Should You Take Iron During Pregnancy?

Pregnancy is truly a miracle of life, but many people think it’s something that happens naturally and effortlessly. TV shows and movies make it seem like getting pregnant is an easy task. But if you’re one of the 12 percent of women in the United States who has difficulty getting pregnant or carrying a pregnancy to term, then you know that having a baby is not nearly as easy as it’s made out to be. (1)

Adding insult to injury, birth defects and significant pediatric health conditions are also on the rise. At least one in every 33 pregnancies in the U.S. will result in birth defects such as Down syndrome, spina bifida, and congenital heart defects. (2) Rates of developmental disabilities in U.S. children are even higher: more than 1 in 6 children will develop a learning disability, autism, or ADHD, to name a few. (3) A growing number of pediatric diseases are also being diagnosed annually, such as cancer and diabetes. (4) While these statistics are scary to think about, we should take comfort in knowing that there is something we can do to support a healthy pregnancy, fertility, and a healthy baby.^†

Click here to learn more about prenatal supplements for before, during, and after pregnancy.

Nutrition During Pregnancy

If you’re pregnant, considering becoming pregnant, breastfeeding, struggling with infertility, or just wanting to support healthy fertility, then optimizing your nutrition is of the utmost importance. The nutrients from the food we eat before, during, and after pregnancy provide the building blocks required to grow a robust baby. The reality is that giving birth to a healthy child begins before we are even pregnant. Sadly, many women are lacking the essential nutrients required to have a healthy pregnancy and baby.

We live in a time where it’s increasingly difficult, if not impossible, to obtain optimal nutrition through diet alone. The soils where most vegetables and fruits grow are overused and have become depleted. This results in produce that is lacking in essential nutrients. Nobody likes to think about it, but many animals are administered growth hormones, antibiotics, and are raised in unsanitary and downright cruel conditions. This translates to meat that is inflammatory and tainted with hormones and antibiotics which we then ingest! The saying “you are what you eat” is true but also frustrating, because in this day and age, it can be difficult to find and afford foods that meet all of our nutritional requirements.

Bioavailable Nutrients for Pregnancy

The good news is that we also live in an era where modern science has developed ways to work around the declining bioavailability of nutrients in food. While it’s still important to eat as well as possible, we can also supplement our diets to ensure that we’re covering our nutrient bases to support a healthy pregnancy and to give birth to a thriving child.

Most women are aware that taking a prenatal vitamin during pregnancy is important, but may fail to realize that all prenatals are not created equally. Many prenatal vitamins on the market contain vitamins and minerals in a form that is not bioavailable, meaning they are not well absorbed or utilized by the body.

Dr. Ben Lynch is a world-renowned naturopathic doctor and creator of the award-winning line of Seeking Health prenatal supplements. He emphasizes that the following nutrients are essential in a prenatal vitamin:^†

• Vitamin A (in an active form like retinol or retinyl palmitate)
• Active, true folate (as methylfolate or folinic acid)
• Calcium (in a bioavailable form like dicalcium malate)
• Choline (as choline bitartrate)
• Active Vitamin B12 (methylcobalamin, adenosylcobalamin, or hydroxocobalamin forms)
• Vitamin D (in the active vitamin D3 form)
• Vitamin K2 (as menaquinone-7)

Obtaining these nutrients in their activated and bioavailable forms (listed in parenthesis above) is extremely important because these are the forms that our bodies are designed to absorb and use. Many multivitamins and prenatal supplements contain nutrients that are not bioavailable. This means they are not well utilized by the body often because they are inactive forms that are difficult for the body to recognize, absorb, and utilize.^†

In addition, some prenatals contain unnecessary ingredients and fillers that may not be well tolerated and can trigger allergies or inflammation in the body. It’s important to read nutrition labels on your supplements very carefully when selecting a prenatal vitamin, or to choose a well-known and reputable product. Seeking Health Prenatal Vitamins are formulated by Dr. Ben Lynch, are recipients of the Women’s Choice Award for the best prenatals available, and contain nutrients in their activated and bioavailable forms, without any fillers or inflammatory ingredients.^†

Calcium vs. Iron During Pregnancy

Just because a prenatal supplement lists an abundance of different vitamins and minerals on the label, doesn’t mean that your body is able to extract all of those nutrients and utilize them effectively. In fact, many nutrients actually compete for absorption in the gut, like calcium and iron. 

