Entertaining the idea of adding a bundle of love to your life?
When preparing your world and your body for a new addition, there are some important elements of a preconception plan that need to be considered.
Preconception is rightly a time to detoxify your body and align with the health values you will be respecting whilst pregnant. This can include anything from ditching or reducing alcohol consumption, to teasing out and eradicating food intolerances. It could also be avoiding fast or fried foods which are high in trans fats, or increasing beneficial plant foods to reduce oxidative stress in the body. All of which will have a profound effect on your fertility as well as your overall health.
It is also time to be sure you are taking enough folate in both it's natural form (commonly found legumes and leafy greens) and as a supplement (I prefer activated folate over folic acid as the later can be increasingly difficult to convert to bioavailability by ~60% of women).
But another valuable element to a preconception plan is pathology testing with the outlook of fine tuning any subclinical or pathological levels, whilst enabling you to choose (and be prescribed) the right supplementation to meet your specific needs.
Below are the main tests I choose for clients. But bear in mind that individualised evaluations are key and sometimes the client will present with a few more necessary investigations. In particular women who have recently come of oral contraceptive pills or other forms of birth control, women who have had previous pregnancies and any woman suffering from a pre-existing condition like autoimmunity.
Iron Studies.
Understanding iron takes a thorough evaluation of what is called your 'Iron Studies'.
Because this trace mineral is one of the most common nutritional deficiencies, particularly in women who often have a low intake coupled with a higher need due to menstrual flow, evaluating it's levels before a pregnancy is vital to both mum and bubs. A good supply is necessary for the growth of your bubs and placenta. And iron is increasingly required for a production of haemoglobin when pregnant, as your circulating blood increases by 30%. Iron deficiency can have adverse outcomes on pregnancy such as a low birth weight or a premature birth. It can also have challenging effects on a mother's health both during her pregnancy and postnatally, especially with possible blood loss in delivery as well as increased demands when breastfeeding. Optimising your iron levels can be as simple as a supplement or an iron transfusion from a well regarded and referred source. The results can be profound, particularly if you have been suffering from low levels for some time, which is often the case.
Full Thyroid potentially including TPO antibodies.
When looking at your thyroid function, medicare commonly covers the assessment of TSH only. However, this only tells us half the story and having a full thyroid assessment is much more informative to the evaluation of your thyroid function. During pregnancy there are huge demands for a heightened supply of thyroid hormones as the developing bubs is dependent on these hormones for neurological development. While deficiency can lead to impaired IQ, a subclinical pathology can result in miscarriage, low birth weight and premature births. As for Mum. Postpartum thyroiditis currently affects somewhere between 5 to 10% Australian women, is a common culprit for postpartum depression, and can develop into more serious thyroid conditions if not properly addressed. Due to the fact that this condition is often triggered by an underlying form of autoimmune thyroiditis that was already present before pregnancy, yet showed no noticeable symptoms, it assures more reason to have a thorough evaluation of this endocrine system.
Iodine.
Definitely one of the most under evaluated, highly necessary, and commonly deficient minerals is iodine. A hypothyroid result from your full thyroid test will often, but not exclusively, indicate an iodine deficiency But whilst not common, iodine deficiency can also be present in a hyperthyroid patient.
Due to iodines key role in producing the active thyroid hormone, and due to the increased demands for thyroid hormones in pregnancy, it is essential to get the supplementation for this nutrient right. Too much can also have a negative effect so having a thorough evaluation by a nutritionist who specialises in pregnancy health is definitely warranted. Deficiency of iodine during pregnancy can damage a mother's thyroid and cause brain impairment to bubs.
Copper:Zinc Ratio.
Getting this ratio right is important to fertility and it is also extra warranted in women who have had previous pregnancies or have had long term birth control use. This is mainly due to the competing relationship of these two minerals, like flips of the coin their ratio should ideally be 1:1.
