The Problem with Prenatal Vitamins

New reports raises concerns as experts call for stricter FDA oversight. Plus: Consumers’ top wellness priorities, new markets, podcast spending, and more

Unsplash / Anshu

At the start of my pregnancy, my doctor casually instructed me to take prenatal vitamins. Great, I said. Do you have some I can purchase? Or specific recs?

“You can get them anywhere,” he told me. “Go on Amazon.”

I did go on Amazon. And I was overwhelmed by hundreds of options: gummies, soft gel capsules, powders, and way, way too many pink-colored bottles. Also: storks. 

I bought the first recommended brand because, I assumed, what’s the difference? The bestsellers are all probably on the up-and-up, right? Besides, I wasn’t given any guidelines on what to look for. I was simply instructed: buy one – any one.

Well it turns out that popular prenatal supplements are often mislabeled, with vitamin dosages all over the place. As I recently reported, many might not contain what they claim — and not even include vital nutrients altogether. 

The U.S. Government Accountability Office (GAO), a government agency tasked with auditing federal institutions, studied the “best-rated” and “top-selling” prenatal supplement brands (according to leading retailer websites and parenting outlets.) Per my report:

The organization discovered, among other findings, that none of the prenatal gummies contain any iron. Some soft gels lacked iodine. In addition, vitamin C levels widely varied from 20 milligrams to 120 milligrams per serving. 

One product contained a significantly high amount of folic acid that could potentially pose a health risk for the development of the baby (based on standards established by the National Academy of Medicine). 

In addition, researchers found trace amounts of two heavy metals — specifically, lead and cadmium — in half of the brands tested. While the minuscule amounts are not a considerable health concern, they are a testament to the fact that consumers often have little, if any reassurance, about what’s inside a supplement bottle. 

Interestingly, nearly half of these products had labels stating they had undergone some form of third-party verification (although they performed similarly to non-verified products). 

I was surprised because I — the supplement skeptic that I am — just assumed prenatal vitamins was a less murky sector; it’s not a contested supplement — unlike, say, “memory-boosting” pills or ridiculous sea moss supplements. I wasn’t as suspicious as I usually am.

Pieter Cohen, M.D., an associate professor at Harvard Medical School and internist at Cambridge Health Alliance with expertise in supplements, tells me that the physician blessing factors in. “Guards are down because those of us in medicine are recommending that our patients take them.”

Karen L. Howard, Ph.D, a director at GAO, noted that there are simply no standards for what amounts or which nutrients are required to be in a prenatal supplement. Even supplements prescribed by a physician aren’t guaranteed. 

“Sometimes people think, ‘Well, my doctor prescribed this, so it must be much better than the ones that you can just buy off the shelf,” says Howard. “But they are all subject to the same level of oversight.”

GAO’s investigation follows a 2023 study published in The American Journal of Clinical Nutrition that found that 99% of affordable prenatal supplements don’t contain appropriate doses of the key micronutrients required. Researchers studied 400 prenatal products — only one had “optimal nutrition.”

Of course, inaccurately labeled products plague the greater supplement industry: Supplements notoriously lack the more rigorous regulations imposed on pharmaceutical drugs because they don’t require FDA approval before being marketed. The FDA does not monitor efficacy, safety, or proper labeling.

So what’s the solution?

Experts I interviewed had a few specific ideas on how the FDA could better regulate the wild supplement industry. There are bills, regulation tweaks, etc. It’s not enough, says Dr. Cohen, to just require manufacturers to register their supplements. Read the full story

Previously on supplements: 

• Bloomberg: Are Viome’s Poop-Tests and Supplements Full of ____?

• WSJ: Sea Moss Brands Sure Do Promise a Lot

Below, 30+ links on the latest in the wellness industry. Become a paid subscriber for full access:

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