Conception folic acid

Folic Acid | CDC

CDC urges all women of reproductive age to take 400 micrograms (mcg) of folic acid each day, in addition to consuming food with folate from a varied diet, to help prevent some major birth defects of the baby’s brain (anencephaly) and spine (spina bifida).

About folic acid

Folic acid is a B vitamin. Our bodies use it to make new cells. Think about the skin, hair, and nails. These–and other parts of the body – make new cells each day. Folic acid is the synthetic (that is, not generally occurring naturally) form of folate used in supplements and in fortified foods such as rice, pasta, bread, and some breakfast cereals

Why folic acid is important before and during pregnancy

When the baby is developing early during pregnancy, folic acid helps form the neural tube. Folic acid is very important because it can help prevent some major birth defects of the baby’s brain (anencephaly) and spine (spina bifida). The neural tube forms the early brain and spine.

Women of reproductive age need 400 mcg of folic acid every day

All women of reproductive age should get 400 mcg of folic acid every day to get enough folic acid to help prevent some birth defects because
- About half of U.S. pregnancies are unplanned, and
- Major birth defects of the baby’s brain or spine occur very early in pregnancy (3-4 weeks after conception), before most women know they are pregnant.

When taking folic acid, a higher dose than 400 mcg of folic acid each day is not necessarily better to prevent neural tube defects, unless a doctor recommends taking more due to other health conditions.
- When planning to become pregnant, women who have already had a pregnancy affected by a neural tube defect should consult with their healthcare provider. CDC recommends that these women consume 4,000 mcg of folic acid each day one month before becoming pregnant and through the first 3 months of pregnancy.

Learn more about CDC’s folic acid recommendations here.
Learn more about the recommended intake level of folic acid here.

When to start taking folic acid

Every woman of reproductive age needs to get folic acid every day, whether she is planning to get pregnant or not, to help make new cells.

Are folate and folic acid the same thing?

The terms “folate” and “folic acid” are often used interchangeably, even though they are different. Folate is a general term to describe many different types of vitamin B9.

Types of folate can include

Dihydrofolate (DHF)
Tetrahydrofolate (THF)
5, 10-methylenetetrahydrofolate (5, 10-Methylene-THF)
5-methyltetrahydrofolate (5-Methyl-THF or 5-MTHF)

Food fortification is a way to add vitamins or minerals, or both, to foods. Some rice, pasta, bread, and breakfast cereals are fortified with folic acid. These foods are labeled “enriched.” Folic acid is a specific type of folate that does not generally occur naturally.

Folic acid is the ideal form of folate to use for food fortification. It is more stable than types of natural food folate, which can easily be broken down by heat and light. Folic acid is better suited for food fortification because many fortified products, such as bread and pasta, are cooked.⁶

CDC recommends that women of reproductive age who could become pregnant consume at least 400 micrograms (mcg) of folic acid every day. However, it’s difficult to get 400 mcg of folic acid through diet alone. You can get 400 mcg of folic acid each day by taking a vitamin with folic acid in it, eating fortified foods, or a combination of the two, in addition to consuming a balanced diet rich in natural food folate.

How to get enough folic acid to prevent neural tube defects

In addition to eating foods with folate from a varied diet, women can get folic acid from

Taking a vitamin that has folic acid in it:
- Most vitamins sold in the United States have the recommended daily amount of folic acid (400 mcg) that women need for the prevention of neural tube defects. Vitamins can be found at most local pharmacy, grocery, or discount stores.
Eating fortified foods:
- You can find folic acid in some breads, breakfast cereals, and corn masa flour.
Getting a combination of the two: taking a vitamin that has folic acid in it and eating fortified foods.

If taking folic acid for reasons other than neural tube defect prevention, talk to your healthcare provider.

Learn more about where to find folic acid in the United States here.

More Information

For more information, visit the Frequently Asked Questions page.

