Please ignore the vitamin nay-sayers here if you're a fertile woman.

[pnwmom]

Last edited Sat Dec 21, 2013, 05:16 AM - Edit history (2)

Half of all pregnancies occur by accident, and the most critical time for folic acid is during the first couple weeks -- before most women even know they're pregnant.

So all fertile women with any chance of becoming pregnant are still supposed to be taking a multivitamin every day, or at least a folic acid supplement containing 400 mg. This has been proven to reduce the rate of spina bifida and other birth defects.


Since half of all pregnancies are unplanned, doctors still strongly advocate that any woman who "might" get pregnant -- even accidentally -- take multivitamins containing 400 mg of folic acid. An additional supplement is recommended during pregnancy. This has been proven to reduce the rate of spina bifida and other serious defects.

From the CDC:

http://m.cdc.gov/en/HealthSafetyTopics/LifeStagesPopulations/Pregnancy/QAfolicAcid

Q: Why can’t I wait until I’m pregnant—or planning to get pregnant to start taking folic acid?

A: Birth defects of the brain and spine (anencephaly and spina bifida) happen in the first few weeks of pregnancy; often before you find out you're pregnant. By the time you realize you’re pregnant, it might be too late to prevent those birth defects. Also, half of all pregnancies in the United States are unplanned.

These are two reasons why it is important for all women who can get pregnant to be sure to get 400 mcg of folic acid every day, even if they aren’t planning a pregnancy any time soon.


Q: Can’t I get enough folic acid by eating a well-balanced healthy diet?

A: It is hard to eat a diet that has all the nutrients you need every day. Even with careful planning, you might not get all the vitamins you need from your diet alone. That’s why it’s important to take a vitamin with folic acid every day.


From the March of Dimes:

http://www.marchofdimes.com/pregnancy/take-folic-acid-before-youre-pregnant.aspx

Who should take folic acid?
All women, even if they’re not trying to get pregnant, should take folic acid.

Folic acid helps prevent NTDs only if taken before pregnancy and during the first few weeks of pregnancy, often before a woman may even know she’s pregnant. Because nearly half of all pregnancies in the United States are unplanned, it's important that all women take folic acid every day.

How can you get folic acid?
Before pregnancy, take a multivitamin that has 400 micrograms of folic acid in it every day. Most multivitamins have this amount, but check the label to be sure.

During pregnancy, take a prenatal vitamin each day that has 600 micrograms of folic acid in it. Your health care provider can prescribe a prenatal vitamin for you. You can also get prenatal vitamins over the counter without a prescription.

Most women don’t need more than 1,000 micrograms of folic acid each day. But some women, like those who’ve had a pregnancy affected by NTDs or women with sickle cell disease, may need more. Talk to your provider to make sure you get the right amount.

Can you get folic acid from food?
Yes. Some flour, breads, cereals and pasta have folic acid added to them. Look for “fortified” or “enriched” on the package to know if the product has folic acid in it. Even if you eat fortified or enriched foods, be sure to keep taking your multivitamin or prenatal vitamin with folic acid.

[freshwest]

1. Watching with bated breath:

Hey, don't knock it, it's got fiber!

Yes, fertile ones, take your folic acid. It's doctor recommended!

[gollygee]

2. Some of us need iron too

[pnwmom]

4. Excellent point. Thanks! n/t

[Ghost Dog]

76. Eat spinach (ie. dark green leafy vegetable):

A natural source of both folate (folic acid & B12) and iron...

Will look below now to see what is generally considered a 'well-balanced healthy diet' here... And why it appears to be considered to be not easily obtainable in the USA.

Of course I can see the need for carefully measured appropriate doses of appropriate vitamin and mineral supplements where necessary.

[magical thyme]

79. the iron in spinach is not bioavailable due to high levels of oxalate

which may even remove iron from your system. Although combining it with foods rich in oxalic acid (brocolli, iirc) may help.

Also, boiling spinach removes up to half its folate, although microwaving it doesn't.

One reason it can be hard to get the nutrition from diet alone is preparation impacts the nutrients. Sometimes raw is better, but other times cooked is better, and different methods of cooking have different impacts as well.

[Ghost Dog]

80. Thanks, I usually eat salads or steam the veg, hate to overcook;

but I looked this up.

I'm suspecting in my case (at 59, male, single but with friends, smokes, drinks but eats well & excercises), maybe a litlle iron and perhaps vitamin-B12 deficiency.

Maybe why I get occasional cravings to eat eg. liver, shellfish, lentils, beans... which I usually satisfy by finding the ingredients and cooking for myself what my body seems to be asking me for. (Sure, I have time on my hands between bouts of work, and some limited financial resources which I conserve by living simply).

