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Pregnancy and Folic Acid

Posted Dec 02 2008 11:29am

What are folate and folic acid?

Folate (FOH-layt) is a vitamin found naturally in many foods. Folate helps your body make new cells.

Folic (FOH-lik) acid is the man-made form of folate. It can be taken in vitamin pills. It is also added to many grain products. These include cereals, breads, and flours.

Why do women need folate?

Folate helps keep your blood healthy. Not getting enough can cause a type of anemia (uh-NEE-mee-uh). Having anemia means you have fewer healthy red blood cells than normal. This makes it hard for your blood to carry enough oxygen throughout your body.

Signs that you may have anemia:

    * Feeling very tired
    * Headache
    * Sore mouth and tongue
    * Pale skin

Folate can also help prevent some birth defects (problems with the baby). Getting enough folate before and during pregnancy can help prevent certain defects of the baby’s spine and brain:

    * Spina bifida (SPEYE-nuh BIF-ih-duh) is a problem with the spine. The nerves that control leg movements and other functions do not work. Children with spina bifida often have lifelong disabilities. They may also need many surgeries.

    * Anencephaly (an-en-SEF-uh-lee) is when most or all of the brain does not develop. Babies with this problem die before or shortly after birth.

Experts think that folate might also help prevent:

    * some cancers
    * Alzheimer’s (AWLTS-heye-merz) disease
    * hearing loss as you age

More research is needed to know this for certain.

How much folate should women get each day?

Most women need 400 micrograms (mcg) of folate each day, even if they are not planning to get pregnant. Folate is needed before and during the first weeks of pregnancy to help prevent birth defects. Because half of all pregnancies in the U.S. are not planned, women who can become pregnant should aim to get 400 mcg folate each day. That way, if they do become pregnant their babies will be less likely to have birth defects.

Some women need more folate each day:

    * If you are pregnant, you need 600 mcg.
    * If you are breastfeeding, you need 500 mcg.

Talk with your doctor about how much folic acid to take if:

    * You had a baby with spina bifida or anencephaly and want to get pregnant again. Your doctor may give you a prescription for 4,000 mcg folic acid. That is 10 times the normal dose. Taking this high dose of folic acid can reduce your chances of having another baby with these birth defects.

    * You have a family member with spina bifida. Your doctor may give you a prescription for 4,000 mcg folic acid.

    * You have spina bifida and want to get pregnant.

    * You are taking medicines that affect how your body uses folate. These include some of the medicines for:
          o Epilepsy
          o Type 2 diabetes
          o Rheumatoid arthritis
          o Psoriasis
          o Inflammatory bowel disease

    * You have kidney disease and are on dialysis.

    * You have liver disease.

    * You have celiac disease.

    * You abuse alcohol.

How can women get enough folate or folic acid each day?

The easiest way is to take a vitamin pill. Most U.S. multivitamins have 400 micrograms (mcg) folic acid. Check the label on the bottle to be sure. Or you can take a pill that only contains folic acid.

Not all vitamin bottles have the amounts of vitamins that their labels say they do. And they may contain harmful chemicals. When choosing a brand of vitamins, look for a mark that says USP or NSF. These "seals of approval" mean that the pills are safe and have the amounts of vitamins stated on the label.

You can also eat foods that are high in folate, such as:

    * Beans and lentils
    * Peas (black-eyed peas, chickpeas, green peas)
    * Juices (orange, tomato, grapefruit, pineapple)
    * Fruits (oranges, cantaloupe, honeydew melon, avocado, papaya, raspberries)
    * Soymilk
    * Vegetables (green leafy vegetables such as spinach, lettuce, turnip greens, mustard greens, collard greens, and Chinese cabbage; broccoli; Brussels sprouts; asparagus; artichokes; okra; corn; cauliflower; potato; beets; green onions; sweet red peppers)
    * Nuts
    * Sunflower seeds
    * Peanuts and peanut butter
    * Liver
    * Giblets

You can also eat foods that have had folic acid added to them, such as:

    * Breakfast cereals (Some have 100% of the Daily Value of folic acid in each serving)
    * Breads
    * Flours
    * Pastas
    * Cornmeals
    * White rice

Check the label on the package to see if the food has folic acid. The label will tell you how much folic acid is in each serving. Sometimes, the label will say folate instead of folic acid.

Can women get too much folate or folic acid?

You can't get too much folate from foods that naturally have folate. But it is possible for some people to get too much folic acid. Taking more than 1,000 mcg of folic acid a day may cause nerve damage in people who do not have enough vitamin B12 in their bodies. People at risk for not having enough vitamin B12 include:

    * People who don’t eat meat, eggs, or dairy products (vegans)
    * People ages 50 years and older

Source: National Women’s Health Information Center, U.S. Department of Health and Human Services,

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