What I Look For When Selecting Supplements for Fertility and Pregnancy
It is dizzying to see how many nutritional supplements are on the market these days. Even as a registered dietitian, it sometimes takes me a while to determine which supplements are worth taking and which are made by a company who has a very talented marketing team. Most people do not know what to look for when selecting supplements, and unfortunately may end up overpaying for an underperforming product.
Part of what I do is evaluate clients’ supplementation regimen. Since most of my clients are pregnant or trying to become pregnant, a handful of daily supplements is not unheard of. I find that many make supplement decisions based on what a pretty label claims instead of evaluating what the actual supplement contains. Most clients get very general advice from their doctors and specific brands and ingredients are not discussed. That is where I come in!
In general, these are some rules that I follow when evaluating supplementation plans and supplements. Please note that these are my personal opinions and should not be accepted as a guide for every single situation and scenario.
1. I do not choose supplements that provide a “proprietary blend” of ingredients when dosages are not listed on key ingredients. I need to see the quantity of the nutrients that are included in the supplement. A proprietary blend clumps a few ingredients together, and the amount of each ingredient is not shared on the label. Take CoQ10 for example; this antioxidant is known to support fertility goals. Many “fertility-boosting” supplements contain CoEnzyme Q10 (CoQ10). However, clinical trials have suggested that it may help with fertility challenges when it is taken in a specific dose. Many studies focused on male fertility suggest that a man requires AT LEAST 150 mg of CoQ10 to offer any benefit. How much is in a proprietary blend? 150 mg? 5 mg? I don’t know, and companies often won’t share this information with me. Unless I see a quantity that coincides with the research, I do not choose that supplement. (loads of male fertility and nutrition info can be found here!).
I am. not saying that every proprietary blend is a scam. And I am not saying that I will never be ok with a supplement that contains a proprietary blend. Some blends contain ingredients that are not key to my goals as a dietitian and therefore containing them is not a make-or-break. It depends on the scenario.
2. There must be studies about the nutrient or supplement that is not funded by the manufacturing company. I base all of my recommendations on what the medical literature suggests. Many supplements claim that they are “clinically proven”, but when you dig a little deeper, the studies that they use to make this claim may be funded by the company who makes the supplement. It is not an independent study, and therefore bias cannot be ruled out.
I am going to go out on a limb and try to use an analogy here. Imagine if you are trying to determine whether your homemade pie is better than your neighbors. In one scenario, you conduct a taste-test yourself and then conclude that your pie is the best. In another scenario, you give the two pies to a random person, blindfold them, and then ask them to determine which pie is the best. Now which result would you trust more? The results from the test where you say that your pie is the best, or the test where a random person says that your pie is the best?
3. I choose certain versions of nutrients over others, and often it costs more.In the population I work with, I believe that quality matters. In many cases (not all), certain nutrients are better absorbed and utilized in one version vs another or are available in a natural form instead of a synthetic for,. Some versions of nutrients that I prefer for my clients include:
- Methylcobalamin instead of cyanocobalamin when Vitamin B12 Is being supplemented. Cyanocobalamin is the synthetic form of Vitamin B12.
- Ubiquinol form vs. ubiquinone when Coenzyme Q10 is being supplemented. Ubiquinone is the oxidized form of CoQ10.
The supplements I recommend are often a little more expensive than the drugstore brand versions, but I do believe that you get what you pay for. Choosing high-quality supplements with high-quality nutrients is 100% worth it in the long run, especially when pregnant or ttc. (I share my professional discount when I am able to help offset the cost. I think it is that important!).
4. Omega 3 supplements should contain adequate amounts of both DHA and EPA, and preferably in a liquid form like a gelcap.I see many “omega 3” supplements on the market. Many people do not realize that there are different omega-3 fatty acids that fall under the category, not just DHA. I choose supplements that provide both DHA and EPA omega-3 fatty acids because I think that both are important during this time. I also choose supplementation that is in a liquid form (like a gelcap) because I question the stability of these fatty acids when they are provided in other ways (like how they are delivered in some multi vitamins).
5. The supplements must be third-party tested. Since supplements in the USA are not regulated, one cannot assume that what you are paying for is what you are actually getting. I must see some kind of indication that the supplement was verified by a third party for quantity and purity. Some indications are the USP seal and the NSF seal.
6. Over-supplementation should be based off of a doctor’s recommendation. While some is good, more is better…right? Not always. I have seen my share of clients who have started taking fertility “boosting” supplements on top of their prenatal vitamins and a result is consuming WAY too much of certain nutrients. While women certainly benefit from supplementation of nutrients during this time in their lives, taking in too much may result in some consequences of their own. Anything beyond what your doctor recommended should be green-lighted before it’s use.
7. Supplementation from pills are recommended if getting the same amount of the nutrient from a food source is not an option. Can I get the client to consume the same amount of nutrients through food? Many clients are taking a TON of nutritional supplements based off of suggestions from social media or their docs. I always prefer food over pills, and whenever possible I determine whether a simple food addition can be used instead of a pill. I see a better compliance with clients when food is being prescribed, I don’t have to questions quality, and in some cases absorption is better. When I see a client taking a selenium supplement, I try and get them to eat a Brazil nut instead. Lycopene supplementation going on? Considering eating one tomato-rich dish or serving of watermelon may do the same job, and is much yummier.
8. If probiotics are being mail-ordered, make sure they are being delivered appropriately if the supplement is not heat-resistant. Many probiotics are heat-sensitive and will essentially die if they are heated beyond 100 degrees (F). If this is the case for yours, make sure that you are not ordering from a company that offers quick delivery and will ship with an ice pack. Otherwise, having your probiotics sitting in the hot UPS truck may cook them to the point that they are essentially useless to your body.
I hope this helps determine how to pick from the sea of choices out there. I am always happy to help with supplement evaluation (and actually think it’s fun!). Feel free to email me at NutritionNowCounseling@gmail.com if you have any questions (or want to explore my nutrition audit process).