Iron Optimization During Pregnancy and Beyond
Anemia and other iron related concerns are very common in pregnancy. In fact, in some of my earlier pregnancies before I understood iron metabolism, I had a difficult time keeping my hemoglobin and ferritin at ideal levels. In my recent pregnancies, I approach iron optimization with greater understanding and intention.
The Importance of Iron in Pregnancy
Iron is crucial for optimal health, especially for mother and baby during pregnancy. Conversely, anemia is associated with various problems in pregnancy. In the absence of sufficient iron, the cells and therefore the body are not properly oxygenated. This can have far reaching implications for the mother and baby including pre-term labor, low birth weight, and developmental concerns. It is important for mama to have sufficient iron stores for postpartum recovery. Sufficient iron levels decrease the risk of both postpartum hemorrhage and depression. A pregnant mother may have iron problems due to nutrient deficiencies, impaired gut health, inflammation, infections, or simply not consuming iron-rich foods. So, it is important to get a functional medicine workup before pregnancy to minimize these complications.
Lab Testing
Most OBs and midwives will check a CBC which includes valuable information about the iron status in the red blood cells for the astute provider. I like to look even deeper at other markers such as serum iron, transferrin saturation, ferritin, vitamin B12, and folate. These labs provide a more robust picture of why a mother may be anemic. If you are concerned about your iron status, find a provider who will order then and is skilled in their interpretation.
Red Blood Cells: a part of a CBC, the Blood Cell Count (RBC) measures the total number of red blood cells in the blood. The values are used to determine different types of anemia. Other key components of a CBC include MCV, MCH, MCHC, and RDW, which are all metrics of the red blood cells and are used to assess the size, shape, color, etc. of the red blood cells. These also give information about iron status and anemia.
Hemoglobin: hemoglobin shows the amount of hemoglobin in the serum. Hemoglobin is the major carrier of oxygen on RBCs, so low hemoglobin cause hypoxia in the cells and is a significant concern during pregnancy.
Serum Iron: the amount of iron in the bloodstream and indicative of iron absorption.
Transferrin saturation: this marker measures the percentage of transferrin that is saturated or filled with iron.
Total Iron Binding Capacity: the TIBC calculates the amount of total binding proteins and their capacity to bind to iron in the bloodstream.
Unsaturated Iron Binding Capacity: the UIBC looks at the amount of iron-transporting protein (transferrin) that is not bound to iron. It is used in conjunction with total serum iron to calculate the total iron-binding capacity (TIBC)
Ferritin: ferritin is a key biomarker for iron status throughout the entire body. It is a protein that stores iron and releases it in a controlled manner when needed. A functional lab range for pregnancy is roughly 30 to 80ng/mL.
Vitamin B12: this test measures the amount of vitamin B12 in a serum sample. When supplementing with B12, serum levels will increase, but not necessarily show an accurate picture. Methylmalonic acid (MMA) Is another reliable marker for B12 status and an increased level can indicate B12 deficiency. A vitamin B12 deficiency could indicate B12 deficiency anemia as Vitamin B12 is crucial for the development of red blood cells.
Folate: this measures the folate (vitamin B9) in the serum. Folate deficiency can also contribute to anemia as it is essential for producing DNA and for the division of red blood cells.
As you can see, there are many lab markers that are important to glean valuable information about iron status, especially during pregnancy. Our team at Restorative Wellness Center is trained to look at iron from a comprehensive and holistic point of view.
Iron Support
Sufficient iron is needed to deliver oxygen to the growing baby and placenta along with meeting the demands of mama’s increased blood volume and preparation for delivery and postpartum. There are many factors at play with iron assimilation and cellular uptake. It is important that the cells are saturated with iron while not pushing too much iron into the tissues. Some supplements that I personally took during my pregnancies include:
Grassfed beef liver or beef spleen: either of these beef products offer bioavailable iron in food form. Make sure to source products from responsibly-raised grass-fed animals only.
Vitamin C: either whole food vitamin C or ascorbic acid help the body properly assimilate iron. Plus, higher doses of vitamin C in pregnancy are associated with less miscarriages, quicker deliveries, decreased tearing, and hemorrhage. It can prevent preeclampsia and preterm labor.
Lactoferrin: is found in colostrum and improves iron uptake in the small intestine and regulates iron distribution within the body while protecting against iron overload. Supplementing with colostrum can also boost immune function and gut health.
Ferrum phosphoricum: a homeopathic cell salt that enhances iron absorption by hemoglobin in the red blood cells. This often increases hemoglobin and ferritin levels along with modulating the immune system.
Digestive enzymes: crucial for proper nutrient absorption. You want to breakdown and assimilate all of the important nutrients in your food to be used for your health and baby’s development.
Red raspberry: red raspberry leaves in tea or tincture form are a pregnancy tonic when used in the second and third trimesters. They nourish the uterus in preparation for a smooth delivery while also providing iron and vitamin C.
These products are linked on my Fullscript account under the Iron Support for Pregnancy plan. As always, you can receive 10% off on all orders of these professional supplements.