How Much Folate To Take During Pregnancy

Can I Get Folate From Food

Folic Acid and Pregnancy

Yes. You can get a natural serving of folate from a healthy diet rich in

  • dark leafy greens, such as spinach and romaine lettuce

  • broccoli

  • melons

  • strawberries.

You can also find folic acid in fortified foods like breakfast cereals, bread, white rice, and pasta. Just check the label to make sure the food has been fortified with folic acid.

Why Is Folic Acid Important During Pregnancy

Folic acid is a B vitamin found in many supplements and fortified foods. Its the synthetic form of folate. Folic acid is used by your body to make new cells and produce DNA. Its required for normal growth and development throughout your life.

Taking folic acid is particularly vital before and during pregnancy. Its important for the proper organ development of a developing baby.

Research shows that taking folic acid before you get pregnant may help prevent birth defects including serious neural tube defects such as spina bifida, encephalocele , and anencephaly.

Where To Get Pregnancy Supplements

You can get supplements from pharmacies and supermarkets, or a GP may be able to prescribe them for you.

If you want to get your;folic acid from a multivitamin tablet, make sure the tablet does not contain vitamin A .

You may be able to get free vitamins if you qualify for the Healthy Start scheme.

Find out more about the Healthy Start scheme.

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How Much Ferrous Iron To Take During Pregnancy

Danish researchers wanted to determine what the lowest dose of folic acid would be, to prevent iron deficiency and anemia in women who are pregnant. They found that a supplement of 40 mg ferrous iron/day from 18;weeks of gestation appears adequate to prevent folic acid or iron deficiency in 90% of the women. Further, this dosage of folic acid during pregnancy prevented iron deficiency anemia in at least 95% of the women after they had their babies .

To learn more about being pregnant, read 10 Tips for a Healthy Pregnancy From a Nurse Midwife.

I welcome your thoughts on folic acid and pregnancy below, but I cant offer medical or health advice. Talk to your ob-gyn or family doctor if you arent sure about how much folic acid to take during pregnancy.

Sources: 1) VA Hodgetts, RK Morris, A Francis, J Gardosi, KM Ismail.;Effectiveness of folic acid supplementation in pregnancy on reducing the risk of small-for-gestational age neonates: a population study, systematic review and meta-analysis.;BJOG: An International Journal of Obstetrics & Gynaecology, 2014; 2) Milman, N., Bergholt, T., Eriksen, L., Byg, K. E., Graudal, N., Pedersen, P., & Hertz, J. . Iron prophylaxis during pregnancyhow much iron is needed? A randomized doseresponse study of 2080 mg ferrous iron daily in pregnant women.;Acta obstetricia et gynecologica Scandinavica,;84, 238-247.; and 3) ;Prenatal Nutrition Guidelines for Health Professionals Folate Contributes to a Healthy Pregnancy via Health Canada.

What If I Forget To Take It

Can I Take Folic Acid Throughout Pregnancy

Missing 1 or 2 doses probably will not matter. But if you keep forgetting to take your folic acid, or you do not want to take it, speak to your doctor.

If you stop taking your folic acid:

  • in pregnancy – the risk of your baby having neural tube defects may increase
  • for folate deficiency anaemia – your symptoms may get worse or new symptoms may appear
  • to reduce the side effects of methotrexate – you’ll be more likely to get side effects from methotrexate

If you forget to take folic acid:

  • once a day – take your missed dose as soon as you remember. If it’s nearly time for your next dose, skip the missed dose and just take your next dose as normal. If you remember on the day you take your methotrexate, wait a day and take your missed dose the following day.
  • once a week – take your missed dose as soon as you remember, unless you take methotrexate that day. If you remember on the day you take your methotrexate, wait a day and take your missed dose the following day. After this, go back to taking your weekly dose on your usual day.

Never take 2 doses to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you.

You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

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When Should You Start Taking A Prenatal Vitamin With Folic Acid

Even if youre not planning to become pregnant right away, dont wait to start taking a prenatal vitamin that contains folic acid. Since about half of all pregnancies in the U.S. are unplanned, its smart to already be taking this important nutrient in case you suddenly realize youve conceived.

And some major birth defects related to the brain and spine can happen in the first few weeks of pregnancy, which is often before most women know theyre expecting.

Do People With Mthfr Need More Folate

First off, those without MTHFR variations are recommended to take in 400-600 mcg of folate in the 2-6 months leading up to pregnancy with the goal of normalizing serum folate levels prior to conception. During pregnancy, continue to aim for a minimum of 600 mcg per day.

Research suggests that those with MTHFR variations often have lower folate status and therefore may need a dosage of 800 mcg per day to normalize serum folate levels prior to conception and to maintain adequate folate levels during pregnancy. Also note that MTHFR carriers have higher choline needs and choline is equally important for reducing the risk of neural tube defects .

