Multivitamins for TTC, Pregnancy & Breastfeeding

[cheekyfrog]

Excessive intake - folate is generally considered non-toxic, although excessive intakes above 1,000mg per day over a period of time can lead to malaise, irritability and intestinal dysfunction. The main risk with excessive folate intake is that it can mask a vitamin B12 deficiency so it is best to consume these two vitamins within the recommended amounts.

[~Jo~]

I thought I heard that high doses are causing bigger babies??

Jo

[Lady Zaidie]

In the UK, at least, a lot of our foods are artificially laced with folate, iron, vitamins... so our GPs advise us to eat all this fortified stuff when we're pregnant and just take the 500μg folate tablets you can buy - I'm taking full-on pregnancy vitamin pills too, so getting quite a high dose of everything (for the UK standards). I think I usually take 1mg of folate a day or there abouts due to the doses in food (400μg comes from the tablets).

[Mumintaz]

Originally Posted by kbowman

Excessive intake - folate is generally considered non-toxic, although excessive intakes above 1,000mg per day over a period of time can lead to malaise, irritability and intestinal dysfunction. The main risk with excessive folate intake is that it can mask a vitamin B12 deficiency so it is best to consume these two vitamins within the recommended amounts.

The key here is above. Folate comes in dosages of micrograms (mcg), not milligrams (mg). The only reason you would be taking any number of MILLIGRAMS of folate would be for specific conditions under medical supervision.

Lisa

[Inanna]

Keen, I have mislead you a bit when I read your post I re-read what I had written. The show transcript refers to the affect of folate on DNA - not of the affect of Folate on miscarriage. Sorry for this, I often tap away whilst working on something else and I didn't write clearly.

To make myself clearer: Folate is an age old treatment for miscarriage - foods and herbs with a high folate content were given to women who habitually miscarry or threaten to miscarriage. This was meant to be a separate statement. Medicine has also noted that low folate levels seem to correlate to higher miscarriage rates. If you would like more information on this I can scrounge that up also. I must say clearly that there have been studies done on this and the outcome is quite inconclusive. Some studies seem to illustrate a link and others don't. So, again this will be up to the individual to investigate and decide on what they feel fits. However, I do believe in time science will uncover more on this...

Largely there is concern that miscarriage rate seems to be increasing. This can be attributed in part to the increased maternal age but also many alternate practitioners and infact many mainstream practitioners suggest that a large amount of folate has been depleted in our daily food. As Ryn pointed out many foods now are fortified with folate in an attempt to bridge the deficit if you like. In years past we grew our food in our gardens and picked it and ate it. It was alive and whole without contact with pesticides and artificial fertilisers.

It must be remembered that folate as with any b vitamin is destroyed in part by heat. Pollution and chemicals also deplete our vitamin b so these things we need to be mindful of. In reality it is thought that the daily folate intake of our grandmothers exceeded 5mgs or 5000mcgs. Folate is a measured in milligrams and micrograms and is regularly given to women at 1mg or 1000mcgs. As Sally said her clinic does this. My ob recommends a minimum of 800mcgs and other colleagues more. This is I surmise because it has been made apparent that we just don't get enough and perhaps it is impacting on our fertility (our ability to conceive and/or hold a pregnancy). If this is all just conjecture than the increase can do no harm as long as we are aware to increase our b12 intake. (I believe)

Certainly the rate of neural tube defects has markedly declined since women were advised to consume folate. For some of us 400-500mcgs isn't enough. This can be because perhaps we don't eat enough folate rich foods in our diet to supplement the folate tablet we take, or perhaps our bodies don't absorb the folate adequately. aOr perhaps we are exposed to smoke and other situations that serve to deplete vitamin B

By no means do I advocate every woman taking 5mgs - though I don't believe it would harm a woman to do so, as long as she also took b12 and had adequate other b vitamins. I do however believe that every pregnant woman or woman considering conception take at least 1mg which is 1000mcgs.

Also the statements I made with regard to folate and chromosomal defects are separate. Again, I could try and rustle this up too if women are interested. The link between the above is contentious with some. I won't go into it here, but happy to try and supply more info.

I understand that many people are told differing things from their care providers and it is best to do some independent investigation yourself and talk to your care provider and then form a decision.

Sorry again Keen for the misleading way I wrote. If you do want any further info I would be happy to try and put my hand on it.

In summary I am aware that parts of this post are opinion based on researching these areas. I strongly urge individuals to investigate for themselves and ask lots of questions of their care providers.

I hope you find this interesting...

Here is the transcript from Catalyst:

DNA Doctor
Reporter: Paul Willis
Producer: Stephen Burstow
Transcript
Related Info
2 June 2005
We all know that as we get older, we start to wear out. Even our most individual blueprint for life, our DNA, becomes progressively more damaged as we get older. And damaged DNA can be the starting point for several degenerative diseases and cancer. Now someone is looking out for the health of your DNA and the good news is, you can do something about it.
Narration: Getting older means wearing out.

But it's not just muscles, joints and organs that suffer.