That's always been my approach. I've almost never consulted a doctor in my life, and still have no relationship with any doctors now.



Sure, I realise that for all women it's different.

[magical thyme]

82. iron deficiency is more common in women

due to losses during menstruation.

I am in a similar situation to you. My only ongoing relationship with any doctors is at work (med lab tech). I grow as much of my own veggies as I can, eat as healthy as I can so my cravings tend to be specific to needed nutrients.

I believe that the better quality diet you eat and the more in touch you stay with your body, the more specific and appropriate any cravings will be. That's been my experience, and I vaguely remember reading it somewhere...

[Ghost Dog]

83. Yep.

There was a nicely documented, although one of many just anecdotal accounts, of a guy who lost his yacht while singlehandedly crossing the Atlantic. Was adrift in the dinghy for weeks. Started out catching fish and eating just the white flesh. After a while his cravings became so strong he was carefully eating, raw, all the innards and skin...

Survived to tell the tale. Doctors confirmed he'd done the right thing, instinctively.

[kcr]

3. Which is why it's a good idea to listen to your doctor

and not people on the internet, period.

[kickysnana]

5. Great Aunt Lela, rest her soul, was not blessed with children until she bought her juicer...

at age 45 in 1951. So my ex had his a first cousin in his Dad's family to pal around with.

She told of being one of 12 kids on a small farm in the south where her Mom tried not to play favorites but Lela started developing rickets so her Mom made it Lela's job to help milk the cow and then told her to drink a ladle of milk for her hard work.

Must have worked because she had beautiful teeth in her 80's.

[pnwmom]

6. Thanks for the story. And the reminder.

It's not always easy or even financially feasible for everyone to get all the nutrients they need from their diet alone.

[Bazinga]

51. She must have also done something else.

I don't want to shoot you down, because a healthy diet is extremely important. But rickets is a deficiency in vitamin D, not calcium. Cow's milk has no natural vitamin D, it is added to store bought milk as a supplement.

[Fawke Em]

55. Maybe it was from being out in the sun while she milked the cow?

But the calcium did help her teeth.

[kickysnana]

69. The milk story is from her childhood, the pregancy was in middle age. n/t

[magical thyme]

78. Not true. it can be caused by a deficiency of vit. D, phosphorus or calcium

Vitamin D is needed to metabolize calcium and is the most common cause, but not the only cause. Bone is made of calcium and phosphorus. It's deficiency of or the inability to metabolize calcium and/or phosphorus that leads to rickets.

[truedelphi]

7. No longer fertile

But way back when, I consumed my folic acid and my iron, and while pregnant I took magnesium as well.

It is so odd to me about how people consider vitamins to be the work of the devil, yet the same people don't mind the fact that MSG is in so many foods, causing depression right and left. MSG is in so many processed foods. Breads and cookies and anything coated with breading probably has MSG.

MSG is no longer called MSG on most food labels; rather it is called "tapioca starch" or "enhanced wheat protein" and other odd ball names. including the use of the term "spices" for MSG.

Some substitute names for MSG:

Glutamic acid (E 620)
Glutamate (E 620)
Monosodium glutamate (E 621)
Monopotassium glutamate (E 622)
Calcium glutamate (E 623)
Monoammonium glutamate (E 624)
Magnesium glutamate (E 625)
Natrium glutamate
Yeast extract
Anything “hydrolyzed”
Any “hydrolyzed protein”
Calcium caseinate, Sodium caseinate
Yeast food, Yeast nutrient
Autolyzed yeast
Gelatin
Textured protein
Soy protein, soy protein concentrate
Soy protein isolate
Whey protein, whey protein concentrate
Whey protein isolate
Anything “…protein”
Vetsin
Ajinomoto

[pnwmom]

8. I'm supposed to be avoiding MSG because it is often

derived from wheat. And my husband has a problem with any MSG. Thanks for the list. I wasn't aware of all of these names.

[truedelphi]

12. Yep. On account of needing to avoid MSG,

I make the little bit of bread the household now eats. Same with cookies, muffins, etc. Since I don't eat wheat, I bake the baked goods using rice flour and tapioca flour as substitutes - if the recipe calls for two cups of wheat flour, I use 1 and seven eighths cups of rice flour, with the rest as tapioca flour. (Too much tapioca flour and the baked good ends up weirdly over-chewey, but if I bake without the tapioca flour, it doesn't have any body.)

Basically everything in our fridge right now is produce: celery, beets, onions, tomatoes, green beans. Except for dairy products.