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The Nutrient Every Woman Needs Before Pregnancy

Folic acid, or vitamin B9, is an essential nutrient that every woman should take, whether planning to get pregnant or not.

If youre planning to become pregnant, you already know how important a healthy diet, exercise and getting plenty of sleep are, but one of the most important ways to ensure a healthy pregnancy is to get enough folic acid prior to conception.

Folic acid, the synthetic form of folate or Vitamin B9, is one of many super-star nutrients that our bodies need to run on all cylinders. Everyday new cells are rapidly reproducing in every organ of our bodies but without folic acid, none of it would happen.

Folic acid has a very important role in making those cell reproductions possible and happen in an efficient manner, Tama Bloch, RDN, a pediatric research scientist with Abbott says.

During pregnancy, folic acid becomes even more important because of its role in the prevention of neural tube defects .

Why Folic Acid is Important

Neural tube defects are birth defects of the spinal cord such as spina bifida, the brain such as anencephaly, and Chiari malformation, another type that causes brain tissue to descend into the spinal canal.

Neural tube defects affect approximately 300,000 babies worldwide each year but between 50 and 70 percent of neural tube defects can be prevented when women take folic acid in a prenatal vitamin or supplement.

Folic Acid and Folate: Make It a Daily Habit

Folic Acid: How Much Do You Need?

Real Food Matters For More Than Just Folate

The Importance of Folic Acid During Pregnancy

Ive long been an advocate of a real food diet for pregnancy, which is one that is made primarily of foods that have not been processed in a way that reduces their nutritional value. Refined grains, by default, are processed to remove nutrients and then food scientists attempt to replace part of what was lost with synthetic vitamins. In situations of extreme food scarcity, this is better than unfortified white flour, but its not ideal.

In addition to the issues with synthetic folic acid, refined grains are high-glycemic, meaning they spike blood sugar. Elevated blood sugar has a slew of its own problems related to fertility and pregnancy, including increasing the risk of birth defects .

Wouldnt it be better to get your folate from REAL FOOD and in a form that your body recognizes and can appropriately metabolize? Thats what I believe should be emphasized for optimal fertility and pregnancy outcomes.

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Vitamin C In Pregnancy

Vitamin C protects cells and helps keep them healthy.

It’s found in a wide variety of fruit and vegetables, and a balanced diet can provide all the vitamin C you need.

Good sources include:

  • soya drinks with added calcium
  • bread and any foods made with fortified flour
  • fish where you eat the bones, such as sardines and pilchards

But My Doctor Says Only Synthetic Folic Acid Is Proven To Prevent Neural Tube Defects

This rebuttal comes up often and unfortunately, reflects a lack of understanding of nutritional biochemistry.

Ill leave it to the folate researchers to explain how weve ended up in a quandary where we dont have enough data to recommend the biologically active form of folate that is not only the primary type of folate in food, but also the primary form of folate in our blood, our red blood cells, and cord blood.

Although there are no clinical trials on the effectiveness of 5-methylTHF in preventing NTDs , metabolic studies have shown that 5-methylTHF is a biologically active form of the vitamin and it seems to be at least as effective as folic acid in improving folate biomarkers. The literature clearly shows that a better food folate intake is associated with better folate markers and that food folate can prevent NTDs . Folic acid can prevent NTDs by increasing serum or blood folate level. 5-MethyTHF can effectively increase serum or blood folate markers. Therefore, supplementing with 5-methylTHF for NTD prevention seems to be rational esting the efficacy of 5-methylTHF against a placebo would be unethical. Comparing the preventive effect of folic acid with a proposed better alternative will require following several thousands of pregnancies over a long time. The costs of testing 5-methylTHF against folic acid would be extremely high. We do not have any reason to assume that a randomized controlled trial is justified before recommending 5-methylTHF.

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How Can You Get Folic Acid From Food

You can get folic acid from food. Some foods are fortified with folic acid. Fortified means a food has folic acid added to it. Check the product label to see how much folic acid you get in each serving. Look for the word fortified or enriched on labels on foods like:

  • Bread
  • Flour
  • Pasta
  • Products made from a kind of flour called corn masa, like tortillas, tortilla chips, taco shells, tamales and pupusas
  • White rice

Some fruits and vegetables are good sources of folic acid. When folic acid is found naturally in food its called folate. Foods that are good sources of folate are:

  • Beans, like lentils, pinto beans and black beans
  • Leafy green vegetables, like spinach and Romaine lettuce
  • Asparagus;
  • Peanuts ;
  • Citrus fruits, like oranges and grapefruit
  • Orange juice ;

Its hard to get all of the folic acid you need from food. Even if you eat foods that have folic acid in them, take your vitamin supplement each day, too.;

Folic Acid: Natural Or Synthetic

Folic Acid and How it Affects Women During Pregnancy

A lot of doctors say that, no matter if you have already follow a healthy and well balanced diet, folic acid should be taken through supplements. This is mainly because is hard to eat every day 1 kg of spinach, for example, to ensure the daily dosage of folate. Moreover, they say that the human organism isn`t able to store folic acid from one day to another, so it takes a daily diet that`s extremely rich in this substance, which is hard to accomplish.

