Folate or folic acid prenatal

Folate and Folic Acid in Pregnancy

Folate and its cousin folic acid are vital for developing a healthy baby because it prevents neural tube defects. Since the neural tube develops within the first 28 days of pregnancy, it is recommended all women of childbearing years consume folate. Folate prevents certain heart abnormalities, cleft palate and cleft lip. It also lowers the risk of developing anemia, miscarriage, preterm delivery and low birth weight. It can be found in fortified breakfast cereals, lentils, spaghetti, rice, beans, broccoli, orange juice, spinach and strawberries.

Folate (vitamin B-9) is important in red blood cell formation and for healthy cell growth and function. The nutrient is crucial during early pregnancy to reduce the risk of birth defects of the brain and spine. The recommended daily amount of folate for adults is 400 micrograms (mcg). Women who are planning pregnancy or could become pregnant are advised to consume 400 to 1,000 mcg of folic acid a day.

Folate is found mainly in dark green leafy vegetables, beans, peas and nuts. Fruits rich in folate include oranges, lemons, bananas, melons and strawberries. The synthetic form of folate is folic acid. It’s in an essential component of prenatal vitamins and is in many fortified foods such as cereals and pastas.

A diet lacking foods rich in folate or folic acid can lead to a folate deficiency. Folate deficiency can also occur in people who have conditions, such as celiac disease, that prevent the small intestine from absorbing nutrients from foods (malabsorption syndromes).

What’s the difference between Folic Acid and Folate?

People often use the two interchangeably as they are both forms of vitamin B9 but in fact there is an important difference. Folic acid is the synthesized version that is commonly used in processed foods and supplements. Folate can be found in whole foods such as leafy vegetables, eggs, and citrus fruits.

Research on use of folate and oral folic acid supplements for specific conditions shows:

Birth defects. Research has shown that folic acid supplements can prevent birth defects of the neural tube. Taking a daily prenatal vitamin — ideally starting three months before conception — can help ensure women get enough of this essential nutrient.
Folic acid deficiency. Nutritional folate deficiency is treated with oral folic acid supplements. This type of deficiency is no longer a problem in many countries that fortify foods such as cereal and pasta with folic acid.
Heart and blood vessel disease and stroke. Folic acid works with vitamins B-6 and B-12 to control high levels of homocysteine in the blood. Elevated homocysteine levels might increase your risk of diseases of the heart and blood vessels (cardiovascular disease).
Cancer. Some research suggests that folate might reduce the risk of various cancers.
Depression. Some evidence suggests that folic acid might be helpful in treating depression.
Dementia. There isn’t enough evidence to support folic acid supplementation for the prevention of dementia.

Dr. Chris D. Meletis explains how genetics can determine how well your body metabolizes Vitamin B9

It is estimated that between 25 and 60 percent of the population have a variation in one of their MTHFR genes that negatively impacts their ability to convert folic acid (the synthetic version of B9), and even some of the folate that naturally occurs in foods, into the active form of folate. If you are trying to get pregnant, consider getting your genes tested to determine if you have the MTHFR genetic variation. Knowledge will give you the power to make informed choices about your unique nutritional needs, including whether or not you should choose prenatal and fertility supplements that contain the active, methylfolate form of folic acid.

MTHFR Converts Synthetic to Bioactive Vitamin B9

Vitamin B9 is found as either the synthetic form (folic acid) that appears in many vitamin supplements and fortified foods or the naturally occurring form found in foods (folate). Both the synthetic and most of the food-derived folate we consume must be converted via a natural enzyme pathway in our body to the final bioactive form called L-methylfolate (also known as 5-MTHF). Once MTHF is created, this active form of B9 can enter cells and cross over the blood brain barrier to help nourish our tissues and brains. Successful conversion from folic acid or folate to MTHF is dependent upon a converting enzyme known as MTHFR.

MTHFR is the cause of elevated homocysteine levels tied to frequent miscarriages

Homocysteine is a naturally occurring amino acid produced when proteins are broken down in the body. It is not harmful at low levels, but when present in high concentrations it can lead to a condition called hypercoagulability, in which your blood tends to clot more easily than it should. Women with elevated homocysteine levels are believed to be at higher risk for miscarriage, preeclampsia and even preterm labor – most likely due to the increased clotting caused by the elevated homocysteine levels.