I read labels for about year, but learned almost everything has MSG. Even expensive "organic" Paul Newman brands.

I just started making catsup for us, but the other condiments, like salad dressings, are store bought and have MSG. So I do have some MSG in my diet. Also from when I eat out - no way to avoid it at restaurants.

Oh I just remembered - olives usually don't have anything in the bottle other than olives and salt. Same with many brands of peppers.

For a long long time, I greatly missed Red Vines. (Which are nothing BUT wheat and MSG and food dyes.) But that craving is gone now.

Kosher brands used to mean there was absolutely no MSG. But now many Kosher items have MSG, although, again it is listed using one of the code words. (Big word to look for is "Modified." Modified tapioca starch, modified wheat starch, etc. indicates MSG)

[pnwmom]

20. Thanks for the tips. My husband has been having a lot of MSG

symptoms even though we try to avoid it. Now I realize that we've still been exposed to it. (I can avoid the wheat based types, but there are others.)

[truedelphi]

72. You are welcome. I often feel grateful that this sensitivity didn't happen until

I was an empty nester. I can't imagine trying to bake everything home made, from scratch, with a houseful of hungry teenagers.

It is a lot of work, but with only two of us, I can manage. (M is a great cook and salad maker, too.) I look at my friends, and only the ones eating like this are healthy. Everyone i know who is over sixty and eating gluten and MSG has either Rheumatoid Arthritis, or fibromyalgia.

[Silent3]

9. No study has actually said that some people shouldn't take some kinds of supplements.

Bad reporting, and bad reading of bad reporting, has badly oversimplified and confused the results of narrower and more specific scientific studies, including conflating the negative effects of megadoses of vitamins with the sometimes, in some cases, mere ineffectiveness of normal dosage vitamin and mineral supplements.

[pnwmom]

18. When "some people" is half of the population

during half of their lives, it is irresponsible to discourage people from taking daily multivitamins without making note of this HUGE exception.

[Silent3]

26. My point is to question who is being irresponsible...

...and who is overreacting. Even the bad reporting (which is part of the irresponsibility) doesn't say, "Pregnant women! Don't take folic acid!".

[pnwmom]

29. No, they're saying, "normal" people don't need vitamin supplements.

"For normal, adequately nourished people, vitamin and mineral supplementation produces no detectable benefits in general. It’s only for certain targeted nutritional deficiencies where supplementation can help, and in some cases nutritional supplementation can be harmful."

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=4205900

The above statement is flat out wrong unless you assume that pregnant women AND women in their childbearing years are abnormal.

It is NOT just pregnant women who are supposed to take a daily multivitamin with 400 mg of folic acid. It is ALL women in their childbearing years who are not infertile.

Half of pregnancies are accidental, and the damage from too little folate in the diet occurs in the first couple weeks of pregnancy, when most women don't even know they're pregnant.

That means that the female half of the population for about half of their lifetimes -- during their fertile years -- should be taking a daily multivitamin with 400 mg of folic acid.

But the execrable reporting -- and overwrought hype on DU -- could mislead women into thinking that recommendation has been changed.

American Academy of Obstetrics

http://www.acog.org/~/media/For%20Patients/faq001.pdf?dmc=1&ts=20131221T0027156576

What is folic acid and how much do I need daily?
Folic acid, also known as folate, is a B vitamin that is important for pregnant women. Taking 400 micrograms of folic acid daily for at least 1 month before pregnancy and 600 micrograms of folic acid daily during pregnancy may help prevent major birth defects of the baby’s brain and spine called neural tube defects. It may be hard to get the recommended amount of folic acid from food alone. For this reason, all pregnant women and all women who may become pregnant should take a daily vitamin supplement that contains the right amount of folic acid.

[BuddhaGirl]

10. K & R

Thanks for posting - very important!

[IdaBriggs]

11. Fabulous post!

THANK YOU!!!

[SixString]

14. DURec

[JaneyVee]

15. Not to mention children. If your kids are lacking any nutrients due to

Refusal to eat certain foods poly-vi-sol or other multi-vitamins are a good addition. And don't forget DHA and omega 3's.

[pnwmom]

22. Good point. Thanks! nt

[alarimer]

16. That's not what these studies are talking about and you know it.

They are talking about routine multi-vitamins (such as one-a-day).

Stop deliberately misrepresenting those PEER-REVIEWED scientific studies.

[pnwmom]

17. You are wrong. Any woman who is in her childbearing years

Last edited Sat Dec 21, 2013, 01:32 AM - Edit history (1)

and not infertile is advised by her physician, the American Academy of Obstetrics, the CDC, and March of Dimes, among other medical organizations, to ROUTINELY take a daily multivitamin containing 400 mg of folic -- whether or not she ever plans to get pregnant.

