Prenatal Supplements & Why I Don’t Recommend Elevit
One of the tools a naturopath utilises in practice alongside herbal medicines and lifestyle suggestions is supplements. Naturopaths have access to “practitioner-only” supplements, they require a qualified practitioner to prescribe them as they contain the therapeutic dose of nutrients. The therapeutic dose of a product refers to the amount of a nutrient needed to produce a desired outcome i.e. the amount of folate needed during pregnancy to support foetal neural tube development. Practitioner-only products are governed and regulated by the Therapeutics Goods Administration (TGA) ensuring they are of high quality and have data to support their claims.
However, “over-the-counter” (OTC) supplements are becoming increasingly popular, so much so that you can find them in major supermarket chains and their use is widely advertised. The reason supplements are able to be sold OTC without a practitioner prescription is due to the low dose of the listed nutrients and constituents (possibly rendering the product ineffective), the TGA regards these products as “low risk”.
“For low-risk medicines, the TGA does not evaluate the commercial sponsor's evidence of product efficacy before the product goes on the market, nor do we examine the final product and its label.” ~ TGA.
With the TGA determining OTC supplements “low-risk” due to their low dose, they are unlikely to be effective in correcting underlying nutritional deficiencies or in providing support in times of increased need. A lack of regulation regarding evidence and product labelling can be misleading for consumers.
Why I Don’t Recommend Elevit
Elevit is advertised as an OTC preconception, prenatal and postnatal supplement to support women through the different stages of pregnancy. During the preconception, pregnancy and postpartum phases, there is an increased need for specific nutrients that diet alone may not always be able to meet and therefore supplementation can support the process. Elevit is a low dose, OTC product that does not contain some of the nutrients essential to pregnancy, does contain some that aren’t essential and in forms that may not be the most bioavailable (well absorbed).
Key Nutrients
Folate vs. Folic Acid
These words have come be to used interchangeably, however this is incorrect as the word “folate” is a general term use to cover various compounds including folic acid, folinic acid and 5-MTHF. Each word has come to be associated with the prevention of neural tube defects. Folic acid does not naturally occur in foods and refers to a synthetic form that is used in some supplements and fortified foods. Folic acid requires a number of reactions and catalysts to be activated in order to function within the body – these processes can be more work for the body and can decrease intended outcome of the compound.
Folinic acid and 5-MTHF occur naturally in foods and can be found in high quality supplements, these compounds are considered already “activated” – enabling the body better absorption and increased speed of raising folate status. Elevit contains the synthetic form; folic acid.
Iron
Elevit contains iron in the form of Ferrous Fumarate, in a 2013 study that compared tolerability of different oral iron supplements ferrous fumarate showed to be the least tolerable and most likely to cause gastrointestinal effects such as constipation. Iron may aggravate the symptoms of morning sickness in some women and routine iron supplementation may not be recommended at all stages of pregnancy.
B12
Elevit contains the less bioavailable version of B12 which similar to folic acid requires extra work for the body to convert it to a compound that is easily used, B12 is essential for brain health and neural tube development.
Choline
An imperative nutrient for healthy brain and neural tube development, Elevit does not contain choline!
Vitamin D
The recommended daily dose of Vitamin D for pregnancy women ranges from 1000IU to 2000IU and is important for foetal bone development, maternal blood pressure regulation, prevention of miscarriage & postnatal depression. Elevit contains 200IU – for reference you would get more vitamin D by walking from your home to your car than from Elevit.
Zinc
Zinc plays an important role in the construction of baby’s cells and DNA as well as the foundations for the immune system and reducing poor maternal outcomes. The form of zinc in Elevit (zinc sulfate) is less bioavailable and has been reported to cause gastrointestinal irritation – not fun for those already experiencing nausea and morning sickness.
Copper
Copper is essential for the formation of red blood cells, baby’s heart, blood vessels, skeletal and nervous system. Copper naturally rises during pregnancy and supplementation may be unnecessary as too much copper can displace zinc. Elevit contains 1mg of copper and a very small amount of zinc, overtime this could create a zinc deficiency and copper toxicity in the pregnant woman.
As a naturopath I am qualified to prescribe high quality supplements specific to the individual’s needs, your health and pregnancy is not a one-size-fits-all.
There are some great companies that provide clinically formulated over-the-counter supplements with the active form of key nutrients. Here are my prenatal supplement suggestions: