Can I Take Folic Acid While Pregnant

What Are The Benefits Of Folic Acid

The benefits of folic acid are vast, and loads of research have shown that when this nutrient is started in the months preceding pregnancy, it has important health benefits for expecting women and their babies. These include reducing the risk of:

• Miscarriage. Research has shown that some women have trouble getting or staying pregnant because of a folic acid deficiency.
• Neural tube defects. Three birth defects that are linked to insufficient folic acid are spina bifida, a spinal malformation, anencephaly, a type of brain damage and, less common, Chiari malformation, which causes the brain tissue to extend into the spinal canal.
• Congenital heart defects. These conditions, which affect 40,000 babies a year, can include a hole in the hearts wall, too-narrow valves or blood vessels that are incorrectly formed.
• Gestational diabetes. This type of pregnancy-related diabetes can sometimes be treated with dietary changes, exercise and close monitoring.
• Preterm labor. A diet thats rich in folic acid may help prevent labor before 37 weeks.
• Cleft lip and palate. Folic acid may help prevent this mouth defect in which the lip has an opening in it and doesnt form correctly.

Which Folic Acid Is Best For Conceiving

Though, more testing is needed. For pregnant women, the RDA of folic acid is 600 micrograms . Additionally, its recommended that women who are planning to become pregnant or who may become pregnant supplement with a daily dose of 400 to 800 mcg folic acid starting at least 1 month before becoming pregnant.

Who Can And Can’t Take Folic Acid

Most adults and children can take folic acid.

It’s not suitable for everyone.

To make sure it’s safe for you, tell your doctor before starting folic acid if you:

• have had an allergic reaction to folic acid or any other medicine in the past
• have low vitamin B12 levels or pernicious anaemia
• have cancer
• are having a type of kidney dialysiscalled haemodialysis
• have a stent in your heart

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How Do I Prevent It

The incidence of spina bifida in Canada varies by province but is approximately 1/1000 pregnancies. The best way to protect your baby is to start taking folic acid at least 3 months before you get pregnant. This will decrease the chance of your baby developing spina bifida by about 50%. If you wait until you get pregnant or miss your period to start folic acid supplements, you are too late. The spine forms like an open book and it closes around 42 days from the first day of your last menstrual period, which is approximately 28 days after you ovulate or 14 days after you have missed a period.

You only need to take a daily dose of 400 µg, though most vitamin supplements contain 1000 µg . Women who have diabetes or are taking certain epilepsy medications, women who have previously had a baby with spina bifida and women who are obese need to take higher doses of folic acid ask your health care provider what is right for you.

Because almost half of all pregnancies are unplanned and unfortunately, many women are not on folic acid when they get pregnant, Canada and many other countries around the world require fortification of grains and pastas to increase the intake of folic acid in the population. Since this was done in Canada in 1988, the incidence of spina bifida has decreased.

How Do You Read A Product Label To See How Much Folic Acid Is In A Vitamin Supplement

To find out if a vitamin supplement has folic acid in it, check the label . The label is usually on the back of the bottle. Look for the word folate on the label to see how much folic acid youre getting. The label tells you this information:

• Serving size. This tells you how much of the product is in one serving. One multivitamin usually is one serving.
• Servings per container. This tells you how many servings are in a multivitamin bottle. For example, if two pills are one serving and the bottle has 30 multivitamins in it, thats 15 servings.
• Nutrients, like vitamin D, folate and calcium, in each serving
• Daily value of one serving. DV is the amount of a nutrient in a serving. For example, if the DV of folic acid in a multivitamin is 50 percent, that multivitamin gives you 50 percent of the folic acid you need each day.

Vitamin supplement labels now list mcg DFE of folate, which stands for dietary folate equivalent. Its the amount of folate your body absorbs. If a serving has less than 400 mcg DFE of folate, you need more than one serving to get all the folic acid you need each day.

Labels on food products dont always list the amount of folic acid in the product. Newer food labels that list folic acid will list mcg DFE of folate, just like for vitamin supplements.

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Recommended Folate Intake During Pregnancy

Folate requirements increase during pregnancy. There is a dramatic acceleration in cell division and red blood cell development as the uterus enlarges, the placenta develops, maternal blood volume expands, and the fetus grows . The mother also transfers folate to the fetus . Evidence supports a RDA of 600 mcg DFEs per day to maintain normal folate status during pregnancy .

How Can I Become More Fertile To Get Pregnant

The best way to increase your odds of getting pregnant quickly is to make sure that youre having sex at the right time in your cycle. If you have regular cycles, you will ovulate around two weeks before your period. This means your fertile window will be the seven days before your expected ovulation.

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Taking Too Much Folic Acid While Pregnant May Put Daughters At Risk Of Diabetes And Obesity

Date:

Society for Endocrinology

Summary:

Mothers that take excessive amounts of folic acid during pregnancy may predispose their daughters to diabetes and obesity later in life, according to a new study. With high dose supplements being widely available, the study calls for a need to establish a safe upper limit of folic acid intake for pregnant women.

