How much folic acid is in prenatal vitamins
Folic acid
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Taking folic acid before and during early pregnancy can help prevent neural tube defects in your baby.
Before pregnancy, take a vitamin supplement that has 400 micrograms of folic acid in it every day.
During pregnancy, take a prenatal vitamin that has 600 micrograms of folic acid in it every day.
Take a vitamin supplement with folic acid every day, even if you’re not trying to get pregnant.
You can get folic acid from food, too. Look for fortified foods to make sure you’re getting enough.
What is folic acid?
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:
- Taking a vitamin that has folic acid in it
- Eating foods with folate from a varied diet
- Eating fortified foods
- Getting a combination of the two: taking a vitamin that has folic acid in it and eating fortified foods
How much folic acid do you need?
Here’s what you need to know about taking folic acid to prevent NTDs:
Most women
To help prevent NTDs in your baby, take a vitamin supplement with 400 mcg of folic acid every day before you get pregnant. A supplement is a product you take to make up for certain nutrients that you don’t get enough of in the foods you eat. Start taking 400 mcg of folic acid each day at least 1 month before pregnancy through the first 12 weeks of pregnancy. Your folic acid supplement can be:
- A multivitamin. This is a pill that contains many vitamins and other nutrients that help your body stay healthy.
- A prenatal vitamin. This is a multivitamin made for pregnant women. Your health care provider may give you a prescription for prenatal vitamins, or you can get them over the counter without a prescription.
- A supplement that contains just folic acid
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
If you’re at high risk for having a baby with an NTD, take 4,000 mcg of folic acid each day to help prevent an NTD. Start taking 4,000 mcg of folic acid 3 months before you get pregnant through 12 weeks of pregnancy. You’re at high risk if:
- You’ve had a baby with an NTD in the past.
- You or your partner has an NTD.
- Your partner has a child with an NTD.
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:
- Bread
- Breakfast cereal
- Cornmeal
- Flour
- Pasta
- Products made from a kind of flour called corn masa, like tortillas, tortilla chips, taco shells, tamales and pupusas
- White rice
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:
- Beans, like lentils, pinto beans and black beans
- Leafy green vegetables, like spinach and Romaine lettuce
- Asparagus
- Broccoli
- Peanuts (But don’t eat them if you have a peanut allergy.)
- Citrus fruits, like oranges and grapefruit
- Orange juice (100 percent juice is best. This means one serving of juice is equal to one serving of fruit.)
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:
- Serving size. This tells you how much of the product is in one serving. One multivitamin usually is one serving.
- Servings per container. This tells you how many servings are in a multivitamin bottle. For example, if two pills are one serving and the bottle has 30 multivitamins in it, that’s 15 servings.
- Nutrients, like vitamin D, folate and calcium, in each serving
- Daily value (also called DV) of one serving. DV is the amount of a nutrient in a serving. For example, if the DV of folic acid in a multivitamin is 50 percent, that multivitamin gives you 50 percent (half) of the folic acid you need each day.
Vitamin supplement labels now list “mcg DFE of folate,” which stands for dietary folate equivalent. It’s the amount of folate your body absorbs. If a serving has less than 400 mcg DFE of folate, you need more than one serving to get all the folic acid you need each day.
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
Translated documents are courtesy of the employees of CooperSurgical Inc.
Folic Acid Health Action Sheet
More information
- Centers for Disease Control and Prevention (CDC)
- Show Your Love Preconception Health
Last reviewed: May 2020
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Folic Acid Benefits in Pregnancy
Written by Stephanie Watson
Reviewed by Traci C. Johnson, MD on August 12, 2022
In this Article
- What Is Folic Acid?
- When Should I Start Taking Folic Acid?
- How Much Folic Acid Should I Take?
- What Are the Benefits of Folic Acid?
- Good Food Sources of Folic Acid
Folic acid is a pregnancy superhero! Taking a prenatal vitamin with the recommended 400 micrograms (mcg) of folic acid before and during pregnancy can help prevent birth defects of your baby's brain and spinal cord. Take it every day and go ahead and have a bowl of fortified cereal, too.
What Is Folic Acid?
Folic acid is a man-made form of a B vitamin called folate.
Folate plays an important role in the production of red blood cells and helps your baby's neural tube develop into their brain and spinal cord. The best food sources of folic acid are fortified cereals. Folate is found naturally in dark green vegetables and citrus fruits.
When Should I Start Taking Folic Acid?
Birth defects occur within the first 3-4 weeks of pregnancy. So it's important to have folate in your system during those early stages when your baby's brain and spinal cord are developing.
If you talked to your doctor when you were trying to conceive, they probably told you to start taking a prenatal vitamin with folic acid. One study showed that women who took folic acid for at least a year before getting pregnant cut their chances of delivering early by 50% or more.
The CDC recommends that you start taking folic acid every day for at least a month before you become pregnant, and every day while you are pregnant. However, the CDC also recommends that all women of childbearing age take folic acid every day.
So you'd be fine to start taking it even earlier.
