Folic Acid: Start Before You Conceive

Folic acid is an essential B vitamin. And it plays a role in cell proliferation and growth. It's really important for women who are trying to conceive, because having folic acid on board before conception minimizes the risk of neural tube defects. The main birth defects are those that have to do with the spine formation, the neural tube closure. There are birth defects called spinal bifida which have to do with neural tube closure. And those type of birth defects tend to happen within about 28 days of conception. If you're thinking of pregnancy or potentially being pregnant, I would start taking folic acid supplementation. About half of pregnancies in the US are unplanned. And that's why being on folic acid supplementation for reproductive women is so important. A month prior to pregnancy, the general recommendation is at least 400 micrograms of folic acid. And that number runs through the first three months of pregnancy. In pregnancy itself, 800 micrograms is the typical recommendation. There are a few categories of women who need higher doses. And in those cases, we go up to 4000 milligrams of folic acid. Women who, for example, have a genetic disorder in folic acid synthesis, also women who have a history of a neural tube defect in an offspring or a family history of neural tube defects are typically placed on higher doses. A woman should consult a doctor to see if she's getting enough folic acid. If she has a family history of neural tube defects or other birth defects related to the spine, or if she's ever had a child with that type of a neural tube defect, she may also do that. If she has a history of recurrent miscarriage, because the recurrent miscarriage workup can sometimes point to genetic factors that may find an increased need for folic acid supplementation. For starters, most cereals are actually fortified with 100% of the daily intake of folic acid. So reading a label of your cereal and double checking that is useful. Other types of processed foods are actually often fortified with folic acid. Some of the foods that are high in folic acid are leafy greens, spinach, kale, some of the darker green vegetables. All of those could be supplements of folic acid.