How To Choose The Best Prenatal Vitamins: A Complete Guide

Trying to choose a good prenatal vitamin from the hundreds of products on the market can be a challenging, frustrating, and confusing experience.

So, we are going to set aside some of the more in-depth quality control discussions for another day and focus on some basics, such as packaging, delivery method, and what nutrients, types, and amounts you should look for.

What To Look For in A prenatal vitamin

The first is to avoid getting fooled by some dishonest marketing methods that certain companies employ. There are numerous prenatal vitamin supplements on the market that claim to be whole-food or food-based. The companies we examined that made those claims were not being honest and were not making whole-food prenatal supplements. You can read more about fake whole food supplements in our blog, here, which goes through many of the marketing terms these companies use. While we did see one company attempting to create a whole-food prenatal bar, the amounts of many nutrients, especially choline, were far too low for it to be a viable option. Pregnancy requires higher levels of nutrients, and prenatal vitamins should reflect this. While I am very much a whole food supplement guy, prenatal vitamins are just not an area that it will work for, based on the needs during pregnancy and the average nutrient consumption by most pregnant women. When looking into formulating a prenatal vitamin, in order to make a truly whole food one that met the nutrient levels needed during the average pregnancy, the serving size would have been about thirty-six capsules per day, so it was not realistic and also would have been extremely expensive. We saw a few companies advertising whole food, animal-based prenatal supplements, and they were really problematic because:

• One wasn't a whole food supplement because it has a non-whole food form of magnesium.

• Another contained herbs that many pregnant women should not be using. Most herbs should not be included in a prenatal formula due to a lack of study in pregnant women, and the fact that many herbs are not right for a lot of pregnant women. Certain herbs, such as ginger and nettles (provided they are properly tested and safe), at the correct levels can be helpful additions to a prenatal vitamin. For the most part, though, herbs should be taken separately, under the guidance of your doctor or midwife for safety reasons, not already added into a prenatal. One even contained an herb that is contraindicated for the vast majority of pregnancies.

• The amounts of the various foods included in these formulas were not enough to do really do anything.

  • For example, a full six-capsule serving of this product contained 300 milligrams of colostrum. This is far lower than the amount needed to get a benefit, which is at a minimum of 1000 milligrams.

  • If foods are going to be used, they need to be in the full amounts needed for the benefits. Companies should not just put a bunch of things into it to make the label look good. This is called fairy-dusting. Check out our blog to learn more about this terrible practice.

The second thing to look for when choosing a good prenatal is a basic but very important one: the packaging. Prenatal vitamins should be packaged in dark glass, opaque plastic, or sachets in a box. This is because light will cause some nutrients to break down. Shockingly, one of the best-selling prenatal vitamins on the market is packaged in a clear container. This is an absolutely terrible idea and shows that the company has a serious lack of judgment and quality control. Stay far away if you see prenatal vitamins (or any other supplements) packaged in clear containers.

Later in the article, we cover the other things you should be looking for.

Prenatal vitamin gummies

Next up is the delivery format. The chewable and gummy formats are not really suitable for prenatal vitamins. There is simply no way to fit enough of the nutrients, in their proper forms, needed for a healthy pregnancy into a chewable or gummy. You will be missing many essential nutrients. Liquids are a poor choice because many vitamins are unstable when left in a water-based liquid solution and break down, resulting in a loss of nutrients. The best choices for prenatal vitamins are powders, tablets, and capsules. Avoid one-a-day products as they are either going to be using poor forms of nutrients, lack adequate amounts, or be missing key ingredients like choline. As much as a one a day prenatal vitamin sounds great, it's just not an option if you want to get enough of the nutrients you need in forms that are well utilized by the body.

Capsules and tablets might be boring, but your health is too important to leave to candy.

Which forms and amounts of nutrients should a prenatal vitamin have?

A good prenatal should, to start with, contain the basic nutrients in good forms and amounts. Two things to keep in mind are that you will not get 100% percent of every nutrient from your prenatal, because things such as calcium and magnesium are just too bulky to include the full amounts needed in good forms, without making the serving twelve pills per day. Make sure to check the serving size on the package so you know how many pills you have to take to get the listed amounts. For example, one bottle may have a serving size of five pills and another a serving of two pills.

