FAQ: Taking Folic Acid During Pregnancy

You may have heard all about folic acid being an essential vitamin you need while you’re pregnant. But what is it, why is it important for pregnant women and how much do you need? Read on to learn about the benefits of this important vitamin.

What Is Folic Acid?

Vitamin B9, better known as folate or folic acid (the synthetic form of folate) helps support healthy cell growth and function, and has a special role in stimulating the production of the red blood cells that carry oxygen from the lungs to the rest of your body.

Folic acid is a vitamin everyone needs, but it’s especially important for women before and during pregnancy.

Why Is Folic Acid Especially Important in Pregnancy?

Folic acid can help lower the risk of birth defects, known as neural tube defects, which can affect the brain or spine. These structures are formed from your baby’s neural tube during the first 12 weeks of pregnancy, which is why it's essential to get enough folic acid during the first trimester.

But Folic acid has even more benefits than this. For example, it’s also believed to help guard against other birth defects like congenital heart disease and cleft lip and palate.

Can You Get Folate From Food?

Yes. You can get a natural serving of folate from a healthy diet that’s rich in

• dark leafy greens, such as spinach, cabbage and romaine lettuce

• broccoli

• cauliflower

• brussels sprouts

• chickpeas

• potatoes

• parsnips

• runner beans, peas

• nuts, including peanuts

• tomatoes

• citrus fruits like oranges, lemons and grapefruit

• bananas

• melons

• wholemeal bread

• yeast extract

• fortified breakfast cereals (check the label to make sure).

Keep in mind that your body doesn’t store folate. So, to keep up your levels of this important vitamin and get all its benefits you need to eat these folate-rich foods regularly.

It’s also important to know that eating liver (a source of folate) isn’t safe to eat when during pregnancy. Read about what other foods to avoid while you’re pregnant.

Do You Need to Take a Folic Acid Supplement?

It may be hard for mums-to-be to get the recommended amount of folate from food alone. So, if you’re pregnant, or want to get pregnant, you can ensure you’re getting all the benefits of this essential vitamin by taking a daily folic acid supplement or a prenatal vitamin product that contains folic acid. It’s always safest to check with your doctor first before starting to take a folic acid supplement.

When Should You Start Taking Folic Acid?

You may not know you’re pregnant in your first month. This is why experts recommend that you start taking a daily folic acid supplement straight away – to be on the safe side – if there’s any chance you might become pregnant sometime soon.

If you’ve found out you’re pregnant, and you haven’t been taking folic acid, don’t worry; just begin taking your folic acid supplements as soon as possible.

How Much Folic Acid Do You Need?

Adults in general should get 200 micrograms of folate a day, which most people can obtain by eating a varied and healthy diet. However, if you’re pregnant, or planning to become pregnant, it’s usually recommended that you take a 400-microgram folic acid supplement until you’re 12 weeks pregnant.

Some mums-to-be may have a higher risk of having a baby with a neural tube defect and will be advised by their doctor to take a bigger dose of folic acid.

If you suspect you might be pregnant or are trying to get pregnant, ask your doctor about when to start taking a folic acid supplement and how much to take. Your doctor and midwife may also recommend other pregnancy vitamins such as vitamin D.

Can You Take Too Much Folic Acid?

Taking very high doses of folic acid (1 milligram or more) may not be harmful in itself over a short time, but it may lead to problems if you have low levels of a different, but similar vitamin – known as B12 – in your body.

Vitamin B12 also has an important role in red blood cell production, but it is not the same as folate or folic acid.

The symptoms of a vitamin B12 deficiency can include pale yellow skin, a sore red tongue, tiredness and changes in the way you think and feel. It can also lead to anaemia.

Taking more folic acid than you need can mask these B12 deficiency symptoms, which in turn might cause the condition to remain undetected and untreated.

Just like a folate deficiency, a vitamin B12 deficiency also needs to be treated as soon as possible to avoid serious complications. This is why it isn’t a good idea to make the condition harder to diagnose by taking more than the recommended dose of folic acid.

Talk to your doctor or midwife if you aren’t sure how much folic acid you need during pregnancy.

What Is Folate Deficiency Anaemia?

A folate deficiency (when your body isn’t getting all the folate or folic acid it needs) can lead to a kind of anaemia. This is when you have fewer red blood cells than normal, or a low level of haemoglobin – which carries oxygen around your body – in those red blood cells.

The good news is that it’s usually easy to treat, so serious or irreversible complications are rare, but it’s important to recognise the signs so it can be caught in time.

Symptoms of Folate Deficiency Anaemia

The general symptoms of anaemia can include

• fatigue

• shortness of breath

• feeling faint

• heart palpitations

• loss of appetite, or weight loss.

If you have anaemia caused by a folate deficiency, you may also have

• reduced sense of taste

• diarrhoea

• weak muscles

• numbness or tingling in the extremities

• depression.

These symptoms may also emerge before the folate deficiency develops into anaemia. Keep in mind that some of these symptoms can also be associated with other conditions. If you notice any of the symptoms above, see your doctor as soon as possible for diagnosis and treatment.

Causes of Folate Deficiency

As folic acid is present in many foods, whether naturally or in fortified foods, folate deficiency shouldn’t be something you need to worry about as long as you follow a healthy, balanced diet. However, you can be at risk of this condition if:

• you follow a diet that lacks enough folic acid

• you can’t absorb folic acid due to a disease of the small intestine, for example, coeliac disease

• you suffer from acute liver damage

• you are on long-term kidney dialysis

• you take medication that interferes with absorption, such as anti-convulsant medicine used to treat epilepsy.

If you think any of these may apply to you, or if you’re not sure what dose of folic acid you need, talk to your doctor or midwife to get personalised advice.

Folic acid is only one of the many important nutrients you’ll need when you're pregnant or planning to become pregnant. If you’re interested in learning more about pregnancy nutrition, read more about maintaining a healthy pregnancy diet so you and your little one can stay well-nourished and healthy at this important time.

How we wrote this article The information in this article is based on the expert advice found in trusted medical and government sources, such as the National Health Service (NHS). You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.