Why do homocysteine levels become elevated? Methylfolate, the active form of folic acid, plays a role in converting homocysteine into methionine (a harmless amino acid), so if methylfolate is lacking due to the MTHFR mutation and subsequent inability to convert folic acid to methylfolate, homocysteine can build up to dangerous levels.

Researchers have discovered an association between high homocysteine levels and recurrent miscarriage, which suggests that the MTHFR genetic variation may play a role in pregnancy loss.

The link between MTHFR and PCOS

The most common specific condition that causes infertility in women is polycystic ovary syndrome (PCOS). Women with PCOS are prone to hormonal and metabolic imbalances, including blood sugar dysregulation, also known as insulin resistance. These metabolic issues can cause chronic anovulation (when ovaries do not release an oocyte during a menstrual cycle), oligomenorrhea (irregular periods), hyperandrogenism (too much testosterone) and insulin-resistance. Given this wide range of fertility-related symptoms, it is not surprising that PCOS is a leading cause of infertility.

Many studies are being done to understand the underlying causes of PCOS. A 2014 study found a connection between PCOS and MTHFR gene mutations, with the researchers concluding that a specific MTHFR mutation increases susceptibility to PCOS. The common thread between MTHFR and PCOS once again has to do with homocysteine levels. In general, the most common cause of elevated homocysteine levels (hyperhomocysteinemia) is reduced activity of MTHFR, which results in reduced production of methylfolate. Women with PCOS typically test positive for higher homocysteine levels than other healthier women. Many more studies are currently underway to determine the exact relationship between MTHFR and PCOS.

Our Ultimate Fertility Resource Guide provides the information you need on fertility, tips on how to get pregnant faster, and how to boost fertility through sometimes simple tweaks to your lifestyle and approach. The guide is easy to read and meant for anybody wanting to increase their ability to conceive. It’s a free download and includes coupon codes for essential products. Even free Nightfood Nighttime Ice Cream.

Want to Know More?

Infertility 101: What You Need to Know First
Male Infertility
Female Infertility
Infertility Medications

References

Folate (folic Acid) Mayo Clinic
Effects of myo-inositol, gymnemic acid, and L-methylfolate in polycystic ovary syndrome patients. Gynecol Endocrinol. 2017 Dec 21:1-7.
Maternal folate, alcohol and energy metabolism-related gene polymorphisms and the risk of recurrent pregnancy loss. J Dev Orig Health Dis. 2012 Oct;3(5):327-32.
Association of methylenetetrahydrofolate reductase gene C677T polymorphism with polycystic ovary syndrome risk: a systematic review and meta-analysis update. Eur J Obstet Gynecol Reprod Biol. 2014 Jan;172:56-61.
MTHFR C6777T polymorphism is associated with hyperlipidemia in women with polycystic ovary syndrome. J Hum Reprod Sci. 2012 Jan-Apr; 591):52-56.
Association of the maternal MTHFR C677T polymorphism with susceptibility to neural tube defects in offsprings: evidence from 25 case-control studies. PLoS One 2012:7(10):e41689.

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

What is folic acid and when should I take it?

Folic acid is one of the most important prenatal vitamins. Taking the recommended 400 micrograms of folic acid before and during pregnancy can help prevent birth defects in your baby's brain and spinal cord. In addition to taking vitamins, experts recommend including natural sources of folic acid in the diet.

Folic acid

Definition

Folic acid is an artificial form of the B vitamin called folate. Folic acid plays an important role in the production of red blood cells and helps your baby's neural tube develop into the brain and spinal cord. The best food sources of folic acid are fortified cereals. Folic acid is found naturally in dark green vegetables and citrus fruits.

When should I take folic acid?

Birth defects in an unborn child occur during the first 3-4 weeks of pregnancy. Therefore, your folic acid content is very important in those early stages when your baby's brain and spinal cord are developing.

