A healthy diet pack full of leafy green vegetables is one of the best ways to ensure you and your baby get all the nutrients you need, but with a little parasite taking up residency in your womb, getting the goods isn't always so easy.
Folic acid for pregnancy is essential for the healthy growth and development of the foetus. You might be familiar with the supplement but, do you actually know what it is and why you're taking it?
Let's talk about what exactly folic acid is and why it is so important for growing a healthy baby.
What is folic acid?
Folic acid is a supplement all pregnant women should be taking.
The synthetic form of folate, a B vitamin that is found naturally in certain foods, folic acid is used by our bodies to create new cells and produce DNA which is essential for normal growth and development [1].
Even though there is natural folate, getting enough to ensure a healthy pregnancy isn't always easy, which is why folic acid supplements are so important.
The supplement is commonly added to foods such as bread and breakfast cereals and used in dietary supplements and multivitamin supplements.
What is the difference between folate and folic acid?
The difference between the two is that folic acid is the synthetic form of folate. Folate is a B vitamin that naturally occurs in certain foods such as leafy green vegetables, fruits and legumes and helps the body create new red blood cells that transport our oxygen.
It also aids in healthy foetal development and prevents birth defects. But before you go living off lettuce, eating folate-rich foods doesn't always cut it for pregnant women.
Many women have trouble absorbing the nutrient and folate is water-soluble which means it is easily destroyed in the cooking process. Hence the need for a synthetic form of the nutrient, a folic acid supplement.
Why do pregnant people need folic acid?
Folic acid reduces the risk of birth defects and helps your baby's brain and spinal cord develop. The most common birth defects associated with low levels of folic acid are neural tube defects.
Occurring in the brain and spinal cord, neural tube defects can have dire and deadly effects on the foetus [2].
Serious neural tube defects include:
- Spina bifida: This condition occurs when the baby's spinal column does not close during development [3]. The spinal cord is left exposed and prevents the nerves controlling the legs and certain organs from working. Spina bifida often causes lifelong disabilities and requires multiple surgeries throughout the child's life.
- Anencephaly: This condition means the baby's skull and brain have not fully developed within the womb [4]. It is almost always fatal with the majority of babies with anencephaly dying either before birth or soon after.
Low levels of folic acid have also been linked to miscarriages and anaemia, which is extremely common in women of childbearing age.
When should a pregnant person start taking folic acid?
Many birth defects occur within the first few weeks of conception before most women even know they're pregnant. So it might surprise you to learn that you should start taking folic acid before you even fall pregnant.
This is obviously only possible if you're pregnancy is planned, so if you have only started taking the supplements within your first trimester, don't stress.
Where possible, you should start taking folic acid supplements at least 1 month before conception and continue taking folic acid supplements about 3 months into your pregnancy.
Some experts recommend that all sexually active women take a daily folic acid supplement regardless of if they're trying to conceive.
How much folic acid should you take?
It is recommended that pregnant women take a daily folic acid supplement, however, the levels of folic acid required can change throughout your pregnancy journey.
Here's how much folic acid is recommended during different stages of pregnancy [5]:
- 400 mcg per day while you're trying to conceive.
- 400 mcg a day during the first trimester of pregnancy.
- 600 mcg is recommended a day from months 4-9 of pregnancy.
- 500 mcg of folic acid is recommended a day while breastfeeding.
Choosing a folic acid supplement can be tricky, as not all vitamins are created equally. Did you know that 1 in 3 women have issues absorbing folate?
So even if you are taking your daily dose, you still may not get enough folic acid.
What are the risks of high-dose folic acid supplementation?
Although folic acid is mostly beneficial there can be a risk of taking high-dose folic acid supplements. Your body absorbs 85% of the folic acid consumed from supplements, however, it only uses 50%.
Your liver can only process a certain amount which means excess folic acid can build up in your system which can be harmful.
The most common risks from too much folic acid are:
Accelerated mental decline from ageing
Excessive folic acid has been linked to cognitive decline in people with a pre-existing B12 deficiency.
A study showed that people over 60 were 3.5 times more likely to experience mental decline if they had excessive folic acid in addition to low vitamin B12 levels [6]. However, this link is not confirmed and more studies need to be done within the area.
Hide B12 deficiencies
High levels of folic acid can mask a b12 deficiency [7]. Vitamin B12 and folic acid are used by the body in similar ways so low levels of either can cause similar symptoms, meaning they are sometimes misdiagnosed as each other.
Prolonged B12 can cause nerve damage as well as complications in the formation of red blood cells which keep your heart, brain, and nervous system working properly.
Delayed brain development in children
Getting enough folic acid during pregnancy is essential to decrease the risk of birth defects.
However, getting too much can also have adverse effects on the baby. An excessive amount of folic acid has been shown to increase insulin resistance which can impede the brain development of the baby [8].
There are risks associated with taking folic acid supplements however they are relatively small. Getting adequate folic acid is essential during pregnancy for the healthy growth of your baby so any risks are outweighed by this.
If you are concerned about the risks of folic acid speak to your doctor and always monitor your dose.
Will folic acid increase the chances of pregnancy?
While the link between fertility and folic acid is not confirmed, the research is encouraging. Many studies have found that folic acid might increase your chances of falling pregnant [9].
Multiple studies have found that folic acid supplements can help to regulate menstruation and ovulation. So while folic acid itself might not be what helps you conceive, it can contribute to the overall process.
What happens if folic acid is not taken during pregnancy?
While you could be fine without folic acid, the risk of not taking it is too great. If you do not get adequate levels of folic acid and folate during pregnancy, there is an increased risk of your baby developing neural tube defects.
Neural tube defects affect the spine, spinal cord, or brain and can even cause death. Spina bifida and anencephaly are the two most common neural tube defects that can occur from inadequate folic acid consumption.
Taking folic acid daily is a surefire way to prevent birth defects and ensure your baby's healthy development.
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