Lately, the majority of patients in my clinic are asking about fertility. With infertility rates on the rise, it’s understandable that women want to be proactive. The questions I hear most often?
- What can I do now to prepare my body for pregnancy?
- Will my nutrition really make a difference for my baby?
In this article, we’re going to answer these questions and give you practical tips to optimize your preconception nutrition. Let’s dive in.
The Link Between Nutrition and Fertility
The preconception period – specifically the 3 to 6 months before you conceive – is a critical “window of opportunity” that far too many women overlook. This is the time it takes for an egg to mature before ovulation. By optimizing your nutritional status during this important preparation phase, you aren’t just supporting your own well-being; you’re laying the biological foundation for your future child’s health, IQ, and metabolic resilience.
The connection between what you eat and your ability to carry a healthy pregnancy is profound. Decades of research have consistently shown that nutrition is critical for a healthy pregnancy. Too little or too much of certain nutrients can have far-reaching health consequences for both mother and baby. Examples include:1,2,3,4
- Increased risk of miscarriage
- Low birthweight
- Pre-term birth
- Birth defects
- Mother and infant mortality and morbidity
- Still birth
- Thyroid hormone deficiency for both the mother and the baby
- Anemia
- Pre-eclampsia
- Impaired brain development
- Increased susceptibility to cardiovascular diseases and cognitive impairments
When we talk about nutrition, we aren’t just talking about “eating enough calories.” We’re talking about providing the specific biochemical keys that support hormonal balance and pathways. If your body perceives a nutrient “famine,” it may deprioritize reproduction to ensure your own survival.
The Naturopathic Approach: Testing and Personalization
In my practice, we move beyond the “one-size-fits-all” approach. While a general prenatal vitamin is a start, it is rarely enough for a woman with underlying deficiencies or genetic variations. We implement a “food is medicine” philosophy, but we back it up with data.
I recommend comprehensive nutritional and hormone testing before planning for conception. This includes looking at:
- Thyroid panels: Ensuring your “metabolic thermostat” is set correctly for ovulation.
- Metabolic health: Assessing fasting insulin and glucose, as insulin resistance is a leading cause of ovulatory dysfunction.
- Micronutrient status: Checking levels of iron, B12, vitamin D, and zinc to ensure your “biological tank” is full.
Instead of guessing, we use this information to create a personalized protocol that addresses your unique biochemistry, utilizing targeted supplementation to support your thyroid, hormones, and insulin levels.
6 Critical Deficiencies to Address Before Conception
1. Methylated B-Vitamins (Folate and Vitamin B12)
Folate, also known as vitamin B9, is perhaps best known for its role in preventing neural tube defects (NTDs), which are serious abnormalities of the brain, spine, or spinal cord. And NTDs occur within the first month of pregnancy – often before you even know you’re pregnant. This means if you’re not getting enough folate before and during the early days of your pregnancy, you might be too late to prevent a NTD.
Non-pregnant women should aim for 400 micrograms of folate per day from supplements and/or their diet, while pregnant women should obtain 600 micrograms.5
Folate can be found in a wide variety of whole foods like leafy greens, avocado, and beef liver:6 When looking for a supplement to support your folate intake, it’s important to make sure you’re taking the correct form. Most vitamins and supplements contain folic acid, a synthetic version that many people cannot metabolize efficiently due to a common genetic variation known as the MTHFR polymorphism.7
Because of this, I recommend methylfolate, the “activated” form of folic acid, which bypasses the folate metabolization process and gets directly absorbed by the body.8
Deficiency in cobalamin (also known as vitamin B12) is also associated with significant adverse health outcomes. Babies born to vitamin B12-deficient women may have potentially irreversible impairments in brain development, growth, and psychomotor function.9
While vitamin B12 can be found in foods of animal sources (ex: meat and dairy), you may still have vitamin B12 deficiency due to various factors such as autoimmune conditions or prolonged use of certain medications.10
I recommend the natural, active form of vitamin B12, methylcobalamin, if you’re looking for a supplement.
2. Iron
Iron deficiency is the most common nutritional deficiency in women of childbearing age, largely due to monthly menstruation. Experts estimate that iron deficiency affects almost 50% of pregnancies worldwide.11 As a major component of hemoglobin, iron is the primary vehicle for oxygen delivery throughout your body. Without it, your reproductive organs – and your developing eggs – cannot function optimally.