The older we get, the more damage we do to our own individual blueprint for life: our DNA.

And the consequences of a lifetime's DNA damage could be a range of degenerative diseases and cancers.

But now this man has made the health of your DNA his top priority.

Dr Michael Fenech: We should consider damage to the genome as a fundamental disease that can be diagnosed and treated.

Narration: And the good news is, we can all take simple steps toward a healthier genome.

Dr Michael Fenech: We know that to some degree it depends on the genes you inherit. However, we also know that you can actually reduce that rate of genome damage.

Narration:This could be the biggest breakthrough in preventative medicine since the discovery of vaccination.

Working in the CSIRO's Health Sciences division, Michael has been looking at how a range of simple treatments can effect the health of our DNA

And I'm about to become a guinea pig to test Michael's theories.

He claims that one particular treatment can actually help repair damaged DNA.

But the first step is to look at my DNA and see how much damage I've done to it over the last 40 years.

With a little persuasion my white blood cells are made to divide. In each cell's nucleus the strands of DNA are supposed to make nice neat copies - but sometimes things go wrong.

Dr Michael Fenech: We've been looking for abnormalities and the shape of those nuclei and then the formation of small nuclei called micro-nuclei where the aberrant DNA or the broken DNA tends to be located.

Narration: If the DNA is damaged, the nucleus doesn't divide cleanly into two equal parts. Michael counts the number of these bad copies from 1000 cells.

This gives him a rate for my personal DNA damage which he can then compare to typical rates of DNA damage in people my age. And the results are encouraging!

Dr Michael Fenech: Well we've had a look at your results and that yellow dot over there is you.

Dr Paul Willis, reporter: So I've actually got quite low damage.

Dr Michael Fenech: You are actually tracking not too badly for your age.

Dr Paul Willis, reporter: So there is actually one index on which I'm actually relatively healthy.

Dr Michael Fenech: You are actually doing quite well on this index, although not as well as an 18 or 25 year old.

Dr Paul Willis, reporter: Right.

Dr Michael Fenech: But that would be interesting to see whether it were possible to bring that rate down to somebody who's 20 years younger.

Narration: So, even though my DNA is already in a pretty healthy state, Michael thinks it's possible to undo some of the DNA damage I have already done to my genome.

That's a remarkable claim and I have to admit, I'm sceptical.

So I'm off to Professor Bruce Armstrong at the University of Sydney. He'll know if really is possible to undo some of my DNA damage.

Professor Bruce Armstrong: I think the answer to that is in principle, yes. We do know that there's a dynamic process going on here where DNA has been damaged, DNA is being repaired, damaged DNA is being eliminated from the body and so on and if you can slow down the rate at which DNA damage occurs then you will improve the state of your DNA.

Narration: So time to take the good Doctor's challenge. And the treatment is a pretty simple one.

According to Michael, DNA has its' own set of rebuilding tools built into it's structure but they can't do their job effectively unless there is plenty of folate and B12 around.

Alarmingly, around 9 out of 10 Australians do not have enough folate in their diets to provide for the basic cell functions of DNA replication and repair.

Dr Paul Willis, reporter: By far the best source of dietary folate are chicken livers, fried of course, but I have a cholesterol problem and so these guys are off the menu. If I want to go to vegetables, broccoli and brussel sprouts are great, but I'd still need to eat half a kilo a day to get the folate I need, and I think my wife and friends might complain about the side effects. So I've decided to take pills instead.

Narration: I'll need about 500 micrograms folate or folic acid and 50 micrograms of vitamin B12 daily to help with the DNA rebuilding work.

And, for three months I stuck to the plan. No matter where I went, I faithfully took my folate and B12 every day.
And after three months, I'm itching to know if my DNA has improved!

Dr Paul Willis, reporter: Have I done anything?

Dr Michael Fenech: Yes well it looks like the supplements you were taking have had an effect on the rates of DNA damage in your cells.

Dr Paul Willis, reporter: What sort of impact?

Dr Michael Fenech: Well we observed about a 45% reduction.

Dr Paul Willis, reporter: 45%?

Dr Michael Fenech: Yes.

Dr Paul Willis, reporter: That sounds very good.

Dr Michael Fenech: It's pretty good. The largest reduction was in this type of damage which is actually pretty important because it's thought to create the genomic instability that leads to the genetic changes that initiate cancer.

Narration: This is great news for me - particularly seeing as there are some rather nasty cancers lurking in the family history.

But, once again, the news sounds almost too good to be true. So it's back to Prof Armstrong to put my results into context.

He's already found folate can have an amazing effect in children.

Professor Bruce Armstrong: If we can see a 60% reduction in risk of a childhood cancer possibly as a result of folate in pregnancy. Now your 45% reduction in DNA damage doesn't sound all that implausible.

Narration: Back in Adelaide Michael has big plans for his research findings.

He's proposing the establishment of Genome Health Clinics where people can fine-tune their vitamin consumption to suit their own individual DNA.

And such a clinic would not have to be buried away inside a huge hospital...

