Nutritional Testing When Trying to Get Pregnant
So you’re trying to get pregnant and reading up on all the helpful online advice... Everyone says “eat a healthy diet” -- and then describes what they think is healthy. This is usually accompanied by pretty pictures of salads or fruit smoothies.
But that vague advice may not cut it for you. You are probably already eating well, exercising enough, and trying to live a healthy life.
It may be time for you to dig a little deeper into your health. One way to do that is to get blood tests done to make sure you are not missing out on some key nutritional elements needed for fertility.
Everyone is unique! You have different genetic variants and different lifestyle factors from anyone else. So your needs for certain fertility impacting vitamins may be more or less than others need.
The only way to know for sure what is going on in your body is to do a blood test. Some of these tests may be something that your doctor can order and your insurance could pay part of the cost.
If your doctor doesn’t want to order the tests (or insurance won’t pay for it), another great option is to order lab tests on your own. I’ve partnered with UltaLabs to offer lab testing at a very reasonable price for women who want the option of ordering their own tests.
Let’s dig into some of the research-backed blood markers that can make a difference when trying to conceive.
Having adequate vitamin D levels is important for overall health as well as reproductive function. While your body can make vitamin D from sun exposure on your skin, most of us today are indoors almost all day so don’t get enough sunlight.
The US National Institute of Health recommends that people have vitamin D levels of 20 - 50 ng/mL. But for women trying to conceive, 20 ng/mL may be too low. Studies of women undergoing IVF found that vitamin D levels > 30 ng/mL were more likely to conceive. Other studies point to 40ng/mL as being important for a healthy pregnancy. (study) (study) (study)
The best way to know your vitamin D status is to get a simple blood test done. Your doctor may be able to request the test and have your insurance pay for it. Sometimes, though, it is just simpler and easier to order a blood test on your own. UltaLabs is a convenient way to get the tests that you want at a reasonable price.
Optimal levels for fertility: 40-50 ng/mL
Raising your vitamin D levels:
Getting outside in the sunshine each day is a great way to naturally raise your vitamin D levels. But for people who can’t spend enough time outside with their skin exposed to the sun, vitamin D3 is available as a supplement. Choose one based in coconut oil or another healthy oil rather than soy based.
Excess vitamin D from supplements can cause high serum calcium concentrations. You want to take enough vitamin D to increase your levels to the sweet spot. It is a good idea to re-test again after a few months of supplementing to see what your levels are. The recommended upper limit is set at 4000 IU/day. The Endocrine Society recommends higher doses of up to 50,000 IU/week for 8 weeks for women who have vitamin D deficiency. (study)
Having enough vitamin A is essential when trying to conceive. Studies point to decreased fertility with vitamin A deficiency. And higher levels of retinol (vitamin A) increase the quality of embryos in IVF. One study on in vitro fertilization found that a vitamin A intake of over 700 mcg/day was associated with higher quality embryos. (study)(study)
You may think that you are getting plenty of vitamin A with your prenatal or by eating carrots, sweet potoatoes, and other sources of beta-carotene. But some people have genetic variants that decrease their ability to convert those plant forms of vitamin A into the retinol form the body needs. So you may be eating plenty of beta-carotene but still not have enough true vitamin A in your cells.
The best way to know your vitamin A status is to get a blood test done.
Retinol levels below 20 mcg/dL are considered ‘sub-clinical vitamin A deficiency’. This is the point where many people may experience problems such as poor night vision, greater susceptibility to getting sick, and skin problems.
Raising your vitamin A levels:
Foods that have a high level of the retinol form of vitamin A include liver, butter from grass-fed cows, and cod liver oil. Supplemental vitamin A is also available. Keep in mind that vitamin A is also something that you don’t want to go overboard on when trying to conceive. Extremely high doses of retinol can be detrimental to a baby and cause birth defects.
Folate and Homocysteine levels:
Folate is essential for a healthy baby and most women are aware of the need for folate in their prenatal vitamins.
A common genetic variant of the MTHFR gene can cause you to need more folate, especially when trying to conceive. Women who carry two copies of the MTHFR C677T variant are more likely to have problems with conception. (study)(study)(study)
Folate is needed within the methylation cycle, which is a biochemical way that your body creates methyl groups for use in various reactions. Methylation is important in detoxification of certain toxins, creation of neurotransmitters, making antioxidants, and more.
If you have been taking prenatal vitamins, you likely will show up as having more than adequate folate on a serum blood test. But this doesn’t always tell you how well your body is using the circulating folate and folic acid.
One way to know whether you’re having problems with the methylation cycle, though, is by testing homocysteine. Higher than normal homocysteine levels indicate problems with methylation.
Homocysteine is often measured as a marker of heart disease risk, but it is also important when trying to conceive. High homocysteine levels are tied to lower pregnancy rates in IVF. (study)
An inexpensive blood test can show you if your homocysteine level is high. Normal homocysteine levels are less than 10 umol/L for women. (study)
Raising your folate and lowering homocysteine:
A diet rich in folate includes broccoli, asparagus, eggs, leafy greens, and liver. If you choose to supplement with folate, look for a methylfolate supplement, which is the active form that your body uses. If your homocysteine levels are high, be sure that you get plenty of riboflavin, B6, folate, and B12 either through diet or supplements.
Optimal Thyroid health:
Optimal thyroid health is so important for both your overall wellbeing and for conception.
Women who are hypothyroid are more likely to have problems with infertility. (study)
A standard blood test from your doctor usually includes TSH as a way to check for thyroid health. But testing TSH only tells you whether your pituitary is signaling for more thyroid hormone to be produced. It doesn’t tell you what your thyroid levels actually are.
Instead, if you suspect that you have a thyroid problem, you should test your free T3, free T4, and reverse T3.
According to Stop the Thyroid Madness, a book and website for optimal thyroid function, your optimal ranges are:
- Free T3: should be above mid-range for the test range
- Free T4: should be at or above mid-range for the test range
- Reverse T3: this should be near the bottom of the test range
You also want to check for thyroid peroxidase and thyroglobulin antibodies. If the test results show either of these above range, it indicates an autoimmune thyroid problem, such as Hashimoto’s.
Why order your own lab tests?
While it may seem odd at first to consider paying out-of-pocket for lab tests, there are several big advantages.
First, you won’t need a doctor's visit, which saves you the cost of that co-pay. For some insurance plans, the cost of the doctor’s visit alone is more than the insurance savings on lab tests.
Second, you can easily order and pay for the lab tests online, and then visit the nearest blood draw location whenever it is convenient. For a lot of women, the ability to get the blood test done before work or at lunch is a huge time saver.
Finally, you get the results back in just a couple of days. No waiting for the nurse practitioner to call you with the results. And it is easy to share those test results with your doctor so that they have the information as well.
Taking charge of your health is an empowering action. When getting pregnant is taking longer than you expect, it is easy to get stressed out and frustrated by the lack of answers. Simple steps, like a healthy diet, good sleep, and staying active, are important. But actually knowing what is going on in your body will provide additional clues to areas that need your attention.