The risks of taking too many supplements

Both you and your baby have very specific nutritional needs. There are times when these go beyond what can be provided by a healthy, balanced diet. And let’s face it: none of us eats a perfect diet.

That’s where dietary supplements come in, and why health care professionals consistently advise to take them before, during, and even after your pregnancy. But when taking dietary supplements, the common belief that ‘the more the better’ doesn’t apply. It’s important to get just the right amount of the supplements you need, to skip what you don’t need, and to make sure you don’t take too much of certain nutrients that have can be harmful if taken too much.

Young pregnant woman taking supplements

Additionally, it is important to consider that the totality of your daily nutrient intake (called “Daily Values” in pre- and post-natal supplements), should be a combination of the micronutrients from your food, and those in your supplements. The combination of both of them should stay within healthy limits, especially during pregnancy.

For some nutrients there is a relatively narrow range of safe intake, like vitamin A and folic acid. For these nutrients in particular it is important to make sure you are not going overboard with the combination of fortified foods and dietary supplements or multivitamins.

Folic acid: worth considering

Folate, or folic acid, is an essential water-soluble B-vitamin. Folate is the name of the naturally occurring nutrient found in food. The synthetic form, in supplements or fortified foods, is called folic acid. Folate and folic acid are vital for the formation of the brain and spinal cord from the neural tube and plays a role in supporting your baby’s brain development.

While pregnant, the US Public Health Service recommends taking a dietary supplement of 400 mcg of folic acid daily. You may require additional folic acid if you are carrying multiples, you have a history of neural tube defects, are overweight or have diabetes or epilepsy. In combination with a healthy balanced diet that includes dark leafy vegetables, fruits, nuts, beans, and whole grains; you should be getting the recommended daily allowance for pregnant women, which is 600 mcg of folate.

Interestingly many prenatal dietary supplements contain 800 mcg or more of folic acid. Adding that to the fact that many foods are enriched with folic acid (breads, cereals, flours, and other grain products), the total amount of folic acid you would consume in a day brings a potential risk of going above the desired daily limits.

Although there is a great and essential benefit for getting sufficient amount of folate, taking too much can be detrimental to your health.So our recommendation for a safe folate intake is to consume a varied diet containing natural food folate, to take a daily prenatal supplement that contains 400 mcg of folic acid and to make sure not to go overboard with foods fortified with folic acid. Always check with your doctor whether your personal situation warrants additional folic acid.

Vitamin A: focus on dietary intake should be sufficient

Vitamin A is a fat-soluble vitamin that is naturally present in many foods. It is best known for its role in vision, but it is also important to support immunity and reproduction. During pregnancy, vitamin A is necessary for cell division and for cell differentiation, which occurs during the first trimester, when the body decides which cells will become part of your baby’s brain, muscle, bones, blood, and all other tissue.

There are two different types of vitamin A. The first type, preformed vitamin A, is found in meat, poultry, fish, and dairy products. The second type, provitamin A, is found in fruits, vegetables, and other plant-based products. The most common type of provitamin A in foods and dietary supplements is beta-carotene.

Consuming excessive amounts of vitamin A as retinol (the preformed form and often called vitamin A acetate or palmitate) is detrimental to your child’s development. I. Beta-carotene, the raw material the body converts to vitamin A is safer for you and your baby. Studies suggest that only few people in the US are deficient in vitamin A. Considering that you should be able to get the required vitamin A intake from your diet and the potential negative effects of over supplementation for your baby, we recommend choosing a prenatal vitamin that has no vitamin A or a maximum of 3,000 International Units (IU) and ideally a majority of its form as beta-carotene.

What to Do

  • Focus on eating a variety of foods, using the Dietary Guidelines and My Plate to guide you in your choices. A dietary supplement can provide a safety net against deficiencies, but it is only a complement to a rich, varied, healthy diet.
  • Be aware of fortified foods you regularly eat as this also adds up to your daily dose of nutrient intake.
  • Choose a pre- or post-natal supplement with Daily Values that together with your food intake do not exceed the recommended daily amount unless otherwise specified by your doctor.
  • If you are taking dietary supplements, make sure you follow the instructions and the dosage indicated on the label, unless otherwise indicated by your doctor.
  • Do not self-diagnose nutrient deficiencies for you and your baby. Avoid taking multiple dietary supplements, unless recommendedby your doctor.
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