressed B-12 as well. Why the extra B-12? I know it's important for pregnant vegetarians, but am not sure of it's function otherwise. Thanks!
     
  11. fitnesschick

    fitnesschick Member

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    B12 is needed for healthy nerve tissue, fetal brain development, the production of genetic material, proper cell division and the metabolism of nutrients. there can be problems if you are taking folic acid and your B12 levels are low and you are not supplementing with B12, so it's a good idea to take them together.

    supplements are not necessary for every women, especially if you eat really really well. i think it's a good idea to keep in mind too that supplements do not replace good nutrition. herbs are also a really good way to boost your diet.
    but for the rest of pregnant women, supplements have their place.
     
    Last edited: Aug 18, 2006
  12. Aaron_F

    Aaron_F A Grade Asshat

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    While it has other roles (as mentioned above) one of the proposed mediators of increased NTD risk is a raised blood level of the sulphur amino acid homocysteine.
    One of the major determinants of blood homocysteine is blood folic acid concentrations, with other factors including Vitamin B12 and in some cases B6.
    Not all trials are able to pinpoint a role for B12 in NTD pathogenesis, mainly becuase the effect of B12 is far smaller than folic acid (it is harder to statistically show a relationship between the two items when the effect is very small).
    No human trials can be performed to examine the true relationship between B12/folic acid and development of NTDs as this would be unethical.

    See

    Possible basis for primary prevention of birth defects with folic acid.

    * Eskes TK.

    Department of Obstetrics and Gynaecology, University Hospital, Nijmegen, The Netherlands.

    Prepregnancy counselling is efficient in cases of chronic maternal disease, selection of medication and avoiding bad life habits. A new policy is the use of folic acid in the periconceptional period for the purpose of reducing the chance of having a baby with neural tube defects (NTD). Research in progress at the Department of Obstetrics and Gynaecology in Nijmegen, the Netherlands, is presented demonstrating that a derangement of methionine-homocysteine metabolism could be the underlying mechanism of pathogenesis and prevention with folic acid. Such derangement was found in +/- 20% of cases with NTD, recurrent miscarriage and placental infarcts (abruption) and offers new possibilities for primary prevention in three major areas.

    Maternal hyperhomocysteinemia: a risk factor for neural-tube defects?

    * Steegers-Theunissen RP,
    * Boers GH,
    * Trijbels FJ,
    * Finkelstein JD,
    * Blom HJ,
    * Thomas CM,
    * Borm GF,
    * Wouters MG,
    * Eskes TK.

    Department of Obstetrics and Gynecology, University Hospital St Radboud, Nijmegen, The Netherlands.

    The maternal vitamin status, especially of folate, is involved in the pathogenesis of neural-tube defects (NTDs). Maternal folate administration can prevent these malformations. The precise metabolic mechanism of the beneficial effect of folate is unclear. In this study we focus on homocysteine accumulation, which may derive from abnormalities of metabolism of folate, vitamin B12, and vitamin B6. We studied nonpregnant women, 41 of whom had given birth to infants with NTDs and 50 control women who previously had normal offspring. The determinations included the plasma total homocysteine both in the fasting state and 6 hours after the ingestion of a methionine load. In addition, we measured the fasting blood levels of folate, vitamin B12, and vitamin B6. The mean values for both basal homocysteine and homocysteine following a methionine load were significantly increased in the group of women who previously had infants with NTDs. In nine of these subjects and two controls, the values after methionine ingestion exceeded the mean control by more than 2 standard deviations. Cystathionine synthase levels in skin fibroblasts derived from these methionine-intolerant women were within the normal range. Our findings suggest a disorder in the remethylation of homocysteine to methionine due to an acquired (ie, nutritional) or inherited derangement of folate or vitamin B12 metabolism. Increased homocysteine levels can be normalized by administration of vitamin B6 or folate. Therefore, we suggest that the prevention of NTDs by periconceptional folate administration may effectively correct a mild to moderate hyperhomocysteinemia.




    Maternal plasma folate and vitamin B12 are independent risk factors for neural tube defects.


    * Kirke PN,
    * Molloy AM,
    * Daly LE,
    * Burke H,
    * Weir DG,
    * Scott JM.

    Health Research Board, Dublin.

    Blood was taken at the first antenatal clinic from 56,049 pregnant women. Neural tube defect (NTD) pregnancies (81) were compared to controls (247) for plasma vitamin B12 (B12) (ng/l), plasma folate (microgram/l), and red cell folate (RCF) (microgram/l). Median values were significantly different and were, respectively, 243 and 296 (p = 0.001); 3.47 and 4.59 (p = 0.002); and 269 and 338 (p < 0.001). There was a significant correlation between plasma B12 and RCF in cases (r = 0.31, p = 0.004) but not in controls (r = 0.02, p = 0.725). In cases only, multiple regression showed that both plasma B12 and plasma folate influenced the maternal RCF (multiple r = 0.68, p < 0.001). Plasma folate and plasma B12 were independent risk factors for NTDs, suggesting that the enzyme methionine synthase is involved directly or indirectly in the aetiology. The levels of folate and B12 where increased risk occurred were not those usually associated with deficiency, calling for a re-evaluation of their recommended daily allowances. Whether the aetiology is purely nutritional or a metabolic defect, this study suggests that consideration should be given to including B12 as well as folic acid in any programme of supplementation or food fortification to prevent NTDs.

