Mthfr Is The Cause Of Elevated Homocysteine Levels Tied To Frequent Miscarriages
Homocysteine is a naturally occurring amino acid produced when proteins are broken down in the body. It is not harmful at low levels, but when present in high concentrations it can lead to a condition called hypercoagulability, in which your blood tends to clot more easily than it should. Women with elevated homocysteine levels are believed to be at higher risk for miscarriage, preeclampsia and even preterm labor most likely due to the increased clotting caused by the elevated homocysteine levels.
Why do homocysteine levels become elevated? Methylfolate, the active form of folic acid, plays a role in converting homocysteine into methionine , so if methylfolate is lacking due to the MTHFR mutation and subsequent inability to convert folic acid to methylfolate, homocysteine can build up to dangerous levels.
Researchers have discovered an association between high homocysteine levels and recurrent miscarriage, which suggests that the MTHFR genetic variation may play a role in pregnancy loss.
Folic Acid And The Prevention Of Preterm Birth
Preterm birth , defined as delivery prior to 37 weeks of gestation, complicates 12.5% of all deliveries in the United States. It is a major cause of neonatal mortality and morbidity. Infants born preterm are at risk of short-term respiratory, gastrointestinal, immunologic, and central nervous system complications, as well as long-term motor, cognitive, and neurobehavioral sequelae. As a result, the societal costs of preterm deliveries in the United States alone exceed $26 billion a year.25 Preterm labor represents a syndrome rather than a diagnosis because the etiologies are varied. Approximately 20% of preterm deliveries are iatrogenic and are performed for maternal or fetal indications, including intrauterine growth restriction, preeclampsia, placenta previa, and nonreassuring fetal testing. Although the causes of the remaining 80% of PTB are not well understood, four basic pathophysiologic mechanisms are described: premature activation of the fetal hypothalamic-pituitaryadrenal axis intrauterine infection/inflammation decidual hemorrhage and pathological distension of the uterus.26
The treatment of preterm labor has focused primarily on inhibiting uterine contractions, which has been shown neither to reduce the incidence of PTB nor improve neonatal outcome.27 In the face of such therapeutic nihilism, attention has turned instead to prevention. One of the agents under investigation to prevent PTB in both low- and high-risk populations is folic acid.
How Much Folic Acid Is Needed To Prevent Neural Tube Defects
CDC and the US Public Health Service urge every woman who could become pregnant to get 400 micrograms of synthetic folic acid every day.
One easy way a woman can be sure she is getting enough folic acid is to take a vitamin that has folic acid in it every day. Most vitamins sold in the United States have the recommended daily amount of folic acid that women need to prevent neural tube defects. Vitamins can be found at most local pharmacy, grocery, or discount stores.
You can get your vitamin with folic acid in one of several ways. You can take a multivitamin or a small, single supplement of folic acid. These days, multivitamins with folic acid come in chewable chocolate or fruit flavors, liquids, and large oval or smaller round pills. Many stores offer a single folic acid supplement for just pennies a day.
Another good choice is a store-brand multivitamin, which includes most of the vitamins you need each day. Unless your doctor suggests a special type, you do not need to choose among vitamins for women or active people, or one for people who are on a low carbohydrate diet. A basic multivitamin meets the needs of most women.
Another way to get folic acid is to eat enough breakfast cereal that has been enriched with folic acid every day. Amounts of folic acid in cereals vary, so be sure to check the label on the side of the box to make sure youre getting an adequate amount.
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How Much Folic Acid During Pregnancy
I want my baby to be healthy is the answer of each mother when asked if she wants to have a girl or a boy. But most of the times, women put their future babies in danger even from their first months of life without even noticing.
A lot of women don`t really understand the importance of the regular administration of folic acid before and during the first 3 months of pregnancy. So, the baby is often exposed to the risk of developing severe conditions even from before he`s even conceived. Of course, every mother wants what is best for her baby or/and, with a bit of documentation, precaution and determination, many of the serious health issues can be effectively and easily prevented with a daily intake of at least 70% of the recommended dose of folic acid.
Vitamin D In Pregnancy
You need 10 micrograms of vitamin D each day and should consider taking a supplement containing this amount between September and March.
Vitamin D regulates the amount of calcium and phosphate in the body, which are needed to keep bones, teeth and muscles healthy. Our bodies make vitamin D when our skin is exposed to summer sunlight .
It’s not known exactly how much time is needed in the sun to make enough vitamin D to meet the body’s needs, but if you’re in the sun take care to cover up or protect your skin with sunscreen before you start to turn red or burn.
Vitamin D is also in some foods, including:
Vitamin D is added to some breakfast cereals, fat spreads and non-dairy milk alternatives. The amounts added to these products can vary and might only be small.
