The ground rule
Most sports and wellness supplements have never been tested in pregnant women, so "no evidence of harm" often means "no evidence". South Africa regulates many supplements as foods or unregistered complementary products, and SAHPRA had registered no complementary medicines by August 2026, so a product on the shelf has not been reviewed for pregnancy safety. Check with your gynaecologist, midwife or a registered dietitian before taking anything beyond what has been prescribed.
What to avoid or only use on medical advice
| Supplement type | Why | Evidence/source |
|---|
| High-dose preformed vitamin A (retinol), liver supplements, cod or fish-liver oil | Excess can harm the foetus and the liver; EFSA's upper limit for women of childbearing age is 3 000 µg a day, and the UK expert committee considered intakes above 1 500 µg inappropriate | UK Committee on Toxicity |
| Ashwagandha and other herbal extracts | Avoid in pregnancy and breastfeeding; liver injury cases and regulatory warnings in Europe | European regulator warnings; Björnsson 2020 |
| Pre-workouts and fat burners | High caffeine and stimulant doses; contamination with undeclared drugs is documented in this category | ISSN caffeine; Duiven 2021 |
| Creatine | No human trials in pregnancy; avoid unless a doctor advises | ISSN safety review |
| Beta-alanine, citrulline and other performance singles | Limited data in pregnancy | ISSN beta-alanine position stand |
| Multi-ingredient "beauty" or "detox" blends | Undeclared amounts and botanicals | Label risk |
| Mass gainers | Large servings multiply contaminant exposure; highest lead in a US test was a mass gainer | Consumer Reports 2025 |
Caffeine deserves a number: several South African product pages (for example for Biogen and USN fat-burner products) state that more than 200 mg a day is not recommended in pregnancy. A Biogen Rage Thermo Extreme label dose works out at 600 mg a day by our calculation. Add up coffee, energy drinks, pre-workouts and tablets.
What is often recommended instead?
Your doctor may advise a prenatal vitamin with folic acid (commonly 400 µg, higher in some cases), and may check iron, vitamin D and B12 by blood test. See folic acid before pregnancy. Do not self-prescribe iron: take it when a blood test shows a need (iron guidance). Whey protein and collagen are food-derived and usually discussed case by case: see protein shakes in pregnancy and collagen in pregnancy.
How to lower risk if you do use a supplement
- Tell your doctor or midwife exactly what you take, with the label.
- Prefer short, single-ingredient labels you can read in full.
- Avoid products with "proprietary blends" or disease claims.
- Check the amount of vitamin A, caffeine and herbs on the label.
- Stop and seek care for jaundice, severe itch, palpitations or unusual symptoms.
For example, a plain unflavoured single-ingredient powder from a brand such as ATP Fitness has a shorter ingredient list to review than a pre-workout, but ATP publishes no third-party testing that we could find, and "short list" does not equal "cleared in pregnancy"; discuss it with your doctor. An alternative is simply to get protein from food.
When to see a doctor urgently
Contact your doctor if you took a supplement and develop vomiting, jaundice, severe headache, chest pain or palpitations. Mention supplements at every antenatal visit. For breastfeeding, see supplements for breastfeeding mothers.
Pregnant teenagers need individual medical and dietetic care; do not add supplements without it.
Educational information, not medical advice. Speak to a doctor, pharmacist or registered dietitian before using supplements if you are pregnant or breastfeeding, under 18, taking medication, or living with kidney, liver or heart disease. Prices were observed in October 2026 and are not offers.