If you picked out your own prenatal vitamin, take it to your OB once you're pregnant to make sure it has the recommended amounts of everything you need, including folic acid. All prenatal vitamins are not the same and some may have less or more 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 mcg of folate each day. If you take a multivitamin every day, check to see if it has the recommended amount. If for some reason you don't want to take a multivitamin, you can take folic acid supplements.
Here's how much folic acid is recommended each day in terms of pregnancy:
- While you're trying to conceive: 400 mcg
- For the first three months of pregnancy: 400 mcg
- For months four to nine of pregnancy: 600 mcg
- While breastfeeding: 500 mcg
What Are the Benefits of Folic Acid?
Without enough folic acid in your body, your baby's neural tube may not close correctly and they could develop health problems called neural tube defects.
These include:
- Spina bifida: incomplete development of the spinal cord or the vertebrae
- Anencephaly: incomplete development of major parts of the brain
Babies with anencephaly usually do not live long, and those with spina bifida may be permanently disabled. These are scary problems, to say the least. But the good news is that getting enough folic acid may protect your baby from neural tube defects by at least 50%. According to the CDC, if you've already had a baby with a neural tube defect, getting enough folic acid may reduce your risk of having another child with a neural tube defect by as much as 70%. If you have had a previous child with a neural tube defect, tit is recommended that you increase your daily amount of folic acid to 4000 mcg (same as 4 mg) each day. Check with your doctor about how much you should take.
When taken before and during pregnancy, folic acid may also protect your baby against:
- Cleft lip and palate
- Premature birth
- Low birth weight
- Miscarriage
- Poor growth in the womb
Folic acid has also been suggested to reduce your risk of:
- Pregnancy complications (One report found that women who took folic acid supplements during the second trimester had a reduced risk of preeclampsia.
) - Heart disease
- Stroke
- Some types of cancers
- Alzheimer’s disease
Good Food Sources of Folic Acid
Foods that can help you get more folic acid in your diet include:
- 400 mcg: Breakfast cereals fortified with 100% of the DV, 3/4 cup
- 215 mcg: Beef liver, cooked, braised, 3 oz
- 179 mcg: Lentils, mature seeds, cooked, boiled, 1/2 cup
- 115 mcg: Spinach, frozen, cooked, boiled, 1/2 cup
- 110 mcg: Egg noodles, enriched, cooked, 1/2 cup
- 100 mcg: Breakfast cereals, fortified with 25% of the DV, 3/4 cup
- 90 mcg: Great Northern beans, boiled, 1/2 cup
Folic acid for pregnancy planning
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home » About clinic » Folic acid when planning pregnancy
Any woman who plans to soon become pregnant and become a mother 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.
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.
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 laying and development of the nervous tissue of the embryo, participates in the formation of placental vessels.
Why do you need folate during pregnancy?
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.
- Folate malabsorption (in chronic inflammatory diseases of the stomach and intestines).
- 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. - Taking certain anti-epilepsy drugs and hormonal drugs dramatically reduces 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?
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:
- If a woman has an unbalanced diet, her folic acid level can be low, so it takes time to replenish her reserves.
It usually takes three to four months. - The neural tube of the fetus is laid at such an early stage that a woman may not even be aware of the pregnancy, especially with a long menstrual cycle.
- Folate deficiency can make pregnancy difficult.
Doctors of 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.
We wish you an easy pregnancy and healthy babies!
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Folic acid how to choose. How to take folic acid while pregnant.
January 23, 2021
354 comments
Folic acid, or vitamin B9, is a vital water-soluble vitamin involved in a number of important metabolic reactions in the human body. Also, B9 is one of the indispensable elements in the process of DNA formation, participates in the physiological, that is, correct, development of the fetus.
| ! | The name of the vitamin comes from the Latin folium - "leaf". The fact is that for the first time scientists discovered folic acid in food in large quantities in the leaves of greens: parsley, basil, dill, lettuce and spinach |
Studies have shown that the human body does not produce enough folic acid.
Even if the daily diet consists exclusively of vegetables, the body will not be able to independently provide itself with the necessary amount of folic acid. This must be understood and does not rely only on the diet.
In conditions such as pregnancy, tonsillitis, prolonged use of antibiotics, stress, flu, vitamin B9 reserves are almost completely consumed by the body within two weeks. By using a folic acid supplement in their diet, anyone today can cover or prevent vitamin B9 deficiency and subsequent disease states.
Folic acid benefits
So, let's look at the functions of folic acid in the body
This is a vitamin that is not synthesized either in the liver or in the kidneys, but which must be supplied from the outside every day. A very small amount of vitamin B9 is synthesized by the beneficial intestinal microflora, and this is not enough to cover the costs of the vitamin by the body.
| Why is he so important to us:
|
Immature erythrocytes, red blood cells lose their properties. These red blood cells are called megaloblasts, and the disease associated with them is megaloblastic anemia.
Deficiency symptoms in the initial stages are "general":
- weakness
- lethargy
- bad dream
- daytime sleepiness
- insomnia at night
- dizziness
- degraded performance
- prone to seasonal infections
Due to megaloblastic anemia, all organs receive less oxygen, due to which a separate pathological process begins in each of them.
