Anyone taking calcium with prenatal?

prayingformybaby

hi,

I am in my 26th week. So I had good hemoglobin in May last year - 13.6. This was during my physical. When I visited my gynaec for the first time in September she suggested me to take some additional calcium though my calcium levels were fine in my physical. Maybe she suggested because my prenatal only had 200 mg (15%) of calcium. So I have been taking calcium tablet since then along with my prenatal. My prenatal has 27 mg of iron and also I have been following good diet with lots of iron or at least enough iron. When they tested me for CBC in November, my haemoglobin had fell to 12.4 which was normal range and maybe that's why it didn't catch my eye. They did my CBC again recently and I found my hemoglobin to be 11.4 (normal range 11.5 -15.6). I was wondering why my hemoglobin has declined from 13.6 in May last year to 12.4 in November and now 11.4 even after taking 27 mg of iron in prenatal and following good diet. I read today that if you take calcium along with iron, it hinders with iron absorption. Has anyone read this and has been taking calcium along with iron? Did you see such decrease in your hemoglobin levels since then ?

JessicaB0627

I'm not taking a calcium supplement, but anemia is actually pretty common during pregnancy. Not pregnant my hemoglobin levels are always on the high side, but when I was pregnant with DD and this pregnancy my hemoglobin dipped low enough for me to have to take iron supplements. It's just one of those weird things that happens during pregnancy.

If you're concerned about the calcium hindering your iron absorption can you just take one at night and one in the morning?

ETA: My iron supplement is 45 mg of iron once daily.

Bltbear82

I take my prenatal and also iron and calcium supplements. You need to spread them out by a minimum of 2 hours according to my OB in order to avoid reducing effectiveness. I take the iron twice a day (am and after lunch), prenatal around 10 and calcium before bed. 

prayingformybaby

Thanks, Jessica!  Yes, I had read that in pregnancy hemoglobin/iron goes down due to increase in blood volume. However, it said that it will go down only if you are not taking enough iron. So even if we take enough iron, it can go down? I took my calcium during the day today and will take prenatal at night : )

prayingformybaby

Thanks @Bltbear82! Even I will do that from tomorrow but feeling bad since I am so far in pregnancy and maybe the iron didn't get absorbed properly in my body because of taking calcium along with it 

JessicaB0627

@prayingformybaby Your hemoglobin level is barely low, and most of the time anemia isn't found in pregnant women until the blood draw around 28 weeks, so you really shouldn't worry about it that much. I would just spread out your supplements and talk to your doctor if you're more concerned than that. 

prayingformybaby

Thanks Jessica  yeah, but I was concerned if I made any mistakes that led to decreasing hemoglobin. Too scared to make mistakes. Yep, I am spreading out my supplements from today 

lbachran

So I was severely anemic prior to pregnancy. So anemic that I had developed pica (in the form of compulsively chewing ice) and had to undergo multiple rounds of intravenous iron. I was put on VitaPearl by my reproductive endocrinologist and that combined with my lack of a monthly period has completely cured my anemia. It's a very small gel cap with 150% of the amount of daily iron needed. Because of the conflict with iron absorption and calcium, it has no calcium at all.

In January I added calcium, but only take it as long as it is more than 3 hours after the prenatal. If I mess up my timing, the calcium gets skipped for the day. Antacids and dairy of any kind, high fiber foods, and caffeine can also hinder your absorption of iron. I also take a Vitamin C tablet which can help with absorption if your heartburn can handle it.

ayeshaohara

Pharmacist here: yes it's true that calcium can block the absorption of your iron. Spacing the 2 is best. But if it makes you feel any better...even knowing that I take both of mine together too don't beat yourself up, you didn't do anything wrong. Your "low" hemoglobin is likely a result of pregnancy and not because of how you've been taking your supplements! I would consider your Hb normal for now, you're on the low end of normal but not badly anemic yet. Hope that helps

GoatSnakeMouse

I take my calcium in the morning and my prenatal before bed. I recently had some non-pregnancy-related bloodwork done (my gallbladder is a jerk) that showed that I was anemic, but the Dr said it was normal in pregnant women and nothing to worry about.

prayingformybaby

@ayeshaohara- thank you so much! Does calcium interfere with iron absorption a lot or just a bit? I asked an online Doctor just to get second opinion and he said that it may interfere but even then most of the iron does get absorbed

Sharra13

I have such bad heartburn that I am getting PLENTY of calcium with all the tums and Alka Seltzer I've been popping every day....

ayeshaohara

prayingformybaby said:

@ayeshaohara- thank you so much! Does calcium interfere with iron absorption a lot or just a bit? I asked an online Doctor just to get second opinion and he said that it may interfere but even then most of the iron does get absorbed

To be honest I couldn't give you a number or like a percentage. I'm sure there's some info out there but I honestly wouldn't even know where to look and there will be a lot of other factors in our bodies that would affect it. Some people absorb better, vitamin c increases absorption, other meds, food etc. Taking on an empty stomach does increase absorption though so that's something else to consider! I wouldn't get too hung up about it. Like I said, I take mine together as do many people. 

prayingformybaby

I asked my OB today. She said its fine to take all the supplements together including prenatal and calcium  

peregrinefalconx

 {lurking from June}

I was going to add additional calcium in, but I found that it made me constipated (something I barely had under control anyway). did others experience this?

Your body can only absorb so much calcium at a time which is why it needs to be spread out. Not sure about the iron though.

ayeshaohara

peregrinefalconx said:

 {lurking from June}

I was going to add additional calcium in, but I found that it made me constipated (something I barely had under control anyway). did others experience this?

Your body can only absorb so much calcium at a time which is why it needs to be spread out. Not sure about the iron though.

Calcium is constipating. That's a very common side effect. 

And yes yes your body can only absorb about 500mg calcium at once so if you're taking 2 tabs per day for example it's recommended to take one in the morning and one in the evening. Iron doesn't have the same issue.