Pulling Down the Moon

Importance of Choline Supplement in Pregnancy and Proper Dosage

Jan 12, 2020

Choline is little talked about essential supplement for fertility and pregnancy. It is not technically considered a vitamin, as our bodies can synthesize choline though not enough to meet our daily needs. Choline is a major component of all cell membranes and is a precursor to the neurotransmitter acetylcholine, which is involved in muscle control and memory. Choline is also converted to betaine, which prevents homocysteine levels from becoming elevated. Elevated homocysteine has been associated with increased risk for cardiovascular disease and miscarriage. Choline deficiency may also play a role in the development of fatty liver, as choline is necessary to transport fat from the liver to other tissues in the body.


Choline also has important functions during pregnancy. Choline is essential for baby’s brain development and for DNA methylation, meaning that choline deficiency can have epigenetic effects on the developing baby. There is also evidence that adequate choline intake helps prevent neural tube defects like spinal bifida, which most people associate only with folate/folic acid intake. 


Several studies have compared intakes of 480 mg choline daily to 930 mg choline daily at varying times during pregnancy and found a variety of outcomes. For example, supplementation with 930 mg choline compared to 480 mg throughout the 3rd trimester resulted in faster information processing in 4-13 month old infants. In a similar study, children whose mothers took in 930 mg choline daily performed better with a color location memory task compared to children whose mothers who had only taken in 480 mg choline daily. Another study reported reduced attention and behavior problems and social withdrawal in children at 40 months of age in the group of mothers supplemented with 900 mg choline from the 2nd trimester through delivery in addition to baby being supplemented with 100 mg choline daily through 3 months of age compared to controls.

The daily requirement for choline for non-pregnant women of childbearing age is 425 mg. This goes up 450 mg during pregnancy and further increases to 550 mg during breastfeeding. Less than 10% of pregnant women are meeting their daily requirement for choline, underscoring the importance of focusing on this nutrient.


The impact of choline supplement during pregnancy is an emerging area of research, and currently it seems that 450 mg choline at a minimum is needed to support a healthy pregnancy, but up 900-930 mg is safe and may have long-term benefits to the baby. Animal products are better sources of choline than plant foods–with liver and egg yolks being the best sources–followed by meat and fish and cruciferous vegetables.


Because so few women are meeting even basic daily choline needs during pregnancy, taking a prenatal vitamin that contains choline is a good idea, especially if you are a vegetarian or vegan. Pulling Down the Moon carries two prenatal vitamins, both of which contain choline. TheraNatal OvaVite contains 100 mg choline, and PlusOne contains 450 mg choline. Do you have more questions about optimal choline intake prior to and during a pregnancy? Book a nutrition appointment today!

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Therapeutic Yoga for PCOS?

By Beth Heller • 13 Sep, 2024
There are many reasons that a therapeutic yoga program may benefit women with Polycystic Ovarian Syndrome. PCOS presents very differently in different women but the syndrome as whole is associated with infertility and other adverse health conditions including obesity, diabetes and heart disease. Women with PCOS may also have higher levels of chronic inflammation and elevated levels of circulating stress hormones. The good news is that more and more research suggests that lifestyle intervention including lifestyle intervention including diet and exercise may be the best way to manage PCOS. In addition, new research is showing the benefit of Traditional Chinese Medicine to treat the hormonal imbalances, symptoms like hirsutism and acne, and menstrual irregularity that is associated with PCOS. Another element of PDtM’s PCOS “Action Plan is yoga. Yoga has been shown to lower levels of stress hormones and women with a regular yoga practice have been show to have a “healthier physiological response to stress". Yoga has also been shown to reduce markers of oxidative stress and blood sugar control in people with diabetes as well as improve blood pressure and cholesterol levels in heart disease patients (1). Some of the goals of a therapeutic yoga practice for PCOS include: Standing and seated yoga asana that create an invigorating, but not exhausting, exercise session Twisting poses, which in yoga physiology are believed to help decrease abdominal fat Postures that bring blood to the thyroid gland, an important endocrine gland for metabolism Stimulating agni, the digestive fire, that supports complete digestion and metabolism of foods Mudras (hand yoga) that stimulate different physiological and energetic systems Breathing exercises that induce the relaxation response While lifestyle changes can be very helpful with PCOS, they are not enough on their own. Working in partnership with you physician or Reproductive Endocrinologist and ensuring they are kept up to date on any holistic treatments you may be using is the smartest approach for PCOS management. Yoga for Fertility to support PCOS is available at Pulling Down the Moon in-center starting on Sept 21st and virtually starting on Sept 30th . If you would like to learn more about PDtM’s PCOS Action Plan to manager your PCOS Action Plan with holistic health treatment ( Acupuncture , Massage , Nutrition , and Yoga ) then contact us at 312-321-0004 or email info@pullingdownthemoon.com to get started today! (1) Field, T. Complementary Therapies in Clinical Practice 17 (2011) 1e8
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Pregnancy Passport: Relaxed Mommies Make Healthier Babies