Because vitamin D is only found in a small number of foods, whether naturally or added, it is difficult to get enough from foods alone.
Do not take more than 100 micrograms of vitamin D a day as it could be harmful.
You can get vitamin supplements containing vitamin D free of charge if you’re pregnant or breastfeeding and qualify for the Healthy Start scheme.
There have been some reports about vitamin D reducing the risk of coronavirus . But there is currently not enough evidence to support taking vitamin D solely to prevent or treat COVID-19.
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Folate Folic Acid And L
Defining the terminology is important to any discussion of the role of folate in nutrition and reproductive biology. The term folate is typically used as a generic name for the group of chemically related compounds based on the folic acid structure. Folate, or vitamin B9, is thought of as one of the 13 essential vitamins. It cannot be synthesized de novo by the body, and must be obtained either from diet or supplementation. Dietary folate is a naturally occurring nutrient found in foods such as leafy green vegetables, legumes, egg yolk, liver, and citrus fruit. Folic acid is a synthetic dietary supplement that is present in artificially enriched foods and pharmaceutical vitamins. Neither folate nor folic acid is metabolically active. Both must be reduced to participate in cellular metabolism. l-5-Methyltetrahydrofolate is the predominant micronutrient form of folate that circulates in plasma and that is involved in biologic processes.5
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
Find out more about planning a pregnancy
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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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You Can Find It In Foods
The best place to start getting folic acid during pregnancy is through healthy foods. Some foods are fortified with folate. These foods include enriched breakfast cereals, pasta, rice, and bread. Look at the nutrition labels on fortified grains to make sure that it has 100% of the daily recommended folic acid allowance. There are also many foods that naturally have folate or folic acid:
- Pinto, navy, black, kidney, great northern, and white beans
- Sunflower seeds
What Is A Neural Tube
The neural tube is one of the first things your baby will grow. It will become your babys brain and spinal cord and the bones that enclose them. The neural tube is formed in the first four to six weeks of pregnancy.
A neural tube defect can happen when something goes wrong in the development of a babys neural tube. This can cause a range of disabilities including loss of bladder and bowel control, and paralysis of the legs. In some cases, the effects can be more severe.
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Folic Acid: All Women Every Day
You might think that you can get all the folic acid and other vitamins you need from the food you eat each day. But it is hard to eat a diet that has all the nutrients you need every day. Even with careful planning, you might not get all the vitamins you need from your diet alone. Thats why its important to take a vitamin with folic acid every day.
Todays woman is busy. You know that you should exercise, eat right, and get enough sleep. You might wonder how you can fit another thing into your day. But it only takes a few seconds to take a vitamin to get all the folic acid you need.
How much do you know about folic acid? Take this quiz and find out.
If taking folic acid for reasons other than neural tube defect prevention, talk to your healthcare provider.
What Is The Benefit Of Carrying Out A Vitamin B9 Analysis
Some symptoms may be indicative of a folic acid deficiency. Your doctor may prescribe a prescription for a serum folic acid test if you have the following symptoms: diarrhea, depression, loss of appetite and weight, severe stress, mood changes, anemia, fever, heart palpitations, kidney function disorder, liver and bowel disease, alcoholism, shortness of breath. Your doctor may prescribe folic acid supplementation if you are pregnant or breastfeeding, but also if you have acute infections or cancer.
Vitamin B9 deficiency can cause a megaloblastic defect. Megaloblasts are precursor cells of red blood cells. Therefore, a low serum folic acid content may help in the diagnosis. Normal blood vitamin B9 values are between 5 and 15 μg/L. A lower concentration means that a deficiency is present. It may be advisable to carry out additional tests as this deficiency may be a sign of celiac disease, which has a negative effect on the absorption of vitamins in the gastrointestinal tract.
These new tests or treatments may be necessary with a specialist, for example a specialist in blood diseases or a specialist in diseases of the digestive system .
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How Can I Be Sure I Get Enough Folic Acid
You can get enough folic acid from food alone. Many breakfast cereals have 100% of your recommended daily value of folic acid.
If you are at risk for not getting enough folic acid, your doctor or nurse may recommend that you take a vitamin with folic acid every day. Most U.S. multivitamins have at least 400 micrograms of folic acid. Check the label on the bottle to be sure. You can also take a pill that contains only folic acid.
If swallowing pills is hard for you, try a chewable or liquid product with folic acid.
How To Get Enough Folic Acid To Prevent Neural Tube Defects
In addition to eating foods with folate from a varied diet, women can get folic acid from
- Taking a vitamin that has folic acid in it:
- Most vitamins sold in the United States have the recommended daily amount of folic acid that women need for the prevention of neural tube defects. Vitamins can be found at most local pharmacy, grocery, or discount stores.
