FOLIC ACID

Folic acid is a B vitamin which is responsible for making new cells. The body is unable to store large quantities of folic acid, so it is essential to have a regular supply from the diet. If you are planning to become pregnant or you are pregnant, you will be advised to take folic acid supplements.

Why do women need to take folic acid supplements?

All females need folic acid to produce healthy new cells but it is more important for women who are aiming to conceive and those who are already pregnant to take folic acid supplements. As around half of pregnancies are unplanned and folic acid is essential during the early phases of pregnancy, it is advisable to take folic acid supplements, even if you are not intending to become pregnant. Studies have shown that folic acid can be beneficial for males and females of all ages, with research suggesting that folic acid can help to reduce the risk of heart disease, strokes, some forms of cancer and Alzheimer's disease.

Taking folic acid supplements before and during pregnancy reduces the risk of a baby being born with spinal cord abnormalities and conditions including spina bifida. This is due to the fact that folic acid is essential for the healthy growth of the spinal cord. There is also evidence to suggest that folic acid helps to reduce the risk of a baby having a heart defect or cleft lip and palate. Folic acid can also help to reduce the risk of premature labour.

A recent study has also found that women who took folic acid for twelve months before conceiving had a lower risk of premature birth. It is advisable to take folic acid supplements even if you are not planning on falling pregnant in the immediate future.

How can women take folic acid?

All females should try to take in a minimum of 400 micrograms of folic acid per day and this can be done in the following ways:

• Taking vitamin supplements: most multivitamins contain the recommended daily intake of folic acid, but you should always check the label. Some labels will use the term folate instead of folic acid.
• Taking folic acid supplements: it is possible to buy vitamin supplements which contain folic acid only.
• Diet: folic acid is found naturally in some foods and added to others; eating fortified breakfast cereals (often cereals have labels saying 'fortified with iron and folic acid or folate') is a good way to get your daily intake.

Folic acid is also found naturally in many fruits and vegetables, including:

• Broccoli
• Leafy green vegetables (such as spinach, watercress and rocket)
• Green beans
• Asparagus
• Bananas
• Potatoes
• Sprouts
• Oranges
• Peas
• Folic acid can also be found in fortified bread and nuts

What dosage of folic acid should I take?

The amount of folic acid you need varies:

• If you can get pregnant you should aim to take in 400 micrograms of folic acid per day.
• If you are pregnant you should aim to take in 600 micrograms of folic acid per day.
• If you are breastfeeding you should aim to take in 500 micrograms of folic acid per day.
• If you have had a child with spina bifida and you are planning to be with child again, talk to your doctor about taking folic acid supplements; it is likely that they will prescribe very high doses of folic acid (around 4,000 micrograms per day) to reduce the threat of you having another child with spina bifida. This dose should be taken three months before you start trying and for the first three months of the pregnancy; it is important that you do not get the additional folic acid from multivitamins as you will be taking in higher levels of other vitamins, which may be harmful.
• If you have a higher threat of having a child with spina bifida you may be advised to take a very high dosage of folic acid (up to 5mg per day; this is obtainable on prescription); this includes women who are obese, women who have Coeliac disease, sickle cell anaemia, diabetes or thalassaemia, women who are taking medicine for epilepsy and women who have a spinal cord defect (this is also the case if the woman's partner has a spinal cord defect).
• If you have had a baby with anencephaly or spina bifida and you are not planning to be with child again, it is still advisable to take in 400 micrograms of folic acid per day.

Are there any side-effects?

Taking folic acid supplements does not cause any side-effects; folic acid is a vitamin found naturally in many foods and the body requires it to create healthy new cells. Taking supplements ensures you have a constant supply of folic acid and taking in folic acid during pregnancy is especially important for the health of the baby.

Folic acid and anaemia

If you have a deficiency of folic acid this can cause anaemia, as folic acid, iron and vitamin B12 are required for the production of healthy new red blood cells. If you have a lack of one or more of these key nutrients, this can affect the production of new blood cells and cause anaemia. Folic acid deficiency is usually associated with a diet lacking in sources of folic acid, such as vegetables, fruits and fortified cereals and bread. People who have alcohol and drug addictions also have a high threat of anaemia.

Common symptoms of anaemia include tiredness, general weakness, looking pale, fainting and heart palpitations. Symptoms specifically associated with folic acid deficiency include:

• Reduced sense of taste
• A red, shiny tongue
• Indigestion
• Changes in bowel movements (usually diarrhoea)

Anaemia that is caused by folic acid deficiency can usually be treated effectively with folic acid supplements and changes to the diet. Eating a lot of vegetables and fruit can also help to reduce the threat of folic acid deficiency.