On the other hand, there are voices which claim that folic acid increases the risk of various types of cancer, while folate, which is the natural form of folic acid, protects against cancer and that it`s best for pregnant women to opt for a regimen of healthy foods.

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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

Can You Get Folic Acid From Food

Folic acid is present in daily food, but is not enough to fulfill the bodys needs. Folic acid, in its natural forms folate, found in different foods such as green leafy vegetables, beans, chickpeas, and yeast extract. Bread and cereals are also fortified with folic acid, steer in the liver contain high folic acid. Folic acid taken from food is not enough for the healthy development of the baby, to fulfill the needs you must have to take folic acid supplements along with the food.;

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Why Do I Need To Start Taking Folic Acid Before I Get Pregnant

According to the CDC, getting the daily recommended amount of folic acid into your system a month before the start of your first trimester can reduce the risk for neural tube defects by 50 to 70 percent. This timing of when you take folic acid in pregnancy is crucial because neural tube formation occurs very early. Most women do not know they are pregnant until after neural tube formation has occurred.

Folate And Folic Acid In Pregnancy

Folic Acid Benefits During Pregnancy – Dr Karthik Explains

Folate and its cousin folic acid are vital for developing a healthy baby because it prevents neural tube defects. Since the neural tube develops within the first 28 days of pregnancy, it is recommended all women of childbearing years consume folate. Folate prevents certain heart abnormalities, cleft palate and cleft lip. It also lowers the risk of developing anemia, miscarriage, preterm delivery and low birth weight. It can be found in fortified breakfast cereals, lentils, spaghetti, rice, beans, broccoli, orange juice, spinach and strawberries.

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How Is Folic Acid Different From Folate

Folic acid is structurally and functionally different from folates that exist naturally in food. I say folates because there are many different forms of folate found naturally in food. For this reason, nutrition research refers to them as food folates. While over 150 different forms of naturally occurring folate have been identified, 5-MTHF is the major type of folate found in food. Folic acid is not present in whole foods ; it is only present in foods that are fortified with folic acid.

The term folate is a catch-all for any type of folate, whether natural or synthetic. That means folic acid is a type of folate and 5-MTHF is another type of folate. For the purposes of this article, I will be specifying folic acid any time Im referring to that form of folate.

Psst The folate versus folic acid and MTHFR discussion has come up so many times that Ive devoted several research briefs to the topic on my . If you dont yet follow me there, thats the social media platform I post on most regularly . My research brief posts highlight specific studies related to preconception/pregnancy/postpartum nutrition and why they are relevant to you.

But Isnt Folate Deficiency Rampant

Theres no question that prioritizing folate intake is important to fertility and pregnancy. However, actual deficiency in folate is less common than youve been led to believe.

According to a 2017 analysis of NHANES data , the average intake of folate among women ages 19-50 was on par with the recommended dietary allowance for pregnancy of 600 mcg .

Only 11% of women consumed less than the estimated average requirement, which is 320 mcg. Almost none of the women had low serum folate levels, but a shocking 37-39% had elevated serum folate.

Unfortunately, this study did not look at levels of unmetabolized folic acid specifically, but given that a folic acid intake as low as 200 mcg can result in elevations in UMFA, its likely that much of the folate in those with elevated serum folate levels was in the form of UMFA. This could pose a problem to fertility and pregnancy, as Ill discuss below.

Now also consider that the majority of pregnant women in the U.S. take a prenatal supplement that contains folic acid with an average dosage of 817 mcg folic acid. In addition, those who take a prenatal vitamin or supplemental folic acid are the most likely to consume adequate folate from their diet . That means many women may be exceeding the tolerable upper limit of folic acid when you assess dietary and supplemental folic acid together.

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When Should I Start Taking Folic Acid In Pregnancy

If you are planning a pregnancy, it is important to take a folic acid supplement from 3 months before becoming pregnant. If you find out you are pregnant, try to start taking folic acid as soon as possible up to week 12 of pregnancy.;

If you are past 12 weeks in your pregnancy and did not know you should take folic acid, try not to worry. The risk of this affecting your baby is still very small.;

How To Cope With Side Effects

Folic Acid Benefits in Pregnancy (How Much to Take)

What to do about:

  • feeling sick – take folic acid with, or just after, a meal or snack to ease feelings of sickness. If you’re pregnant, it could be morning sickness that’s making you feel sick.
  • loss of appetite – eat when you’d usually expect to be hungry. If it helps, eat smaller meals more often than usual. Snack when you’re hungry. Have nutritious snacks that are high in calories and protein, such as dried fruit and nuts.
  • bloating or wind – it might help to eat smaller and more frequent meals, eat and drink slowly, and exercise regularly. If the symptoms get worse, contact your doctor straight away.

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