If taking folic acid for reasons other than neural tube defect prevention, talk to your healthcare provider.
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When Should A Woman Start Taking Folic Acid
These birth defects of the brain and spine happen in the first few weeks of pregnancy, often before a woman finds out she is pregnant. All women should get in the habit of taking folic acid daily even when they are not planning to get pregnant. For folic acid to help, a woman needs to take it every day, starting before she becomes pregnant.
Promoting The Use Of Folic Acid Supplementation
According to Canadian survey data, 58% of women said they took a multivitamin containing folic acid or a folic acid supplement in the three months before becoming pregnant . It has been shown that the use of supplements is influenced by economic status and educational background . For instance, the use of folic acid supplements before pregnancy in Canada was lowest among women in lower-income households, among women with less than high school graduation, and among immigrant mothers . Women with unplanned pregnancies, mothers under the age of 25 and single mothers are also less likely to supplement with folic acid .
Although the majority of Canadian women take folic acid supplements in the three months before pregnancy, continued public health efforts are needed to promote awareness of the importance of folic acid supplementation for all women of childbearing age. To avoid increasing socio-economic inequalities in folic acid use, interventions should provide practical support to vulnerable groups .
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Folic Acid Vs Methlyfolate
Folic acid is the synthetic form of folatefound in most leading prenatal vitamin brands. Your body must convert folic acid into methylfolate. Unfortunately, some women may not fully absorb folic acid. Methylfolate is a science-y term for the active form of folate that all women can fully absorballowing this vital nutrient to support their babies. Thats why advanced prenatal vitamins with methylfolate are so important they help mom successfully provide this crucial nutrient to their developing babies.
Are There Risks From Taking Folic Acid
Generally when taken orally, and at appropriate doses, folic acid is safe. If you take too much folic acid your body gets rid of any excess in your urine.
Some people may experience minor side effects from taking folic acid supplements such as:
- Bad taste in the mouth
Signs of an allergic reaction to folic acid include:
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What Causes Folic Acid Deficiency
As folic acid is present in many foods, whether naturally or in fortified foods, folate deficiency should be uncommon. However, you can be at risk for this condition if:
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you follow a diet lacking folic acid
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you canât absorb folic acid due to a disease of the small intestine, for example, celiac disease
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you drink too much alcohol, which can interfere with folic acid absorption
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youâre taking medication that interferes with absorption, such as anti-seizure medications.
When you’re pregnant or breastfeeding, your body needs more folic acid than it normally does. Check with your healthcare provider to make sure you’re getting the proper amount of folic acid for your situation.
Folic acid is only one of the many important nutrients youâll need when you’re pregnant or planning to become pregnant. If youâre interested in learning more about pregnancy nutrition, read more about maintaining a healthy pregnancy diet and all about prenatal vitamins, so you and your little one stay well nourished and healthy.
How Are Neural Tube Defects Diagnosed
Neural tube defects are detected through an alpha-fetoprotein test . AFP is a blood test administered at 16-18 weeks gestation. The test measures alpha-fetoprotein, a substance produced by the fetus and secreted into the amniotic fluid.AFP is also found in the mothers blood. The level of AFP in the mothers blood peaks at about 30-32 weeks. Abnormally high amounts of AFP may indicate that a baby has a neural tube defect.
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When To Take It
Anyone who wishes to become pregnant should start taking folic acid supplements before they start trying.
The reason for this is that neural tube defects occur early in development, often before a person knows that they are pregnant.
As about half of pregnancies are unplanned, experts recommend that anyone who can get pregnant take folic acid supplements. Doing so ensures that even if a pregnancy is a surprise, the likelihood of neural tube defects is low.
Folic acid is water soluble, which enables the body to metabolize it quickly. For this reason, those taking folic acid supplements need to take one every day.
There is no need to take the supplement at a specific time of day or with a meal. However, developing a habit, such as taking a prenatal vitamin every morning with breakfast, may make it easier to remember to take folic acid.
The CDC note that in most cases, each folic acid pill or multivitamin contains
- Banana: 24 mcg per medium fruit
- Spinach: 131 mcg per one-half cup boiled
- Black-eyed peas: 105 mcg per one-half cup boiled
- Avocado: 59 mcg per one-half cup
- Broccoli: 52 mcg per one-half cup
- Orange juice: 35 mcg per three-quarters cup
- Asparagus: 89 mcg per four spears
- Brussels sprouts: 78 mcg per one-half cup
Fortified cereals, such as breakfast cereal and oatmeal, are also high in folic acid. A person can check the label to learn the exact quantity.
It is possible to get enough folic acid from the diet, but the ACOG still recommend taking a supplement while pregnant.