Copper commonly goes together with oestrogen, and zinc commonly goes together with progesterone. During pregnancy and with the use of oestrogen and oral contraceptives, levels of copper commonly increase as the heightened levels of oestrogen retain copper in the body. This can then have the opposite effect on zinc which when lowered has negative outcomes on fertility and can cause growth issues for developing bubs. For mothers, lowered zinc (which is far more common than low copper) is commonly linked with postnatal depression, it is vital for digestive function and immune function, and is instrumental in regulating hormones and neurotransmitters. On the flip side, high copper levels are commonly related to heightened anxiety as well as obsessive compulsive behaviour, which is due to it's role in increasing noradrenaline whilst reducing dopamine. It has further detriment by increasing inflammation in your body, reducing progesterone and indirectly reducing iron absorption. A thorough holistic investigation coupled with pathology testing can really help understand the underlying mechanisms behind impaired Copper:Zinc ratio as well as provide an appropriate treatment plan ahead of future pregnancies.
Vitamin D.
Whilst we are all aware of the damage overexposure to UV can cause, we are far less aware of the increasing deficiency of this vital nutrient, which acts far more like a hormone in the body increasing genetic expression and playing a key role in bub's growth and development. Not to mention mental well-being for mum. It is well recognised that Vitamin D deficiency during prenatal development may increase the risk to a range of diseases such as autoimmune conditions, schizophrenia and type 1 diabetes. It can also play into other nutrient deficient like calcium due to their complimentary relationship and can be causal in pre-eclampsia, gestational diabetes, and low birthweight. Making sure you have adequate Vitamin D stores heading into pregnancy is imperative.
B12 and other methyl donors such as Folate.
These nutrients play many important roles in a healthy pregnancy, one that is worth mentioning is the methylation cycle and the role they play in preventing adverse epigenetic events (modification of gene expression) as methyl donors. Their ample presence can actually repress the expression of certain detrimental genes and understanding their adequacy is important in careful pregnancy planning.
These recommended pathology tests are definitely a good foundation to assessing your body and nutrient levels heading into a pregnancy. Hopefully it goes without saying that finding yourself a specialised Nutritionist, Naturopath or Integrative Doctor is ideal to your preconception planning.
References.
Agarwal, A., Aponte-Mellado, A., Premkumar, B.J.et al.The effects of oxidative stress on female reproduction: a review.Reprod Biol Endocrinol10,49 (2012). https://doi.org/10.1186/1477-7827-10-49
Institute of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation. Nutrition During Pregnancy: Part I Weight Gain: Part II Nutrient Supplements. Washington (DC): National Academies Press (US); 1990. 14, Iron Nutrition During Pregnancy. Available from: https://www.ncbi.nlm.nih.gov/books/NBK235217/
The Royal Women's Hospital (2018). Iron in pregnancy.
https://thewomens.r.worldssl.net/images/uploads/fact-sheets/Iron-in-pregnancy2018.pdf
Forehan, S., (2012). Thyroid disease in the perinatal period. Roayl Australian College General Practitioners. Volume 41, No.8, August 2012 Pages 578-581
https://www.racgp.org.au/afp/2012/august/thyroid-disease-in-the-perinatal-period/
Kharrazian, D., (2020). Pregnancy can trigger hypothyroidism
Serrallach, O., (2018). The Postnatal Depletion Cure. Sydney:NSW, Hachette.
Mulligan, M., Felton, S. K., Riek A., Bernal-Mizrachi, C., (2009). Implications of vitamin D deficiency in pregnancy and lactation. Am J Obstet Gynecol. 2010 May ; 202(5): 429.e1–429.e9.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540805/
Sarah E McKee, Teresa M Reyes, Effect of supplementation with methyl-donor nutrients on neurodevelopment and cognition: considerations for future research,Nutrition Reviews, Volume 76, Issue 7, July 2018, Pages 497–511,https://doi.org/10.1093/nutrit/nuy007
Sharma, S., Litonjua, A., (2013). Asthma, allergy, and responses to methyl donor supplements and nutrients. The journal of allergy and clinical immunology. 133 (5),P1246-1254.
コメント