Doctors often recommend starting prenatal vitamins with folic acid well before pregnancy. A US Centers for Disease Control and Prevention study found that women who took folic acid at least a year before pregnancy reduced their chances of having an early birth by 50% or more.

By 50%

This is how much the risk of early birth is reduced by taking folic acid a year before pregnancy, according to a US CDC study.

Doctors recommend that you start taking folic acid every day, at least a month before you become pregnant, and every day during your pregnancy. If you did not take folic acid before conception, you should start as soon as you know you are pregnant. In addition, doctors recommend that all women of childbearing age take folic acid every day. The general consensus among physicians is that folic acid supplementation should be started as early as possible. The earlier the better.

Even if you choose prenatal vitamins yourself, please take it to your OB/GYN as soon as you become pregnant. The doctor needs to make sure that it contains the recommended amount of folic acid.

Not all prenatal vitamins are the same, and some may have more or less of the vitamins and minerals you need.

How much folic acid should I take?

The recommended dose for all women of childbearing age is 400 micrograms of folic acid per day. If you are taking a multivitamin every day, please make sure it contains the recommended amount of folic acid. If for some reason you don't want to take a multivitamin, you can take a folic acid supplement.

Here is how much folic acid is recommended to take each day in terms of pregnancy:

400 mcg Before pregnancy

400 mcg First 3 months of pregnancy

600 mcg 4 to 9 months of pregnancy

500 mcg During breastfeeding 9002

Without enough folate in your body, your child's neural tube may not close properly. Because of this, he can develop health problems called neural tube defects.

Pathologies:

Spina bifida
Anencephaly
Cleft lip and palate
Prematurity
Low weight
Miscarriage
Poor growth in the womb

Infants with anencephaly usually do not live long, and those who develop spina bifida may be permanently disabled. The good news is that getting enough folic acid can protect your baby from neural tube defects by at least 50%. Studies show that if you've already had a child with a neural tube defect, taking enough folic acid can reduce your risk of having another child with a neural tube defect by as much as 70%.

70% Lower risk

This is how much the risk of having a child with a neural tube defect is reduced when taking folic acid, even if you have already had a child with this pathology.

If you had a previous child with a neural tube defect, it is recommended that you increase your daily folic acid to 4000 mcg (4 mg) each day. Before taking any dosage, we strongly recommend that you consult with your doctor about how much you should be taking.

Folic acid reduces the risk of development:

Complications of pregnancy
Diseases of the heart
Stroke
Some cancers
Alzheimer's disease

How to include folic acid in the diet?

Try to eat green leafy vegetables that contain folic acid, as well as breakfast cereals and fatty spreads with folic acid.

Natural sources of folate:

400 mcg:

Breakfast cereal, fortified with 100% DV, 3/4 cup

215 mcg:

Beef liver, boiled, stewed, 3 oz.

179 mcg:

Lentils, mature seeds, boiled, 1/2 cup

115 mcg:

Spinach, frozen, boiled, boiled, 1/2 cup , 1/2 cup

100 mcg:

Breakfast cereal fortified with 25% DV, 3/4 cup

90 mcg:

White beans, boiled, 1/2 cup

The amount of folic acid recommended for a healthy pregnancy is difficult to obtain from food alone, so it is important to take folic acid supplements. Take a 400 mcg folic acid tablet every day before pregnancy and up to 12 weeks of pregnancy.

Vitamins are not everything

In addition to spontaneous genetic pathologies, there are also hereditary ones. Many of them may not manifest themselves in any way in parents, but they will significantly reduce the quality of life of the child.

Learn more

Are folate and folic acid the same thing?

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

Folic acid types may include:

Dihydrofolate (DHF)
Tetrahydrofolate (THF)
5, 10-methylenetetrahydrofolate (5, 10-methylene-THF)
5-methyltetrahydrofolate (5-methyl-THF or 5-MTHF)

Genetic consultation

If you are just preparing for pregnancy, you should not only adjust your diet and start taking prenatal vitamins, but also consult a geneticist. Taking folic acid does not exclude many other hereditary pathologies, which can only be detected through genetic tests.