Mothers that take excessive amounts of folic acid during pregnancy may predispose their daughters to diabetes and obesity later in life, according to a new study published today in the Journal of Endocrinology. With high dose supplements being widely available, the study calls for a need to establish a safe upper limit of folic acid intake for pregnant women.

A Portuguese research team from the Faculty of Medicine of the University of Porto and the Catholic University of Portugal gave rats 20 times their recommended daily amount of folic acid throughout mating, the pregnancy period and lactation.

These rats gave birth to babies who grew up to be overweight and insulin resistant in adulthood. The babies also grew up to be deficient in adiponectin a hormone that protects them against diabetes and obesity – and had irregular feeding behaviour. All of these symptoms were more pronounced in female adults. On the other hand, rats consuming the recommended daily amount of folic acid had babies who grew up to be healthier adults.

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About Neural Tube Defects

The neural tube is the part of the developing baby that becomes the brain and spinal cord. NTDs occur when the neural tube does not fully close during the early weeks of pregnancy.

This results in spine, brain and skull defects that can lead to stillbirth or lifelong disability. Spina bifida and anencephaly are the most common NTDs.

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How Long Should I Take Folic Acid For

Youre advised to take a daily supplement of folic acid for the first 12 weeks of your pregnancy. If you want to continue beyond this, thats fine. You can also continue to have a diet rich in folic acid by eating fresh green leafy vegetables.

If youre someone who likes to take a pregnancy supplement throughout your 9 months, thats fine too. But just make sure it is one formulated for pregnancy as some vitamins are not advised to be taken in large amounts when youre expecting.

If your GP or midwife is concerned about your iron levels, its a good idea to take iron supplements in a multi-vitamin format rather than just as iron tablets, unless your GP has specifically prescribed them.

A note about folic acid and tongue tie

A scary Daily Mail headline suggested a possible link between taking folic acid in later pregnancy and tongue tie.

Reports said that a journalist mum had been asked by her midwife at 14 weeks if she had stopped taking folic acid by that point in her pregnancy, as there was some suggestion that taking the supplement later on was linked to tongue tie.

We contacted the Royal College of Midwives directly on this one: they told us theyre not aware of any evidence to suggest a connection between taking folic acid in pregnancy and this leading to increases in incidences of tongue tie, and they support official guidelines for folic acid to be taken until at least the 12th week of pregnancy.

Folic Acid And Fertility

The link between folic acid and fertility has come under question in many studies. Recently, it’s been said that folic acid is able to help boost fertility. However, this occurs only at particularly high doses and is not guaranteed to help women. Women with higher than average levels of folic acid don’t necessarily have improved fertility.

Interestingly, studies that feature higher levels of fertility tend to have extremely high doses of this vitamin. Supplementation of anything from 2 to 12.5 times the typical recommended daily amount have been used. Folic acid at such high doses also seems to boost the sperm count of men, promoting their fertility. If you’re having trouble conceiving, you should talk to your doctor before starting folic acid supplements in order to figure out the right amount to take. Too much folic acid can cause unpleasant side effects.

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Can Too Much Folic Acid Harm My Baby

But even though folic acid is important, taking too much could be problematic. Research is pointing to some possible negative effects of consuming too much folic acid, such as impaired fetal growth, increased risks of childhood diseases like asthma and autism, and promoting the growth of some cancer cells.

Is 5mg Folic Acid Good For Pregnancy

While most pregnant women would benefit from daily folic acid doses of 0.4 mg through diet, or folic acid doses of 0.8 to 0.9 mg/d as found in most prenatal vitamins, selected groups of women at high risk might benefit from daily folic acid doses of 5 mg starting from 2 months before conception up to the end of the

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How Do You Know Youre Getting Enough Folic Acid

You can get folate naturally from foods, including:

• Dark green leafy vegetables
• Egg yolks
• Fortified breads and cereals

Your body more easily absorbs folic acid in vitamins or supplements than the folate you get from food. Doctors usually recommend that non-pregnant women and men get 400 mcg daily, whereas pregnant women should get 600 mcg and breastfeeding women should get 500 mcg.

Providers may advise some patients to take higher doses, including:

• Those with a family history of neural tube defects
• Individuals who take certain medications for cancer, epilepsy or autoimmune diseases

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Vegetarian Vegan And Special Diets In Pregnancy

A varied and balanced vegetarian diet should provide enough nutrients for you and your baby during pregnancy.

But you might find it more difficult to get enough iron and vitamin B12.

Talk to a midwife or doctor about how to make sure you’re getting enough of these important nutrients.

If you’re vegan or you follow a restricted diet because of a food intolerance or for religious reasons, talk to a midwife or GP.

Ask to be referred to a dietitian for advice on how to make sure you’re getting all the nutrients you need for you and your baby.