You can also contact CDC-INFO in English or Spanish:

1-800-CDC-INFO (800-232-4636)
TTY: 1-888-232-6348
In English
en español

Folic Acid and Pregnancy (for Parents)

Reviewed by: Thinh Phu Nguyen, MD

Fetal Medicine at Nemours Children's Health

en español El ácido fólico y el embarazo

Having a healthy baby means making sure you're healthy too. One of the most important ways to help prevent serious birth defects in your baby is to get enough folic acid every day — especially before conception and during early pregnancy.

What Is Folic Acid?

Folic acid (or folate) is a B vitamin (B9) found mostly in dark green vegetables like broccoli and spinach, legumes such as beans and peas, and enriched grains.

What Are the Benefits of Folic Acid?

Women who are pregnant or trying to become pregnant should get at least 400 micrograms (0.4 milligrams) of folic acid daily before conception and for at least 3 months afterward. Studies show that this greatly reduces a baby's risk of serious neural tube defects.

What Are Neural Tube Defects?

Neural tube defects are birth defects that involve incomplete development of the brain and spinal cord. The most common neural tube defects are:

spina bifida: when the spinal cord and spinal column don't completely close
anencephaly: when the skull, scalp, and brain do not form properly
encephalocele: when brain tissue protrudes out to the skin through an opening in the skull

These defects happen during the first 28 days of pregnancy — usually before a woman even knows she's pregnant.

That's why it's so important for all women of childbearing age to get enough folic (FOE-lik) acid, not just those who are trying to become pregnant. Half of all pregnancies are not planned, so anyone who could become pregnant should make sure to get enough folic acid.

It's not clear why folic acid has such a profound effect on the prevention of neural tube defects. But experts do know that it's vital to the development of DNA. As a result, folic acid plays a large role in cell growth and development, as well as tissue formation.

How Can I Get Enough Folic Acid?

The U.S. Food and Drug Administration (FDA) requires food-makers to add folic acid to their enriched grain products. So you can boost your intake by eating breakfast cereals, breads, pastas, and rice that have 100% of the recommended daily folic acid allowance. Check the product's label for this information.

But for most women, eating fortified foods isn't enough. To reach the recommended daily level, you'll probably need a vitamin supplement. During pregnancy, you need more of all essential nutrients than you did before you became pregnant.

Prenatal vitamins shouldn't replace a well-balanced diet. But taking them can give your body — and your baby — an added boost of vitamins and minerals. Some health care providers recommend taking a folic acid supplement in addition to a prenatal vitamin. Talk to your doctor about your daily folic acid intake. They might recommend a prescription supplement, an over-the-counter brand, or both.

Also talk to your doctor if you've already had a pregnancy that was affected by a neural tube defect or if you or your partner were affected by one yourselves. The doctor may recommend that you take a higher dose of folic acid (even before a pregnancy).

Reviewed by: Thinh Phu Nguyen, MD

Date reviewed: July 2022

How to drink folic acid and why it is needed during pregnancy

During the bearing of a child, the female body consumes vitamins, trace elements in large quantities. All useful substances are needed, but vitamin B9 plays an important role in planning pregnancy. How much do you need to drink it to get pregnant, bear a child? Do Men Need to Administer Vitamin B9 Before Conception?

Why the body needs vitamin B9

Water-soluble vitamin enters the body with food, synthesized in the intestine. The main role is participation in the creation and support of the functioning of new cells. Therefore, folic acid when planning pregnancy is one of the prerequisites for successful conception. Vitamin performs the following functions in the body: nine0004

participates in DNA replication, production of erythrocytes and leukocytes;
folic acid affects the production of ribonucleic acid, RNA is contained in the cell nucleus, is involved in the coding and expression of genes;
promotes the absorption of proteins, other vitamins;
is part of the synthesis of neurotransmitters that regulate appetite, sleep;
supports fertility functions in women and men; nine0011
has an antioxidant effect, prevents the formation of malignant tumors;
helps to strengthen the protective functions of the body;
reduces the risk of developing atherosclerosis.