What is folic acid and why is it useful: 6 scientific facts

January 19, 2022 read 7-10 minutes

Folic acid is an essential vitamin for expectant mothers. It is important for heart health, helps in cancer prevention, and promotes brain health. Let's figure out what else vitamin B9 is useful for and what foods it is contained in.

In the middle of the 20th century, American biochemists struggled with the secret of a substance that helps pregnant women with megaloblastic anemia. At 19In 1941, they managed to obtain folic acid from spinach leaves, and by 1945 they were able to synthesize it chemically.

The material was commented by Maria Volchenkova, a nutritionist at Best Doctor, a clinical psychologist, a member of the Russian Union of Nutritionists, Nutritionists and Food Industry Specialists, an expert in working with DNA tests.

What is folic acid

Folic acid is a water-soluble analog of vitamin B9 created by scientistsessential for the proper development of the circulatory and immune systems. In 1931, the existence of an unknown substance that helps pregnant women overcome megaloblastic anemia was reported by doctor and researcher Lucy Wills. She noticed that her patients get better after taking the yeast extract.

Only ten years later, scientists were able to establish that this substance was folate, and remove it from spinach leaves. And for the first time it took 4 tons of plants. The drug was called folic acid - from the Latin word folium (leaf). K 19In 1945, they learned how to synthesize it chemically.

Folic acid and all its derivatives are classified as folates. However, there are some differences between the artificial vitamin and B9 found in foods in how they are absorbed and act on the body.

Folate is found in beans, broccoli, leafy vegetables, eggs, beef liver, etc. Remember: the more processed the products are, the less useful substances remain in them. Folic acid supplements are not necessary if a person leads a healthy lifestyle and eats a balanced diet.

What is folic acid good for

We store most of our folate stores in the liver, and the rest in the blood and tissues. This substance is critical for a wide range of functions in the body:

production and health maintenance of new cells;
DNA replication process;
cell division;
metabolism of nucleic and amino acids;
maturation of erythrocytes.

Folate deficiency is associated with an increased risk of megaloblastic anemia and heart disease. Lack of vitamin B9 in pregnant women can lead to various developmental disorders of the child.

Almost half of vitamin B9 is lost during cooking

Folic acid dosage

Synthetic folic acid is almost completely absorbed by the body, while folate, which a person receives from foods, is absorbed by about 50%.

Recommended intake for folate:

Birth to 6 months: 65 mcg/day
Up to 1 year: 80 mcg/day
1-3 years: 150 mcg/day
4-8 years: 200 mcg/day
9-13: 300 mcg/day
From age 14: 400 mcg/day
Pregnant (with an uncomplicated obstetric history): 400–600 mcg/day
Nursing mothers: 500 mcg/day.

Although cases of folic acid overdose are extremely rare, its excess can lead to a number of negative health effects. The daily intake of folate should not exceed 1000 mcg/day.

Folic acid benefits

Since its discovery, folic acid has been considered primarily a "female vitamin". It plays an important role in the maturation of eggs, the normalization of the menstrual cycle, and the development of the fetus. However, further medical research has shown that this substance has many beneficial properties for all.

May prevent pregnancy complications

A sufficient amount of folate in the body of the expectant mother is important for the quality of eggs, their implantation and maturation of the fetus. Often, folic acid supplements are prescribed to pregnant women to prevent birth defects in the development of the child, as well as complications associated with pregnancy, in particular preeclampsia. In addition, high levels of vitamin B9 in the body are associated with a lower risk of preterm birth.

Helps control blood sugar levels

Folic acid can reduce the likelihood of spikes in blood sugar levels and increase the sensitivity of body cells to insulin. A folate-rich diet may reduce the risk of diabetic complications, including neuropathy.

Helps prevent cancer

In the late 1980s, evidence emerged that a diet based on green leafy foods rich in folate, fiber, calcium, magnesium, and other nutrients could prevent colon cancer. In those years, the concept of "folic anti-cancer diet" became popular.

A diet rich in foods rich in vitamins B9, B6 and B12 reduces the risk of breast cancer. Also, with the help of folate, you can slow down the process of tumor growth if it has already appeared.

You can read the continuation of the article at the link to RBC Style.

Obstetrician-gynecologist Gynecologist

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