Find out more about healthy eating if you’re pregnant and vegetarian or vegan.

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Continued Supplementation Throughout Pregnancy

Canadian survey data show that it is difficult for most women of childbearing age to consume enough folate from diet alone to meet their pregnancy needs. Over 75% of non-pregnant/non-breastfeeding women aged 19 – 50 have intakes less than the Estimated Average Requirement Footnote 10 for pregnancy, 520 mcg of DFEs . To meet folate needs during pregnancy, women should consume a varied diet that provides dietary folate , and continue taking a multivitamin containing 400 mcg of folic acid throughout their pregnancy.

Ive Been Trying To Get Pregnant But Havent Been Taking Folic Acid Supplements Should I Stop Trying To Conceive

Ideally, you should take folic acid supplements for two to three months before you conceive and until you are 12 weeks pregnant.

But try not to worry if you havent started taking the supplements yet and start taking it now. You can talk to your GP or midwife if you have any concerns.

1. Sue Macdonald, Gail Johnson, Mayes Midwifery. , p 312.

2. NHS Choices Why do I need folic acid in pregnancy? Page last reviewed: 16/03/2016 Next review due: 16/03/2018

3. NHS Choices Spina bifida Page last reviewed: 04/05/2017 Next review due: 04/05/2020 www.nhs.uk/conditions/spina-bifida

4. NHS Choices Vitamins and minerals Page last reviewed: 03/03/2017 Next review due: 03/03/2020

Review dates

Last reviewed:Next review:

Find out more about planning a pregnancy

• Taking a pregnancy test

  Pregnancy tests work by looking for a hormone called human chorionic gonadotrophin . This hormone is only made in your body when you are pregnant.

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How Folate Helps Prevent Neural Tube Defects

Neural tube defects Footnote 6 include spina bifida and anencephaly. They occur when the neural tube fails to close properly during the third and fourth week of pregnancy. Often a woman doesn’t yet know that she is pregnant during this critical time. A decreased risk of NTD is associated with both increased folate intake and higher red blood cell folate concentrations though the experimental evidence is stronger for increased folate intake and NTD risk reduction .

The risk is reduced when women start taking a daily multivitamin containing folic acid three months before the beginning of pregnancy and continuing in early pregnancy while the neural tube is closing Footnote 7 . The reduced risk has been observed in women who took a supplement containing 360 to 800 mcg of folic acid per day, in addition to an intake of 200 to 300 mcg per day of natural folate .

Many studies also show that multivitamins containing folic acid taken in the early weeks of pregnancy are associated with a decreased risk of oral cleft and cardiovascular anomalies . Some evidence also suggests an association with reduced risk of preeclampsia . This is an area of active and on-going research.

Research Says Multivitamin And Mineral Preparations Promoted For Use During Pregnancy Are Unlikely To Be Needed

No need to take supplements if the content of your fridge looks like this

Any woman who has been pregnant will remember how much effort she put into eating a healthy diet. Many expectant mums also turn to prenatal supplements to optimise their chances of producing a healthy baby and, in later years, a more intelligent child.

But experts now warn that many of these daily vitamins are of little or no use.

The Australian research published in the Journal of the American Medical Association found there was little evidence of benefit after half of the women were given daily supplements while the others took a placebo.

Once the pregnancies were over, the babies were tested at regular intervals until they were seven years old. Results showed no difference between the childrens general intelligence, language skills or overall level of IQ, whether or not their mother had taken supplements while pregnant.

No evidence

These latest findings back up other research , which found no evidence that pregnancy supplements improve the health of women or their babies.

Researchers concluded that for most women who are planning to become pregnant or who are pregnant, complex multivitamin and mineral preparations promoted for use during pregnancy are unlikely to be needed and are an unnecessary expense.

Fergal Malone, head of RCSIs Department of Obstetrics and Gynaecology and Master of the Rotunda Hospital, echoes this advice.

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How Much Will I Take

How much you take depends on why you need folic acid.

Before and during early pregnancy

The usual dose for most women trying to get pregnant and during the first 12 weeks of pregnancy is 400 micrograms, taken once a day.

If there’s a higher risk of neural tube defects during your pregnancy, your doctor will recommended a higher dose of 5mg, taken once a day.

Folate deficiency anaemia

To treat anaemia, the usual dose for adults and children over 1 year old is 5mg, taken once a day, for 4 months.

Sometimes the dose may be increased to 15mg a day.

If your child is under 12 months old, the doctor will use your child’s weight to work out the right dose.

To prevent anaemia, the usual dose for adults and children over 12 years old is 5mg, taken every 1 to 7 days.

This depends on your age, diet and any other health conditions you may have.

For children less than 12 years old, the doctor will use your child’s age or weight to work out the right dose.

If you’re taking methotrexate

The usual dose for adults and children is 5mg once a week, on a different day of the week to your methotrexate.

Some people take 1mg to 5mg once a day, apart from the day when they have their methotrexate.