The reason for all of the above may be a banal lack of vitamin B9. Using the example of megaloblastic anemia, we have shown the importance of folic acid supplementation in the prevention of disease states. The examples given are far from all that vitamin B9 is involved in..
Folic acid during pregnancy
Let us consider in more detail the importance of folic acid for pregnant women and children
According to WHO, folic acid deficiency occurs in more than half of modern women. And it mostly concerns young women. And since during pregnancy and lactation, the body intensifies the use of all useful substances, including B9 - with a vitamin deficiency, corresponding disturbances in the development of the fetus occur.
| ! | Large-scale clinical studies have shown that supplementation with B9 can almost completely (80%) correct folic acid deficiency within two to three months before the planned date of pregnancy |
The fact is that in pregnant women part of the folic acid goes to the intensively growing organism - the child, so the mother does not receive the required amount.
As mentioned above, vitamin B9 is essential for DNA replication processes. It is this process that is most important for the embryo, fetus, and subsequently for the child. After all, the correct laying and development of the internal organs of the child, including the heart and brain, depends on the “quality” of cell division.
The process of formation of the fetal neural tube, from which the entire nervous system is subsequently formed - from nerve fibers to the cerebral cortex, occurs at the first stages of pregnancy. Therefore, it is especially important to meet the target level of folic acid in the first trimester of pregnancy.
So how much folic acid do you need during pregnancy? - 400 μg
The first symptoms of B9 deficiency in pregnant women are noticeable in a week:
- The pallor of the skin
- emotional lability (constant mood swings from joy to irritation and back)
- have problems with cognitive functions
- including with memory
- reduced ability to concentrate
- possible skin rash in the form of acne or age spots
Such symptoms are often erroneously attributed to overwork, bad weather and other causes.
But, the reason for the "bad" condition is banal - a deficiency of folic acid.
| ! | The solution is very simple - eat as much vitamin B9 as possible and take a natural vitamin supplement regularly. Let's try to figure out how to choose the right folic acid. |
How to take folic acid
Dosage 400 or 800
When choosing a dietary supplement, take into account the frequency of daily intake. Most often there are drugs that provide the daily rate for one or two doses. A common question is folic acid 400 mcg is how many mg. we answer 400 mcg - this is 0.4 mg.
| ! | Vitamin B9 is available in convenient dosages: 400 mcg, 800 mcg, 1 mg. |
This diversity is due to different indications for taking a certain dose. Thus, the initial stages of prevention of B9 deficiency are often carried out with an additive containing 800 mcg, and only then they switch to 400 mcg of B9. At the same time, two to three times a year, it is recommended to repeat the course of taking B9 with a dose of 800 mcg.
Folate or folic acid?
Vitamin B9 is commonly found in dietary supplements in the form of methylfolate, one of the most potent forms of the vitamin. The fact is that folic acid itself is not a sufficiently active substance. For example, it is not able to penetrate the blood-brain barrier and enter the brain. To pass this barrier, B9 must be converted to the more active form of folate. Folate is the common name for B9 substances.
"Activation" B9 is often easy. However, sometimes the metabolism of folic acid is hindered due to a number of hereditary disorders due to the MTHFR gene.
As a result, the bioavailability of the vitamin in the amount we need is sharply reduced.
Therefore, the release of an already activated substance, methylfolate, has been established. It is important that methylfolate easily and freely enters the vascular bed, after which it is used by the cells of the body. In addition, methylfolate is non-toxic, which makes it absolutely safe for a healthy human body.
Daily Value of Vitamin B9
Supplemented folic acid has an advantage over food. The bioavailability of the vitamin from the supplement is many times higher.
Vitamin requirements depend on a number of criteria including age, occupation, alcohol use (reduces body stores of vitamin B9), and pregnancy.
| Here are the doses recommended by the World Health Organization, depending on age:
|
A pregnant woman needs an increased amount of B9 - 200 mcg / day is added to the age norm. For example, a pregnant woman at the age of 40 in the first trimester should consume 400 mcg / day of vitamin B9. It should be noted that the benefits and necessity of taking folate during pregnancy has been proven by WHO
During the lactation period - breastfeeding, it is necessary to consume 60-100 mcg / day more than the age norm.
In some cases, pregnant women are advised to consume daily 800 micrograms of folic acid per day . This tactic is used for initially known deficiency of B9, with frequent acute respiratory diseases, megaloblastic anemia, a number of chronic diseases and other conditions.
Also, the dosage of 800 µg is used in the treatment of diseases associated with hypovitaminosis B9, during periods of increased physical and mental activity, stress and for the rapid replenishment of folic acid.
In addition, large dosages are convenient because in this form the supplement can be taken not daily, but once every two or three days.
Folic acid supplement course.
|
Daily intake, on the contrary, will add vitality and contribute to any activity. 
Metafolin stopped taking. Please tell me, is it possible to take Metafolin 400 mcg additionally? Or from the second trimester, folic acid will be enough. 
Why is it dangerous for the fetus? ((( 
