Conception care involves more than just optimising iron levels. However, whole food nutritional care and supplementation can be supportive of holistic care for both the mother and the babe during these ten moons. As a Clinical Nutritionist and a mother, I have personally experienced the significance of this aspect.
First and foremost, it is important to prioritise whole food nutritional practices through diet over supplementation in any season of life.
I’m pretty conservative when recommending iron supplements, whole food or not! With the mother's increased blood volume and therefore red blood cell production during pregnancy, the placenta's growth and the role of oxygen, the molecule that iron transports around the body, in fetal brain development, supporting iron consumption, absorption and utilisation is paramount for this season.
As a Clinical Nutritionist, over the past six years, I have supported many clients with pre-conception and conception care. Initially, I prescribed synthetic supplements and, when necessary, supported iron infusions. However, my approach has evolved due to personal experience and extensive research over the past three years into mineral balancing and iron regulation.
Optimising iron levels for pregnancy should ideally begin before conception. However, this is not always possible, as was the case with my own two surprise pregnancies. I am currently 34 weeks into my second pregnancy as I write this.
Pre-conception care for iron levels takes a holistic approach, considering factors such as gut health, absorption capacity, B12 status, folate levels, and a review of iron studies markers including serum iron, hemoglobin, ferritin (storage iron), and transferrin saturation. Once conception is confirmed, the healthcare provider would typically conduct a full blood panel to assess iron studies, B12, and folate status, if the mother chooses, to establish baseline markers for the pregnancy.
When considering supplementation, here is a guide to understand what the key nutrients are and how they work to support iron levels during pregnancy.
- Iron: Iron is required for every cell and organ system in the body for proper development and metabolic function (1).
- Copper: Copper is required for Ceruloplasmin, a multi-copper-binding protein that acts as an enzyme to support iron absorption and utilisation (2).
- B12: Vitamin B12 is required for DNA synthesis, working with folate in cellular replication. It is crucial for the production and maturation of red blood cells in bone marrow (3).
- Folate: Folate is required for DNA synthesis, working with B12 in cellular replication. It is crucial for the production and maturation of red blood cells in bone marrow (3). Folate is required for neural tube development, which forms the brain and spinal cord in the fetus. It is essential for adequate placental development (4). Folate is the natural, bioavailable form of vitamin B9.
B12 and folate work together synergistically, so it's important to obtain them in the right balance. Taking folic acid, a synthetic form of folate often prescribed by health care providers, can reduce the B12 ratio. This can lead to changes in a cellular pathway called methylation of certain genes, which can affect fetal development and the long-term health of the child. This is why supplementing whole food, natural forms of B12 and folate are paramount, as they are in balance with human physiology.
- Vitamin C: Ascorbic acid supports the absorption of non-haem iron in the intestine. Non-haem iron is from non-animal sources. Non-heme iron is not absorbed as effectively as heme iron, which is from animal products. The absorption rate of iron from heme iron is reported to be 25-30% in consumption of organ meats, while non-haem iron is between 2-9%. Non-heme iron is easily affected by dietary factors such as phytates that are in tea and coffee, grains, and legumes. Heme iron is less affected by these factors (5). Vitamin C stimulates ferritin synthesis, which is the storage form of iron to ensure the maintenance of iron levels. It is also reported that vitamin C facilitates the transferrin-iron uptake pathway. Transferrin is a protein carrier that provides a significant amount of iron for all cellular demands and red blood cell production, ensuring that iron stores are utilised when needed (6).
- Magnesium: This essential mineral plays a role in red blood cell production in the bone marrow (7), as well as hemoglobin, the protein carrier of oxygen within the red blood cell (8). It has been reported that magnesium improves the integrity of the red blood cell (8).
- Vitamin A: Retinol aids the mobilisation of iron from liver stores for hemoglobin synthesis and other physiological functions during pregnancy. It also supports non-heme iron absorption in the gut (9).
My natal iron supplement ritual includes the following products and let’s have a look at why I’ve chosen these:
🩸Organic Spleen and Liver capsules @cellsquared : Spleen is the richest natural source of heme iron, although it lacks the key nutrients for iron uptake. Combined with the liver containing copper, B12, folate, B2 and vitamin A, iron bioavailability (absorption and utilisation) is optimised. This natural source of iron is easily recognised by the body and does not cause any unwanted side effects.
🩸Organic Beef Liver capsules @thankfullynourished: This brand of beef liver is the gold standard on the market as it has higher copper content twofold than other leading brands. Folate is naturally occurring in beef liver and is in its active form. B2 is another vitamin essential in the metabolism of iron and synthesis of haemoglobin, it supports the enzyme function to ensure efficient utilisation of iron in the body (11).
- I take these two supplements together, 2 of each, three times per day with food. Due to the fat-soluble vitamins that are present, consuming with foods ensures that there is bile production to support these nutrients across the intestinal membrane. The reason why I take both and not just the Cell Squared Spleen and Liver is due to the high copper content of the Thankfully Nourished Beef Liver Capsules.
🩸Whole food vitamin C @edenhealthfoods is a powder blend of 100% pure and wild vitamin C from organic, Australian wild berries and greens that is easy to consume whilst pregnant. Whole food vitamin C contains more than just ascorbic acid, it is a complete spectrum of active vitamins, minerals and bioflavonoids that are easily absorbed by the body.
- I take vitamin C twice per day during pregnancy at dosages around 250-300mg per dose, as vitamin C absorption is saturated at 500mg, so any dosages higher than this are excreted. Smaller, more frequent dosages are more effective. I find it is versatile so I can add it to smoothies and breaks up the capsule regime. It is also useful to disguise the flavour of the magnesium drops in water, or you can add to smoothies or gummies.
🩸Natural magnesium @ancientlakes - This liquid magnesium is my favourite form as it doubles up not only as a source of magnesium, it is also a source of trace minerals. It is naturally sourced from an Australian Magnesium Lake, and can be added to water or juice.
- I take 3ml of this magnesium, three times per day mixed in water at meal times.
Please keep in mind the following information:
Iron can feed active viruses (12), so if you fall ill whilst pregnant with a viral infection, it would be a consideration to stop the Spleen and Liver supplements, whilst maintaining the rest of the program as both vitamin C and magnesium support the immune system.
References:
(1) 10.1146/annurev-nutr-082018-124213
(3) 10.1146/annurev.nutr.24.012003.132306
(4) 10.4067/S0370-41062017000200001
(6) 10.1016/j.freeradbiomed.2014.07.007
(12) 10.1038/nrmicro1930