Nutrients derived from our diets and supplements are absorbed through receptors located in the cells that line the wall of our small intestine. Once absorbed, these nutrients are then transferred into the bloodstream where they can be used by the body. These receptors are much like a door which only allows in certain nutrients while excluding others. Some nutrients share the same receptor doors which results in competition for entrance into the body. For example, taking too much iron will make it difficult for calcium to be absorbed into the body (and vice versa) because calcium and iron compete for absorption at the same receptor sites in the small intestine. 

Calcium is an essential mineral during pregnancy required for the development of healthy muscles, teeth, bones, heart rhythm, and blood flow. Low calcium intake during pregnancy has been correlated with the development of preeclampsia, a major health risk for women and their offspring that complicates approximately 10 percent of pregnancies. (5) Several randomized, placebo-controlled studies have found that calcium supplementation during pregnancy significantly reduces the risk of developing high blood pressure and preeclampsia, and also decreases the risk of preterm birth. (6)

Iron is another important mineral used for oxygen transport, DNA synthesis, energy production, and more. The amount of iron needed in pregnancy varies widely between women. Some women will need to take iron, while others should avoid supplementation altogether. Because the body excretes very little iron, it can readily accumulate and lead to iron overload.

Too much iron in the body can become toxic and act as a free radical. Excess levels of iron in the body can also lead to some uncomfortable side effects like constipation, diarrhea, nausea, and vomiting. Iron is also the leading cause of poisoning fatalities in children, so be sure to keep your iron-containing supplements out of the reach of little ones! (7)

While iron supplements can be important for women who have iron deficiency anemia, it’s important to realize that not all types of anemia are related to low iron levels. For example, anemia can also be caused by low levels of folate or vitamin B12. If you have anemia, be sure to work with a knowledgeable doctor who can identify whether your anemia is related to low iron, folate, B12, or another cause.

Should You Take Iron If You’re Pregnant?

Whether or not you should supplement with iron during your pregnancy depends on your unique biochemistry and your current iron status. Laboratory tests that assess your blood levels of iron and ferritin can give insight into this. It’s important to test and not guess! Only your doctor can assess if you should be regularly supplementing with iron. Ongoing lab work to monitor your levels will guide your doctor in determining the right iron dosage for you. If you discover that you don’t need to be taking iron, be sure to choose an iron-free prenatal vitamin. However, it can be difficult to find a quality prenatal that does not include iron as many prenatal vitamins routinely include it.

Because the amount of iron needed during pregnancy can vary widely (and because iron competes with calcium for absorption), Dr. Lynch has taken special care to formulate his line of prenatal supplements to be iron-free while supplying you and your baby with sufficient amounts of calcium and other nutrients (in their active, bioavailable forms) that are critical for a healthy pregnancy. The benefit of supplementing iron separately is that it can be dosed as needed to keep iron levels in the optimal range. Be mindful to take your iron at a different time than your prenatal vitamins, to minimize the competition between iron, calcium, and other minerals.^†

The Bottom Line

If you’re pregnant or thinking about becoming pregnant, struggling with infertility, experiencing recurrent miscarriages, or breastfeeding, then maintaining optimal nutrient levels should be number one on your priority list. The health of our children is directly correlated to the nutrients they receive in utero and through breastmilk, so eating a healthy diet that includes plenty of leafy green vegetables and pastured meats should be prioritized.

In a world where the nutrition of foods has become less than ideal, it is also wise to take a quality prenatal vitamin before, during, and after pregnancy. Routine bloodwork can help determine if you should be supplementing with iron. Because calcium and iron compete for absorption in the gut, it’s a good idea to take an iron-free prenatal vitamin and supplement separately with iron if needed. If you’re looking for a quality iron-free prenatal vitamin or other highly absorbable supplements in their active and bioavailable forms, check out Dr. Lynch’s entire line of award-winning Seeking Health dietary supplements.^†

References

1. https://www.cdc.gov/reproductivehealth/infertility/index.htm
2. https://www.cdc.gov/ncbddd/birthdefects/index.html
3. https://www.cdc.gov/ncbddd/developmentaldisabilities/features/birthdefects-dd-keyfindings.html
4. https://www.ncbi.nlm.nih.gov/pubmed/19464502
5. https://www.ncbi.nlm.nih.gov/pubmed/24960615
6. https://journals.findlay.edu/index.php/ARxCH/article/download/45/49