This means that half of the population for at least half of their lives is supposed to routinely take a multivitamin.

Half of all pregnancies are accidents, and the damage from folate deficiency occurs before most women even know they're pregnant. That is why it is critical that no women get misled by misleading reports that discourage them from taking daily multivitamins that contain 400 mg of folic acid.

Both the March of Dimes and the CDC recommend that all women who are in the childbearing years take a daily multivitamin containing 400 mg. of folic acid.

These recommendations are based on numerous PEER REVIEWED STUDIES.

From the March of Dimes:

http://www.marchofdimes.com/pregnancy/take-folic-acid-before-youre-pregnant.aspx

Who should take folic acid?
All women, even if they’re not trying to get pregnant, should take folic acid.

Folic acid helps prevent NTDs only if taken before pregnancy and during the first few weeks of pregnancy, often before a woman may even know she’s pregnant. Because nearly half of all pregnancies in the United States are unplanned, it's important that all women take folic acid every day.

How can you get folic acid?
Before pregnancy, take a multivitamin that has 400 micrograms of folic acid in it every day. Most multivitamins have this amount, but check the label to be sure.

During pregnancy, take a prenatal vitamin each day that has 600 micrograms of folic acid in it. Your health care provider can prescribe a prenatal vitamin for you. You can also get prenatal vitamins over the counter without a prescription

From the CDC:

http://m.cdc.gov/en/HealthSafetyTopics/LifeStagesPopulations/Pregnancy/QAfolicAcid

Can’t I get enough folic acid by eating a well-balanced healthy diet?

A: It is hard to eat a diet that has all the nutrients you need every day. Even with careful planning, you might not get all the vitamins you need from your diet alone. That’s why it’s important to take a vitamin with folic acid every day.

American Academy of Obstetrics

http://www.acog.org/~/media/For%20Patients/faq001.pdf?dmc=1&ts=20131221T0027156576

What is folic acid and how much do I need daily?
Folic acid, also known as folate, is a B vitamin that is important for pregnant women. Taking 400 micrograms of folic acid daily for at least 1 month before pregnancy and 600 micrograms of folic acid daily during pregnancy may help prevent major birth defects of the baby’s brain and spine called neural tube defects. It may be hard to get the recommended amount of folic acid from food alone. For this reason, all pregnant women and all women who may become pregnant should take a daily vitamin supplement that contains the right amount of folic acid.

[SidDithers]

19. +1...nt

Sid

[pnwmom]

21. You still haven't acknowledged that half of the population

during half of their lives should routinely be taking a multivitamin containing 400 mg of folic acid -- according to the CDC, the March of Dimes, and the American Academy of Obstetrics.


Worse, with your irresponsible and overblown OP, linked to a cancer surgeon who "knows his shit," you're actively discouraging women in their childbearing years from taking a supplement that has been proven to lower the incidence of Spina Bifida, a life-threatening birth defect.



American Academy of Obstetrics

http://www.acog.org/~/media/For%20Patients/faq001.pdf?dmc=1&ts=20131221T0027156576

What is folic acid and how much do I need daily?
Folic acid, also known as folate, is a B vitamin that is important for pregnant women. Taking 400 micrograms of folic acid daily for at least 1 month before pregnancy and 600 micrograms of folic acid daily during pregnancy may help prevent major birth defects of the baby’s brain and spine called neural tube defects. It may be hard to get the recommended amount of folic acid from food alone. For this reason, all pregnant women and all women who may become pregnant should take a daily vitamin supplement that contains the right amount of folic acid.

[Marr]

85. +1, this is getting ridiculous.

[Spider Jerusalem]

23. No-one has said "pregnant women shouldn't take folic acid"

there is a difference between specific prophylaxis and general supplements. The studies that say "there is no benefit from multivitamin supplements" are specifically referencing cognitive decline and mortality from cancer and heart disease. They don't address the use of folic acid in pregnacy at all, nor do they recommend against it. You're tilting at windmills.

[KitSileya]

24. Considering how many even here on DU just read the headline,

and don't bother reading the articles, it is not tilting at windmills to get the message out that there is a huge exception to the "Taking vitamins is useless"-headline, which you *know* is what news media sensationalized the findings to say.

[pnwmom]

32. The news media and certain DUers. nt

[SidDithers]

25. +1...nt

Sid

[pnwmom]

27. ALL women of childbearing capacity, whether they are pregnant or not,

should be taking a multivitamin with 400 mg of folic acid in it, according to the American Academy of Obstetrics, the CDC, and the March of Dimes.

