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Should I take more folic acid?

In medicine it is well known that woman who have diets rich in folic acid or take folic acid supplements, reduce the incidence of conditions like Spina bifIda in their babies. However experts are now worried that most women are not getting enough folic acid and are not taking it at the right times.

What is folic acid?

Folic acid is a chemical belonging to the B group of vitamins. It is also known as vitamin B9, folacin and folate. Folic acid is needed by the human body for development and maintenance of the nervous system. This is especially important for the developing foetus and preventing against many congential defects that may affect the spine, brain, heart, limbs and palate.

It also plays a crucial role in the manufacture of our DNA, which is the bodies genetic blue print. Research also suggests that it may have role in protecting us from heart disease. The mineral however has to be taken from our diet as the body is unable to manufacture it, however it is only needed in very small amounts.

Where do I get folic acid from?

I always stress this; we should be able to get all the necessary nutrients from a balanced diet. However with today's lifestyle this isn't always possible and sometimes supplements maybe required. Foods that are rich in folic acid tend to be leafy vegetables which are dark green in colour. Good sources of folic acid are:

Spinach, kale, Brussels sprouts
Beans and legumes
Yeast and beef extracts
Fortified cereals

How much folic acid do I need?

Adults need about 200 micrograms per day, it is thought that a balanced diet should provide this amount. However women who are planning to have a baby need to increase this by an additional 400 micrograms per day so that their total intake is around 600 micrograms per day. They need to be taking this additional 400 micrograms (total 600 micrograms) up to and including the 12th week of pregnancy.

When do I need to increase my folic acid intake?

Medical science understands that the first 4 weeks of pregnancy is when the most important neurological development occurs. It is during this time that the spinal cord develops and during this time when having sufficient levels of folic acid is crucial. Currently it is recommended that women trying to get pregnant should be taking extra folic (up to 600 micrograms per day in total) acid at least 3 months before becoming pregnant and for up to 12 weeks in to the pregnancy.

Can too much folic acid be harmful?

It is important to always discuss increase supplementation with your doctor. Especially if you're on medication. There are certain conditions like Epilepsy, where certain medications may be affected by an increase in folic acid supplementation.

It is also important not to be over zealous with folic acid supplementation, especially as daily amounts in excess of 1000 micrograms may mask anaemia caused by vitamin B12 deficiency. Vitmain B12 is also crucial for healthy nerve cell function and DNA formation.

There is some research that taking over 700 micrograms may increase the risk of conditions that cause cognitive decline later on in life, at present this requires further research and it is doubtful that the average adult would consume that much per day without a large amount of additional supplementation.

Take home messages

Speak to your doctor first
Ensure you have a balanced diet
The additonal 400 micrograms is only required 3 month prior conception to 12 weeks in to the pregnancy.

Dr Shazan Chughtai MB BS

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