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Vitamin D and Pregnancy

August 13, 2018
Katie Visco

Our modern day world and diet normally safeguard against any serious vitamin deficiency, partly thanks to vitamin-enriched foods and the many options available to us. In fact, science has debunked the multivitamin craze and shown how an overdose on certain vitamins and antioxidants are in fact  harmful for our health. However, some lingering deficiencies still persist—with one of the most notorious being vitamin D—and you should do something about it, as side effects and repercussions are serious, with a study leading us to believe that sufficient vitamin D is associated with successful pregnancies and births.

Read on to understand:

  • Vitamin D Deficiencies
  • What Vitamin D Does
  • Getting Enough Vitamin D
  • Whether You’re Deficient

Deficiencies

It is estimated that 42% of people in the U.S. have a vitamin D deficiency. This high number makes sense since symptoms of a vitamin D deficiency are easy to miss. Though an extreme deficiency results in rickets, a milder deficiency over a long period of time has been associated with:

  • Decreased bone density
  • Cancer
  • Cardiovascular disease
  • Depression
  • Weight gain
  • Reduced immune function
  • Diabetes
  • Hypertension
  • Glucose intolerance
  • Multiple sclerosis

Deficiencies tend to be more common in young women, infants, the elderly, and people with darker skin. This last bit is because vitamin D synthesis partly depends on sun exposure, and higher levels of melanin in the skin protects against the sun.  

What’s new is the possibility that sufficient vitamin D levels might be associated with successful pregnancies and live births. A National Institute of Health (NIH) study published in The Lancet Diabetes & Endocrinology examined the relationship between aspirin intake and miscarriage, but it also measured participants’ vitamin D levels. In a secondary analysis of this study, researchers found that women who had sufficient levels of vitamin D were 10% more likely to become pregnant and 15% more likely to have a live birth.

pregnant woman

Though more research needs to be done on this, as the NIH just released their report on May 30, 2018, the findings only reaffirm the need to address the vitamin D deficiency that has been rampant lately. Even if future research debunks this recent report, previous studies have women with higher vitamin D levels prior to in vitro fertilization have higher pregnancy rates than those who do not, making this issue especially applicable to IVF patients.

The Role of Vitamin D

Though called a vitamin, vitamin D is actually a hormone. If you know anything about hormones, you’ll know that they play so many roles in the body. In fact, hormones are the initiators of your body’s menstrual cycle and changes during pregnancy; you certainly have heard of estrogen, progesterone, HCG, and oxytocin. These are all hormones. Maybe it’s not so surprising, then, that researchers are seeing a link between and successful pregnancies.  

The fact that vitamin D is a hormone elevates it a bit in its importance, as it has many roles. These include:

  • Allowing the body to absorb calcium from food
  • Indirectly enhancing the muscles’ ability to contract by producing a byproduct
  • Lung health
  • Immunity to infection and disease

There are two types of vitamin D, D2 and D3. However, vitamin D3 is more important than D2, as it is the form that is stored in the body. Supplementing with vitamin D3 raises blood levels of vitamin D almost twice as much as D2.

Getting Enough Vitamin D

Since symptoms of deficiency are obscure, the only real way to know if you’re deficient is through the 25-hydroxy vitamin D blood test. Results of 20 nanograms/milliliter to 50 ng/mL is commonly considered sufficient while less than 12 ng/mL qualifies as a deficiency.

However, there is some disagreement, mostly due to conflicting research findings. For example, the Institute of Medicine issued a report concluding that anything under 20 ng/mL is too low. The Endocrine Society recommends a minimum level of 30 ng/mL.  

Naturally, there are two ways your body accumulates vitamin D: diet and sunlight. However, you cannot satisfy your vitamin D needs through diet alone, as foods containing high amounts of vitamin D are not very common, or are not usually eaten on a daily basis in large enough quantities.

As the recommended amount is 600 international units (IU) for everyone ages 1-70 and 800 IU for adults older than age 70, here are some foods that contain vitamin D:

  • Wild-Caught Salmon, 3 ounces: 447 IU (over 100 percent DV)
  • Mackerel, 3 ounces: 306 IU (76 percent DV) — though not recommended before and during pregnancy due to high mercury levels
  • Tuna Fish, 3 ounces: 154 IU (39 percent DV); the ACOG (American College of Obstetricians and Gynecologists) recommends limiting white albacore tuna to 6 ounces per week
  • Fortified Milk, 1 cup: 124 IU (31 percent DV)
  • Sardines, 2 sardines: 47 IU (12 percent DV)
  • Beef Liver (yum!), 3 ounces: 42 IU (11 percent DV)
  • Eggs, 1 egg: 41 IU (10 percent DV)
  • Fortified Cereal, 1 cup: 40 IU (10 percent DV)
  • Caviar, 1 tablespoon: 37 IU (9 percent DV)
  • Mushrooms, 1 cup: 2 IU (1 percent DV); this is vitamin D2, but it still counts for something.
vitamin D food

If you are trying to increase your vitamin D levels through food, try eating pregnancy friendly fish more often, especially now that the FDA recommends that women trying to get pregnant are who are pregnant already eat 8 to 12 ounces (about 2 to 3 servings) of fish low in mercury per week. Fish to avoid entirely due to high mercury levels include king mackerel, shark, swordfish, marin, orange roughy, and tilefish, and you should limit white albacore tuna to 6 ounces per week.

Since it’s impossible to reach your vitamin D needs through food alone, getting enough sun is essential. Your body synthesizes vitamin D on its own when you are exposed to ultraviolet B rays of light. However, those living in regions with bad winters will have a difficult time with this, explaining why vitamin D deficiencies are more common in the northern part of the United States. The farther you are from the equator, the fewer UVB rays reach the earth due to the angle at which they hit the atmosphere.

Living in northern regions of the U.S. is particularly a challenge, then, as the Vitamin D Council notes that if you live in New York City, for example, you produce very little vitamin D from the sun from November to March. Besides this, people go outdoors less now than ever before so that they’re not getting as much sun.

Finally, supplements are increasingly becoming more common due to emerging research and recommendations of vitamin D levels.

Are You Deficient?

girl in wheat field

Considering how widespread vitamin D deficiencies are and the challenge that geographic location poses when it comes to getting enough from the sun, you might want to consider a supplement, especially if you are experiencing these symptoms of a vitamin D deficiency:

  • Weak immune system—getting sick often
  • Fatigue
  • Bone and back pain
  • Depression
  • Impaired wound healing
  • Bone loss
  • Hair loss
  • Muscle pain

If you live in a region where the sun is not out for part of the year, such as the northeast, or if you tend to never eat foods containing vitamin D, you might want to consider a supplement and get your vitamin D blood levels tested.  

There is not agreement on an optimal vitamin D dose to take; different medical organizations recommend different doses, but nevertheless, talk to your doctor first about an optimal dosage for you, and perhaps a recommendation on a reputable supplement brand.

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