Can Dietary Supplements Cause Birth Defects?

I’m hoping to get pregnant soon, so I was disturbed to hear the FDA saying that pregnant women shouldn’t use supplements. Is this correct? What do you think about using herbs and other supplements during pregnancy?

I don’t blame you for being confused. The Food and Drug Administration (FDA) has gone back and forth on whether or not supplement manufacturers can market products directly to women for treatment of pregnancy-related symptoms such as morning sickness and swollen legs.

Here’s what happened: First, the FDA announced that any supplements intended for treatment of symptoms related to pregnancy would be treated like drugs, meaning the supplements would have to go through extensive testing before being approved for sale to pregnant women. However, the agency did an about-face and announced that the products could, in fact, be sold as supplements — and wouldn’t have to undergo the testing and approval process.

Most recently, the FDA reversed itself yet again — this time barring supplement manufacturers from making claims that their products were suitable as treatment for pregnancy-related symptoms. This last move came in response to warnings from birth defect experts who say not enough is known about the safety of taking supplements during pregnancy. Much of their anxiety comes from the thalidomide scare of the 1960s. Thalidomide was a drug marketed to pregnant women for morning sickness (and also used as a sleeping pill), but it turned out to cause terrible fetal deformities. Since then, most of us in the medical community have become extremely careful about recommending products to pregnant women.

After all this flip-flopping, the good news is that the agency now plans to hold a public hearing on April 24 to gather information on the potential hazards of taking dietary supplements during pregnancy.

My own view is that women should avoid taking herbs during the first trimester of pregnancy. However, everyone agrees that women need increased amounts of vitamins and minerals such as calcium, iron — and particularly, folic acid before and during a pregnancy to prevent birth defects such as spina bifida. The Centers for Disease Control and Prevention (CDC) recommends increasing the intake of folic acid to 400 microgram per day, beginning at least one month before conception and continuing through the first trimester.

Since you’re hoping to become pregnant soon, I recommend consulting your family doctor or gynecologist about the vitamins and minerals you should be taking at this time. Have an honest and open discussion. If you are using herbal supplements now, it would be a good idea to stop before you actually become pregnant — just as you should avoid alcohol now in order to eliminate the chance of any possible harm to your baby during the earliest stages of pregnancy. Good luck.

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