This is not "specific prophylaxis" for pregnant women. This is a general supplement for all women of childbearing age who are not infertile. In other words, half of the human population, for half of their lives, should be taking a daily multivitamin with 400 mg of folic acid. That is a huge exception to the claim that there is NO benefit from multivitamins for "normal" people, which some DUers are proclaiming.

Women in their childbearing years ARE normal people.

American Academy of Obstetrics

http://www.acog.org/~/media/For%20Patients/faq001.pdf?dmc=1&ts=20131221T0027156576

What is folic acid and how much do I need daily?
Folic acid, also known as folate, is a B vitamin that is important for pregnant women. Taking 400 micrograms of folic acid daily for at least 1 month before pregnancy and 600 micrograms of folic acid daily during pregnancy may help prevent major birth defects of the baby’s brain and spine called neural tube defects. It may be hard to get the recommended amount of folic acid from food alone. For this reason, all pregnant women and all women who may become pregnant should take a daily vitamin supplement that contains the right amount of folic acid.

[Spider Jerusalem]

28. Which is not what the report in the Annals of Internal Medicine was addressing.

[pnwmom]

30. I am addressing the following quote from an anti-vitamin diatribe,

that used the Annals of Internal Medicine Report as a jumping off point for broad and false generalizations.

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=4205900

I remember during medical school that more than one of my faculty used to have a regularly repeated crack that the only thing that taking vitamin supplements could do for you was to produce expensive pee. My first year in medical school was nearly thirty years ago now; so it’s been a long time. During the nearly three decades since I first entered medical school, I have yet to see any evidence to persuade me otherwise. If you eat a well-rounded diet, you don’t need vitamin supplementation.

SNIP

For normal, adequately nourished people, vitamin and mineral supplementation produces no detectable benefits in general. It’s only for certain targeted nutritional deficiencies where supplementation can help, and in some cases nutritional supplementation can be harmful.

The above statements are flatly contradicted by the CDC, the American Academy of Obstetrics, and the March of Dimes, all of which make the same recommendation:

All women of childbearing age/capacity are still advised to take a daily multivitamin with 400 mg of folic acid, whether or not they plan to become pregnant.

Do you understand now? It is NOT true that "normal" people can get everything they need from a healthy diet (assuming that they have the access and means for a healthy diet.) Women of childbearing age/capacity are normal people, and yet the CDC recommends that they should routinely be taking a daily multivitamin with 400 mg of folic acid -- whether or not they ever plan to become pregnant.

[truedelphi]

73. Our soils are very depleted of many minerals and vitamins. And if RoundUp is used,

The crop has a high likelihood of being impacted by fungal growth, molds, and bacteria.

Supplements are a vital part of my lifestyle, and I don't care what anyone says about it. Good to know that the CDC, the American Academy of Obstetrics, and the March of Dimes encourage women to take certain vitamins.

[gollygee]

53. It was about everyone, or "all normal people" anyway

and a good half of women, so 25% of people, need to take a multivitamin every day.

[Spider Jerusalem]

56. Did you read it?

Or are you arguing out of ignorance like everyone else?

[magical thyme]

81. vitamin D supplementation was supposed to reduce falls?

And here I thought it was related to the uptake of calcium to prevent rickets in children and osteomalacia in adults. Oh, and to preventing cervical cancer.

[pnwmom]

31. But people here ARE saying "normal people don't need supplements."

Aren't pregnant people normal people?
Aren't fertile women in their childbearing years normal people? They should all be taking supplements.



http://www.democraticunderground.com/?com=view_post&forum=1002&pid=4205900

For normal, adequately nourished people, vitamin and mineral supplementation produces no detectable benefits in general. It’s only for certain targeted nutritional deficiencies where supplementation can help, and in some cases nutritional supplementation can be harmful.

Wrong!

[Spider Jerusalem]

33. "targeted nutritional deficiencies"...like, not getting adequate folic acid?

That's actually correct.

[pnwmom]

37. The recommendation for folic acid supplements is NOT targeted

to women with nutritional deficiencies. It's recommended for ALL women of childbearing capacity, whether or not they have a folic acid deficiency and whether or not they plan to become pregnant.

[Spider Jerusalem]

38. Except if they're at risk of bearing children with neural tube defects..

then they clearly have a deficiency. http://www.cam.ac.uk/research/news/folic-acid-deficiency-can-affect-the-health-of-great-great-grandchildren

Which again is not what the article cited from the Annals of Internal Medicine is dealing with. It doesn't say "no-one should take supplemental folate during pregancy". It does say "there is no measurable benefit from multivitamin supplements in morbidity or mortality with chronic disease, and no benefit for cognitive decline". These are very different things. The benefits of folate in preventing certain birth defects are well-known and not in dispute here.

