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Understanding Folic Acid: What, When and Why?

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Understanding Folic Acid

Published April 2024

Professor Kelton Tremellen – Repromed Medical Director SA

When you take a leap in your life, it’s understood that you begin to subconsciously take more notice of the relevant things around us. For example, when trying for a baby, it’s difficult to miss announcements of pregnancy on Facebook, sales on baby strollers, or the inundation of ads on TV for folic acid supplements.

We’re advised to take folic acid when trying for a baby, but why? What is it? When should you take it?

Folic acid/folate explained: the basics

Folate is a B-group vitamin (B9) needed for healthy growth and development. When the vitamin is found naturally in food, it is called folate, however it is referred to as folic acid when it is added to food or used as a dietary supplement. In other words, folic acid is the synthetic version of folate.

Like vitamin C, folate is a water-soluble vitamin that isn’t stored in your fat cells. This means your body cannot retain a reserve of folate and any excess is released through your urine. In order for your body to have enough folate, you need to keep up a regular intake either through a natural diet or supplements.

Why should I take folic acid supplements?

Folic acid is vital in ensuring our bodies create enough red blood cells, repair our DNA and aid cell growth. Especially important for women who are pregnant or planning to conceive, folic acid helps prevent the foetus from developing major congenital deformities of the brain or spine, including neural tube defects, such as spina bifida and anencephaly. Folate/folic acid also prevents the formation of cleft lip and palate, and may reduce the likelihood of a premature birth.

Taking folic acid may also decrease your risk of experiencing pregnancy-related complications, such as preeclampsia, heart disease, and stroke.

Depending on your diet, you may naturally consume enough folate most days, however taking either folic acid or multivitamin supplements may be a good way to keep track of your intake and be sure you’re taking enough.

When should I take folic acid, and how much should I have?

With so many supplement products on the market, it can be difficult to know what our bodies really need, and when. It may be confusing seeing advertisements that suggest taking folic acid supplements months before you aim to conceive, however, it may prevent neural tube defects, which occur at a very early stage of development – even before many women learn they’re pregnant.

It is recommended that you begin to take folic acid supplements at least one month before you want to conceive and continue during your pregnancy. The general recommendation is that women should take 400 -500 micrograms of folic acid per day during this time.

Some women will choose to take folic acid supplements specifically, while others may choose to monitor intake through multivitamins, a natural diet or a mix of both. Many multivitamins on the market do include the general recommended dose of 400 micrograms per day, however it is important to chat to your doctor before taking anything new, particularly if you are pregnant.

Women at a higher risk

There may be instances where your doctor may suggest taking more than the general recommended dose of folic acid – sometimes up to 10 times more than the dosage for pregnant women at low risk.

You may be at a greater risk having a baby born with a neural tube defect (NTD) if:

  • You already have a baby with a NTD
  • You personally have a NTD
  • You have a close relative affected by a NTD
  • You have type 1 diabetes
  • You are overweight

Folate as part of a natural diet: top folate-rich foods

As with most vitamins, it is best to try to include natural folate as part of your diet as much as possible before turning to upping your intake of supplements. Top folate-rich foods include:

  • Leafy or dark green vegetables such as spinach, asparagus, broccoli and lettuce
  • Cereals
  • Wholegrain bread
  • Bananas
  • Legumes such as beans and lentils
  • Mushrooms
  • Beef liver and kidney
  • Orange juice

Things to remember

You should not take folic acid supplements if you have ever had an allergic reaction to folic acid, and discuss any concerns with your doctor. There may be a number of reasons your doctor may recommend against taking folic acid supplements and you should let your doctor know if you have had any past health complications.

Like all supplements, folic acid may have some side effects in some people, particularly if taken in extreme doses for a long period of time. If you experience abdominal cramps, diarrhea, rashes, nausea or other painful of uncomfortable symptoms while taking folic acid or other vitamin supplements, you should chat to your doctor or specialist before continuing to take the supplements.

If you have been trying to have a baby and have any questions or concerns about your fertility, you can call our fertility nurses for a free chat.

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