During this first pregnancy I have had quite a few questions around what supplements I’m taking, nutrition, lab testing, and so much more so I thought I would do a blog post to cover it all!
Everyone will have their unique concerns and specific areas they want to prep for when it comes to conception. I have a health history of estrogen dominance and hypothyroidism, so these were my two biggest concerns when entering pregnancy. While I do testing regularly each year, I specifically timed a DUTCH hormone test, thyroid panel & iodine test, full monty panel, GI map stool test, and hair mineral test (of course) in the months leading up to when we planned to start trying to conceive. I do not think everyone needs to do all of this testing, but this is what I do for a living, so I of course, took advantage of the resources that I have. Let’s dig into the purpose and findings of each test.
DUTCH Hormone Test
This is a dried urine sample that looks at sex and stress hormones. I wanted to ensure I was making enough progesterone and that my estrogen:progesterone balance was good. My DUTCH test showed that I am making plenty of estrogen and progesterone and that they were in balance (see image below–you want arrows pointing in the same/similar direction).
The test also looks at stress hormones. I had a good cortisol pattern (see below), although my production of cortisol isn’t great, but this is related to a long battle with thyroid health. My thyroid health has improved a lot over the years where I don’t need medication but will be something I continue to work on for the long term. When thyroid health or hormone use isn’t working optimally, it can impact cortisol clearance, which eventually impacts how much you make.
I was happy with my overall pattern, though. You can see cortisol dips a bit in the afternoon, which is why I prioritize an afternoon snack always and go up a bit at night. This is actually a huge improvement for my pattern overall. I used to have a bigger dip in the afternoon and a much bigger increase at night. I worked on improving my meal frequency and not going too long without food, and my wind-down routine at night. In the beginning days of my business, when I was working full time, I worked a lot at night. This led to my cortisol having that increase. Luckily, I’ve worked on those habits, and it has come down.
Important note: While I’m sharing my preconception labs, remember that this is just one look. I have done many labs over the years, so I am comparing them to my previous results. One thing I’m not looking for–perfection. I’m looking for improvements and information that can help me optimize my health during pregnancy and beyond.
Thyroid Panel & Iodine Test
I do thyroid panels regularly because I used to take thyroid medication and now utilize iodine to support my thyroid, so I wasn’t necessarily doing these just for preconception but to continuously check-in. My thyroid panels have been all over the place. When I first got diagnosed with hypothyroidism when I came off the pill, my TSH was over 6 (optimal is .5 to 2), and I was barely making any free T4 (inactive thyroid hormone). This is when I first tried thyroid medication, but unfortunately, I had a poor reaction. My hair fell out, I had heart palpitations, and I felt wired constantly. Over the years, I have gone on and off but always feel better off. This led me to focus on minerals on my HTMA as well as looking more into iodine.
I think I had two big factors playing into my thyroid health over the years:
As I worked on improving potassium sources in my diet and helping my body become more resilient to stress as well as reducing unnecessary stressors (this could be a whole post on its own), I noticed that my thyroid function improved. One big step for me, though was iodine. I did an iodine loading urine test, which showed I was deficient in iodine. This is likely why I did not tolerate thyroid hormone well. I did an iodine protocol and began to add more and more iodine in and was able to see huge improvements in my labs. My Free T4 went from .6 to 1.1 (still needs work but WAY better), and my free T3 went from 2.3 to 3.0. My TSH went up at first because that’s the normal reaction to iodine–it’s telling your body to make more thyroid hormone, but over time went down to 3.08 (was previously above 5).
One thing I want to say about thyroid labs is that people obsess over TSH and don’t pay enough attention to free T4 and T3. I had many times when I was taking thyroid medication, and my TSH would go down to 1-1.5, but my free T4 and T3 would be way below optimal. Again, you don’t just want to go for what’s optimal on your labs; you want to see improvements over time and how things are shifting. One thing that really helped my T3 as well was eating consistently. I would get caught up in work, and food would be the last priority. When I shifted this habit, I noticed a big improvement in how I felt overall, but also in my T3 levels.
