Which of the following dietary supplements is recommended for a pregnant lady on Heparin?
Heparin tends to reduce the calcium levels and cause bone de-mineralisation leading to osteoporosis. With high doses, heparin tends to affect the vitamin D metabolites in the blood. This effect is more pronounced in pregnant patients where the calcium levels fall even with low doses of heparin. Hence pregnant patients on heparin should increase the dietary supplement of calcium. Ref: Harrisons textbook of medicine 16th edition, Page 2263 ; Clinical Pharmacy By William Hughes; 2nd edition, Page 14
Folic acid
Calcium
Zinc
Copper