[pnwmom]

39. All fertile women are supposed to take the folic acid supplements

whether or not they are known to have an increased risk of bearing children with spina bifida.

What I said in my OP is that fertile women should ignore the nay-sayers and take their daily vitamins with folic acid -- because that's what the CDC, the American Academy of Obstetrics, and the March of Dimes all recommend.

And nothing you have said changes that.

The article in the Annals of Internal Medicine has been repeatedly interpreted here to support the idea that "normal" people don't need supplements. My OP is to remind "normal" women in their childbearing years that they still need to take their vitamin with folic acid. Nothing has changed with regard to that recommendation.

[Spider Jerusalem]

40. The article says nothing at all about folic acid for childbearing women

and not really, you make a mistake in assuming that just because a woman is fertile she may have children (which many, shockingly, choose not to; is it the 1950's, already?)

You're arguing a point that isn't made by the source you're arguing against, it says nothing to the subject and in fact is dealing with something completely different than the prophylactic use of specific targeted supplements.

[pnwmom]

41. I'm not arguing about the journal article. I'm arguing with the idiots

who are using it to claim that "normal" people don't need supplements.

Normal women with any chance of becoming pregnant SHOULD be taking multi-vitamins that contain folic acid.

[Ghost Dog]

77. But why 'multivitamins'?

Why not just the particular supplements (eg. folic acid) the particular target (the individual person) requires?

Too expensive/unprofitable for your medical/pharmaceutical industry, perhaps?

[pnwmom]

84. Store brand multivitamins are often cheaper

than separate supplements, especially since many people need supplementation in more than one thing -- both folic acid and Vitamin D, for example.

[Ilsa]

52. Thepoint is that many of those women with unplanned

Pregnancies WILL Choose to carry to term, even if they didn't intend to ever become a parent. They should already be on folic acid supplements because they may not realize they are pregnant for several weeks. This has nothing to do with 1950s thinking.

BTW, I have known quite a few women who didn't want to be parents, but still thought that abortion was wrong, something they wouldn't do.

[Marr]

87. +1

[longship]

34. For Christ fucking sake!

This science says abso-fucking-nothing about targeted supplements. For instance, like women of child-bearing age who, if they they get pregnant should have been taking folic acid supplements all along. Nor does it say anything about any other specifically targeted nutrient which may have a deficit in a specific population cross section.

These studies examined only general supplements used by the general population.

Of course, if you are a woman of child bearing age, you should supplement with folic acid, and maybe iron. (Your doctor should be aware and should recommend as needed.)

But this study was not about targeted supplements like folic acid. It's about the looney toons who take mega doses of multivitamins because vitamin sellers are telling them that they need them. If you are over 50, take Centrum! Your kids need a Barney Rubble chewable to get through their day!

Well, that ship has now sailed. The research on this has been building for some number of years, ever since Linus Pauling's Vitamin C and the Common Cold was thoroughly debunked.

General vitamin and mineral supplementation is a waste of money, unless you are in a specific group where such supplementation is indicated by the science. For instance, folic acid in child bearing aged women, and possibly iron as well.

The difference is: targeted supplements are good; general supplements are worthless. That's what these studies are about.

So, if you are a woman of child bearing age, you should take folic acid, and maybe iron. But loading up on other stuff might be throwing away money for nothing (expensive piss for water soluables), or put your health in danger (for fat soluables). Your physician is your best guide in these affairs. (I am presuming they are an MD.)

[pnwmom]

35. These studies have been twisted by people here and elsewhere

to claim that they support the thesis that no "normal" people need supplements.

So, unless you claim that women of childbearing age are not "normal" people, then you will have to agree that this interpretation of these studies is flat out wrong.

Also, the recommendation of the March of Dimes, the CDC, and the American Academy of Obstetrics is that women get their folic acid by taking a regular multivitamin containing 400 mg. of folic acid. (rather than by taking folic acid alone)


Here are the kind of claims people are making who are exaggerating the conclusions of the studies.

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=4205900

"I remember during medical school that more than one of my faculty used to have a regularly repeated crack that the only thing that taking vitamin supplements could do for you was to produce expensive pee. My first year in medical school was nearly thirty years ago now; so it’s been a long time. During the nearly three decades since I first entered medical school, I have yet to see any evidence to persuade me otherwise. If you eat a well-rounded diet, you don’t need vitamin supplementation.

