Pregnancy Supplements: Take vs Avoid

Roughly 90% of pregnant women fall short of choline's adequate intake. Vitamin A retinol over 10,000 IU is teratogenic. The pregnancy supplement aisle is a minefield of hot-trending herbs that should never be there. Below: ACOG / NIH / WHO consensus, in two short lists.

Take (with clinician sign-off)

1. Folate (5-MTHF) — 600–800 µg.
2. Choline — 450 mg/day (Adequate Intake). ~90% of mothers fall short.
3. DHA (algal or fish) — 200–300 mg/day.
4. Vitamin D3 — 1,000–2,000 IU.
5. Iron (if deficient) — 27 mg (RDA).
6. Iodine (in prenatal) — 150 µg.
7. Prenatal multivitamin (ACOG) — once daily.

Avoid

1. Vitamin A retinol > 10,000 IU/day — teratogenic.
2. Kava (any form) — liver risk.
3. St. John's Wort — CYP3A4 induction.
4. Green tea extract (high) — folate antagonist.
5. Ashwagandha — abortifacient (theoretical).
6. Saw palmetto / Pygeum — hormonal.
7. Comfrey / coltsfoot — pyrrolizidine alkaloid toxicity.
8. Kratom, phenibut, tianeptine — unapproved.

Bottom line

The "take" list is short, regulated, and boring. The "avoid" list is full of products you can buy at any health-food store today. If a supplement is currently trending on TikTok, the default during pregnancy is no.

See the full pregnancy breakdown with regulatory citations on Discover →