Studies have indicated that women who regularly consume iron supplements or have high dietary iron intake have a lower risk of ovulatory infertility.12 Furthermore, because pregnancy causes your blood volume to expand by nearly 50%, entering pregnancy with low iron stores (ferritin) could put you at a much higher risk for profound fatigue, complications during birth, and postpartum depression.13 For the child, maternal iron deficiency during pregnancy is associated with delays in language and motor outcomes, anemia, and other developmental difficulties.14
The recommended daily intake for iron is 18 milligrams per day.15 This requirement increases to 27 milligrams per day for pregnant women, especially for those in the second and third trimesters.16
3. Iodine
Iodine deficiency is often “silent” but could have a massive impact on fertility due to iodine’s role as the primary building block of thyroid hormone production.17 If you’re iodine deficient, your thyroid cannot produce enough T4 and T3. This can lead to subclinical hypothyroidism, a condition that often prevents regular ovulation or makes it difficult for an embryo to implant.18
aBeyond fertility, iodine is the single most important nutrient for a baby’s brain development. Severe iodine deficiency can lead to significant neurological impairment. But even mild-to-moderate deficiency during preconception and pregnancy has been associated with lower IQ scores and decreased verbal and reading abilities in children.19,20
The recommended daily intake of iodine is 150 micrograms for adults and 220 micrograms for pregnant women.21 Iodine can also be found in iodized salt, fish (tuna and cod), seaweed, and dairy products.
4. Vitamin A (Provitamin A Carotenoids)
There is often confusion surrounding vitamin A because high doses of synthetic versions (like those in acne medications) can be harmful. However, preformed vitamin A (retinol) is essential for human reproduction as it plays a pivotal role in egg quality, the healthy development of the embryo, and the health and maintenance of the uterine lining.22
If you take supplements, it’s important to monitor your total intake of preformed vitamin A (retinol and retinyl esters), especially if you’re pregnant. Excessive amounts of preformed vitamin A from supplements paired with that from animal sources (like organ meats) could increase your risk of vitamin A toxicity.23
Provitamin A (carotenoids), another source of vitamin A, can be found only in plants, such as sweet potatoes and leafy greens. There is a lower risk of reaching toxic vitamin A levels with carotenoids, but the conversion of carotenoids into active retinol is often inefficient.
I recommend a diet that includes both plant- and animal-based sources of vitamin A first and then supplementing if needed based on personal nutrient testing.
5. Omega-3 Fatty Acids (DHA and EPA)
The modern Western diet is severely lacking in anti-inflammatory omega-3 fatty acids (specifically EPA and DHA) and overloaded with pro-inflammatory omega-6 fats. Research suggests that the omega-6 to omega-3 ratio increased from 4:1 during Paleolithic times to a whopping 20:1 today.24
Along with the increase in omega-6/3 ratio, we’ve seen significant rise in autoimmune, allergic, and inflammatory diseases.25
Simply put, most people need to consume more foods rich in omega-3 fatty acids.
When a mother has adequate omega-3 levels before and during pregnancy, the benefits to the child include:26,27
- Lower risk of pre-term birth
- Better cognitive scores
- Improved fine motor skills
- Better sleep patterns in infancy
- Reduced risk of low birth weight
All women of childbearing age should consume at least 250 milligrams per day of DHA plus EPA from diet or supplements. Pregnant women should consume an additional 100 to 200 milligrams per day of DHA. If you’re a pregnant woman with low DHA intake, you may need to increase your supplementation even more.28
Examples of omega-3-rich foods include fatty fish (salmon, sardines), walnuts, flaxseeds, as well as eggs and dairy products fortified with omega-3s.29,30
6. Magnesium
Magnesium is involved in over 300 enzymatic reactions, yet it is frequently depleted by stress, caffeine, alcohol use, gastrointestinal issues, and use of certain medications.31,32,33 In the preconception phase, magnesium is essential for managing insulin levels and balancing progesterone and estrogen.34,35 Because insulin resistance can disrupt the delicate balance of estrogen and progesterone, magnesium serves as a foundational nutrient for restoring regular ovulatory cycles.36
Additionally, magnesium helps regulate the hypothalamic-pituitary-adrenal (HPA) axis (your body’s stress response system), hence why it’s often called “nature’s relaxant.”37 High levels of the stress hormone cortisol can effectively “shut down” the reproductive system. By supporting the nervous system and improving sleep quality, magnesium signals to the body that the environment is safe for implantation and pregnancy.38
The recommended daily intake of magnesium is 310 to 320 milligrams per day for all women, and 350 to 360 milligrams per day for pregnant women.39
Magnesium-rich foods include leafy greens, legumes, nuts, seeds, and whole grains.40
Why Your Prenatal Vitamin Might Not Be Enough
“Supplement overwhelm” is one of the most common frustrations I hear from women. Many are taking at least a dozen – often low-quality – supplements that are packed with fillers, artificial colors, and poorly absorbed forms of nutrients. In fact, in a 2023 study published by the University of Colorado, only one out of more than 20,000 prenatal and general vitamins analyzed had target doses of vitamin A, vitamin D, folate/folic acid, calcium, iron, and omega-3s.41
In other words, the vast majority of prenatals in the United States don’t meet the nutrient needs of pregnant women.