SNIP

For normal, adequately nourished people, vitamin and mineral supplementation produces no detectable benefits in general. It’s only for certain targeted nutritional deficiencies where supplementation can help, and in some cases nutritional supplementation can be harmful."

________________________

Being a fertile woman is not an abnormal condition, folic acid supplements aren't only for women with nutritional deficiencies, and eating a well-rounded diet doesn't guarantee you don't need vitamin supplementation.

[Niceguy1]

36. you should never take advice

From an internet forum...

Facts are rarely important in the most popular threads so why would it be different in these ?

[LeftyMom]

42. I thought it was anti-choicers and the Bush administration who wanted to declare women pre-pregnant?

That same argument, that you shouldn't do X because you might get pregnant, would prevent women from drinking socially or eating any number of things (fish, soft cheeses) or drinking coffee or using any number of common household chemicals or blah blah blah.

[pnwmom]

43. No, this isn't the same argument. This isn't about NOT doing something

because you might get pregnant. And there is no downside to a woman of childbearing capacity routinely taking a simple, store brand multi-vitamin as is recommended by the CDC and the American Academy of Obstetrics.

This is about the importance of women maintaining good folic acid levels because half of all pregnancies are accidental. And no woman in her right mind wants to give birth to a baby with spina bifida when she could have prevented it by taking a multivitamin.

[LeftyMom]

44. You're still assuming that women are pre-pregnant.

If women should take supplements they don't otherwise need because they might have an unwanted pregnancy, shouldn't they also avoid social drinking because they might get pregnant? No woman wants to have a baby with FAS after all.

It's a stupid and somewhat sexist argument because the underlying problem is unwanted pregnancy, not the behavior of women.

[pnwmom]

45. Folic acid supplements don't prevent a woman from partying or doing

anything else to impinge on her freedom.

It's not comparable to saying a woman shouldn't socially drink.

[LeftyMom]

46. Supplements cost money and they have risks, side effects and potential benefits.

The solution isn't assumed pre-pregnancy, it's improved family planning.

[pnwmom]

47. Not when half of pregnancies are accidental. The risk is too great.

and store brand vitamins cost pennies a day.

Spina bifada is a terrible life sentence to impose on another person because you didn't take a multivitamin and got pregnant and went through the pregnancy anyway.

Anyone who would knowingly take that risk, without a serious mitigating factor, is heartless and irresponsible.

[LeftyMom]

48. Eating soft cheeses when you might get pregnant is heartless and irresponsible.

Standing downwind of a smoker when you could conceivably be pregnant is heartless and irresponsible.

Once the woman is assumed to be in a decades-long state of potential pregnancy, where does the control (however well-meaning) stop?

The data DO NOT support routine vitamin supplementation. The notion that a healthy woman needs to spend 30+ years of her life taking entirely useless and potentially harmful supplements on the off chance that she might have a birth control failure, and might carry that pregnancy to term and might have an inadequate diet (unlikely considering that folate supplements are mandated in many foods, and the trend toward less processed foods in general and whole grains in particular means more women are eating things naturally high in folate) and the pregnancy might suffer an exceedingly unlikely defect stupid and controlling.

Planned pregnancies have greatly improved outcomes. Women don't need to live in a perpetual state of pre-pregnant anticipation, we need to take care of our own damned bodies.

[pnwmom]

49. The data DO support the CDC's recommendation and

the American Academy of Obstretic's recommendation and the March of Dimes' recommendation for supplementation of folic acid. STRONGLY. You couldn't be more wrong about this.

Half of pregnancies are still unplanned. Public health advisories take this into account, even if you live in a fantasy world where nobody ever gets pregnant accidentally.

[LeftyMom]

50. The recommendation was issued in the 90's. Pre whole grain everything. Before mandatory BC coverage.

Before the emphasis on LARCs in contraception. Most importantly, before most of the data on the inadvisability of vitamin supplementation in otherwise healthy people.

[El_Johns]

57. The recommendation still stands. And it wasn't before "pre-grain everything".

http://www.cdc.gov/ncbddd/folicacid/recommendations.html

[El_Johns]

58. If a woman is liable to give birth to a child with birth defects, she isn't "healthy" -- whether she

is "anticipating" getting pregnant or not.

[LeftyMom]

59. That is an odd definition of health. Women could get more/less healthy by changing partners.

[El_Johns]

60. Neural tube defects don't have anything to do with one's partner. They have to do with the

health of the mother.

