Celiac Central recently issued a fact sheet on how Celiac Disease can effect infertility AND it also includes areas that pregnant celiacs should take into account when working with their doctor!! You can download the form here.
The four vitamins mentioned on this sheet- Iron, Folic acid, Calcium and Vitamin D - are important for every pregnant woman, but Celiacs have a tougher time getting what they need because many of us have challenges with absorption through our damaged gut. In addition, there is a lack sophistication in gluten free foods in that many are not fortified with vitamins. Most Americans get a good portion of their vitamins in their foods such as bread, crackers, pasta etc.
IRON: As I have written about before, its very difficult for a Celiac to get enough Iron without supplementing their diet with a fortified cereal and / or pills. If you don’t take care of getting enough while you are pregnant, this will be one of the reasons you are exhausted during your pregnancy, especially in the first trimester as your body starts making a lot of extra blood for the baby and your own system to support it.
Most pregnant women (and frankly most people!!) distain taking iron pills because they make you constipated. Eating fortified cereal is a great alternative. Check out my post on Rice Chex and the trick to iron absorption – hint you have to eat something with vitamin C while eating something with iron or its moot.
FOLIC ACID: This is critical for every pregnancy! And to be more specific its most important at the very, very start. The baby uses folic acid as its brain forms in the first few weeks. It prevents spinal bifida. This means women who are trying to conceive should already be taking folic acid. Folic Acid is also important for developing the baby’s DNA and extra blood your body makes to support the additional load on your circulatory system.
Celiacs again are at a disadvantage here because many foods that are fortified with Folic Acid have gluten in them. In 1998 the FDA approved and further encouraged Folic Acid fortification in an effort to reduce the number of spinal bifida births by 25%. This means you likely need more than the advertised 600mg / daily marker. My doctor and my nutritionist asked that I pump that up to 800mg/day.
Good news? Rice Chex does have a decent amount of Folic Acid. If you incorporate Rice Chex into your diet for Iron you will also get some Folic Acid.
CALCIUM: At least 1200 mg/day is recommended for pregnant women. BUT, a lot of Celiacs are also lactose intolerant. For those of you with this problem (or if you are like me and hate milk) you need to find calcium alternatives and supplements. I talk here about seaweed as a calcium alternative, but there are many other options including flax seeds, almonds, papaya, oysters, clams and other shellfish.
VITAMIN D: There is a ton of new research being done on Vitamin D making it really important to not rely exclusively on your doctor or a pregnancy book to understand the latest on Vitamin D. Do your own research. There is a laundry list article on wikipedia on Vitamin D to give you a sense of all of the links that have recently been discovered including a link to Multiple Sclerosis.
On challenge with Vitamin D is that everyone – EVERYONE – has a different level of absorption so you must get tested frequently to see your own scores and monitor them. My score was a measly 18 the first time I got tested. YIKES! Its supposed to be 150. I went to Argentina for 2 weeks and started taking Vitamin D at the same time. Next test showed up at 180 – too high. I was just tested again and my score went back down to 15. ARGH! I live in New York City and spend most of my life with sun screen on which limits my exposure to the sun. I continue to work with supplements.
Vitamin D is one of the those vitamins that your body does not get rid of if it has too much so its dangerous to start supplementing, especially if you are pregnant, without actively testing. I ask my doctor to throw in a test here and there during my prenatal visits which has made it very easy for me to track my progress, or lack there of.
Let me know if you have found any of your own tricks when trying to achieve the right balance of vitamins during a gluten free pregnancy!
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