When it comes to pre-conception and pregnancy nutrition, the supplementation with folate has become widespread. However, there are numerous factors affecting the absorption of folate and how the body uses it. These factors include dose and form of the vitamin (no supplement should contain more than 400mcg of folic acid so always check the label). Folic acid in (some) supplements is synthetic and the daily dose should not exceed 200mcg. Calcium folinate is approximately 50% active, while Methyl folate is the most viable and natural form of the vitamin. In many cases, a good combination provides the best outcome.
Furthermore, any folate supplement should be taken with or part of a complete-B rather than on its own.
When it comes to pre-natal and pregnancy supplements, many contain copper. Modern farming practices and drinking water treatment involve copper meaning that most women are not deficient in this mineral:
- Copper is present in our drinking water – one litre of unfiltered tap water can contain up to 400 mcg of copper.
- Food farming and animal feed-lots have lead to a deficiency of zinc with raised copper levels;
- processed foods are often high in copper;
- the air around mining and agriculture contains higher amounts of copper;
- copper from IUDs leaches into the body;
- copper sulphate is used in drinking water reservoirs as an algicide.
High copper levels should be reduced prior to conception as elevated copper can block the absorption of both zinc and iron. High copper can also exacerbate post natal depression. Copper levels can be easily screened with blood pathology.
There are various brands of supplements on the market – it is always best to compare for quality and ingredients.
If you are considering starting a family, contact us at True Medicine on 0468 774 633 to ensure optimum nutrient levels. Any supplements should always be prescribed according to your needs and be of the highest quality.
Prenatal care: What you need & nothing you don’t
Article courtesy of BioConcepts Innovative Nutritional Solutions
Recent Australian research suggests that pregnant women or those preparing for pregnancy should have no need for copper supplementation. The results clearly demonstrate that we already get enough, or more than enough, naturally through our drinking water and supplementing copper without assessing serum levels could have negative implications for these patients.1
Additionally, direct associations between excess serum copper and postnatal depression (PPD) are also evident. Copper levels appear to be significantly higher in women with a history of PPD compared both to non-depressed women and to depressed women without a history of PPD.2
Although copper requirement is increased during pregnancy and lactation3, the analysis of over 200 first draw drinking water samples from different parts of NSW found that almost 100% and 56% of samples contained detectable concentrations of copper and lead, respectively. Of these detectable concentrations, copper exceeded Australian Drinking Water Guidelines (ADWG) in 5% of samples and lead in 8%.1
Which folate forms are best during preconception care always sparks much debate but the consensus is that a blend of folates has you covered. Combining the highly researched folic acid form and the biologically active L-5-MTHF is a clinically validated choice during preconception, pregnancy and lactation.
Not all forms of folate have been equally examined and with over 5000 scientific publications, folic acid is by far the most heavily researched and it is specifically this form that has demonstrated to increase red blood cell folate levels and provide a protective role for the prevention of neural tube defects (NTD).4
It is too simplified to omit folic acid because of reported issues with polymorphisms linked to NTD and unmetabolised folic acid (UMFA)5 and instead it is crucial to identify the minimum effective intake of folic acid required to help prevent neural tube defects while also minimising the risk of potential negative outcomes in certain populations.5
The research indicates that UMFA can appear with doses lower than 400mcg per day in certain population groups, but one of the most cited studies into UMFA demonstrates ≤ 200mcg per day of folic acid, even in addition to folic acid fortified foods, results in no UMFA in serum.6 Evidence suggests that consuming folic acid together within a B complex enhances folic acid metabolism reducing the prevalence of detectable UMFA.7
Theoretically, all forms of folate including methylfolate may indeed increase blood folate levels providing a NTD protective role, however research has still not conclusively proven this which is why reason stands for the advocacy of folic acid during preconception and conception.8
- Harvey, P. J., Handley, H. K. & Taylor, M. P. Widespread copper and lead contamination of household drinking water, New South Wales, Australia. Environ. Res. 151, 275–285 (2016).
- Crayton, J. W. & Walsh, W. J. Elevated serum copper levels in women with a history of post-partum depression. J. Trace Elem. Med. Biol. 21, 17–21 (2007).
- Uriu-Adams, J. Y., Scherr, R. E., Lanoue, L. & Keen, C. L. Influence of copper on early development: Prenatal and postnatal considerations. BioFactors 36, 136–152 (2010).
- Chitayat, D. et al. Folic acid supplementation for pregnant women and those planning pregnancy: 2015 update. J. Clin. Pharmacol. 56, 170–5 (2016).
- Hekmatdoost, A. et al. Methyltetrahydrofolate vs Folic Acid Supplementation in Idiopathic Recurrent Miscarriage with Respect to Methylenetetrahydrofolate Reductase C677T and A1298C Polymorphisms: A Randomized Controlled Trial. PLoS One 10, e0143569 (2015).
- Kelly, P., McPartlin, J., Goggins, M., Weir, D. G. & Scott, J. M. Unmetabolized folic acid in serum: Acute studies in subjects consuming fortified food and supplements. Am. J. Clin. Nutr. 65, 1790–1795 (1997).
- Obeid, R. et al. Folic acid causes higher prevalence of detectable unmetabolized folic acid in serum than B-complex: a randomized trial. Eur. J. Nutr. 55, 1021–1028 (2016).
- Saldanha, L. G., Dwyer, J. T., Haggans, C. J., Mills, J. L. & Potischman, N. Perspective: Time to resolve confusion on folate amounts, units, and forms in prenatal supplements. Adv. Nutr. 11, 753–759 (2020).