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Folic acid, or folate, is a B vitamin. The word folate comes from folium the Latin word for leaf. Folate happens naturally in food, particularly in dark, green leafy vegetables. Folic acid is the synthetic form supplied in multivitamins and foods fortified with folic acid. Researchers discovered folate’s importance in preventing anemia about 70 years ago. But only in recent years have they learned of the link between folate deficiency and certain birth defects. Why is folic acid important?Most people have heard about the importance of folic acid for women during their childbearing years. But what’s all the fuss about? Getting enough folic acid can reduce the risk for neural tube defects (NTDs). Folic acid only helps, however, if it’s taken before getting pregnant and during the first trimester of pregnancy. What is the role of folic acid in preventing birth defects?A critical period of fetal development happens during the early weeks of pregnancy, often before a woman is aware she is even pregnant.
One of the earliest structures to form is the neural tube. This structure is flat at first, but rolls into a tube by only 1 month after conception to become the brain and spinal cord. Without enough folic acid, the cells in this structure can’t function or grow properly and the tube doesn’t close. The spine, skull, and brain can be affected, with open or closed abnormalities. Two of the most common types of NTDs are spina bifida and anencephaly. Spina bifida is a condition in which a portion of the spinal cord and the surrounding structures develops outside, instead of inside the body. Anencephaly is a condition in which the brain and skull bones do not form properly and results in parts of the brain being absent. Researchers have found that the risk for NTDs is significantly lowered when a woman gets extra folic acid in addition to a healthy diet from 1 month before conception through 2 to 3 months after becoming pregnant.
Folate happens naturally in many foods, like dark, leafy green vegetables, legumes (dried beans and peas), and fruits (oranges, bananas, melons, and most berries. But often it’s not enough. To help women get the amount they need, the FDA requires folic acid to be added to enriched breads, breakfast cereals, pastas, rice, and other grains. The developing baby needs folate to make healthy new cells, and to make DNA and RNA (genetic material). These are cell-building blocks. Folate also is essential to form normal red blood cells and certain amino acids. These are important functions during pregnancy and infancy. This is a time when cells rapidly divide and grow. How much folic acid is recommended for women of childbearing age?Women who may become pregnant should take a supplement containing 400 mcg of folic acid. To help reduce your risk, take the folic acid supplement in addition to eating foods naturally rich in folate and those fortified with folic acid. Because some women will need additional folic acid, it’s important to talk with your health care provider about the amount that is right for you. While some birth defects can be prevented through prenatal care, it's important to know what treatments may exist if your fetus is diagnosed with a birth defect.
Folic acid is a vitamin that every cell in your body needs for healthy growth and development. If you take it before pregnancy and during early pregnancy, it can help protect your baby from birth defects of the brain and spine called neural tube defects. The neural tube is the part of a developing baby that becomes the brain and spinal cord. NTDs happen in the first month of pregnancy, before you may know that you’re pregnant. This is why it’s important to have enough folic acid in your body before you get pregnant. NTDs affect about 3,000 pregnancies each year in the United States. If all women take 400 micrograms (also called mcg) of folic acid every day before getting pregnant and during early pregnancy, it may help prevent up to 7 in 10 (70 percent) NTDs. Because nearly half of all pregnancies in the United States are unplanned, all women who can get pregnant should take folic acid every day. Some studies show that folic acid also may help prevent birth defects in a baby’s mouth called cleft lip and palate. A cleft lip is a birth defect in which a baby’s upper lip doesn’t form completely and has an opening in it. How can you get enough folic acid?There are several ways to get enough folic acid:
How much folic acid do you need?Here’s what you need to know about taking folic acid to prevent NTDs: Most women
Take a vitamin supplement with 400 mcg of folic acid each day, even if you’re not trying to get pregnant. During pregnancy, take a prenatal vitamin each day that has 600 mcg of folic acid in it. Folic acid only works to prevent NTDs before and during the first few weeks of pregnancy. Later in pregnancy, you need 600 mcg of folic acid each day to help your baby grow and develop. Women at high risk for NTDs
Studies show that taking 4,000 mcg of folic acid before and during early pregnancy can help reduce your risk of having another baby with an NTD by about 70 percent. Ask your provider how to safely get this much folic acid. It’s not safe to take several multivitamins or prenatal vitamins because you can get too much of other nutrients, which may be harmful to your health. Your provider can help you figure out the best and safest way for you to get the right amount of folic acid. How can you get folic acid from food?You can get folic acid from food. Some foods are fortified with folic acid. Fortified means a food has folic acid added to it. Check the product label to see how much folic acid you get in each serving. Look for the word “fortified” or “enriched” on labels on foods like:
Some fruits and vegetables are good sources of folic acid. When folic acid is found naturally in food it’s called folate. Foods that are good sources of folate are:
It’s hard to get all of the folic acid you need from food. Even if you eat foods that have folic acid in them, take your vitamin supplement each day, too. How do you read a product label to see how much folic acid is in a vitamin supplement?To find out if a vitamin supplement has folic acid in it, check the label (also called supplement facts). The label is usually on the back of the bottle. Look for the word “folate” on the label to see how much folic acid you’re getting. The label tells you this information:
Labels on food products don’t always list the amount of folic acid in the product. Newer food labels that list folic acid will list mcg DFE of folate, just like for vitamin supplements. If you have an MTHFR variant, can taking folic acid help prevent NTDs in your baby?Yes. If you have an MTHFR variant, taking 400 mcg of folic acid every day before and during early pregnancy can help prevent NTDS in your baby. MTHFR stands for methylenetetrahydrofolate reductase. It’s an enzyme (protein) that helps your body break down and use folate. One MTHFR variant (called MTHFRTT or CT genotype) is a change in your body’s MTHFR gene that makes you use folate more slowly than usual. Genes are parts of your body’s cells that store instructions for how your body grows and works. They are inherited (passed from parents to children). MTHFR variants are inherited. If you know you have an MTHFR variant or you think it runs in your family, talk to your provider. Your provider may want to test you for an MTHFR variant if you have high levels of a substance in your blood called homocysteine. Too much homocysteine in your blood can cause heart conditions, blood clots and stroke. You can find out your homocysteine levels with a blood test. If your level is high, you can have a genetic test to see if you have an MTHFR variant. A genetic test looks for changes in genes that can cause birth defects or other medical conditions. You may have heard not to take folic acid if you have an MTHFR variant because it can increase your risk of pregnancy complications and your baby having health problems. The Centers for Disease Control and Prevention (also called CDC) recommends that all women take 400 mcg of folic acid every day before and during early pregnancy. If you have an MTHFR variant, talk to your provider. Additional versions of this article are available in: Arabic, Chinese Simplified, Hindi, and Urdu Folic Acid Health Action Sheet More informationLast reviewed: May 2020 |