My thyroid labs prior to getting pregnant were the best they had been in a while, but not perfect. Again, not looking for perfect, just trying to understand where my body is at as far as thyroid function and what it needs to support it.
Because I have this history of hypothyroidism, I have continued to test once a trimester throughout pregnancy. This is what my midwife recommended. I honestly think all women should do this, but it’s especially important if you have a thyroid history. Want more info on thyroid panels and iodine testing and protocols? I go through this inside my course Master Your Minerals.
Full Monty Panel
This is a panel that looks at your iron status, vitamin A, vitamin D, copper, zinc, and magnesium RBC. I think this is a very helpful panel to do prior to conception to better understand how much vitamin A you need and to see how well you are using iron. So many women are told they are anemic in the third trimester, and this isn’t the case for most. Learn more about this in my podcast episode with Loren. My retinol was a little lower than I wanted (around 44 but based on my vitamin D levels, I would like to see it closer to 70), so this showed me that beef liver and cod liver oil would be helpful for me during pregnancy. Overall, I was using iron efficiently and felt great about my copper and zinc status.
GI Map Stool Test
I didn’t necessarily have any digestive symptoms, but one reason I wanted to do a GI map stool test prior to pregnancy was to see how my immune system and digestion were functioning and if I had any not-so-great bacteria present. I didn’t have any streptococcus species, which I was grateful for since Group B Strep is of concern during pregnancy and birth. My immune system was not as optimal as I wanted, but overall there wasn’t anything super concerning. Interestingly enough, I started to develop eczema in the corners of my eyes in the last week, so it’s been helpful to see my old GI map test. I had one strain of bacteria staph aureus, which can contribute to eczema. I’ve never had eczema and wasn’t even totally sure what it was at first. Luckily, one of my RD friends is an eczema expert and has been helping me with some supplements and food changes. I will be sharing much more about this in my third-trimester update!
Hair Tissue Mineral Analysis
I couldn’t wrap up my preconception testing without mentioning HTMA. I do an HTMA 2-3 times a year anyway, so this was just part of my normal routine, but some things I was looking for prior to conceiving on my HTMA:
Again, you do not need to do all of this testing prior to pregnancy. I spread this out over a few months prior to conceiving and would not recommend doing this all at once since it can be overwhelming. If you’d like more information on how to do hair mineral testing along with assessing thyroid and iodine tests, you can find that all inside my course Master Your Minerals.
Now that we’ve covered my labs and what I learned from them, I can make sense of why I decided not to take a prenatal and build my own instead. According to my labs, health history, and nutrition needs during pregnancy, these are the supplements I decided to take:
If I did not feel like eating folate-rich foods (there were days in the first trimester where I didn’t), then I would take a methyl-folate supplement that was 400mcg. I was getting some folate from adrenal cocktails, beef liver, and food each day, but I made sure I covered my bases if I didn’t think those needs were being met.
So why did I not take a prenatal? Because there’s no prenatal, that would meet my needs. I needed way more vitamin A than I could ever get in a prenatal. I also like to avoid synthetic versions of vitamin A since those can be toxic to the liver and don’t work the same way in our bodies. I also needed more iodine than I would ever find and magnesium. I look at beef liver as a whole food multivitamin, so I expanded from there.
Learn more about my take on prenatals in this blog post.
Supplement Changes Throughout Pregnancy
After the first trimester, I was eating normally again and no longer had to consider the methyl-folate. I also developed a cavity (yay), so I added in vitamin K2 (I got the Purely K from Mitolife). I also added in Women’s Pro Flora to help avoid a positive Group B Strep test.
Since developing eczema, I have added in some immune support and stopped that probiotic, and swapped for a different one. I’ll share more on this during the third-trimester update.