By Beth Heller, MS RYT • 15 Aug, 2024
As I’ve said before, it took me seven years and five pregnancies to get two kids. So, while pregnancy was a joyful time for me on some levels, it was also a time of stress and sleepless anxiety. In fact my business partner Tami will often joke that my pregnancies were some of the most stressful times of her life. Honestly, though, without yoga, massage and acupuncture I think I would have bitten my fingernails to the quick waiting for Jackson and Calvin to arrive safely. What I didn’t know then was that seeking relief for anxiety through holistic means was also good for my boys. A growing body of clinical evidence now suggests that prenatal stress, depression and/or anxiety is linked to adverse health outcomes for both moms and babies including preterm birth, preeclampsia and even future risk of chronic disease and obesity (1). Women, especially women who have struggled to conceive, may feel guilty about experiencing anxious emotions during this “blissful time". Yet preparing for a new baby, no matter how hard one had to work to get it, can be stressful. Changes in the body during pregnancy, including the strains of a growing belly and nighttime muscle cramps, can also disrupt sleep, which increases stress. Rather than worry about worrying, we suggest you take the bull by the horns and enjoy a 360 degree self-care program during pregnancy. And honestly, it will never again be as easy to justify self-care like acupuncture , massage and yoga as it is when your efforts are a “double-dip – good for mom and great for baby. Here are several strategies for decreasing maternal stress and improving overall well-being during pregnancy: 1. Get acupuncture. A 2010 study in Obstetrics and Gynecology found that acupuncture treatment alleviated symptoms of stress and depression in pregnant women and women experiencing infertility (2, 3). Acupuncture has also been shown to be effective at managing morning sickness, back and pelvic pain and labor pain. Make sure, however, that you see a practitioner who is experienced in treating pregnancy. 2. Do prenatal yoga. Compared to controls, women who did prenatal yoga experienced significant reductions in physical pain from baseline to post intervention compared with women in the third trimester whose pain increased. Women in the yoga group showed greater reductions in perceived stress and trait anxiety in their third trimester than women from the control group (4) The same women also experienced better sleep and less wakefulness (5). 3. Get prenatal massage. Research shows that women who received prenatal massage reported decreased depression, anxiety, and leg and back pain. Cortisol levels decreased, which decreased excessive fetal activity; the rate of baby prematurity was also lower (6). 4. Seek expert prenatal nutrition counseling. There are specific nutritional strategies for managing weight gain, avoiding conditions like Gestational Diabetes and Pre-eclampsia and improving digestion (less heartburn, avoid constipation). At Pulling Down the Moon we target our prenatal nutrition consults based on trimester. Get your passport to pregnancy relaxation by getting started today with prenatal care in Chicago , Highland Park , or virtually ! Gift certificates are also available at our online store shop.pullingdownthemoon.com . 1. Entringer S et al. Prenatal stress and developmental programming of human health and disease risk: concepts and integration of empirical findings. Curr Opin Endocrinol Diabetes Obes. 2010 Dec;17(6):507-16. 2. Smith CA. 1. SMith The effect of acupuncture on psychosocial outcomes for women experiencing infertility. J Altern Complement Med. 2011 Oct;17(10):923-30. Epub 2011 Oct 6 . 3. Manber et al. Acupuncture for depression during pregnancy: a randomized controlled trial. Obstet Gynecol. 2010 Mar;115(3):511-20. 4. Beddoe AE et al. The effects of mindfulness-based yoga during pregnancy on maternal psychological and physical distress. J Obstet Gynecol Neonatal Nurs. 2009 May-Jun;38(3):310-9. 5. Beddoe AE et al. Effects of mindful yoga on sleep in pregnant women: a pilot study. Biol Res Nurs. 2010 Apr;11(4):363-70. 6. Field, T. (2010). Pregnancy and labor massage therapy. Expert Review of Obstetrics and Gynecology , 5, 177-181.
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