Dr Michael Fenech: You could go to the clinic, give your blood sample and after three months to find out whether the change you have made for your diet has actually caused you any benefit or might have caused you harm.

It could possibly be a shop front in Rundle Mall, definitely.

Narration: So in the not too distant future, busy people will be able to participate in this break through in preventative medicine with a simple blood test in a shop-front clinic.

And if my own experience is anything to go by, it will be a simple and painless process that could help prevent some serious illnesses down the track.

Story Contacts
Dr Michael Fenech
CSIRO
Prof. Bruce Armstrong
University of Sydney

[EllyBoo72]

I have read that folate should be taken "at least a month" before conception. I would have thought that starting it a week or so before conception would have been adequate??
What do you think?

[Liz]

I think it's recommended that with a planned pregnancy you should take it 3-4 months in advance.

[Lady Zaidie]

As i understand it, it takes 3 months to get into your system. Like any other thing, you need to build it up over time - you only retain part of each tablet, so need to up the folate concentration of your blood slowly. Having said that, so many things like cereal etc are fortified with folic acid these days that your levels could already be quite high.

[Liz]

Oh.. and for during.. my OB said it was only 'important' for the first trimester. After the first trimester, he was only concerned about taking iron. But I continued with the multivitamins which had the folate for my own health anyway.

The other girls are have said what i was going to say in regards to it getting in your system.
I was slack with #1 DD, i didnt take anything at all. But with #2 DS i started takeing them as soon as we decided to ttc. Reason being, 2 yrs older and felt my boby needed it, lol.
I have to say that i certainly noticed the benefit after he was born, i didnt feel as washed out and didnt look pale at all. With DD i was anaemic (S) and fainted after birth and nearly again at home. But second time i was fine.
I take Elevit as it has one of the highest doses of Folate.

[jja]

Don't forget the egg is developing for about 2 weeks before conception, and like Ryn said it can take time to make sure you have enough folate in your system. So I suppose that's why they say 1 month. The folate reduces the chances of Neural Tube Defects like Spina Bifida and Anencephaly. These come about as a result of the neural tube failing to close properly, which happens between 23 and 26 days after conception (one end closes before the other). The neural tube is a tube that the embryo forms, and as it develops each end is suppose to close off. If it doesn't close properly you get a NTD. Spina Bifida when the "bottom" end of the tube doesn't close off properly, and Anencephaly when the "top" end doesn't close properly.

[Lady Zaidie]

Acutally, anencephaly is a bit worse than that (I once had to give a lecture on this - but don't worry, I'll do a summary!). It can occur anywhere in the first trimester with varying degrees of severity. "Encephal-" refers to the brain (an- being without) and even if the neural tube seems OK at first, the brain still needs to develop: an early defect would be no brain at all; a late defect would be the hindbrain being formed but not the forebrain (something checked for at the 20w scan): previously no-one suspected there was anything wrong with these babies until they were born. They could sometimes breathe and control their heart on their own, but never wake up or "think". It's rare and very, very sad, but a very good reason why I was on folic acid for a year before becoming pregnant: first for three months before I came off the Pill, then "just in case" when we were using mechanical contraceptives.

[Karina]

I have been taking folate for a few months now as I read it takes about 2 months to build up a good level of it in your body, and its good to have it there already before you get pregnant.

[*Rae*]

Gee - after reading that info gals i'm relieved that i've been taking my folate and multivitamins for months now - phew!!! Thanks.

[EllyBoo72]

Thanks for your replies! Very interesting.
Ryn,Jja; Can I pick your brains some more? Here is my (real) scenario;
I took Elevit with folate, Vit C, Omega Oil, etc for the 5 Months prior to having embryos made.(2years ago)
I am about to use one of those (stored) embryos, and by the time it needs to be put in I would have taken Elevit with folate, for 3 weeks.
So my questions are; Does the fact that I was on vitimins before the embryos were made count? And would 3 weeks worth prior to me conceiving (using the embryos) be adequate?
Thanks guys.

[Lady Zaidie]

I'd say you should get the folate into your blood asap - as you know, the baby takes all your nutrients to grow, and folate is necessary. At first, the baby is in a little "egg" - it feeds off what it already has in there - but very early on it suckers into you and becomes the most wonderful parasite ever, but pretty much from implantation the baby is using your blood content. That's why drinking in the TWW doesn't have doctors too worried, most of it is pre-implantation and you're not affecting your baby with blood alcohol.

I'd say that it maybe takes a couple of weeks to "bulk up" your blood with vitamins and minerals, more if you were really run-down before, but remember things like breakfast cereal, bread and vegetables contain folate so you should be OK. You can't really overdose taking one tablet a day even if you're not pregnant, so that's why I'd go for as long as possible, but three weeks before implantation should be fine.

Best of luck for the FET!

[min]

i take megafol and have been for a couple of months. I think it is 5 times the reccommended dose because my 1st cousin was born with Spinabifida.

[EllyBoo72]

Ahh, Thanks Ryn, I Feel a bit better now. I eat stax of weet bix, so food wise, should cover some of it LOL!!!