Does Your Prenatal Vitamin Provide Enough Vitamin D
Dr. Jay Pennock
Vitamin D continues to be a hot topic, with new articles published seemingly every day. Currently, there are over 10 times as many reviews and editorials published on vitamin D in medical journals than there were 20 years ago.
This new generation of research shows that vitamin D plays a much wider role in our health than we previously thought. In fact, Vitamin D regulates more than 1000 human genes, and most of our bodies’ tissues and cells have vitamin D receptors1.
We now know that the importance of vitamin D extends far beyond bone health—recent research links vitamin D deficiency to not just osteoporosis but also cardiovascular disease, autoimmune diseases, diabetes, depression, parathyroid problems, and cancers2-4.
We also know that most pregnant women in the United States have insufficient levels of vitamin D. A study published in 2010 documented that 7 out of every 10 pregnant in the US are not getting enough vitamin D5!
Low vitamin D levels during pregnancy are detrimental to not only the mother’s health but also cause the fetus to develop in a low vitamin D state. When we consider that fetal and early-life vitamin D insufficiency has been associated with an increased risk of childhood wheezing, respiratory infection, diabetes, multiple sclerosis, and mental health disorders, we can understand why I recommend that all pregnant and lactating women ensure that their prenatal vitamin supplement provides enough vitamin D6-9.
We get Vitamin D naturally as our bodies absorb sunlight and UV rays stimulate skin cells to synthesize it. However, our understanding of the damage caused by UV radiation has appropriately led to the use of sunscreens and better protection from the sun, which in turn has led to a significant decrease in endogenous or natural Vitamin D in our bodies.
How much vitamin D is enough? I recommend that pregnant and lactating women choose a prenatal vitamin that provides at least 800 I.U. of Vitamin D daily. That’s because increasing evidence indicates that the current vitamin D recommendations (of 200-600 I.U. daily) may be inadequate for raising maternal vitamin D levels to the levels needed for optimum maternal and infant health5, 10-13.
Women should also pay attention to the form of vitamin D contained in their prenatal vitamin. There are two forms of vitamin D supplements: vitamin D3 (cholecalciferol)—which is the form our bodies make when exposed to sunlight—and vitamin D2 (ergocalciferol), a synthetic form made by irradiating plants. Vitamin D2 is only 10-30% as effective in raising vitamin D levels and is not regarded as a suitable form of vitamin D supplementation14. Lastly, I recommend that pregnant and lactating women choose an effervescent prenatal multivitamin, for two main reasons. First, it frees women from having to swallow pills or tablets and this will help ensure compliance. (Pills and capsules can cause reflux or nausea.) But I also recommend effervescence because it offers better absorption, so that women can be sure their bodies are actually using the nutrients they are taking. Hormonal and physical changes during pregnancy alter the functioning of the stomach and intestines, and the effervescence of Oxylent aids absorption and ensures the availability of the vitamins and minerals to both mother and baby. My favorite brand is Prenatal Oxylent from a company called Vitalah. Not only does Prenatal Oxylent contain 800 I.U. Vitamin D3 but it also contains a strong panel of other micronutrients required for pregnancy and lactation. Making the choice to take a high quality, effervescent prenatal multivitamin supplement such as Prenatal Oxylent goes a long way towards ensuring both mom and baby are getting the nutrition they need to thrive.
Dr. Jay Pennock is a licensed, board-certified Physician of Emergency Medicine and has been practicing in the emergency department of Salinas Valley Medical Center for 15 years. Dr. Pennock’s practice in the emergency department is the epitome of western medicine; this experience has led him to develop a strong belief in the need for balance in medicine, and in the need for prevention of illness through healthier lifestyles with exercise, fresh air, better eating habits, and rechanneling of stress. Dr. Pennock graduated from Union College with a Bachelor’s degree in Philosophy and earned his Doctor of Medicine degree from New York Medical College. Dr. Pennock has been a Fellow of the American College of Emergency Medicine and currently serves as the Chairman of the Physician and Well Being Committee at Salinas Valley Medical Center.
References
- Tavera-Mendoza LE, et al. Cell defenses and the sunshine vitamin. Sci Am 2007;297:62-5,68-70,72.
- Holick MF. Vitamin D Deficiency. N Engl J Med 2007;357:266–281.
- Garland C, et al. The Role of Vitamin D in Cancer Prevention. Am J Public Health 2006;96:252–261.
- Lappe JM, et al. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr 2007;85:1568–1591.
- Ginde AA, et al. Vitamin D insufficiency in pregnant and nonpregnant women of childbearing age in the United States. Am J Obstet Gynecol 2010;202:436.e1-8.
- Camargo CA Jr, et al. Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age. Am J Clin Nutr 2007; 85:788-95.
- Devereux G, et al. Maternal vitamin D intake during pregnancy and early childhood wheezing. Am J Clin Nutr 2007;85:853-9.
- Karatekin G, et al. Association of subclinical vitamin D deficiency in newborns with acute lower respiratory infection and their mothers. Eur J Clin Nutr 2009;63:473-7.
- Zipitis CS, et al. Vitamin D supplementation in early childhood and risk of type 1 diabetes: a systematic review and meta-analysis. Arch Dis Child 2008;93:512-7.
- Hollis BW, et al. Vitamin D requirements during lactation: high-dose maternal supplementation as therapy to prevent hypovitaminosis D for both the mother and the nursing infant. Am J Clin Nutr 2004; 80(Suppl):1752-8S.
- Hollis BW, et al. Assessment of dietary vitamin D requirements during pregnancy and lactation. Am J Clin Nutr 2004;79:717-26.
- Cockburn F, et al. Maternal vitamin D intake and mineral metabolism in mothers and their newborn infants. Br Med J 1980;281:11-4.
- Ala-Houhala M, et al. Maternal compared with infant vitamin D supplementation. Arch Dis Child 1986;61:1159-63.
- Houghton LA, et al. The case against ergocalciferol (vitamin D2) as a vitamin supplement. Am J Clin Nutr 2006;84:694–697
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