    Maternal plasma folate and vitamin B12 are independent risk factors for neural tube defects.


    * Kirke PN,
    * Molloy AM,
    * Daly LE,
    * Burke H,
    * Weir DG,
    * Scott JM.

    Health Research Board, Dublin.

    Blood was taken at the first antenatal clinic from 56,049 pregnant women. Neural tube defect (NTD) pregnancies (81) were compared to controls (247) for plasma vitamin B12 (B12) (ng/l), plasma folate (microgram/l), and red cell folate (RCF) (microgram/l). Median values were significantly different and were, respectively, 243 and 296 (p = 0.001); 3.47 and 4.59 (p = 0.002); and 269 and 338 (p < 0.001). There was a significant correlation between plasma B12 and RCF in cases (r = 0.31, p = 0.004) but not in controls (r = 0.02, p = 0.725). In cases only, multiple regression showed that both plasma B12 and plasma folate influenced the maternal RCF (multiple r = 0.68, p < 0.001). Plasma folate and plasma B12 were independent risk factors for NTDs, suggesting that the enzyme methionine synthase is involved directly or indirectly in the aetiology. The levels of folate and B12 where increased risk occurred were not those usually associated with deficiency, calling for a re-evaluation of their recommended daily allowances. Whether the aetiology is purely nutritional or a metabolic defect, this study suggests that consideration should be given to including B12 as well as folic acid in any programme of supplementation or food fortification to prevent NTDs.

    Dose-dependent effects of folic acid on blood concentrations of homocysteine: a meta-analysis of the randomized trials.

    * Homocysteine Lowering Trialists' Collaboration.

    BACKGROUND: Dietary supplementation with B vitamins that lower blood homocysteine concentrations is expected to reduce cardiovascular disease risk, but there has been uncertainty about the optimum regimen to use for this purpose. OBJECTIVE: The objectives were to ascertain the lowest dose of folic acid associated with the maximum reduction in homocysteine concentrations and to determine the additional relevance of vitamins B-12 and B-6. DESIGN: A meta-analysis of 25 randomized controlled trials involving individual data on 2596 subjects assessed the effect on plasma homocysteine concentrations of different doses of folic acid and of the addition of vitamins B-12 and B-6. RESULTS: The proportional reductions in plasma homocysteine concentrations produced by folic acid were greater at higher homocysteine (P < 0.001) and lower folate (P < 0.001) pretreatment concentrations; they were also greater in women than in men (P < 0.001). After standardization for sex and to pretreatment plasma concentrations of 12 micromol homocysteine/L and 12 nmol folate/L, daily doses of 0.2, 0.4, 0.8, 2.0, and 5.0 mg folic acid were associated with reductions in homocysteine of 13% (95% CI: 10%, 16%), 20% (17%, 22%), 23% (21%, 26%), 23% (20%, 26%), and 25% (22%, 28%), respectively. Vitamin B-12 (x: 0.4 mg/d) produced 7% (95% CI: 4%, 9%) further reduction in homocysteine concentrations, but vitamin B-6 had no significant effect. CONCLUSIONS: Daily doses of > or =0.8 mg folic acid are typically required to achieve the maximal reduction in plasma homocysteine concentrations produced by folic acid supplementation. Doses of 0.2 and 0.4 mg are associated with 60% and 90%, respectively, of this maximal effect.
     
    Last edited: Aug 18, 2006
  13. fit'n'healthy

    fit'n'healthy Senior Member

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    Thanks, I meant to say "helps prevent" or reduces the risk, instead of prevents. Thanks for all the good info you have shared!
     
  14. fitnesschick

    fitnesschick Member

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    thanks for the great info aaron :)
     
  15. homeschoolmom

    homeschoolmom Well-Known Member

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    Wow Aaron! Thanks! Cardiovascular disease runs in our family and my mother has been taking extra folic acid and B-12 for several years now(and has bugging me to do it as well). It's interesting to me that homocysteine levels are also implicated in neural tube defects. Thanks for sharing the study!:wave:
     
  16. Aaron_F

    Aaron_F A Grade Asshat

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    Dont bank on it reducing the risk for CVD either :( most trials to date have shown no effect :(
     
  17. andi

    andi anyone selling sleep?

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    Hmm, I wonder why my OB didn't prescribe me to take any prenatals:confused: and my app isn't until 4 weeks from now!
     
  18. colo1278

    colo1278 I'm growing a person!

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    that is odd. I would either call them now and ask for an Rx or even better, just go get an over-the-counter one yourself.
     
  19. jrb1980

    jrb1980 Well-Known Member

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    Regarding iron, note that inadequate iron intake can cause fatigue, as well as premature delivery of a low birth weight baby.
     

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