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The Supplement Myth
Key dietary supplements in fertility and preconception
In episode 6, Laura explains to us how to choose the right food supplements when you want to make a baby.
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Summary
🔊 This program is an information program by a trained professional. This is generic advice and is not a personalized diagnosis. In all cases, we recommend that you be followed by a gynecologist and/or a midwife for individualized follow-up.
What you will learn in this episode
Key supplements in fertility and preconception
- The role of vitamin B9 in fertility and pregnancy
- How cUnderstand the doses in mcg and in “dietary folate equivalents”
- Why vitamin B12, Coenzyme Q10 and iodine are also important
- In which cases it is necessary to be particularly vigilant (age, vegetarianism, stress, thyroid...)
Vitamin B9: the basis for preconception
Vitamin B9 is the most well known preconception supplement and is regularly prescribed by gynecologists and midwives. It participates in the closure of the neural tube of the embryo and in the proper functioning of methylation, a key process for DNA, detoxification, and numerous metabolic reactions.
- A B9 deficiency can reduce the quality of gametes. (oocytes and sperm) and increase the risk of miscarriages, cardiovascular disorders or liver detoxification, with a particularly marked impact on women;
- Folic acid is the most studied form of B9 : there is a great deal of experience on its safety and on the doses used in preconception and early pregnancy;
- In France, The recommendations speak of around 600 mcg of dietary folate equivalents (EFA) per day for women who may be pregnant and up to the 12th week of pregnancy.
💡 Key figures
THEHANDLES recommends an intake of 600 mcg/day of dietary folate equivalents (EFA) for women likely to become pregnant and in early pregnancy, with an upper safe limit of 1,000 mcg/d of folate (folic acid + 5-MTHF forms).
Folic acid, methylated B9 and conversions
To switch from micrograms of folic acid to dietary folate equivalents (EFA), a conversion factor is used.
- Below 400 mcg of folic acid, a factor of 1.7 is used: 400 mcg of folic acid ≈ 680 mcg EFA, which remains compatible with the 600 mcg EFA guidelines at the beginning of pregnancy.
- Methylated B9 is better absorbed, but the conversion factors change:
- Up to 399 mcg, the conversion factor remains 1.7 (as for folic acid)
- Starting with 400 ug of methylated B9, a factor of 2 is applied: 400 mcg → 800 mcg EFA, we already exceed the recommended 600 mcg EFA
There is an upper safe limit for total folate of 1,000 mcg per day (folic acid + 5-MTHF salts), not to be exceeded over time.
⚠️ You should always check the rates indicated on the boxes of all types of supplements and adapt it to your own situation.
Laura's recommendation:
- I follow the recommendations of my gynecologist or midwife if I do not have a known MTHFR gene mutation;
- If I take methylated B9, I stay under 400 mcg (or at least I don't significantly exceed it), to limit the risk of exceeding the safety limit of 1,000 mcg EFA per day.
- Laura also recalls thatprolonged intake of B9 can mask a deficiency in B12, which is why it often combines B9 and B12, especially in preconception.
Vitamin B12, coenzyme Q10 and iodine
Vitamin B12 is a little less standardized than B9 in the protocols, but remains important in fertility, especially in the case of a vegetarian or vegan diet.
- Laura relies on the blood test: she likes to dose “active” B12 (not reimbursed), to have a more detailed vision of the real status;
- For the standard serum dosage, it seeks to be in the upper third of the norm instead, which gives more margin for pregnancy plans.
Coenzyme Q10 plays a central role in mitochondria, the “power plants” of cells.
- It supports the mitochondrial quality of oocytes and gametes in general, helping cells to produce enough energy and providing an antioxidant effect.
- Laura recommends it especially in long fertility courses or assisted reproduction courses, and recalls that in Germany, it is sometimes integrated into protocols.
- Some situations decrease coenzyme Q10:
- The age
- Chronic stress
- Vegetarian or vegan diets
- Diabetes or a chronic inflammatory site
- Some drug treatments
If I am concerned by these factors, Laura advises to Discuss coenzyme Q10 specifically with a health professional
👉 Finally, iodine is a key nutrient in preconception and pregnancy.
- It is often associated with the thyroid, but iodine deficiency also opens the door to greater sensitivity to endocrine disruptors and may have consequences for pregnancy and fetal development.
- Laura is always seeking medical advice for iodine, because it interacts directly with the thyroid.
In her practice, especially in Eastern France, she very frequently notes urinary iodine levels below the desired values.
- The recommended intakes of iodine are of the order of 150 mcg/day for adults, and rise to about 200—250 mcg/day for pregnant or breastfeeding women according to French and international references. ;
- There are few early signs of deficiency; in marked deficiencies, the thyroid may fail and a goiter may develop.
The dosage of urinary iodine is not reimbursed in France, which reinforces the interest of talking to a doctor.
🔎 Useful definitions
Methylation : a chemical process by which a small methyl group is added to a molecule (such as DNA or certain proteins), which changes its functioning without changing the base sequence. This mechanism plays an important role in the regulation of gene expression and in numerous metabolic reactions.
___
Mitochondria : Internal structure of the cell often described as an “energy powerhouse” because it produces ATP, the main energy molecule used by the body. Good mitochondrial function is essential for cells that require a lot of energy, such as oocytes.
___
ATP (adenosine triphosphate) : molecule that serves as an “energy currency” for cells: it provides the energy necessary for most biological reactions (muscle contraction, active transport, synthesis of molecules, etc.).
