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The Importance of Blood Screening Tests Each Trimester | WeNatal

The Importance of Blood Screening Tests Each Trimester | WeNatal
Many nutrients impact baby's development and mom's health leading up to and throughout pregnancy and breastfeeding. It may be surprising to know that many of these nutrients are not always included in lab work ordered by physicians when a woman is preparing for pregnancy. Some of these are even missing once mom becomes pregnant! When you speak with your doctor, we encourage you to advocate for the following lab tests, ideally before, and definitely during, each trimester of pregnancy:
  1. 1. Thyroid hormones:
  2. Low thyroid can impair fertility, baby’s development, and slow down metabolism among other issues. Many conventional practitioners will only check Thyroid Stimulating Hormone (TSH) and/or T4. However, it’s ideal to get a full thyroid panel checked during each trimester, especially if you have known thyroid dysfunction or are on thyroid medication. A full blood panel includes: 
    • TSH
    • Free T4 and Free T3
    • Reverse T3
    • Thyroid Peroxidase Antibodies (TPOAb)
    • Thyroglobulin Antibodies (TgAb)
  1. 2. Iron:
  2. The need for iron increases with pregnancy and is crucial for preventing anemia in mom and carrying oxygen to all cells and tissues. Yet iron is not the only marker to check, especially if you have historically low levels. A full iron panel includes:
    • Serum Iron
    • Serum Ferritin
    • Transferrin 
    • TIBC (Total-Iron Binding Capacity)
    • UIBC (Unsaturated Iron-Binding Capacity
Blood tests during each trimester of pregnancy can provide you with invaluable information to help optimize the health of parents and baby.

3. Vitamin D:

Vitamin D impacts the immune system, thyroid, and baby’s development, and reduces the risk of preeclampsia, low birth weight, and more. Given vitamin D’s multiple important functions, coupled with widespread vitamin D deficiency, it should come as no surprise that we recommend checking levels periodically throughout pregnancy and lactation. Ask your doctor to check 25-Hydroxy Vitamin D.

  1. 4. Insulin and blood sugar:
  2. Checking for gestational diabetes is standard toward the end of the second trimester. However, there are markers you can check earlier to identify risk of developing gestational diabetes and help prevent it from developing in the first place. It all starts with insulin resistance, but most physicians do not check insulin or average blood sugar levels until someone is already diagnosed with diabetes or gestational diabetes. Ask your doctor for the following:
    • Fasting Insulin
    • Fasting Glucose 
    • Hemoglobin A1c (a 3 month average of your blood sugar)

5. MTHFR (Methylenetetrahydrofolate reductase) DNA Analysis:

While this is not a nutrient, a variation of this gene can impact how your body processes fertility-boosting nutrients including folate, B12, and choline. An MTHFR variation can also increase the risk for birth defects, especially neural tube defects like spina bifida, as well as pregnancy loss and preeclampsia. Knowing your MTHFR status is very important if you plan to, or are actively trying to, get pregnant. You only need to get this checked once.

Blood tests during each trimester of pregnancy can provide you with invaluable information to help optimize the health of parents and baby. Unfortunately, most standard Western medical care does not take a proactive or preventative approach to testing for nutrient deficiencies. Fortunately, there are many tests that are easy to do and readily available, including all of those listed above. If your physician is not comfortable with interpreting the results, we suggest working with a functional medicine practitioner. Every person is different and a “normal” result may look different from an “optimal” result. A functionally-trained practitioner can help identify areas of imbalance and develop an individualized plan based on you and your baby’s unique needs. To find a practitioner local to you, you can visit the IFM website. 

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Lisa Dreher

Lisa Dreher

Lisa is a registered dietitian/nutritionist with a Master’s Degree in Nutrition and Integrative Health. She has been practicing for over a decade and works full time at Dr. Mark Hyman's UltraWellness Center in Lenox, Massachusetts.

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