Vitamin B9 is included in the complex therapy in the treatment of disorders in the immune system, diabetes mellitus, intestinal diseases, inflammatory processes in the oral cavity and dermatological diseases. nine0004

Regularly taking B9 is necessary for people over 50 years old. The substance improves sleep, stabilizes blood pressure, reduces the risk of diabetes. Folic acid helps in the prevention of heart attack, heart disease and blood vessels, accelerating the process of cell regeneration, maintaining healthy skin and hair.

Important! Folates normalize the menstrual cycle, delay the onset of menopause. Affect ovulation - with regular use, anovulatory cycles are less common. nine0004

Positive effect

Doctors recommend that both parents drink folic acid before pregnancy 3-4 months before conception. This will help reduce the risk of developing various pathologies in the fetus and diseases in the mother.

The substance is involved in the laying of the cardiovascular, nervous system of the fetus, the work of immunity, affects hematopoiesis. With a deficiency, the facial bones are formed incorrectly, the child is born with a "cleft lip". With a lack of B9a newborn is often diagnosed with severe heart defects, defects in the development of the genitourinary system.

The dosage of preparations with folates at the stage of preparation for bearing a child, the doctor will select the future parents after the examination. Drinking folic acid during pregnancy is important for the normal formation of the placenta, the prevention of miscarriages, premature births, complications of the gestational period.

B9 deficiency leads to the development of congenital pathologies in the fetus. Therefore, it is important to start introducing folic acid in order to maintain a constant concentration of the substance in the body. Sign up for an online consultation if you need to choose a drug. Our doctors will remotely select analogues, recommend acceptable doses. nine0004

Norm and dosage

Artificial workers and children under 3 years old should be given 70 mcg per day, at 4-6 years old - 0. 1 mg. Then every three years you need to increase the dosage by 0.05 mg, by the age of 16 the daily dosage is 0.3 mg.

Dosages for planning conception for adults:

Name nine0061	Recommended daily dose, mcg
Folic acid rate	400
During pregnancy	460-800
lactation period nine0004	500

Men at the stage of preparation for conception are recommended to take up to 400 mcg of vitamin per day, in the pathological course of pregnancy - from 1500 mcg.

Why do men need

Folic acid for conception is also necessary for men so that a woman can become pregnant, endure and give birth to a healthy child.

Benefits of folate for men: nine0004

improve the production of viable sperm, increase their activity;
maintain the volume and quality of ejaculate;
reduce the risk of male infertility;

In addition, it has a beneficial effect on the work of the nervous, immune, digestive systems.

Important! Folates reduce the likelihood of mutations in male germ cells. This reduces the risk of fertilization of the egg by a sperm with defects, the development of genetic abnormalities in the fetus. nine0004

What is dangerous deficiency

If the process of formation of the neural tube is disturbed, the fetus develops defects that are incompatible with life:

anencephaly - complete or partial absence of the cerebral hemispheres, bones of the cranial vault, soft tissues;
splitting of the spinal column;
violation of the process of formation and development of various internal organs;
intrauterine fetal death. nine0011

Even if there are no congenital pathologies, with a lack of folate during pregnancy, children experience a delay in growth and development.

With a deficiency of B9, women develop folate deficiency anemia caused by impaired hematopoiesis in the bone marrow. Signs - pallor, weakness, lowering blood pressure, tachycardia, unstable stool, enlarged spleen. Other consequences may be:

depression; nine0011
disruption of the gastrointestinal tract, dyspeptic disorders;
deterioration in the condition of hair, nails;
infertility, early miscarriage, placental abruption, premature birth, stillbirth.

A man, against the background of a deficiency, has problems with spermatogenesis, the number of viable spermatozoa decreases, and infertility develops.

For vitamin B9 deficiencyMen have an increased risk of developing prostate and testicular cancer. Therefore, it is very important to take vitamin complexes in a timely manner. Since the market is full of vitamins, you need to understand which one is right for you. The doctors of the Teledoctor24 service will help you figure this out.

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Why there is a shortage

nine0002 Acute folate deficiency is rare, the substance is produced in the body in the required amount.

