I always ask my patients to bring all their supplements with them to their appointments, and I’m not exaggerating when I say that many arrive with a bagful of bottles. They frequently share that they’re not sure whether the supplements are working for them, or how much they should be taking. I’m sympathetic. Contrary information is everywhere. We’re drowning in data, while starving for information. How can the average person be expected to make sense of it all?
While each of us have unique nutritional needs, there are a few supplements women, in particular, should think it about when it comes to their health.
Vitamin B6
Vitamin B6 (pyridoxine) plays an important role in the production of fuel and energy, and it is critical for optimal function of the brain as well as the nervous and immune systems. It is also involved in the production of neurotransmitters gamma-aminobutyric acid (GABA), serotonin, norepinephrine, and dopamine, all of which positively affect mood. Low levels of B6 increase the risk for depression and impair cognition, attention, and memory.
In spite of how important vitamin B6 is to health, research shows than more than 30 million Americans are low in this nutrient. Women are almost twice as likely to be deficient in vitamin B6 as men, a statistic that may be related to their use of B-depleting oral contraceptives and/or hormone therapy during menopause.
While women are especially vulnerable to B6 deficiency, they can also obtain unique benefits from supplementing with this vitamin. Numerous studies have found vitamin B6 to be effective for treating symptoms associated with PMS, and B6 has also been shown to help relieve morning sickness during pregnancy.
Vitamin D
Vitamin D is critical for many functions in the body. You probably already know that having adequate levels is necessary for healthy bones, but it might surprise you to learn that the active form of vitamin D interacts with more than 30 different tissues in the body and affects more than 1,000 genes. In other words, it’s important for a whole lot of things other than your bones! Here are some of the roles vitamin D plays in the body:
- Helps maintain muscle strength
- Has a significant impact on the immune system
- Increases our resistance to infections, particularly bacterial and viral infections that impact the respiratory tract
- May protect against colorectal cancer
- Supports healthy heart function and blood pressure
Adequate vitamin D is essential for all women, but it’s especially key for those who plan on becoming pregnant. Studies show having adequate vitamin D during pregnancy can be protective for both mom and baby. And remember, for healthy bones, vitamin D needs to partner with calcium, magnesium and vitamin K2.
In spite of its vital role in women’s health, vitamin D deficiency/insufficiency is a problem in this country. This is particularly true for women who are dark-skinned, spend most of their time indoors, regularly use sunscreen, live in northern latitudes, and/or are overweight or obese. If you’re worried that you may be deficient in vitamin D, consider having your levels checked. You can speak to your healthcare provider, or order your own test from Request A Test for $59 (price may vary).
Iron
Iron is necessary for normal growth and development, plays a key role in DNA synthesis, and is an essential component of hemoglobin, the protein in blood that is responsible for carrying oxygen from the lungs to all body tissues. This mineral also plays a critical role in cellular energy production, immune function, and reproduction (among other things).
Unfortunately, many women lack sufficient amounts of this vital nutrient. Menstruating women need a constant supply of iron to counter the monthly loss from menstruation, and pregnant women need even more. Iron demands go up in pregnancy—a pregnant woman needs 27 mg per day versus 18 mg for a menstruating, non-pregnant female.
One of the big issues with iron supplementation is that it can cause significant GI upset. I have seen many pregnant women with iron deficiency anemia not take their iron because it made them so sick to their stomach. This year, a study conducted at the University of Maryland found that a low dose, food-based iron paired with folate, B12, and beets increased iron levels in women without any adverse effects. MegaFood Blood Builder was the product used in the study, the same iron that is used in their Baby & Me 2 prenatal that I formulated.
Magnesium
You’d be hard pressed to find a body system that doesn’t rely on magnesium to do its job. Yet government surveys show that roughly 50 percent of us don’t get the RDA for magnesium in our diet. Why aren’t more people aware of this public health problem?
Chronically low levels of magnesium have been linked to diabetes, high blood pressure, heart disease, sudden cardiac death, migraines, menstrual cramps, depression, osteoporosis, and asthma. Some of the many conditions that magnesium can help prevent or may benefit include:
- Anxiety and irritability
- Depression
- Postmenopausal osteoporosis
- Hypertension
- Preeclampsia during pregnancy
- Heart arrhythmias and stroke
- Metabolic syndrome
- Migraines
- Menstrual cramps
- Muscle tension
- Asthma
Whew! You can you see why I want to get the word out to women about this marvelous mineral and its benefits.
A well-formulated prenatal
Keeping yourself and your baby nourished during pregnancy can be a daunting task, which is why choosing a quality prenatal vitamin is so important. It’s hard enough for women to get the nutrients they need when they’re just eating for one! A well-formulated prenatal can help fill in gaps in your diet, making sure both you and your baby get the support you need.
