Is this your First Pregnancy?

Did your gynecologist insist you on taking folic acid during the first trimester of pregnancy? 

Do you wonder, what is the use of Folic Acid in pregnancy?

If you are clueless, it’s okay. Even I was like you when I heard about folic acid for the first time from my gynecologist. So, this blog will give you all the answers to the above-asked questions as well as give you a deep understanding of how folic acid and pregnancy are interconnected.

Folic acid during pregnancy
First time pregnancy

Have you conceived for the first time?

When I got pregnant for the first time. As I said before, the first supplement my gynecologist asked me to take was the Folic Acid Supplement. Generally, I hate having tablets as it leads to constipation, and with nausea, I was very reluctant to take tablets. But my doctor insisted on taking the Folic Acid tablet up to 12 weeks compulsorily. She said Folic Acid during pregnancy is important and abruptly finished her conversation to move on to the next patient.

With so many questions in my mind. I was a little perturbed by her insistence and more disturbed by the little information she gave. I became very curious and then decided to research more to know why folic acid in pregnancy is so important.

Here I share my views and the research I have done on this wonderful B Vitamin. They act as a savior in protecting your fetus at a very early stage to say even before you realize you are pregnant.

What actually does Folic Acid do during Pregnancy?

To start with, Folic acid is the B Vitamin(commonly known as B complex) that is produced synthetically to the meet body’s demand and Folate is its natural form. To know more about Folic Acid, it’s important to know about Folate first.

What is Folate?

Folate is a water-soluble B vitamin that is available naturally in dark green leafy vegetables, legumes, and meat.

What is Folic Acid?

Folic Acid is the synthetic form of Folate. The folic acid is man-made and is added as a supplement in the multivitamins or fortified in the meals to meet the human folate needs. Because, in most of the cases, the folate supplement in our diet is not enough.

What’s the difference between Folate and Folic acid, when it’s in your body?

Folate since its natural form of vitamin it’s easy on our body. It gets processed easily and enters our bloodstream. Even if it’s excess your body will be able to flush it out.

Impact of folic acid in your body

But folic acid on the other hand doesn’t get processed or metabolized easily. Hence there are high chances of Unprocessed Folic Acid getting into the bloodstream. Research claims that a high level of unprocessed or unmetabolized folic acid can cause serious health issues like increasing the risk of cancer and masking Vitamin B12 deficiency.

What are the benefits of Folic acid during pregnancy?

Folic Acid plays a crucial role in neural tube development. A neural tube is initially an oval-shaped tissue in the embryo which changes into a tube in 28 days after conception.

A sufficient amount of Folic Acid helps in the proper closure of the tube. It’s the same tube through which a baby’s brain and spinal cord get developed later. 

In case of insufficiency or deficiency of Folic Acid, the chances of the tube not closing properly is more. This can result in disabilities like spina bifida (when a tube near the spine is not closed properly) and Anencephaly(when a tube near the brain is not closed properly). So it is very important to have Folic Acid, especially for a pregnant woman in the early stage to avoid birth defects and miscarriage. Folic acid is also given as one of the prenatal vitamins to help in conceiving.

Folic acid helps in building new cells in the body starting from your brain cells, red blood cells. It goes to build even the genetic material inside the cells that’s our DNA and RNA.

The most common question: What food is folic acid in…?

Folic acid is generally added to your multivitamins and fortified cereals. The natural form of B9 Vitamin Folate, it is a water-soluble vitamin which is naturally present in below Indian foods:

  1. Any green leafy vegetable like Spinach, Methi leaves
  2. Lentils
  3. Broccoli
  4. Beef/Chicken Liver
  5. Flaxseeds
  6. Pinto Beans & Soya beans
  7. Black eyes Peas
  8. Beetroots
  9. Avocado

What is Folic acid recommended dose?

The recommended folic acid pregnancy doses are below:

First trimester: 400mcg

Second and third trimester (folic acid pregnancy after 12 weeks): 600mcg

It is important to know, the recommend pregnancy dosage can increase or decrease based on the individual absorption rate of the folic acid in your system and your previous pregnancy history. So it is strictly recommended to take the doctor’s suggestion before starting your dosages. Especially after you complete your first trimester. source: CDC

Folic Acid in pregnancy, when to STOP taking it?

Ideally, the baby’s neural tube growth gets completed in the first 12 weeks. So it’s not really required to take the folic acid supplement separately as you did before and it’s okay to stop taking the individual tablets.

 Moreover, Mom-to-be is advised to have calcium and iron tablets in the second and third trimester and these tablets contain the required dose of folic acid as well. So, still your folic acid intake continues.

Too much Folic acid during pregnancy…

In 2018, the American Journal of Clinical Nutrition did a randomized control study to find the correlation between too much Folate levels during pregnancy. Its impact on the production of genes required for brain development and genetic programming.

The group of women from FASST (Folic Acid Supplement in the Second and Third Trimester) units present in the study were enrolled and randomly provided either a folic acid supplement or a placebo. The main aim of the study was to observe the changes or influence in the genes (called epigenetic consequences) required for brain development.

And the results were shocking; they could find a direct relation of folic acid overdose with brain-related defects. For example, slow brain development in the baby was one such defect. But comparatively no such visible changes or defects were noticed with set of women who took placebos.

In 1965, a study suggested that the neural tube defect(NTD) was because of altered epigenetics (change in DNA structure which can lead to any nerve-related complications). To avoid NTDs the need for folic acid (folate) was made essential. But now, this research concludes that folic acid overdose in pregnancy can act in reverse and can cause more harm to the infant body than any good.

It is critical to take the folic acid supplements before and during the first trimester to avoid neural tube defect but there is no proof till now to say how Folic Acid can benefit the woman in the second and third trimester.

Even though there could be many other factors influencing the study other than the presence of Folic Acid in the bloodstream. Anything for that matter, that is taken too much can be more harm than good. So it’s safe to take only the mentioned dosage or to be on the safer side include folate consciously in your diet in place of folic acid during your second and third trimester to avoid folic acid overdose in pregnancy.

Is high Folic Acid intake a risk factor for Autism?

Though there are many kinds of research that say the low or high level of Folic acid has increased the risk of Autistic Spectrum Disorder. But there are few kinds of research which are claiming otherwise.

Hence, there is no clear cut conclusion. But to be on the safer side, it is important to take the right folic acid dosage during pregnancy by taking the advice of your gynecologist.

Is 5mg of Folic Acid too much when pregnant?

1mg is equal to 1000 mcg. The folic acid dosage during pregnancy to say precisely the first trimester is 400 mcg.

Until, unless the doctor prescribes you 5mg (which is 10 times more than the required dosage). You are not supposed to take it.

Why has my Doctor prescribed me 5mg folic acid?

According to NHS, Doctors will prescribe 5mg up to 12 weeks only if you come in the below categories:

  • If your previous pregnancy was affected due to neural tube defect.
  • A family history of neural tube defect includes you and your partner.
  • If you have diabetes or taking medicine to cure epilepsy.

Apart from the above scenarios, if your doctor insists on 5mg dosage, please take a second opinion.

Personally, after doing this study, I took the Folic Acid dose completely in my first trimester. From the second trimester, I started with Iron and calcium supplement which again contained a considerable amount of folic acid. So I did a blood test in my second trimester to recheck my folate levels to be on the safer side and also started including green leafy vegetables weekly twice in my diet.

Hope this article helped you in understanding more about folic acid tablet use in pregnancy. Please let me know your queries or any other doubts in the comment section. I will be very glad to help you.

Thanks for reading!


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