NEW YEAR TIMES BESTSELLER . USA TODAY BESTSELLER . #1 AMAZON BESTSELLER
SARA GOTTFRIED, MD
Here Are Dr. Sara's Top Genetic Tests...
Dr. Sara recommends "Pathway FIT" for everyone who wants to test 200 genes that tell them:
- The best food plan, % carbs, % protein, % fat
- The optimal exercise for their DNA
- The needle-moving supplements that you most need
BEFORE YOU GET PREGNANT or DURING EARLY PREGANCY
Dr. Sara recommends "Carrier Status Testing"
- Get the genetic insights you need for you and your partner to make smart decisions, way in advance
- This test offers the preconception and prenatal screening that I recommend (and more of the American College of Obstetricians and Gynecologists recommended conditions than other carrier tests on the market)
- Go here to learn more
AFTER THE BABY
Dr. Sara recommends "Mommy DNA Insights"
- Helps you to better manage post-baby weight loss
- Identifies behaviors that may need to be managed
- Gives detailed information to promote improvement in overall health and wellness
- Go here to learn more, or go to www.pathway.com
- Greenberg JA, Bell SJ. "Multivitamin Supplementation During Pregnancy: Emphasis on Folic Acid and l-Methylfolate." Reviews in Obstetrics and Gynecology 4 (3-4) (2011): 126-7. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3250974/
- Greenberg JA, Bell SJ, Guan Y, Yu YH. "Folic Acid supplementation and pregnancy: more than just neural tube defect prevention." Reviews in Obstetrics and Gynecology 4 (2) (2011): 52-9.
Folate (vitamin B(9)) is an essential nutrient that is required for DNA replication and as a substrate for a range of enzymatic reactions involved in amino acid synthesis and vitamin metabolism. Demands for folate increase during pregnancy because it is also required for growth and development of the fetus. Folate deficiency has been associated with abnormalities in both mothers (anemia, peripheral neuropathy) and fetuses (congenital abnormalities). This article reviews the metabolism of folic acid, the appropriate use of folic acid supplementation in pregnancy, and the potential benefits of folic acid, as well as the possible supplementation of l-methylfolate for the prevention of pregnancy-related complications other than neural tube defects.
- Bentley S1, Hermes A, Phillips D, Daoud YA, Hanna S. "Comparative effectiveness of a prenatal medical food to prenatal vitamins on hemoglobin levels and adverse outcomes: a retrospective analysis." Clinical Therapeutics 33(2) (2011): 204-10. doi: 10.1016/j.clinthera.2011.02.010.
BACKGROUND: The role of folate in pregnancy is well established, with most prenatal vitamins (PNVs) on the market containing at least 800 μg of folic acid. Folic acid must be converted in the body to L-methylfolate, the natural and biologically active form of folate. The role of vitamin B(12) in pregnancy is less characterized, and most PNV formulations contain only 0 to 12 μg. The present study was undertaken to evaluate whether taking a prenatal medical food containing L-methylfolate and much higher doses of vitamin B(12) results in higher hemoglobin levels and thus, a lower incidence of anemia during pregnancy.
OBJECTIVE: The objective of this exploratory study was to evaluate the effects of the prenatal medical food versus standard PNVs on hemoglobin levels and adverse outcomes throughout pregnancy.
METHODS: For this retrospective analysis, we reviewed the charts of female patients taking either a prenatal medical food or standard PNV during pregnancy. Hemoglobin levels measured at initiation of prenatal care, end of second trimester, and delivery were recorded. Patients who had received additional iron supplementation, beyond that contained in the prenatal medical food or PNV they were taking and before anemia screening at the end of the second trimester, were excluded from the study. Fisher exact test, χ(2) test, student t test, and ANOVA were used to evaluate differences between the treatment groups.
RESULTS: Data were analyzed from 112 charts: 58 patients (51.8%) were taking the prenatal medical food; 54 patients (48.2%) were taking standard PNVs. Mean (SD) age at first prenatal visit was 27 (4.6) years in the medical food group and 28.8 (3.5) years in the PNV group (P = 0.024). Mean (SD) body mass indices were 29.1 (6.5) and 31.7 (8.9) in the medical food and PNV groups, respectively (P = NS). In the medical food group, 35 women (60.3%) were white/Caucasian, 17 (29.3%) were African American, and 6 (10.4%) were of other races. In the PNV group, 24 women (44.4%) were white/Caucasian, 25 (46.3%) were African American, and 5 (9.3%) were of other races. However, race was not significantly different between the two groups. At end of second trimester and at delivery, mean (SD) hemoglobin levels were higher in the prenatal medical food group (11.8 [1.1] g/dL and 11.8 [1.3] g/dL, respectively) than in the PNV group (11.3 [1.2] g/dL and 10.7 [1.2] g/dL, respectively) (P = 0.011 and P = 0.001, respectively). Significantly fewer cases of anemia were reported at end of second trimester in the prenatal medical food group than in the PNV group (39.7% vs 74.1%; P = 0.001).
CONCLUSIONS: In the present study, supplementation with a prenatal medical food containing L-methylfolate and high-dose vitamin B(12) may maintain hemoglobin levels and decrease rates of anemia in pregnancy more effectively than standard prenatal vitamins; however, prospective, controlled studies are warranted. ClinicalTrials.gov identifier: NCT01193192.
- Seremak-Mrozikiewicz A. "Metafolin--alternative for folate deficiency supplementation in pregnant women." [Article in Polish] Ginekol Pol 84 (7) (2013): 641-6.
Proper folate supplementation is required in order to ensure proper folate concentration in the organism, and consequently to prevent the development of numerous complications in general population and pregnant women. Metafolin (stable calcium salt of L-5-methyltetrahydrofolate acid, L-5-MTHF) is the most active form of reduced folate circulating in plasma, which directly enters the metabolic process of folate. After administration metafolin shows optimum absorption, comparable or higher bioavailability as well as physiological activity when compared tofolic acid. Metafolin supplementation is effective in decreasing plasma homocysteine, as well as increasing folate in plasma and erythrocytes, in pregnant and breastfeeding women or those who wish to conceive. In addition, metafolin administration omits the multistage process of reduction before entering the folate cell cycle, as well as a possible deficiency of activity of enzymes participating in the reduction of folate process in the intestine epithelium (DHFR and MTHFR enzymes). So far no potential adverse and toxic effects of metafolin management have been reported. The published findings require confirmation in larger groups of patients and an additional analysis of the presence of particular genotypes of 677C > T polymorphism of the MTHFR gene. Analysis of the recent literature reposts suggests that metafolin could be an effective and safe alternative to folic acidsupplementation and could effectively prevent complications in pregnancy and series birth defects in fetuses and newborns.