I did a hair mineral test halfway through pregnancy and switched from a Slow 1 to a Fast 1, and my calcium decreased a lot. This led to me increasing calcium-rich foods and adding in either pearl powder or the living bone supplement from Ancestral Supplements. I take this at night with magnesium to help sleep and have noticed that I wake up feeling much more rested, which is amazing.
I do use herbs at times like red raspberry leaf, nettle leaf (not stinging), ginger, oat straw (very rich in minerals), and chamomile, mostly in tea form. I don’t consider these supplements.
Another big question I’ve gotten is if I have had symptoms throughout pregnancy. I did have some nausea from weeks 6-11, but that resolved pretty quickly. I managed that by eating every 2 hours and eating a protein before I ate my carb. I did use ginger, but I really feel like eating more protein and eating it first made the biggest difference in my nausea. Also managing reflux. As hormones are increasing in the first trimester and Hcg, this can lead to nausea and relax the esophageal sphincter. This can lead to reflux, and while you might not actually have a burning sensation, nausea is a very common symptom of reflux. Adding magnesium bicarbonate to my adrenal cocktails helped reduce this as well. I drank ginger tea regularly throughout the day, and it made it all manageable.
I haven’t had any crazy cravings throughout pregnancy or really felt that different, which I’m grateful for. People are always asking how I feel, and my answer is always good. My energy is good, my brainpower is good (although this dipped around week 11/12 but has returned), and I am sleeping well. My biggest issue during this pregnancy has been sleeping. I am a back sleeper, and adjusting to sleeping on my side was rough, but I have it down now. It took me two pregnancy pillows, but the C-shaped pillow is a dream. I also got an eight-week-old puppy, which meant I was waking up twice a night for about a month, but we are in a good routine now. Yes, I now have three dogs. Meet our new family member, Diego, below. He’s a mini poodle, and he’s absolutely perfect.
I have had some reflux now that my belly is getting bigger, but I added 1/8 tsp baking soda first thing when I wake up and then use magnesium bicarbonate in my adrenal cocktails and that is completely gone. Highly recommend!
I have felt really good physically throughout pregnancy, but this isn’t by luck. I started seeing a Webster-based chiropractor right away and have gone twice a month ever since. I can’t tell you how much I look forward to those visits. Any aches or pains I’m feeling are completely gone, and everything is reset. This has been especially helpful as my belly grows. I also have been conscious of my posture. Sometimes my lower back hurts, but this is usually an issue with my posture. I started using an exercise ball to sit on while working or put my desk in the standing position. If I am on my feet all day, I have to be extra conscious of my posture and activate my core. Otherwise, my back hurts like never before, and I feel terrible. I learned this quickly, and seeing my chiropractor and having those reminders has been helpful.
I also have remained very active. I still workout four days a week and have been doing Mamastefit’s programming since I was 5 weeks. I like it because it’s two lower-body days, two upper-body days, with some cardio (very light) mixed in. I didn’t think I would want to do cardio when pregnant, but it actually feels really good. I mostly ride the bike. This programming also includes specific movements for different stages of pregnancy and has substitutions based on how you feel. There is a huge focus on pelvic floor breathing, and that is incorporated into every exercise. At first, this was a lot for my brain to process, but now I do the breathing without even thinking about it. This has really built up my confidence for birth and in my pelvic floor health in general.
So what’s on deck for the third trimester? I am getting ready to complete my blood sugar testing, third-trimester thyroid labs, hemoglobin, and Group B Strep test. I am working with a homebirth midwife, so I am not doing the glucose tolerance test and instead have opted to test my blood sugar for a few days. I will share how I did all of that in my third-trimester recap. I will also talk more about Group B Strep prevention and new eczema I’ve been dealing with. Lastly, I will share how I’m preparing for postpartum.
I hope this was interesting and helpful!
You can listen to the birth story of my first daughter and my experience with our first postpartum period on the Are You Menstrual? podcast.
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