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Which supplements are not safe during pregnancy in South Africa?

Healthnews24 editorial deskUpdated 3 min read
Answer first

In South Africa, avoid high-dose preformed vitamin A (retinol) and fish-liver oils, ashwagandha and other herbal products, stimulant pre-workouts and fat burners, and uncleared extras such as creatine or beta-alanine unless your doctor agrees. Keep total caffeine modest. Take only what your gynaecologist or midwife recommends, such as folic acid, because most sports supplements have not been studied in pregnancy.

  • EFSA's upper limit for preformed vitamin A in women of childbearing age is 3 000 µg a day; the UK expert committee considered intakes above 1 500 µg inappropriate in pregnancy.
  • Ashwagandha should be avoided in pregnancy and breastfeeding; creatine has no human trials in pregnancy.
  • South African product pages for several fat burners state more than 200 mg of caffeine a day is not recommended in pregnancy.
  • SAHPRA had registered no complementary medicines as of August 2026, so shelf products have not been reviewed for pregnancy safety.

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.

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

  1. Tell your doctor or midwife exactly what you take, with the label.
  2. Prefer short, single-ingredient labels you can read in full.
  3. Avoid products with "proprietary blends" or disease claims.
  4. Check the amount of vitamin A, caffeine and herbs on the label.
  5. 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.

ATP Fitness is a commercial partner of Healthnews24 and its products are featured on this site. Rankings follow our published method, and every pick, including ATP Fitness, shows its price maths and trade-offs. Read our disclosure.

Sources

  1. UK Committee on Toxicity: lay summary of the statement on the effects of excess vitamin A on maternal health
  2. Björnsson HK et al. (2020) Ashwagandha-induced liver injury: a case series from Iceland and the US
  3. Guest NS et al. (2021) ISSN position stand: caffeine and exercise performance. JISSN
  4. Spotlight (14 Aug 2026): Inside the Box with Dr Andy Gray: are complementary medicines effectively regulated in South Africa?
  5. Duiven E et al. (2021) Undeclared doping substances are highly prevalent in commercial sports nutrition supplements. J Sports Sci Med 20:328

Educational information only, 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.

Cite this page: Healthnews24, “Which supplements are not safe during pregnancy in South Africa?”, updated 27 October 2026, https://www.healthnews24.co.za/answers/supplements-to-avoid-in-pregnancy-south-africa/. Plain-text version: /answers/supplements-to-avoid-in-pregnancy-south-africa.md