1. Vitamin A

   1. Look for products that contain a combination of preformed vitamin A (retinol) and carotenoids. Some people have a genetic condition where they do not convert carotenoids like beta carotene into vitamin A very well, so a combination of both will ensure that you are getting enough.

2. B1 (Thiamine)

   1. Most prenatal vitamins contain Thiamine HCL. There is a more advanced fat-soluble version of thiamine called benfotiamine. Befotiamine is better absorbed and stays in the body longer. We recommend choosing prenatal vitamins with benfotiamine instead of thiamine HCL.

3. B2 (Riboflavin)

   1. Choose those that use the methylated form, riboflavin-5-phosphate, as many people have a genetic issue that affects their ability to convert riboflavin into riboflavin-5-phosphate. Look for at least two milligrams per day.

4. B3 (Niacin or Niacinamide)

   1. The niacinamide form of vitamin B3 does not cause the unpleasant flushing that niacin can cause. Look for at least eighteen milligrams per day.

5. B5 (Pantothenic Acid)

   1. Look for at least six milligrams per day.

6. B6 (Pyridoxine)

   1. Choose those that use the methylated form, pyridoxal-5-phosphate, as many people have a genetic issue that affects their ability to convert pyridoxine HCl (hydrochloride) into pyridoxal-5-phosphate (p5p). In addition, pyridoxine HCL has begun to be linked to certain health issues. Adequate levels of pyridoxal-5-phosphate can help to reduce nausea. Look for at least 25 mg P5P per day. If the pyridoxine HCL form is used, look for lower amounts.

7. B7 (Biotin)

   1. Look for at least thirty micrograms per day. If there is a larger amount of biotin in the prenatal, you may need to stop taking it for a few days before blood work, as biotin can interfere with specific blood test results.

8. B9 (Folate)

   1. Avoid products that contain folic acid. Instead, look for L-methylfolate or 5-MTHF forms of folate. Many people have a genetic methylation issue that affects their ability to convert folic acid into l-methylfolate. Additionally, many people already consume excessive amounts of folic acid in their diet from fortified foods. Avoid products that just list folate, as many of these products may actually have folic acid but are misleading people by saying folate. Look for at least one milligram (one thousand micrograms) per day.

9. B12 (Cobalamin)

   1. Avoid products that use cyanocobalamin. Many people have a genetic issue that affects their ability to convert cyanocobalamin to methylcobalamin. Instead, look for products that use methylcobalamin, adenosylcobalamin, and hydroxocobalamin. Also, avoid products that just say B-12 or cobalamin, as it is important to know what form is being used. Look for at least three milligrams per day.

10. Vitamin C

    1. Look for those that use buffered vitamin C (calcium ascorbate) in order to make it gentler on the stomach. Look for at least eighty-five milligrams of vitamin C.

11. Vitamin D

    1. Look for those that contain at least 1,000 IU of vitamin D3 per day. Avoid those with vitamin D2 as this form is not as well utilized by the body as vitamin D3.

12. Vitamin E

    1. Look for prenatal vitamins that use mixed forms of natural tocopherols, not just alpha-tocopherol or synthetic dl-alpha-tocopherol. Look for at least 15 mg (22 iu) per day.

13. Vitamin K

    1. There are multiple forms of vitamin K found in supplements. The most common are K1 and K2 ( MK-7 and MK-4). Look for products that have a combination of vitamin K1 and K2 types. Avoid products that only use the K2 MK-7 form, as this form may not pass well from the placenta to the fetus.

14. Calcium

    1. Avoid prenatal vitamins containing calcium carbonate or tricalcium phosphate; instead, look for those that use glycinate, malate, or MCHA, as these are better absorbed and will be easier on the digestive system.

       1. Keep in mind that calcium is very bulky and takes up a lot of space, so you will not be able to get 100% of the daily value in prenatal vitamin supplements.

15. Iron

    1. A good prenatal should have at least fifteen milligrams of iron per serving. Look for fully-reacted glycinate or bisglycinate forms, as these are easier on the stomach and are much less likely to cause constipation. In addition, a fully reacted bisglycinate form of iron will not interfere with the absorption of other minerals in the prenatal vitamin, unlike other forms of iron, such as ferrous sulfate. Unfortunately, a lot of products claim to contain fully-reacted forms of iron, but in often only have partially reacted forms. A prenatal with multiple pill servings will be better as you can split the dosage up during the day, increasing absorption and reducing stomach upset.

