What to look for in your prenatal

What to Look for In Your Prenatal

Optimizing your health before trying to conceive as well as during pregnancy can help improve the overall health of your future baby. Along side a healthy diet I generally recommend starting a good quality prenatal vitamin.

Both men and women should consider starting a prenatal or preconception multivitamin about three months before trying to conceive. For women I then recommend continuing the prenatal during pregnancy and while nursing to help prevent nutrient deficiencies.

There are several nutrients that when not at optimal levels can have a negative impact on both overall health, conception rates and health pregnancy. When choosing a prenatal you should be aware that there are more and less desirable forms of several vitamins.

You want to ensure that the

  • Dose is between 2-4 capsules per day (A one-a-day will not be able to provide the essential nutrients that you require)
  • Free of dyes, talc and other unnecessary additives.
  • Ideally the prenatal will be in a capsule or liquid format for optimal absorption instead of a hard-packed tablet that can be more difficult to absorb nutrients from.

Here are some key things to look for:


Taking either folate or 5-methyltetrahydofolate (5-MTHFR) will be better utilized then folic acid which is synthetic and not as easily converted to its active form. Approximately 50% of the population has a reduced ability to convert synthetic folic acid to its active form 5-MTHFR. If you are one of these individuals and are not consuming the active 5-MTHFR form, this can contribute to higher rates of infertility, miscarriage, and neural tube defects. For this reason, if I don’t know the genetic status of my patient, I recommend a supplement with the active form of folate 5-MTHFR.


The number 1 reason most women stop taking a prenatal vitamin is because it causes constipation. Therefore, it is very important to check what form your iron is as some absorb as low as 5% and others have absorption closer to 100%. The side effects of iron come from it staying in your intestines instead of being absorbed so this is super important when choosing your prenatal.

Making sure your iron is at an optimal level before trying to conceive as well as during pregnancy is very important. If iron is low this can impact the ability for your body to circulate both nutrients and oxygen necessary to sustain a healthy pregnancy. Heme iron or iron glycinate forms are both well absorbed and are generally well tolerated causing very little constipation, while seeing good improvements in iron levels.


B12 comes in different forms with methylcobalamin being one of the active forms that is more easily absorbed. B12 is a nutrient that is important for neurological development and for DNA replication. Ensuring optimal levels is both important for development your egg during preconception as well as overall health for the baby during your pregnancy.

Vitamin D

Low vitamin D can contribute to bone loss, depression, sleep disorders, immune deficiencies, and hormonal imbalances. There are also multiple studies that have shown deficient vitamin D can impair the body’s ability to achieve, as well as maintain, a pregnancy.


Calcium is important during pregnancy as it aids in development of musculoskeletal, nervous and circulatory systems. Between diet and supplemental sources you need around 1000mg/day. Most diets in North America provide between 400-1000mg/day so you do not need to get 1000mg from supplementation. For calcium to absorb properly the ideal form is a citrate or MCHC form. Calcium carbonate which is often used in antacid medications helps with heartburn but isn’t well absorbed. Calcium can also compete with iron for absorption. If the prenatal has iron in an iron glycinate form this form absorbs in the small intestine and doesn’t compete with calcium so you improve the absorption of both.


Magnesium is a mineral that is used in hundreds of pathways in the body. It is important for development of muscle, nerve and immune function. Deficiency in magnesium can contribute to preeclampsia (high blood pressure in pregnancy) so it is important to ensure you are getting enough during your pregnancy.

Magnesium citrate or glycinate are both typically well absorbed while magnesium oxide will often remain in the digestive system.

A simple blood test can be run to assess your status of each of these nutrients. This is something you can discuss with your health provider.



Optimal Form

Less Desirable Form


Citrate or Malate



Citrate or Picolinate



Folate or ideally 5-MTHFR (5-methyltetrahydrofolate)

Folic Acid


Methyl Cobalamin



Heme, Citrate or Glycinate

Ferrous Fumarate

Vitamin D


D2 (ergocalciferol)


Citrate, Malate or Glycinate





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