Dr. Sanjay Kumar Bhattacharyya
Obstetrics and Gynecology
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Patient's Query
Hi doctor,
I am 38 year old female and I have been confirmed pregnant today, both in urine and blood. This is the first time I have got pregnant naturally. I have had no gynecological complication so far. We have been attempting since last one year and have had follicular study regularly every month. The last follicle was detected on day 14 with 9 x 19 mm and the endometrium thickness was 11 mm. I have not been on any medication until now. I have been taking supplementation like multivitamin, iron, folic acid, salmon Omega 3, Royal Jelly, Vitex, CoQ10 and all protein protein powder. Today is 16 DPO, urine test positive, blood beta hCG 293, hemoglobin 11.8, thyroid T3 130, T4 6.5 and TSH 3.11.
I have been suggested by a local gynecologist, however, I prefer to take a second opinion regarding recommended medicine and nutrition. Would you be able to suggest me the requirement of any medication? I would like to know the actual requirement of folic acid and B12 for my age during pregnancy. I have attached my the detailed list of the products I am using for your reference. Shall I continue to take multivitamin daily? Also, my husband told me that excessive usage of folic acid may create some complications. Also, my doctor has prescribed to take Susten 200 mcg and Ecosprin 23 mg. Would you suggest any further recommendation? What are the dos and don'ts for the above. I am looking forward to hear from you.
Hello,
Welcome to icliniq.com.
First of all, I like to clear that you need not have to take so many supplements and medicines from now. This is useless and often undesirable. The recommendation is to take Folic acid 5 mg once a day and if needed some tablets for nausea, Doxylamine, iron, calcium and othersupplementation should be started after the first trimester. Now, regarding Ecosprin (low dose Aspirin) and Susten (progesterone), each doctor has a different opinion. As per your age is concerned, I do not find they are essential, but it is of no harm. You can start them from now. The most important part of this pregnancy is your age. At 38 years, you need a screening for some syndromes like Down's, which is more prevalent in pregnancies in elderly women. You need blood tests at 10 to 14 weeks of pregnancy depending on the center. Otherwise, as a general care, take plenty of rest, avoid strenuous jobs, alcohol, smoking and intercourse. Wear light garments and take plenty of water along with a homemade diet.
Patient's Query
Thank you doctor,
I understand that other supplements are not required for the first trimester. Please let me know about vitamin B12 and the required dosage in the first trimester. It would be of great help if you could suggest the same as for Folic acid.
Hello,
Welcome back to icliniq.com.
The point is that you need not have to take any extra form of vitamin B12 as it is available plenty of food of animal origin. The dose 2.5 mcg is needed, which you can get through your daily diet. However, a recent study shows it is better to take it with folic acid, which could help in a way to prevent development of birth defect. Still, I must tell you that the recent guidelines do not have any such firm opinion to start or take vitamin B12 additionally in the first trimester.
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