16. Magnesium

    1. Avoid prenatal vitamins that use 100% oxide (occasionally, a company may use a small amount of oxide, less than five percent, to make them easier on the stomach, but the rest is in a good form) or carbonate forms. Instead, look for forms such as glycinate or bisglycinate, as these will be better absorbed and be easier on the stomach and digestive system.

       1. Keep in mind that magnesium is very bulky and takes up a lot of space, so you will not be able to get 100% of the daily value in a prenatal capsule.

17. Selenium

    1. Avoid prenatal vitamins that use sodium selenite. Instead, look for selenomethionine, a safer organically bound form of selenium, which is better absorbed and easier on the stomach and digestive system. Look for at least sixty micrograms per day.

18. Zinc

    1. Zinc is so important for fetal development. According to the NIH, pregnant women are one of the groups most at risk of zinc deficiency:

       1. Pregnant women, particularly those starting their pregnancy with marginal zinc status, are at increased risk of becoming zinc insufficient due, in part, to high fetal requirements for zinc. Lactation can also deplete maternal zinc stores, and for these reasons, the RDA for zinc is higher for pregnant and lactating women than for other women.

          1. Based on that information from the NIH, make sure your prenatal vitamin contains at least twelve milligrams per day,

    2. Avoid prenatal vitamins that use the oxide form. Instead, look for glycinate or bisglycinate, which are better absorbed and easier on the stomach and digestive system.

19. Copper

    1. Avoid prenatal vitamins that use the oxide form. Instead, look for forms such as glycinate or bisglycinate, which are better absorbed and easier on the stomach and digestive system. Look for at least one milligram per day.

20. Manganese

    1. Avoid prenatal vitamins that use the oxide form. Instead, look for forms such as glycinate or bisglycinate, which are better absorbed and easier on the stomach and digestive system. Look for at least two milligrams per day.

21. Chromium

    1. Look for forms such as GTF and glycinate, as these will be better absorbed and easier on the stomach and digestive system. Look for at least thirty micrograms per day.

22. Manganese

    1. Avoid prenatal vitamins that use the oxide form. Instead, look for forms such as glycinate and bisglycinate, as these will be better absorbed and easier on the stomach and digestive system. Look for at least two milligrams per day.

23. Molybdenum

    1. Avoid prenatal vitamins that use the oxide form. Instead, look for forms such as glycinate or bisglycinate, as these will be better absorbed and easier on the stomach and digestive system. Look for at least fifty micrograms per day.

24. Potassium

    1. Avoid prenatal vitamins that use the oxide or carbonate form. Instead, look for forms such as glycinate or bisglycinate, which are better absorbed and easier on the stomach and digestive system.

25. Boron

    1. Avoid prenatal vitamins that use the oxide form. Instead, look for forms such as glycinate or bisglycinate, as these will be better absorbed and easier on the stomach and digestive system. Look for at least twenty milligrams per day.

26. Vanadium

    1. Avoid prenatal vitamins that use the oxide form. Instead, look for forms such as glycinate or bisglycinate, as these will be better absorbed and easier on the stomach and digestive system. While vanadium does not have a recommended daily value, it plays a very important role in blood sugar levels in the body. While most prenatal vitamins don't contain vanadium, it is essential to ensure that your prenatal vitamin does.

Important nutrients lacking in most prenatal vitamins

Three nutrients are so incredibly important, but they often go unmentioned and are either absent or present in tiny amounts in most prenatal vitamins. Despite well-known deficiencies of these nutrients in large numbers of pregnant women, the vast majority of prenatal vitamin manufacturers don't put enough of these, and in many cases, none at all, in their products.

1. Choline

   1. Choline is so important to the health of the developing fetus. It performs a number of critical roles. Pregnant women need about 450 mg per day. The average consumption in the United States is about 278 milligrams per day for women. So, look for products that contain at least 200 mg of choline (400-500 would be ideal) per serving in order to ensure you get to the 450 mg needed. I cannot emphasize enough the importance of getting a prenatal vitamin with large amounts of choline. It is so ridiculous that so many do not contain or contain just a very small amount of this vital nutrient. Frankly, products lacking a sufficient amount of choline should not be labeled as prenatal vitamins. It's strange how the best-selling prenatal vitamin talks about the importance of choline on its website but then only puts a paltry fifty-five milligrams in its product; shame on them. Check out our blog to learn more about the importance of choline.