But this is subject to the normal functioning of the digestive system.

Vitamin B9 deficiency occurs in various pathological conditions in the body and an unhealthy lifestyle:

anemia;
diseases in which the process of absorption of nutrients in the intestine is disrupted;
long-term use of combined oral contraceptives;
bad habits, abuse of caffeinated drinks.

But adults planning to conceive should not take the beneficial substance in high dosages. With an excess of B9, bloating, a bitter taste in the mouth, nausea, and loss of appetite are disturbing. In rare cases, severe allergic reactions, fever, bronchospasm are observed. nine0004

Pay attention! Folate deficiency often occurs with strict diets, constant consumption of food after heat treatment.

Artificial or natural folates

To replenish vitamin B9, you can take special complexes or products. Products containing this vitamin are represented by a wide range, which includes beef liver, leafy greens, cod liver, walnuts, forest, mushrooms, millet, buckwheat, cheese, cottage cheese. nine0004

Synthetic folates have greater bioavailability. When using vitamin B9 with food, 1 mcg equates to 0.6 mcg of synthetic folic acid. After heat treatment, its amount is reduced by 90%, so it is necessary to use gentle cooking methods.

Reception features

The use of folic acid during the gestation period is necessary only under the supervision of a physician. Independently, focusing on the reviews, you can not prescribe vitamins for yourself. nine0004

Folate intake - things to remember:

If your doctor has prescribed prenatal vitamins with folate, you do not need to use additional folic acid.
Vitamin B9 should not be taken simultaneously with anticonvulsants, painkillers, antimalarial drugs, antibiotics and cytostatics, vitamin B12.
It is important to include folic acid in the diet every day, preferably at the same time. nine0011
Do not change the dosage yourself, follow the instructions for use.
When prescribing folates, it is imperative to warn the doctor about the presence of chronic diseases, the features of therapy.
Ascorbic acid promotes better absorption of vitamin B9.

Folacin is poorly or not absorbed at all when taken on an empty stomach, with smoking and alcoholism. Stress, lack of sleep, and overwork negatively affect the absorption process. nine0004

At the stage of pregnancy planning, you need to start taking folic acid 3-4, sometimes 6 months before conception. Usually the drug should be taken before childbirth and after the birth of the child.

Important! Folic acid should not be taken for allergic reactions, elevated estrogen levels, asthma, malignant tumors.

FAQ

How to recognize a folic acid deficiency?

Memory problems, irritability, lack of concentration, and irritability are common consequences of folate deficiency. Nausea and pain in the abdomen are disturbing, painful sores form in the mouth, the work of the heart and blood vessels is disrupted.

Can you get the amount of folic acid you need from foods?

A sufficient amount of the substance can be obtained from products. These are offal of poultry, liver, chickpeas, spinach, asparagus, broccoli. Folic acid is found in avocados, oranges, sunflower seeds. nine0004

Is it important to take folic acid to get pregnant?

For the development and growth of the fetus, new cells are needed, the formation of which is impossible without vitamin B9. Therefore, folic acid deficiency often occurs during pregnancy.

Expert opinion

Folic acid before pregnancy is one of the important elements at the planning stage of conception, during the gestation period. With a deficiency, pathologies of the neural tube of the fetus and other pathologies in the newborn occur. To avoid problems, both parents need to take folic acid 3-4 months before the planned pregnancy. nine0004

We publish only verified information

Article author

Menshikova Maria Viktorovna obstetrician-gynecologist nine0004

Experience 38 years

Consultations 1816

Articles 74

Specialist with extensive practical experience. He has a certificate of a mammologist, a certificate of professional certification. Participates in foreign business trips and individual training programs (Los Angeles).

