Can You Take Prenatal Vitamins and Multivitamins Together?

We know how important it is to take in enough nutrients while pregnant, but is it okay to take prenatal vitamins and multivitamins together? Dr. Kenosha Gleaton is here to set the record straight. 

By OBGYN and fertility expert Dr. Kenosha Gleaton

Are prenatal vitamins and multivitamins the same? Is it okay to take both at the same time? Let’s take a closer look at what makes prenatal vitamins different from regular multivitamins. 

What Is In a Prenatal Vitamin?

If you’re trying to conceive (TTC) or are pregnant, I’m sure you’ve already seen the push for prenatal vitamins. There’s a reason that they’re so important, and it has a lot to do with overall pregnancy and health outcomes for yourself and your baby. Prenatal nutrition is vital for promoting the growth and healthy development of your pregnancy, and prenatal vitamins make it fairly easy to reach your daily recommended intake in just a few swallows.  [1] 

Prenatal vitamins are different from regular multivitamins because they include specific nutrients required for fetal development. [1] While some multivitamins may include some of these nutrients, it’s not a guarantee that all will. There are even some benefits of taking prenatals before actively TTC.  

Folate

Folate is a great example of a vital nutrient for pregnancy. Most prenatal vitamins will include a pretty high amount of folate (Natalist Prenatal Vitamins for Women include 1,330 mcg per serving) whereas your typical multivitamin likely does not. Folate is a form of folic acid and plays a huge role in fetal development, decreasing the risk of neural tube defects tremendously. [2] 

Iron

Iron’s role in the body is always important, but especially during pregnancy. The amount of blood in the body increases by about 50% during pregnancy, and is needed to help transport oxygen and other nutrients throughout the body. [3] Iron is especially helpful for making hemoglobin, making it possible for red blood cells to do their job properly. Prenatal vitamins take this added need for iron into account and usually have a pretty high iron content! 

DHA

Another nutrient often left out of multivitamins is DHA, docosahexaenoic acid, which is a long name for an omega-3 fatty acid. DHA is especially important for fetal neural development and is correlated to key developmental milestones as well as problem-solving abilities in infants! [4-5] 

Iodine

Iodine is an important mineral that’s vital for organ development and nervous system development. Research shows that iodine needs are enhanced in pregnant women, and deficiency may lead to goiter formation as well as neural impairment in offspring. [6] 

There are plenty of other vitamins and minerals that are found in prenatal vitamins; find a comprehensive prenatal vitamin checklist here. The main takeaway is that prenatal vitamins are formulated with specific pregnancy needs in mind, making them an essential part of TTC and pregnancy. 

Prenatal Vitamin Dosage

A common complaint about prenatal vitamins is the size of the pills. In general, dosages should be giving you close to the recommended dietary allowance (RDA) for pregnancy, but this can look different depending on the brand. [1] There is a lot of nutrition to pack into a daily pregnancy prenatal vitamin, which is why the size is often so large. If you’re more of a gummy vitamin person, there are some tasty prenatal gummies on the market. Natalist also has prenatal daily packets that are five manageable pills, rather than one or two huge pills! 

In general, your prenatal vitamin should help you achieve close to the following amounts per day [7]:

• Vitamin A RDA is 770 μg/d
• Vitamin C RDA is 85 mg/d
• Vitamin D RDA is 15 μg/d or 600 IU
• Vitamin E RDA is 15 mg/d
• Vitamin B12 RDA is 2.6 μg/d
• Folate RDA is 600 μg/d 
• Iron RDA is 27 mg/d
• Calcium RDA is 1,000 mg/d
• Iodine RDA is 220 μg/d
• Magnesium RDA is 350 mg/d

It’s assumed that some of these nutrients will be consumed through your diet, so the amount listed on your vitamin bottle and the amounts you see listed above may not match exactly. [1] Be sure to check your bottle for specific dosages, or talk to your healthcare provider if you’re concerned about your vitamin intake. 

Prenatal Vitamins and Multivitamins: Can I Take Them At The Same Time?

Since they have some of the same ingredients, is it okay to take pregnancy prenatal vitamins and women's multivitamins together? The short answer is no, it’s not recommended to mix the two. [1,8] There is such a thing as vitamin toxicity, which can occur when there is an excessive amount of vitamins or minerals in the body, and can lead to some toxic side effects. [8] Paying attention to tolerable upper intake levels (UL) is especially important if you’re taking any supplements in addition to a prenatal vitamin. ULs are the highest level of daily intake that can be consumed without posing health risks. Not all vitamins have ULs, which is why you should talk with your healthcare provider about any supplements you’re taking or are interested in taking. 