   2. Choline is a key partner to folate, as it is an important methyl donor and serves as a key component of methylation. Choline and folate are closely interconnected in the body’s one-carbon metabolism pathway – both contributing to the body’s methyl pool to maximize methylation potential. Adequate levels of both are needed for healthy fetal development.

2. Iodine

   1. Iodine is an essential nutrient that supports the proper brain development of the fetus. Pregnant women need about 220 mcg per day. According to the NIH, a substantial portion of the US pregnant population are deficient in iodine. Intakes vary, averaging between 144 and 181 mcg per day. Women who did not consume dairy had even lower levels. Look for prenatal vitamins containing at least 150 mcg of iodine to ensure you are getting enough iodine from both food and supplements. Selling a prenatal vitamin without iodine is doing a real disservice and should not be legal.

      1. If you have hyperthyroidism, please talk to your doctor before consuming any supplements with iodine.

3. Omega-3 fatty acids, such as DHA.

   1. These are very important for a healthy pregnancy. Over 90% of women do not get enough of these valuable fatty acids. However, this is one nutrient that you should be taking separately. You might be thinking, well, if it is so important, shouldn’t it be in the vitamins?

      1. Omega-3 fatty acids, such as DHA and EPA, oxidize and go rancid quickly when exposed to certain minerals, including iron, which are found in many prenatal vitamins. In addition, it is tough to put enough DHA into a prenatal vitamin to get an effective dose. Those are the reasons why we recommend a separate DHA supplement.

      2. Rather than using a prenatal with DHA, take a good prenatal and a separate whole-food DHA supplement.

Common Problems with Prenatal Vitamins

Besides being low or lacking in many important nutrients, there are a number of other problems with many prenatal vitamins.

The first is potency issues. Many prenatal vitamins contain less than the amounts listed on the label. For example, one popular prenatal gummy was found to contain much less vitamin D than claimed on the label.

The second is poor forms of nutrients. Many prenatal vitamins use cheap forms of nutrients that are poorly utilized by the body. You want the best forms of nutrients as listed above.

Third is counterfeit prenatal vitamins. Websites, like Amazon, that allow third-party supplement sellers, are rampant with counterfeit supplements. Check out our blog to learn more about this.

The fourth is poor testing. Many prenatal vitamins are not appropriately tested for things like adulterants and contaminants. The right testing, not just testing, is needed.

The fifth is non-fully reacted and chelated minerals and vitamins. Many prenatal supplements claimed to use specific forms of nutrients, but when we dove a little deeper, often these were not what they claimed to be. For example, a few products claimed to have magnesium glycinate, but it was not really magnesium glycinate; it was just magnesium carbonate blended with the amino acid glycine, not a real mineral chelate. You can learn more about this issue (which is not unique to prenatal vitamins) in our blog.

Third-party tested prenatal vitamins

Many companies are advertising that their prenatal vitamins are third-party tested. Unfortunately, this has become a marketing gimmick, not a marker of quality. There are several reasons for this, including:

• Wrong testing methods are being used.

• Fake or counterfeit lab tests

• Dry labbing

• Only a small number of things are tested for, rather than all of the things that should be.

• And a whole lot more!

Visit our blog for an in-depth examination of the issues with third-party testing and what you really should be looking for.

How should you take prenatal vitamins?

Prenatal vitamins should be taken with a full glass of water (makes them easier on the stomach) and a meal that contains some fat, to improve absorption of fat-soluble nutrients.

It is best to split the dosage up, such as with breakfast and lunch, rather than take them all at once, as this will make them easier on the stomach and increase absorption of the nutrients.

Ideally, prenatals should be started at least three months before pregnancy.

The Best Prenatal Vitamin

After reviewing all the prenatal vitamins on the market, I could no longer find one that met all the criteria outlined in this article, due to changes we didn't like, manufacturing issues, and a significant price increase that began to appear in a brand we were using. This created a dilemma for me. Do I recommend one that didn't meet the high standards we expect and laid out in this article, or do we not have a prenatal vitamin because none met our standards? Do I lie to people and tell them how wonderful something is when it really wasn't? None of those seemed like good options to me. So I had to go back to the drawing board to come up with a solution. The only thing I could come up with that would completely solve the problem was to formulate one myself and find a good partner company to produce it to my standards. This was not going to be a private-label prenatal vitamin that we slapped our name on, made for hundreds of other companies; it was going to be a unique and comprehensive formula. After a ton of research and way too much math (definitely not my strong suit), I finally had my formula.

