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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Are Folic Acid, Calcium And Iron Advisable During Early Pregnancy?

Hello doctor 1)Was advised 5 mg of folic acid (folvite) daily during my first trimester Recently read that excess of folic acid may cause autism or asthma a in infant Is ABOVE true 2)Into 4th mth now n advised to take a prenatal daily content as below 800 mcg folic acid 800 mg calcium 1200 mcg vit D3 27mg Iron 200 mg Dha Plus other micro nutrients in it e.g. Vit c Vit B12 Vit E thiamine riboflavin IS the ABOVE dose correct Waiting anxiously for your reply Regards
Tue, 27 Dec 2016
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Dietitian & Nutritionist 's  Response
Welcome to HCM,
1) mcg and mg are very different and sometimes confused. The typical dose of folic acid in pregnancy is 400mcg. Five mg is unheard of. The statement about increased risk for autism with very high doses of folic acid comes from a recent review finished in 2013. The study did show an increased risk for autism with an excessively high intake of folic acid which increased further if high B12 levels were added.2) A regular prenatal vitamin is what I recommend to my patients. There is no need for vitamin E supplementation in pregnancy, it is a fat soluble vitamin so too much can be stored and build up in the fatty tissues.

For most water soluble vitamins (B's included), excessive amounts are excreted in the urine. Mega doses are not included in this statement. The DHA you speak of is an essential fatty acid and is fine. A search of the literature showed that vitamin E supplementation is not needed or advised during pregnancy as I said earlier.

I do not know who is providing you advice, but the advice is unsafe and not supported by evidence as well as potentially harmful to the outcome. I highly suggest that if you do take a supplement, take a regular prenatal that meets 75% of the needs for a pregnant woman or 100%.

Recommended dietary intakes are put out by the US National Institutes of Health are are searchable for needs during pregnancy. You may access these and use as a guide when looking at prenatal labels.

Congratulations on your pregnancy and hope all is well. Kathy J. Shattler, MS,RDN
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Are Folic Acid, Calcium And Iron Advisable During Early Pregnancy?

Welcome to HCM, 1) mcg and mg are very different and sometimes confused. The typical dose of folic acid in pregnancy is 400mcg. Five mg is unheard of. The statement about increased risk for autism with very high doses of folic acid comes from a recent review finished in 2013. The study did show an increased risk for autism with an excessively high intake of folic acid which increased further if high B12 levels were added.2) A regular prenatal vitamin is what I recommend to my patients. There is no need for vitamin E supplementation in pregnancy, it is a fat soluble vitamin so too much can be stored and build up in the fatty tissues. For most water soluble vitamins (B s included), excessive amounts are excreted in the urine. Mega doses are not included in this statement. The DHA you speak of is an essential fatty acid and is fine. A search of the literature showed that vitamin E supplementation is not needed or advised during pregnancy as I said earlier. I do not know who is providing you advice, but the advice is unsafe and not supported by evidence as well as potentially harmful to the outcome. I highly suggest that if you do take a supplement, take a regular prenatal that meets 75% of the needs for a pregnant woman or 100%. Recommended dietary intakes are put out by the US National Institutes of Health are are searchable for needs during pregnancy. You may access these and use as a guide when looking at prenatal labels. Congratulations on your pregnancy and hope all is well. Kathy J. Shattler, MS,RDN