How much folic acid should I take while trying to get pregnant?

How Much Folic Acid Should I Take While Trying to Get Pregnant?

Folic acid is a B vitamin that plays an important role in fetal development and preventing birth defects. If you’re trying to conceive, getting adequate folic acid is crucial. But how much do you need and when should you start taking it? Here’s what you need to know about folic acid intake before and during pregnancy.

What is Folic Acid?

Folic acid, also known as vitamin B9 or folate, is a water-soluble B vitamin found naturally in foods. It helps the body produce new cells and is especially important during periods of rapid cell growth, like in a growing fetus.

Folic acid helps prevent neural tube defects, which are serious abnormalities of the brain and spinal cord. It also aids the placenta and supports healthy fetal tissue growth.

Why Take Folic Acid Before Pregnancy?

Doctors recommend women start taking folic acid supplements even before getting pregnant. Here’s why:

  • Rapid fetal development – A baby’s neural tube, which forms the brain and spine, develops within the first 28 days of conception, often before many women realize they are pregnant. Taking folic acid preconception helps ensure adequate levels as soon as the fetus starts forming.
  • Prevents defects – Getting sufficient folic acid in the periconception period greatly reduces the risk of neural tube defects like spina bifida and anencephaly. It may also prevent other birth defects like cleft lip and palate.
  • Builds stores – It takes time for folic acid levels to build up within your body after starting supplements. Beginning supplementation before conception allows levels to optimize by the time you get pregnant.
  • Corrects deficiencies – Many women have low dietary folate intake or deficiencies without realizing it. Supplementing prior to pregnancy can help fix insufficiencies.
  • May aid conception – Some research indicates folic acid supplements can boost fertility, especially in women with fertility issues due to folate deficiency.

What is the Recommended Daily Amount?

The recommended folic acid intake for all women of childbearing age is 400-800 mcg (0.4-0.8 mg) per day. Once you become pregnant, the amount increases to 600-1000 mcg (0.6-1 mg) daily throughout pregnancy and breastfeeding.

These recommendations are based on preventing neural tube defects, the toxicity threshold, and the optimal blood concentration of folic acid during pregnancy.

When is the Best Time to Start Taking It?

Ideally, you should begin taking a folic acid supplement 3 months or more prior to conception. This allows time to correct any undetected deficiencies and ensure you have adequate folate status in the earliest days after fertilization occurs.

If you haven’t been supplementing but want to get pregnant soon, start taking folic acid tablets daily as soon as possible. You will still benefit even if you haven’t built up stores over months.

Can You Get Enough from Diet Alone?

It’s difficult to consume the recommended 400-800 mcg of folic acid from food sources alone. Fortified cereal, bread, pasta and rice provide about 100-200 mcg per serving. Other folate-rich foods include leafy greens, asparagus, broccoli, citrus fruits, beans and lentils.

However, folate from foods may not be as bioavailable and your individual intake can vary widely day to day. Taking a daily supplement ensures you consistently meet your needs, even if your diet is lacking.

Should You Take More than the RDA?

There is no evidence that exceeding the recommended daily amount offers any added benefits. The FDA has set the tolerable upper limit for folic acid at 1000 mcg (1 mg) per day for women over 18 years old.

Too much folic acid can mask a vitamin B12 deficiency. It may also possibly increase the risk of certain cancers when taken in very high amounts for prolonged periods.

Aim to meet but not significantly exceed the recommended daily intake level from both foods and supplements combined.

Are there Risks or Side Effects?

Folic acid is water soluble, so any excess is flushed out in urine. Doses up to 1000 mcg per day are generally recognized as safe. However, some potential side effects can include:

  • Nausea, loss of appetite, bloating, gas, bad taste
  • Trouble sleeping
  • Skin reactions
  • Seizures (in people taking anticonvulsants)
  • Zinc deficiency

Allergic reactions are rare but possible. High doses can lead to abdominal cramps, diarrhea, rash, sleep disorders, irritability, confusion, nausea, and seizures in susceptible people.

Who Should be Cautious Taking Folic Acid?

Certain individuals should exercise some caution with folic acid:

  • People with anemia or B12 deficiency – High doses may mask or worsen these conditions.
  • Those taking anticonvulsant or anti-seizure medicines – Folic acid may interact with these drugs.
  • Patients getting methotrexate therapy – Folic acid could make this medication less effective.
  • Anyone with allergies or sensitivities – Speak to your doctor if you’ve reacted poorly to folic acid or other B vitamins in the past.

The Bottom Line

Adequate folic acid intake before and during early pregnancy can help prevent serious neural tube defects as well as support a healthy pregnancy. Aim for at least 400 mcg of synthetic folic acid per day from supplements, in addition to food sources, for at least 3 months before conception. You can continue taking 600-800 mcg daily throughout pregnancy. But too much folic acid can pose risks, so don’t exceed the upper limit of 1,000 mcg per day without medical supervision.

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