Since adequate nutrition is vital during pregnancy, I generally recommend that women look for a prenatal that contains all of the standard vitamins and minerals AND:
- 150-250 mcg of iodine
- 200-450 mg of choline
- 100-300 mcg biotin
- 400 mcg methylfolate
Let’s take a closer look at some of these nutrients.
Choline is important for your developing baby’s brain health, particularly the parts of the brain that affect learning ability. Animal studies clearly show that choline offers lifelong cognitive benefits, and human studies are now showing similar results. In 2016, the FDA set a daily value for choline at 550 mg per day, which I was glad to see. And in 2017, the American Medical Association recommended that all prenatal vitamins include meaningful amounts of choline. When I worked with MegaFood in formulating their Baby & Me 2 prenatal, we included 300 mg of choline to ensure women would get adequate amounts while pregnant and/or breastfeeding.
Folate (vitamin B9) is another nutrient that’s essential for a healthy pregnancy and the development of your baby. But if you’re one of up to 30% of Americans with a genetic mutation known as MTHFR, your body may not be able to metabolize the synthetic folic acid commonly found in supplements. To make sure you get the folate you need during pregnancy, choose a prenatal that contains methylated folate (methylfolate), a form of the vitamin your body can actually use.
Iodine is vitally important for a baby’s development during pregnancy and while being breastfed. Given that only 20% of the salt sold in the US contains iodine (and we don’t want women eating a bunch of salt), I support the American Thyroid Association’s recommendation that all pregnant and breastfeeding women supplement with 150 mcg per day of iodine (usually as potassium iodide).
I already addressed the importance of vitamin D and iron during pregnancy, as well as how many women are lacking these nutrients. Pregnant women should maintain their vitamin D level at >30 ng/mL. If you need supplemental iron while pregnant, look for a prenatal that has an absorbable form of iron that won’t irritate your stomach.
In addition to these nutrients in your prenatal, you will want to make sure you are getting 200-400 mg of DHA, a long chain omega 3 fatty acid that is your crucial for your baby’s brain and eye development. It is available in fish oil and there are vegan sources.
Probiotics are important during pregnancy, particularly during the last trimester. Look for a product that includes Lactobacillus rhamnosus HN001, which has been shown to help reduce the risk of asthma and allergies in the baby.
Calcium and magnesium are also very important but they should be taken separately from your prenatal, as they can interfere with iron absorption.
If, like most women, you’re trying but failing to eat a great diet—or if you have a specific medical condition, take prescription medications, are planning on becoming or are pregnant or nursing, are an athlete, over the age of 50, or just want to enhance your health—I believe a few strategically chosen nutritional supplements could make a big difference in helping you reach your wellness goals. I hope this list is useful to you, my sisters.
Heard you at the Buffalo Niagara Convention yesterday and also when you came to Buffalo a few years ago. I wish you lived in Buffalo as I would love to have you as my doctor!
Aw…. thank you.
Hello Dr Low Dog,, I am an admirer of your work and I have been in your lecture. I just read the national geographic magazine you did and bravo, great. I would like to share that I see in my health town of Truth Or Consequent many people taking herbs, and I believe some of the herbs are thyroid blockers as are the goitrogenic vegetable. I was wondering if you could say which one should be avoided by those with hypothyroidisms?
Hi Joanne, great question. In addition to goitrogens, keep a look out for gluten, as up to 5% of those with Hashimoto’s will develop celiac. Those with autoimmune thyroid disease are also often found to have subclinical celiac. Look for environmental causes such as perchlorate or iodine excess (more than 1 mg/d), which can trigger Hashimoto’s in those with positive antibodies or family history. Iodine is tricky, though, many goitrogens are only a problem when consumed in large quantities in the presence of low dietary iodine, as they compete with iodine for the first step in thyroid hormone production. Check supplements – if not pregnant or breastfeeding – should provide no more than 150 mcg per day. As far as herbs: bugleweed (Lycopus), blue vervain (Verbana spp), and gromwell (Lithospermum) are the main ones that should be avoided. Lemon balm (Melissa), as tea, is fine – but do not exceed more than 2 grams per day.
What about the oxidative effects of iron. Is that a concern?
Hi Abigail, it really is the Goldilocks approach with iron. You don’t want too much or too little… just enough. Women who menstruate monthly or who are pregnant often benefit from taking a multivitamin with some iron. If you have had a hysterectomy, are past menopause, or do not have monthly cycles for other reasons (e.g., IUD), then you should not take supplemental iron unless instructed to by your health care provider. The upper tolerable limit set by the government is 45 mg per day. Your supplement should only provide up to 18 mg per day.
Dr Low Dog
I just saw you at the Chicago Midwinter Convention. Finally a CE course that had interesting and useful information.
What brand of vitamins do you recommend for women, men and kids? Do you have a recommendation for a good multivitamin or taking the supplements talked about above? Missed hearing you speak in Portland this year at the dental convention due to the pandemic.
I recommend MegaFood vitamins. I formulated the men and women’s multivitamins.