1982 - 1986 NPO MONIIAG - obstetrician-gynecologist
1987 - 1989 VNITs OZMIR - obstetrician-gynecologist
1989 - 1992 departmental polyclinic st. Moscow - Kurskaya - obstetrician-gynecologist
1992 - 2001 NPO MONIIAG - obstetrician-gynecologist
2007 - 2008 NP KMIKM - doctor administrator
2009 - 2013 Pereslavl Central District Hospital, women's consultation - obstetrician-gynecologist
2020 to present Teledoctor24 LLC - doctor - consultant (gynecologist)

Folic acid for pregnancy planning

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home » About clinic » Folic acid when planning a pregnancy

Any woman who plans to become pregnant and become a mother in the near future should consciously and carefully prepare for this new status. And if everyone knows about a healthy lifestyle, parting with bad habits and walking in the fresh air, then expectant mothers often ignore the intake of certain vitamins and medicines before pregnancy. One such remedy is folic acid. nine0004

What is folic acid?

Folic acid is vitamin B9. Often you can hear the generalized name - folates, they are derivatives of this vitamin. We must understand that we get them from food, and folic acid tablets are a synthetic agent that is already converted into folates inside the body.

All derivatives of vitamin B9 play an important role in hematopoiesis, that is, the formation of new blood cells. Therefore, the lack of these substances leads to anemia - a condition in which there are not enough red blood cells, or they are irregular in shape and do not perform their functions. Folates have another very important feature: they stimulate the formation of nucleic acids (DNA and RNA), which are the basis of all body cells. Therefore, it is folic acid that is necessary for all rapidly dividing human tissues, including embryonic tissues. nine0004

The role of folic acid:

participates in the formation of DNA in all cells, that is, the source of hereditary information;
stimulates hematopoiesis;
indirectly blocks the formation of cancer cells;
restores muscle tissue;
during pregnancy: plays a role in the formation and development of the nervous tissue of the fetus, participates in the formation of placental vessels.

Why do you need folate during pregnancy? nine0006

During pregnancy, especially in the early stages, the consumption of folate increases dramatically. All cells of the embryo are intensively dividing in order to eventually form full-fledged tissues. The nervous tissue of the future man is transformed especially quickly and difficultly. And it is she who requires a large amount of folic acid.

Folic acid deficiency during pregnancy can occur due to the following reasons:

Insufficient intake of folate from food.
Genetic disorders of the folate cycle. In rare cases, a woman's body lacks the necessary enzymes (MTHFR). As a result, folic acid is not converted to folates, and they do not perform the necessary functions. Intermediate metabolic products accumulate in the body, which can lead to cardiovascular diseases, tumor processes, infertility and miscarriage. In the presence of such a mutation, it is recommended to take folic acid derivatives, for example, Metafolin. It is absorbed faster and in greater volume. nine0011
Certain anti-epilepsy and hormonal drugs dramatically lower blood folate levels:

oral contraceptives;
barbiturates, diphenylhydantoin;
sulfa drugs (for example, biseptol), which inhibit the synthesis of vitamin B9 by the intestinal microflora;
drinking alcohol also lowers their levels.

At what stage of pregnancy should I take folic acid supplements? nine0006

Folic acid intake to prevent fetal malformations should be started already at the stage of preparation for pregnancy, at least three months before the intended conception. That is why pregnancy should be planned. If conception occurred unexpectedly, then you need to start taking the drug as soon as it became known.

Reasons for taking folates at the stage of pregnancy planning:

With an unbalanced diet, a woman can have a low level of folic acid, so it takes time to replenish her reserves. It usually takes three to four months. nine0011
The neural tube of the fetus is laid at such an early stage that a woman may not yet be aware of the pregnancy, especially with a long menstrual cycle.
Folate deficiency can make pregnancy difficult.

Doctors at the Intime Family Planning Clinic give the following recommendations for taking folic acid: in most cases, three months before conception and throughout pregnancy, you need to take 400 micrograms of folic acid per day. In some cases, the dosage is advised to increase: up to 1 mg per day for epilepsy and diabetes; up to 4 mg per day if there have been children with neural tube defects in the past Increased doses of folates can only be prescribed by a doctor after a thorough examination. The dose of folic acid during pregnancy remains the same. nine0004

We wish you an easy pregnancy and healthy babies!

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