In my practice, a high-quality preconception protocol includes supplements that are:
- Bioavailable: Using methylated forms of vitamin B and chelated minerals (like magnesium glycinate) that the body can actually absorb.
- Comprehensive: Many standard vitamins omit critical nutrients like choline (essential for brain health) or provide insufficient amounts of vitamin D and zinc.
- Personalized: Taking too much of a nutrient you don’t need can be just as problematic as a deficiency.
Ultimately, preconception support should go beyond a generic prenatal, focusing on what your body can absorb, what it truly needs, and what will best support a healthy foundation for pregnancy.
Gain Confidence With Preconception Support in Boston
The journey to motherhood is a profound transition. It’s completely normal to feel nervous about infertility or the health of your future child. But by shifting your focus to preconception nutrition, you are taking proactive, evidence-based steps to support your fertility and your baby’s future health.
Getting pregnant is cause for celebration. But thriving during pregnancy and optimizing your child’s chance for vibrant health is even better. By addressing these six common deficiencies and personalizing your approach through testing, you can approach conception and pregnancy with confidence.
If you’re ready to stop the guesswork and create a personalized preconception plan, schedule a complimentary 15-minute consultation today.
References:
- https://www.jandonline.org/article/S2212-2672(14)00501-2/fulltext
- https://www.nrfhh.com/Exploring-the-far-reaching-consequences-of-malnutrition-during-pregnancy-and-beyond,192940,0,2.html
- https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1476672/full
- https://pmc.ncbi.nlm.nih.gov/articles/PMC4927329/
- https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/
- https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9380836/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9380836/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC4561829/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC4561829/
- https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2822546
- https://publish.kne-publishing.com/index.php/ACTA/article/view/21035
- https://pmc.ncbi.nlm.nih.gov/articles/PMC4375689/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC4375689/
- https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/#h3
- https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1476672/full
- https://www.nature.com/articles/s41598-025-16545-w
- https://my.clevelandclinic.org/health/diseases/23544-subclinical-hypothyroidism
- https://www.mdpi.com/2079-7737/11/10/1507
- https://www.sciencedirect.com/science/article/pii/S0022316623726023
- https://ods.od.nih.gov/factsheets/Iodine-Consumer/
- https://pubmed.ncbi.nlm.nih.gov/21693195/
- https://www.nejm.org/doi/full/10.1056/NEJM199511233332101
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8504498/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8504498/
- https://publications.aap.org/pediatrics/article-abstract/111/1/e39/28488/Maternal-Supplementation-With-Very-Long-Chain-n-3?redirectedFrom=fulltext
- https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/
- https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/
- https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/
- https://www.health.harvard.edu/diet-and-nutrition/omega-3-foods-incorporating-healthy-fats-into-your-diet
- https://pmc.ncbi.nlm.nih.gov/articles/PMC7761127/
- https://www.sciencedirect.com/science/article/abs/pii/S0271531784801323
- https://pmc.ncbi.nlm.nih.gov/articles/PMC7761127/
- https://uconnfertility.com/2020/02/boost-your-fertility-with-this-essential-mineral/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9548361/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC11013220/
- https://pubmed.ncbi.nlm.nih.gov/21835188/
- https://www.mdpi.com/2072-6643/9/5/429
- https://ods.od.nih.gov/factsheets/Magnesium-Consumer/
- https://ods.od.nih.gov/factsheets/Magnesium-Consumer/
- https://www.sciencedirect.com/science/article/pii/S0002916523000035?dgcid=author
