Lets start off by saying that preconception care is so much more than just folate.
Secondly, Preconception care should begin well before conception I'd say a minimum of 4 months and continue through pregnancy and breastfeeding. It takes 100 for eggs to mature and 116 for sperm to generate, so it is recommended that preconception care be undertaken for at least 4 months before you attempt to conceive. Thirdly, choosing any off-the-shelf preconception supplement often means that you end up taking:
The wrong amounts of the nutrients
Poorly absorbable forms
Forms that can be harmful, such as in the case of an MTHFR genetic variation.
Folate (vitamin B9) is an essential nutrient required for DNA replication, growth and the development of the fetus and the formation of the neural tube. As deficiencies are associated with congenital abnormalities such as orofacial clefts, anencephaly and spina bifida, it is recommended that all women take folate as part of a preconception preventative strategy.
Risk factors for folate deficiency may include:
Less consumption of foods with folic acid
Too much consumption of alcohol
Certain medical conditions such as celiac disease
While Elevit Pregnancy Multivitamin does contain more than just folate, its’ key feature is 800mcg folic acid, which is close to double many other prenatal vitamins you may have seen.
Now, may be thinking "if so, many people are deficient, more is better, right?"
Key Notes Here:
Folic acid is not the same as folate.
More is not always better
What are the forms of folate?
Folate is the form of folate naturally found in foods such as leafy green vegetables, eggs, legumes, liver and citrus fruits. Folic acid on the other hand is the synthetic form of folate, that’s often in fortified foods or supplements.
It is important to understand that neither of these forms of folate are metabolically active, meaning that they must go through processing by the body, to be able to used in the many biochemical reactions in which activated vitamin B9 is required.
What About Active Folate?
One form of active B9 is folinic acid. This needs to be metabolized in the body by a process called methylation, via the enzyme methylenetetrahydrofolate reductase (MTHFR), with the end result being the most active form of folate: 5-methyltetrahydrofolate (5-MTHF).
In as much as 40%-50% of the population, genetic variations limit this conversion capability of folic acid. This ultimately results in the inability to convert inactive folate to active folate (5-MTHF).
Consequently, for some, this can cause a buildup of B9 in the body which can be dangerous to the developing fetus. A growing body of research indicates that this can be a contributing factor to recurrent miscarriage.
In addition to this, commonly known brands thatr can be simply picked up and purchased from a shelf without advice (such as Elevit and Blackmores) are formulated with a form of B12 called cyanocobalamin.
Cyanocoblamin is a synthetic form of B12 that occurs only in trace amounts in human tissues. This form of B12 takes many steps for the body to utilise the B12 and depending on your genetics, this may not be done well meaning you can have less active B12 which is important for fertility.
Furthermore, brands such as Swisse, Blackmores and Elevit contain poorly absorbed forms of magnesium such as magnesium oxide.
Magnesium oxide is said to have a low fractional absorption rate of 4%.
Meaning its almost pointless to be paying money for.
HOWEVER, magnesium oxide (due to poor absorption) is considered an osmotic laxative.
Elevit and Blackmores are also missing one important nutrient that is vital for pregnancy and that is choline. Choline is involved with all stages of early reproduction, from basic fertility and egg health, to specifically supporting fertilization and implantation. It is also important for babies’ tissue and brain development.
So, taking all of this into account, what is the best prenatal vitamin to take?
I would suggest some testing to personalize this choice myself.
This is because multi vitamins rarely contain enough of each nutrient to fix a deficiency, so you may need additional supplementation and or dietary modification.
However, I prefer brands with active forms of bioavailable and high-quality nutrients such as:
Eagle Tresos Natal (which can be purchased via the practitioner only section of the website by filling in your details) Melbourne Naturopath | Nutritionist (discoveringbalance.com.au)
OR
Naturobest - who also offer a Preconception multi for men (soon to be welcomed to the online store).
