From the FDA Drug Label
Hematocrit, reticulocyte count, vitamin B12, folate and iron levels should be obtained prior to treatment. The FDA does not specify when "prior to treatment" is in relation to pregnancy, but it does mention that vitamin B12 levels should be obtained.
- Vitamin B12 levels should be checked before starting treatment, but the label does not explicitly state this should be done before pregnancy. However, it is implied that vitamin B12 levels should be known before pregnancy due to the increased need for vitamin B12 during pregnancy 1.
From the Research
Maintaining adequate vitamin B12 levels before pregnancy is crucial, with a recommended daily intake of 2.6 mcg through diet or supplements, as evidenced by the most recent study 2.
Importance of Vitamin B12
Vitamin B12 plays a vital role in DNA synthesis, methylation, and erythropoiesis, making it essential for women planning pregnancy.
- Good dietary sources include animal products like meat, fish, eggs, and dairy.
- For those with absorption issues or following plant-based diets, a supplement of 1,000-2,000 mcg daily is advisable, as suggested by 3.
- Women with known B12 deficiency may require higher supplementation under medical supervision.
Benefits of Adequate Vitamin B12 Levels
Adequate B12 levels before conception help prevent neural tube defects, support proper DNA synthesis, and reduce the risk of pregnancy complications like preeclampsia and preterm birth, as highlighted in 4 and 2.
- B12 deficiency during pregnancy can lead to developmental issues in the baby and maternal anemia.
- It's recommended to begin optimizing B12 levels at least three months before attempting conception, as part of comprehensive preconception care alongside folate supplementation, as suggested by 5.
Recommendations
Women planning pregnancy should aim for a daily intake of 2.6 mcg of vitamin B12 through diet or supplements, and consider consulting their healthcare provider for personalized advice, as supported by the latest evidence 3 and 2.
- Regular monitoring of vitamin B12 levels can help identify deficiencies and guide supplementation.
- A well-balanced diet and appropriate supplementation can help ensure adequate vitamin B12 levels, reducing the risk of pregnancy complications and supporting maternal and fetal health, as emphasized in 6 and 5.