Fat-Soluble Vitamins

The reason some vitamins can become toxic in high amounts is because the body has a hard time getting rid of them. [8] Vitamins are either fat-soluble or water-soluble, meaning the way they are dissolved and absorbed differs. Water-soluble vitamins are easily shed through urine if they are consumed in excess. Fat-soluble vitamins need fat or oil from food in order to be dissolved and absorbed, and are then stored in the liver and fatty tissue. [9] Fat-soluble vitamins are harder to shed if consumed in excess, making toxic effects more likely. The four main fat-soluble vitamins include vitamins A, D, E, and K. [9] 

Overconsumption of Vitamin A

Vitamin A taken in very large amounts may lead to hepatotoxic effects, visual changes, hair and skin changes, and may even cause birth defects. [1,8] 

Overconsumption of Vitamin D

Extremely high vitamin D consumption may lead to calcium buildup, causing nausea and vomiting, weakness, and frequent urination. Toxicity of vitamin D may also progress to bone pain and kidney problems. [10] 

Overconsumption of Vitamin E

High amounts of vitamin E may lead to nausea, vomiting, diarrhea, headache, and blurred vision. [8] 

Overconsumption of vitamin K is very rare, and there have been no reports of toxicity in the general population. [9] 

When Should I Start Taking Prenatal Vitamins?

Want to know when you should start taking a prenatal vitamin? It's recommended that women of reproductive age begin taking a prenatal one to three months before trying to conceive. [1] We know that about 45% of pregnancies in the US are unplanned, and vital nutrients like folate should be prioritized the first month after conception. [1,2,11] The sooner you can start taking a prenatal vitamin the better, even if you aren't trying to conceive within the next few months. 

Key Takeaways

• Prenatal vitamins are formulated with specific pregnancy needs in mind, including the health and development of a growing embryo.
• Prenatal vitamins and multivitamins contain many of the same nutrients, but prenatals likely have a few additional vitamins or minerals, such as iron, DHA, iodine, and folate. 
• Dosage for prenatals varies depending on the brand, so you should always check your bottle for specific instructions. Make sure you talk to your healthcare provider about the supplements you are taking to ensure you’re taking in the adequate amount of vitamins and minerals.
• There is such a thing as vitamin toxicity, which is why it is not recommended to take a multivitamin in addition to a prenatal vitamin. 
• Fat-soluble vitamins like vitamins A, E, and D, are more likely to result in toxic side effects if intake exceeds the UL. 
• If you suspect you have a deficiency or are worried about your vitamin intake, talk to your healthcare provider about your supplement routine.

Sources:

1. Nutrition During Pregnancy. American College of Obstetricians and Gynecologists. FAQ 001. June 2023. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy
2. Pitkin RM. Folate and neural tube defects. Am J Clin Nutr. 2007;85(1):285S-288S. doi:10.1093/ajcn/85.1.285S
3. Hytten F. Blood volume changes in normal pregnancy. Clin Haematol. 1985;14(3):601-612.
4. Hoffman DR, Boettcher JA, Diersen-Schade DA. Toward optimizing vision and cognition in term infants by dietary docosahexaenoic and arachidonic acid supplementation: a review of randomized controlled trials. Prostaglandins Leukot Essent Fatty Acids. 2009;81(2-3):151-158. doi:10.1016/j.plefa.2009.05.003
5. Braarud HC, Markhus MW, Skotheim S, et al. Maternal DHA Status during Pregnancy Has a Positive Impact on Infant Problem Solving: A Norwegian Prospective Observation Study. Nutrients. 2018;10(5):529. Published 2018 Apr 24. doi:10.3390/nu10050529
6. Glinoer D. Pregnancy and iodine. Thyroid. 2001;11(5):471-481. doi:10.1089/105072501300176426
7. Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride (1997); Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (1998); Dietary Reference Intakes for Vitamin C, Vitamine E, Selenium, and Carotenoids (2000); Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc (2001); and Dietary Reference Intakes for Calcium and Vitamin D (2011). These reports may be accessed via www​.nap.edu.
8. Wooltorton E. Too much of a good thing? Toxic effects of vitamin and mineral supplements [published correction appears in CMAJ. 2003 Aug 19;169(4):283]. CMAJ. 2003;169(1):47-48.
9. National Research Council (US) Committee on Diet and Health. Diet and Health: Implications for Reducing Chronic Disease Risk. Washington (DC): National Academies Press (US); 1989. 11, Fat-Soluble Vitamins. Available from: https://www.ncbi.nlm.nih.gov/books/NBK218749/
10. Zeratsky, Katherine. What is vitamin D toxicity? Should I be worried about taking supplements? Mayo Clinic. March 2022. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/vitamin-d-toxicity/faq-20058108
11. Unintended Pregnancy. CDC. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion. March 2023. https://www.cdc.gov/reproductivehealth/contraception/unintendedpregnancy/index.htm

Originally published January 16, 2023. Updated for accuracy and relevancy on January 5, 2024. 

Dr. Kenosha Gleaton is board-certified in gynecology and obstetrics and is the Medical Advisor of Natalist. She received her MD from MUSC and completed her residency at Carolinas Medical Center in Charlotte, NC.

Dr. Gleaton is passionate about women, health equity, and mentoring. She is the CEO of The EpiCentre, an OBGYN spa-like practice, and is a Clinical faculty member of Charleston Southern University. She is also a member of the American College of Obstetrics & Gynecology, the American Association of Gynecologic Laparoscopists, and the American Association of Professional Women.