Supplement Research

Should My Prenatal Multi-Vitamin Have Iron?

by Cassandra Delage, Founder and CEO

Published June 7, 2024 — Last Reviewed April 5, 2024

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Excerpt

Iron supplementation is key in prenatal nutrition to prevent anemia and support fetal development. However, recent findings suggest that indiscriminate use of iron supplements may pose risks, as individual iron needs vary and excess intake can cause gastrointestinal issues.

Introduction

We understand that the world of prenatal supplements can be overwhelming, especially with conflicting information online. Many mothers shared their confusion about where to start and what to trust.

The Importance of Personalized Iron Supplementation

Iron is vital during pregnancy, aiding in hemoglobin synthesis, oxygen transport, and fetal growth. Traditionally, iron supplements have been recommended to meet the increased demands and prevent maternal anemia. However, new research shows that a one-size-fits-all approach may not be appropriate given the individualized nature of iron requirements and the risks of excess intake.

The Debate

On one hand, iron supplementation is recommended during pregnancy for maternal and fetal well-being, but, on the other hand, needs vary among individuals and excessive supplementation of it can cause constipation.

Individualized Iron Requirements

Iron needs during pregnancy depend on factors like pre-existing iron stores, dietary habits, genetic predispositions, and health conditions.

Pre-existing Iron Stores:

Pregnant women enter pregnancy with varying levels of iron stores, influenced by factors such as previous dietary intake, menstrual blood loss, and genetic predispositions. Those with depleted iron stores are at a higher risk of developing iron deficiency anemia and may require supplemental iron to meet their increased needs [1].

Hemoglobin Levels:

Doctors often check hemoglobin levels to see if someone has enough iron in their body. However, just looking at hemoglobin levels might not give the full picture, especially for pregnant women. Studies have shown that even if a pregnant woman's hemoglobin levels look normal, she might still have low iron stores in her body. This means that relying only on hemoglobin levels might miss out on detecting iron deficiency in some pregnant women. So, it's important for healthcare providers to do more tests to check iron levels properly during pregnancy [2].

Dietary Habits:

Dietary intake of iron-rich foods significantly impacts iron status during pregnancy. Vegetarian or vegan pregnant individuals may have lower iron intake from animal sources and may require closer monitoring and supplementation if dietary intake is insufficient to meet their iron needs [3].

Genetic Factors:

Genetic variations in iron metabolism genes can influence individual susceptibility to iron deficiency or iron overload during pregnancy. Polymorphisms in genes encoding proteins involved in iron absorption, transport, and storage may predispose individuals to altered iron status and necessitate tailored interventions [4].

Important to Note

Some women may need extra iron to prevent or treat anemia, while others might have sufficient levels or risk iron overload, making a blanket recommendation unsuitable.

Risks of Excessive Iron Supplementation

Too much iron from supplements or fortified foods can lead to constipation, nausea, vomiting, and abdominal discomfort. Long-term high doses can cause oxidative stress, tissue damage, and impaired immune function. Conditions like hemochromatosis or thalassemia increase the risk of iron overload, so supplementation should be approached cautiously.

"Before I was pregnant, I didn't realize how important supplements were. It can be overwhelming to find the right one, but knowing what to look for makes a huge difference."

— Sarah, Mother (to-be)

Role of Dietary Iron Sources

Including iron-rich foods like lean meats, poultry, fish, legumes, nuts, seeds, and fortified cereals in your diet, paired with vitamin C-rich foods, enhances iron absorption. Consulting a dietitian can help balance dietary intake and supplements to meet individual iron needs without overdoing it.

Conclusion

The traditional approach to iron supplementation during pregnancy is evolving with new evidence on individualized needs. While iron is crucial, excess intake can cause complications, highlighting the need for personalized supplementation plans. Assessing pre-existing iron stores, hemoglobin levels, dietary habits, and genetic factors ensures the right balance. A diet rich in iron and vitamin C, along with professional guidance, supports optimal iron levels for maternal and fetal health.

Title

References to the research cited in this article can be found in the "References" tab at the top of this page.

Contributors

Author(s)

Cassandra Delage

Founder and CEO of Bia

References

Bia follows strict article guidelines and only uses credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. In addition, when necessary, each article is reviewed by a member of our healthcare community to further ensure up-to-date information.

[1] Sauder KA et al. Selecting a dietary supplement with appropriate dosing for 6 key nutrients in pregnancy.

[2] Teichman J, Nisenbaum R, Lausman A, Sholzberg M. Suboptimal iron deficiency screening in pregnancy and the impact of socioeconomic status in a high-resource setting. Blood Adv. 2021; 5(22): 4666-4673.

[3] Barton JC, Wiener HH, Acton RT, et al. Prevalence of iron deficiency in 62,685 women of seven race/ethnicity groups: the HEIRS study. PLoS One. 2020; 15(4):e0232125.

[4] Lönnerdal B. Calcium and Iron Absorption—Mechanisms and Public Health Relevance. Int. J. Vitam. Nutr. Res. 2010, 80, 293–299.

[5] Name JJ, Vasconcelos AR, Valzachi Rocha Maluf MC. Iron Bisglycinate Chelate and Polymaltose Iron for the Treatment of Iron Deficiency Anemia: A Pilot Randomized Trial. Curr Pediatr Rev. 2018;14(4):261-268.

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