Best Prenatal Vitamins for a Gluten Free Pregnancy

Prenatal vitamins are a pregnancy reality – even before you get pregnant you should begin taking pre-natal vitamins because the baby’s brain begins its most critical formations in the first few weeks of pregnancy. BUT, if you are a celiac this is even more important. Most folic acid in the American diet comes from fortified foods such as gluten filled cereals and pastas. Its a mistake to think that you can get enough of the more critical things a baby needs without supplements. Read more about this here.

Nutramedix Gluten Free PregnancyI have been using two supplements that I adore and highly recommend! Both are made by NutraMetrix. One is their Calcium Complete and the other is their Prenatal Activated Multivitamin.

The plus about these? They are crystalized requiring you to make a small drink with them each day. This increases absorption something every celiac needs!! They are isotonic which is a fancy way of saying that if you drink them on an empty stomach they are designed to be absorbed / flow into your body more quickly. Celiacs have enough issues with absorption with our weak guts making this approach a win/win.

I made the decision to split my dose of these vitamins into 2x a day which eliminated the stomach irritation I had initially to the iron in the Pre-natal vitamin. Most women complain about the iron in pre-natal supplements, but I recommend trying to take one with iron. Without it you will be wiped out as your body stands up the baby’s blood supply which happens at the start of pregnancy but continues as your baby grows.

The critical vitamins that you need are well provided for in the suggested dose (using stats from both bottles):

Calcium: 750 mg / 75%

Folic Acid: 800mg / 100%

Iron: 20mg / 111%

Vitamin D: 1,000 IU / 250%

I will continue taking these after the pregnancy as well to keep me stable as I produce breast milk and my body gets adjusted to not having a placenta to help out. Its a good idea to keep providing your body with suplemental support as it adjusts to life after the baby and changing hormones!

I am not a reseller or affiliate for these – this is a personal recommendation! I buy mine from my acupuncturist.

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The Fabulous 4 vitamins: Key nutrients in a Gluten Free Pregnancy

who are you?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!

Creative Commons License Photo Credit: bies via Compfight

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Gaining weight: The BIG issue during a Gluten Free Pregnancy

I am entering my 29th week of pregnancy and am stil a bit aggravated about my week 28 check-in! Week 28 Gluten Free PregnancyWhat I have discovered on my path is that the only thing most doctors are concerned with, if they give celiac disease any credence at all(I found one that does), is whether or not the baby is growing.

This translates into a sonogram every 4 weeks where the baby is measured for growth. My doctor seems to be measuring the baby’s femur and her weight each time.

While the baby did grow quite a bit – 1pd 2oz in the past 4 weeks – my weight increased by 1 pd. And the doctor was not pleased about this. She said she is concerned. When I asked her to articulate what she was concerned about, she didn’t really have an answer beyond “you are a celiac so we have to pay attention to your weight gain.”

I got home and was upset and worried. I felt like a bad mom.

Then I looked at the data. Withthings Weight Graph Gluten Free PregnancyI decided to geek out during my pregnancy about my weight and I AM REALLY glad I did. After learning that this would be the the one thing they were tracking and having a strange scale experience during my first pregnant visit, I decided to take matters into my own hands.

During the first appointment I noted that the scale at the office weighed me in at 9 pounds more than I weighed at home. I got a little nervous trusting their measurements. When I asked the nurse about it she reported that “all the scales in the office are different.” This was not a side comment! She shared that one day she weighed herself on all the scales, one right after the other, and there was a variance of 10 pounds between some of them.

Um, ok. Isn’t that a big DEAL when your practice is full of woman whose weight you are tracking? I told my doctor about it and she rolled her eyes.

So I took things into my own hands. My husband found a scale that reports weight over wi-fi to a web page. Its called a WithThings. This link will take you to my amazon store to check it out. Its extremely accurate scale that also records your BMI and fat percentages. I have lost about 2 pounds of muscle during this process which has been good for me to monitor and keep working on.

Maybe this sounds a little daunting, blasting your weight over your local network. BUT if you are a Celiac I recommend it. This will be a primary point of focus during your pregnancy. Withings also has an iphone app. I wish I knew about this before this last visit!! but I have it loaded and ready for my next one.

Back to last week. I was upset when I got home and worried about the baby. But after the initial worry / shock passed I was able to pull up my Withings chart and see the trend of my weight gain and see ok, I am doing fine. According to the March of Dimes, I am on track. My numbers: total weight gain so far is 18 pounds at 28 weeks. 

And further, in checking around, the baby is actually doing great!! She is a little bigger (not surprising since I am 5 ft 10 1/2 inches tall) than average according to this chart on babycenter.com.

I feel better now. And I am a little aggravated that the doctor I saw couldn’t think outside of the 4 week window of weight gain. But I also see I need to advocate for myself – and I can during my next visit.

 

 

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Sources of Iron in Pregnancy

Throughout my pregnancy I have been amazingly tired leading me on a search to find more iron in my diet. During my first trimester I was sleeping about 18 hours a day – at times more. Now in the second trimester I seem to cycle through a few good days and then crash out on the 3rd day exhausted again. I realize I am building a human from scratch!! But does it have to be this bad?

The standard recommendation for pregnant women is 27 mg of iron/day (and some sources say 30mg). Most women who are NOT gluten-free have an easy time accomplishing this by eating iron-fortified foods. Guess what? There are hardly ANY gluten free fortified foods.

Gluten Free Rice ChexI went to see a nutritionist a few weeks ago at the Celiac Center at Columbia University Hospital  to see if she had any great ideas on what I could be doing to improve my “situation.” We talked about many things that I will post about but her recommendations around iron surprised me.

  • She advised me to make sure I was combining Vitamin C and Vitamin A with everything I ate that has iron, like nuts and beans (non-heme iron) to help with absorption.
  • She recommended I eat Rice Chex.

I am probably the last person you will see woofing down Rice Chex. I hate milk! But after talking it through with her she made a compelling case for how advanced the fortification of iron is in a product like Rice Chex (make sure it says Gluten Free on the box) verses other small Gluten Free food companies that are trying fortify their products.

I was pretty blown away to see that Rice Chex has between 45-50% of the recommended daily iron intake. WARNING!! This is not 45-50% of a pregnant woman’s intake!! A good guideline is to assume your intake is two times the intake of the recommended intake used for nutrition labels. Women are supposed to get 18mg vs 27 mg while pregnant. Quick math is that a product with 50% of the daily intake only meets 25% of a pregnant woman’s daily intake.

 

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