What I imagine I look like when I'm doing research.

Moss Nutrition Prenatal Select

Thankfully, our friends at Moss Nutrition were willing to step up to the plate and produce my prenatal formula. Let's get into what makes this prenatal different from any other on the market.

First up are the levels of nutrients. Seeing as most prenatal vitamins are missing or very low in key nutrients, I wanted to make one that addressed that crucial issue. This prenatal will have all of the nutrients needed in the full amounts, with the exception of calcium and magnesium. Although it contains a good amount of them, it was not possible to fit the full 100% daily value without making the serving size approximately twelve capsules or using poor-quality forms of them.

Second, it uses the better forms of vitamins and minerals. Many prenatal vitamins use subpar forms of nutrients to reduce production costs. While this may be good for the bottom line, pregnancy is the worst time to cut corners on a product.

It uses fully reacted, chelated minerals. The more deeply I dug into a lot of prenatal vitamins, so many had problems with claiming certain types of minerals, but most were not truly chelated, with claimed amounts of minerals not possible based on the forms they claimed to be. Sorry, I know this isn't very clear. Here's what this really means, using magnesium glycinate as an example. Five hundred milligrams of real magnesium glycinate, which is around fourteen percent elemental magnesium (the actual amount of magnesium you get), will contain about seventy milligrams of elemental magnesium. So if a product claims to use 500 milligrams of magnesium glycinate, but claims to have one hundred and forty milligrams of elemental magnesium, they are not using real magnesium glycinate. We ran into this time and again when looking at prenatal vitamins.

Almost all of the minerals in this formula are true chelates supplied by Balchem in Utah. These minerals undergo extensive testing, and the company's minerals division has been making minerals since 1956.

Real mineral chelates, such as calcium bisglycinate, are not affected by dietary components that can reduce the absorption of traditional mineral supplements (like calcium carbonate), including oxalates and phytates, because they are already bound to an amino acid. In addition, the type of iron found in this prenatal does not reduce the absorption of other minerals in it like ferrous sulfate can, which is the most common form of iron in prenatal vitamins.

It utilizes a stable form of L-methylfolate instead of folic acid, allowing individuals with MTFHR mutations to use it. Each batch of this folate is tested for a variety of contaminants to ensure it's truly l-methylfolate. One thing we were consistently finding was that a lot of the l-methylfolate in many prenatal vitamins was not stable, which led to low potencies at expiration date, and was mixed with other forms of folate in order to reduce costs, but these other folates were not listed on the label. Having a good source of this was essential.

It contains the appropriate amounts of zinc, iodine, and choline. These are three nutrients that are so, so important for pregnancy, but most women do not get nearly enough of them in their diet. Despite how essential these are and the general deficiencies of these nutrients, it drives me absolutely nuts that nearly all prenatal vitamins shortchange these three nutrients quite dramatically.

It contains 25 milligrams of the methylated form of B6, which may help to reduce nausea in pregnancy.

It also contains a potent ginger extract to help mask the smell of the pill, as many prenatals have an unpleasant odor, and to help soothe and calm the stomach. I wanted to make sure that the experience of taking a prenatal was more pleasant than with traditional prenatal supplements.

It would have been a lot easier to slap together a me-to prenatal product, but it was worth the extra time and effort to create something that would truly help women and that I could be proud of.

Moss Nutrition Prenatal Select will be ready to order soon. If you would like to be notified when it is ready, email us at info@rooted-nutrition.com, and we will let you know.

Prenatal vitamin support

We know this is a lot of information, so if you have questions about prenatal vitamins, don’t know where to start, or need support, we are always available to help. Drop us an email anytime at info@rooted-nutrition.com, or book a free call, and we will be happy to help you on your health journey!

I hope this article provided you with valuable information and helped you make a more informed choice when choosing a prenatal vitamin. Don’t forget to check out the rest of our pregnancy center for more great information on everything from healthy eating during pregnancy to breastfeeding!