Folic acid plays a vital role in pregnancy and foetal development. Ideally, you should start taking this vitamin even before you start trying to conceive.
Curious about how much folic acid you should be taking and why?
We are breaking down everything you need to know about why it's so important to take folic acid for your general health as well as its importance when trying to conceive and in early pregnancy.
What is folic acid?
Folic acid is a synthetic form of the B vitamin, folate [1]. One of the many advantages of folic acid is that it is easily added to fortified foods, such as rice, pasta, bread and some breakfast cereals, or taken as a supplement.
While folic acid is made in a laboratory to be a similar chemical structure to folate, it is not identical. In fact, one of the main drawbacks of folic acid supplements is that they can be hard for our bodies to absorb effectively (but more on that in a minute).
What is folate?
Folate is the natural form of vitamin B9 in food [2]. Folate is derived from the Latin ‘folium’, meaning leaf — and yes, green leafy vegetables are some of the richest food sources of folate!
You'll also find folate in other vegetables such as beans and peas, nuts, and in fruits like oranges, bananas, and strawberries. This vitamin is needed to produce healthy red blood cells and for the rapid growth necessary in pregnancy and foetal development.
Folate also plays a vital role in breaking down homocysteine — an amino acid that can be extremely harmful to the body. Unlike folic acid (the most common ingredient used in prenatal supplements), methylated folate has high bioavailability.
This means it's easily absorbed by your body and can deliver the full benefits of this vitamin, without some of the nasty side effects of folic acid supplements.
What are the benefits of folic acid and folate?
There is a stack of benefits to consuming enough folate in your diet, these include:
Treating folate deficiency
A diet that lacks foods rich in folate can lead to a folate deficiency [1]. Folate deficiency can also occur in people who have a genetic mutation or have conditions such as coeliac and Crohn's disease as it can be harder for their body to absorb folate.
Folate deficiency can also cause anaemia. Anaemia is a condition in which you have too few red blood cells and affects the oxygen your tissue receives. Symptoms of a folate deficiency include fatigue, grey hair, mouth sores, tongue swelling, growth issues and more.
Taking a folate supplement is a great way to build up your folate and prevent folate deficiency, especially when trying to conceive and in early pregnancy.
Preventing birth defects and pregnancy complications
Folate is important for pregnancy because it can help prevent birth defects known as neural tube defects, such as spina bifida [3]. Spina bifida is one of the most common birth defects [4].
It occurs in the first four to six weeks of pregnancy when the brain and spinal cord are forming. The chance that pregnancy will be affected by a neural tube defect is less than one in 1,000.
Neural tube defects can be diagnosed during the 12-week ultrasound scan, but are more likely to happen during the anomaly scan that is carried out at around weeks 18 to 20.
The good news is that most cases of neural tube defects can be prevented if you have enough folate before and during early pregnancy.
Supporting brain health
More and more evidence suggests that folate is essential for brain health — across all age groups, particularly older people [5].
Folate and folic acid supplements have been used to treat people suffering from memory loss, Alzheimer's, and Dementia and there's evidence that suggests elderly people who take large amounts of folic acid can decrease their chances of developing Alzheimer's [5].
Reducing the risk of heart disease
Folate and folic acid have also been known to decrease heart risk by breaking down homocysteine, an amino acid that may damage the inner walls of arteries. This type of damage can boost the risk of a stroke or heart attack.
A review that included 30 studies with more than 80,000 total participants showed that supplementing with folic acid led to a four per cent reduction in overall heart disease risk and a 10 per cent reduction in stroke risk [6].
Folic acid side effects
Generally, when taken orally, and at appropriate doses, folic acid is safe. However, you should not consume folate in supplements or fortified foods and beverages in large amounts, unless recommended by a healthcare provider.
In some people, the process of digesting folic acid can be slow and inefficient and this can mean a build-up of levels in the body. Where normally your body can get rid of excess folic acid in your urine, a malfunctioning metabolism can affect this [7].
Side effects of folic acid may include:
- Nausea
- Bad taste in the mouth
- Loss of appetite
- Confusion
- Irritability
- Sleep pattern disturbance
It's also important to be aware that folic acid supplementation during pregnancy can also increase the risk of infant asthma. More severe symptoms may include difficulty breathing, and itchy or swollen skin.
If you think you are having a severe reaction make sure you seek medical attention straight away.
What are the benefits of folic acid for men?
A folate deficiency is less common in men, but taking a supplement can improve heart health, hair, mental health conditions like depression and, of course, fertility.
Women aren't the only ones to benefit from folic acid during conception. One study showed that men who consume high levels of folic acid through the foods they ate (over 700 mcg a day) actually lowered their risk of sperm abnormalities by up to 20 per cent [8].
Can men take folate?
Yes! There is substantial evidence to support the role of folate in sperm development. However, as with any supplements, it's important to consult a GP before kicking off a folic acid regime.
How folate is absorbed in the body
It's good to know that folic acid and folate are absorbed differently in the body.
Natural folate from foods is easier for the body to absorb, while folic acid requires an additional processing step in your liver to be converted to folate before it can be used by your body.
When should you take folic acid supplements?
The best way to ensure you're getting enough folate before conceiving and in the early stages of pregnancy is to take a daily folic acid supplement. A supplement form of folic acid is actually better absorbed than that from food sources — 85 per cent vs. 50 per cent, respectively [2].
And, while folic acid is generally used in most prenatal supplements, it's not the most effective kind of folate.
In fact, one in three people actually have trouble absorbing folic acid due to a common genetic variant, which is why Kin's Prenatal contains methylated folate, which can be absorbed by everyone, while also being necessary for early neural development.
Medical professionals recommend you take folate as soon as you start trying for a baby (or ideally for three months before) and during the first 12 weeks of pregnancy.
You might want to continue taking folic acid after the 12-week mark too, to help make blood – especially if you are at risk of anaemia. It's also safe to continue taking folic acid while breastfeeding.
How much folic acid should you take?
According to the Australian Dietary Guidelines, the recommended dietary allowance for people planning a pregnancy is at least 400 micrograms (0.4mg) of folic acid or folate per day [9].
However, this amount may be increased by your doctor if you're at risk of having a baby with a neural tube defect — usually to around 500 micrograms (0.5mg).
Why would a doctor prescribe folic acid?
If you are in the risk category for having a baby with a neural tube defect, your GP may prescribe a folic acid or a folate supplement.
Typical higher risk factors include previously having a pregnancy affected by a neural tube defect, a family history of neural tube defects (particularly on the biological father's side), having diabetes or sickle cell disease, and/or being overweight [10].
Is it good to take folic acid every day?
Totally! You don't have to be pregnant, or be thinking of trying for a baby to take folic acid. Good nutrition is for everyone, and folic acid has proven benefits of keeping red blood cells healthy, lowering the risk of heart disease and boosting brain function.
Before starting any folic acid supplements, it's best to consult your doctor so they're aware and can investigate whether or not you need dietary supplements.
When it comes to giving your baby the best start in life, the nutrients you consume (even before you start trying) matter.
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