🎯 Actions concrètes
- If I am in preconception, I always discuss vitamin B9 with my gynecologist or midwife ;
- I check that my folate intake meets both the recommendations (≈ 600 mcg EFA) and the safety limit (1,000 mcg/day), especially if I combine several supplements;
- If I take a B9, I also talk about B12 with my health professional, especially if I eat a vegetarian or vegan diet;
- I am not starting supplementation with coenzyme Q10 or iodine alone: I seek medical advice and, if possible, appropriate examinations;
- If I am over 35, suffering from chronic stress, a vegetable/vegan diet, diabetes, inflammatory disease or long-term treatment, I report these elements to my doctor in order to best adapt any supplements.
.png)
Summary
🔊 This program is an information program by a trained professional. This is generic advice and is not a personalized diagnosis. In all cases, we recommend that you be followed by a gynecologist and/or a midwife for individualized follow-up.
What you will learn in this episode
Key supplements in fertility and preconception
- The role of vitamin B9 in fertility and pregnancy
- How cUnderstand the doses in mcg and in “dietary folate equivalents”
- Why vitamin B12, Coenzyme Q10 and iodine are also important
- In which cases it is necessary to be particularly vigilant (age, vegetarianism, stress, thyroid...)
Vitamin B9: the basis for preconception
Vitamin B9 is the most well known preconception supplement and is regularly prescribed by gynecologists and midwives. It participates in the closure of the neural tube of the embryo and in the proper functioning of methylation, a key process for DNA, detoxification, and numerous metabolic reactions.
- A B9 deficiency can reduce the quality of gametes. (oocytes and sperm) and increase the risk of miscarriages, cardiovascular disorders or liver detoxification, with a particularly marked impact on women;
- Folic acid is the most studied form of B9 : there is a great deal of experience on its safety and on the doses used in preconception and early pregnancy;
- In France, The recommendations speak of around 600 mcg of dietary folate equivalents (EFA) per day for women who may be pregnant and up to the 12th week of pregnancy.
💡 Key figures
THEHANDLES recommends an intake of 600 mcg/day of dietary folate equivalents (EFA) for women likely to become pregnant and in early pregnancy, with an upper safe limit of 1,000 mcg/d of folate (folic acid + 5-MTHF forms).
Folic acid, methylated B9 and conversions
To switch from micrograms of folic acid to dietary folate equivalents (EFA), a conversion factor is used.
- Below 400 mcg of folic acid, a factor of 1.7 is used: 400 mcg of folic acid ≈ 680 mcg EFA, which remains compatible with the 600 mcg EFA guidelines at the beginning of pregnancy.
- Methylated B9 is better absorbed, but the conversion factors change:
- Up to 399 mcg, the conversion factor remains 1.7 (as for folic acid)
- Starting with 400 ug of methylated B9, a factor of 2 is applied: 400 mcg → 800 mcg EFA, we already exceed the recommended 600 mcg EFA
There is an upper safe limit for total folate of 1,000 mcg per day (folic acid + 5-MTHF salts), not to be exceeded over time.
⚠️ You should always check the rates indicated on the boxes of all types of supplements and adapt it to your own situation.
Laura's recommendation:
- I follow the recommendations of my gynecologist or midwife if I do not have a known MTHFR gene mutation;
- If I take methylated B9, I stay under 400 mcg (or at least I don't significantly exceed it), to limit the risk of exceeding the safety limit of 1,000 mcg EFA per day.
- Laura also recalls thatprolonged intake of B9 can mask a deficiency in B12, which is why it often combines B9 and B12, especially in preconception.
Vitamin B12, coenzyme Q10 and iodine
Vitamin B12 is a little less standardized than B9 in the protocols, but remains important in fertility, especially in the case of a vegetarian or vegan diet.
- Laura relies on the blood test: she likes to dose “active” B12 (not reimbursed), to have a more detailed vision of the real status;
- For the standard serum dosage, it seeks to be in the upper third of the norm instead, which gives more margin for pregnancy plans.
Coenzyme Q10 plays a central role in mitochondria, the “power plants” of cells.
- It supports the mitochondrial quality of oocytes and gametes in general, helping cells to produce enough energy and providing an antioxidant effect.
- Laura recommends it especially in long fertility courses or assisted reproduction courses, and recalls that in Germany, it is sometimes integrated into protocols.
- Some situations decrease coenzyme Q10:
- The age
- Chronic stress
- Vegetarian or vegan diets
- Diabetes or a chronic inflammatory site
- Some drug treatments
If I am concerned by these factors, Laura advises to Discuss coenzyme Q10 specifically with a health professional
👉 Finally, iodine is a key nutrient in preconception and pregnancy.
- It is often associated with the thyroid, but iodine deficiency also opens the door to greater sensitivity to endocrine disruptors and may have consequences for pregnancy and fetal development.
- Laura is always seeking medical advice for iodine, because it interacts directly with the thyroid.
In her practice, especially in Eastern France, she very frequently notes urinary iodine levels below the desired values.
- The recommended intakes of iodine are of the order of 150 mcg/day for adults, and rise to about 200—250 mcg/day for pregnant or breastfeeding women according to French and international references. ;
- There are few early signs of deficiency; in marked deficiencies, the thyroid may fail and a goiter may develop.
The dosage of urinary iodine is not reimbursed in France, which reinforces the interest of talking to a doctor.
🎯 Concrete actions
- If I am in preconception, I always discuss vitamin B9 with my gynecologist or midwife ;
- I check that my folate intake meets both the recommendations (≈ 600 mcg EFA) and the safety limit (1,000 mcg/day), especially if I combine several supplements;
- If I take a B9, I also talk about B12 with my health professional, especially if I eat a vegetarian or vegan diet;
- I am not starting supplementation with coenzyme Q10 or iodine alone: I seek medical advice and, if possible, appropriate examinations;
- If I am over 35, suffering from chronic stress, a vegetable/vegan diet, diabetes, inflammatory disease or long-term treatment, I report these elements to my doctor in order to best adapt any supplements.
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