The Case: 

• Katherine is 37years old and 20 weeks pregnant
• Since early in her pregnancy, she’s had stiff joints and been exhausted and extremely nauseous.
• Prenatal vitamins made her morning sickness worse and time wasn’t making anything better. 
• Katherine was having trouble keeping food down and was worried about getting sufficient nutrients to the fetus. 

The Investigation

During the first trimester of pregnancy, it’s common to experience nausea and fatigue. For most women, the body finds it’s new equilibrium by the second trimester. When Katherine came to me with continued issues, I knew we had to dig a bit deeper into her diet and look at what she’d done to prepare her body for pregnancy. 

Kristin Mallon is a Registered Nurse (Certified in Inpatient Obstetric) and a midwife. She’s a pregnancy expert, published author and co-founder of Vibrant Beginning Pregnaceuticals. She’s delivered thousands of healthy babies. Her focus is on helping women prepare their bodies optimally before, during and after pregnancy through high-quality nutrients.  

The First Trimester

Kristin explains that the body experiences an influx of hormones (specifically estrogen, progesterone, and human chorionic gonadotropin or hGC) when fertilization occurs. This is why so many women experience symptoms like morning sickness, nausea, and fatigue in the first few months of pregnancy - their bodies are reacting to the change in hormones. Some women may also experience breast tenderness, low-grade headaches, gastro-intestinal upset, and change in appetite (which may be caused by an aversion to food or smells).

When Things Don’t Get Better in the Second Trimester

For most women, the body learns to deal with the increased hormones and the symptoms dissipate after three months of pregnancy. However, for some women the symptoms persist. This may have to do with genetics - some women are predisposed (based on how fast their body metabolized hormones) to experience a more difficult pregnancy. However, these symptoms may have nothing to do with the increased hormones, they may, in fact, have more to do with nutritional status. 

Metabolic vs. Nutrition

It’s important for a woman to know if her persistent symptoms are related to nutritional status or a metabolic issue. If it is nutrition, than the course of action would be to adjust the diet and increase supplements to support nutritional needs. This is often the traditional approach. However, if it is a metabolic issue, this approach won’t help and may in fact be fruitless since the additional nutrients won’t be metabolized and absorbed. 

Preconception Nutrition

Many women shift their focus to nutrition after they get pregnant. Kristin recommends starting to focus on nutrition at least twelve weeks before attempting to get pregnant. This includes focusing on nutrition and taking prenatal vitamins. However, not all prenatal vitamins are formulated optimally. 

Selecting a Prenatal Vitamin

For most women, a single prenatal vitamin is not going to do the trick. Most prenatal vitamins are not formulated correctly and may include unnecessary elements like dyes, fillers and non-natural ingredients. 

Prenatal Iron

Many prenatal vitamins contain iron and this is something that Kristin does NOT recommend. Iron slows down your gastrointestinal tract and can cause constipation. Your digestive system will also slow down due to pregnancy so having too much iron in your system when you become pregnant can exacerbate the nausea and vomiting common in the first trimester. In addition, iron binds with calcium which decreases the body’s ability to absorb both minerals. Only 9 - 10% of women actually need to supplement their iron during pregnancy so it should not be the default. 

Unclear Pregnancy Nutritional Needs

The only official recommendations Americans have (from the Food Nutrition Board, Institute of Medicine, or the CDC) for nutritional needs during pregnancy is 400 - 800 micrograms of folic acid and 100 - 150 micrograms of iodine. That’s it. Kristin recommends also including at least 250 milligrams of DHA and 100 milligrams of EPA (essential fatty acids and omega 3s) which are beneficial to fetal brain development. B vitamins , specifically 100 micrograms of methylated B 12. The other B vitamins (1, 3, and 6) are also important to keep energy up during pregnancy and for neurological development for the fetus. Pregnant women should also be getting 500 mg of calcium, and look at magnesium, zinc, selenium, chromium, copper, vitamin A and D.

Healthy Diet May Not Be Enough

Even women with a very healthy, clean diet may need to take a second look at their actual nutrient intake. With farming practices being what they are, food doesn’t hold as much nutrients as it used to. This is why many women need supplements to get all of the nutrients they need. Eating macro (not from big farms) is another way to increase nutrient intake through food. To be sure, women can have their micronutrients test through a functional medicine doctor (or clinic) to determine if they are deficient on a cellular level.

Make Sure its Methylated

When considering supplements with B vitamins, look for the “methylated” form. This is the bio-available version so it makes it easier for the body to absorb and digest. Specifically, methylated folate and methylated B vitamins. 

Mystery Solved

Conversations with Katherine revealed that her preconception of nutrition had not been ideal which meant that her body was starting the pregnancy at a deficit. In addition, her current tests showed that she was extremely low in all of her vitamins and minerals. Plus, her test were high in a few inflammatory markers (specifically High Sensitivity CRP) so it was no wonder she was dealing with joint stiffness. 

Getting sufficient nutrients when you have morning sickness can be a challenge. This is why choosing activated, natural and methylated vitamins is so critical because then the body can absorb them very quickly and use them more efficiently. Katherine started with the methylated prenatal vitamin Prenatal Brilliance by Vibrant Beginning. Within a week the nausea had subsided. This prenatal has a good blend of all the necessary vitamins but Katherine was so deficient we topped it up with extra B6 and Vitamin D. To further treat her inflammation, we added an EPA and DHA blend form Prenatal Brilliance which would also help the baby’s brain development.

Eliminating Health Mysteries

For Katherine we were able to identify the cause of her extended morning sickness and help her feel better and provide more nutrients to her baby in less than a week. She thought she was doing everything right, but she’d chosen the wrong prenatal supplement. Who would have guessed that the cure was the cause? Could this be the missing clue for you or someone in your life? 

Links:

Thanks to my guest Kristin Mallon. Please check out her website www.integrativeobstetrics.com and connect with her (and learn more about Vibrant Beginning) on Facebook or Instagram.  

Suggested Products:

Prenatal Brilliance 

Brilliant DHA

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