[LeftyMom]

62. There's a genetic component to risk.

[El_Johns]

74. There's a genetic component to the quantity of vitamins & minerals one needs too. Fact remains,

folic acid supplementation is recommended for women of childbearing age, and it reduces neural tube and related birth defects.

Which suggests that a large proportion of such women don't get an optimal amount of folate (& likely other nutrients) in their regular diets.

[xmas74]

64. I had my well-woman yesterday

(happy early birthday to me) and my OB/Gyn still recommended a that I take a supplement, just in case. I'm on bc, I have abnormal periods and my chances of getting pregnant are slim. I don't really want another child. She recommended it because, as she put it, "things happen when you least expect it." She also said that if "things were to happen" she'd be more than happy to discuss all my options and make any referrals needed but that it's "better to be safe than sorry".

I'm no longer young. I don't have that many years of fertility left and I'm already at a low risk of actually getting pregnant. I also, compared to most of society, worked in a mental institution in my early to mid twenties and saw all kinds of birth defects. After seeing what I saw, I'll take my chances with the supplement, until I become menopausal.

[LeftyMom]

65. Following the advice of your particular doctor, who knows your situation, is good.

Myself, I'm 32. I eat very well. My chances of an unplanned pregnancy are only slightly above what they would be if I were surgically sterilized, because LARCs are awesome. I don't believe I'd continue a pregnancy if lightning were to strike- I have zero interest in parenting a teenager and a toddler at the same time and I don't especially like babies anyhow. My PCP does not advise that I take any vitamin supplements, but says we may revisit that if I change my bc method or as I get older.

When in doubt ask your own doctor, who knows your actual situation. The end.

[xmas74]

68. Exactly.

Take a supplement, don't take one-just talk to your doctor.

I saw this all over Facebook, with women saying they were no longer taking supplements for this reason. I wonder how many were actually recommended by their physician and how many were recommended by the sales clerk at GNC?

I eat relatively well, though I cheat like everyone does on occasion. (Work in catering and it's hard not to sample at times.) I'm almost 40, early menopause is common in my family and the symptoms are showing. My periods are now abnormal, skipping around quite a bit and my doctor says that, unfortunately, there's not too much they can do at this stage of the game unless I really want to protect my fertility. (She'd send me to a specialist.) At this stage, I don't want a teen and a baby at the same time. Of course, if a pregnancy ever did happen I might change my mind, thinking it's the "last chance". I don't want to know.

What I hate about media coverage about something like this is that the media only covers half the story and the public reads less than half of what they cover. One of the women I know on FB has decided to go off of everything, including the multi with folic that her OB/Gyn recommended. She just had her second child at 41 and comes from a family with pregnancies later. (Her younger sister was born when their mother was in her early 50's, I believe.) She's someone who should still stay on it because it could affect her directly.

[Romulox]

54. How about let's not *anybody* take medical advice from DU's far-right fringe??? nt

[Puglover]

63. Best post in thread thus far.

[IdaBriggs]

66. ^== This!!!

[Marr]

88. How about don't take medical advice from any random stranger on the internet?

The article itself is quite clear.

[PowerToThePeople]

61. I am male and will not stop taking my multi-vitamin. n/t

[Egalitarian Thug]

67. When I look at the people you're complaining about, and then the list of people I already

ignore, I find that all of the people on the first list have been on the second list for years.

I don't understand the motivation behind it, but theses fools apparently slept through, didn't attend, or just couldn't understand the lessons in their Org Chem and Bio classes. If they had a clue they could simply learn the etymology of the word vitamin and begin to shed some scales.

[vanlassie]

70. Just popping here to mention that if one has certain MTHFR gene mutations, they can not convert

synthetic folic acid to methylfolate. Those people need to supplement with folate, NOT folic acid.

[pnwmom]

71. Thanks! n/t

[Number23]

75. I started getting throat infections for some unknown reason a few years ago

Where my tonsils were swelling up like watermelons. One time had TWO doses of antibiotics for the same infection that did absolutely nothing. The doctor was convinced that I would need my tonsils out soon.

Now, whenever I get that twingey feeling in my throat I do two things: drink as many cups of hot tea with honey and lemon as I can stand and take two chewable Vitamin C morning and night. Usually by the second day of doing this, the twinge is gone. Have not had a throat infection in four years.

My husband gets terrible leg cramps sometimes at night. We'll be asleep and then all of sudden he starts yelling like a banshee. Every single time, I get him a Magnesium tablet and within 20 minutes he's knocked out again. Anyone that sees no benefits to vitamins ain't looking.

[Marr]

86. If I'm not mistaken, this point was specifically addressed in the thread to which you refer.

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=4188190