Folic acid is one of the first medications prescribed to all women who find out they are pregnant. Sometimes gynecologists advise taking folic acid even at the stage of pregnancy planning.
In this article, we will analyze the need to prescribe folic acid to pregnant women, the timing of the prescription, the permissible doses of the drug and the duration of use.
Why is folic acid so necessary for pregnant women?
Folic acid belongs to the B vitamins. It is a water-soluble vitamin B 9. IN human body it is capable of being synthesized by the microflora of the large intestine.
But it is synthesized in the intestines in small quantities. This amount is completely insufficient to cover the daily need for it.
Where to get the missing amount of folic acid? From food. But even with the diversity and proper nutrition a person often does not receive enough daily folic acid.
During heat treatment of the product or as a result of prolonged exposure sunlight Vitamin B 9 is destroyed by it.
Therefore, during pregnancy, a deficiency of folic acid inevitably occurs in a woman’s body. In this regard, even ardent opponents of taking medications during pregnancy do not neglect taking folic acid.
It is especially important to make up for this deficiency in the early stages - during the period of active growth of the fetus, the formation of all its organs and systems. It is in the first 12 weeks of pregnancy folic acid should enter the woman’s body in large quantities.
Vitamin B 9 is involved in the process of cell division. Without the normal process of cell division, organogenesis (the formation of organs and body systems) is impossible.
Folic acid is also necessary for hematopoiesis and the formation of blood cells (erythrocytes, platelets, leukocytes). And this is also very important not only for the fetus’s body, but also for the mother’s body. After all, anemia during pregnancy is a fairly common problem.
A deficiency of this vitamin can lead to fetal malformations (defects of the spinal column, abnormalities in the development of the child’s maxillofacial region, and others).
The role of folic acid is very important in the formation and formation of the neural tube - the rudiment of the future nervous system of the fetus.
Therefore, among the pathologies of fetal development in conditions of folic acid deficiency, malformations of the nervous system are possible. For example, various disorders of brain development can lead to intrauterine fetal death, stillbirth, or the birth of a sick child.
Folic acid plays an important role in the synthesis of amino acids and nucleotides.
Proteins in the child’s body are built from amino acids.
DNA is built from nucleotides - the carrier of the genetic information of the organism. Therefore, at normal concentrations of folic acid, the structure of DNA molecules is formed without damage or mutations.
If there is not enough folic acid in the body of a pregnant woman, then over time a toxic substance, homocysteine, begins to accumulate. It can damage the walls of blood vessels, which can lead to dire consequences during pregnancy.
Damage to the vascular wall is fraught with premature placental abruption, which can lead to premature birth.
Also increased level homocysteine may contribute to the development of cardiovascular diseases.
Vitamin B 9 takes part in the formation of the placenta and its blood vessels. Therefore, its lack can lead to uteroplacental insufficiency.
With a deficiency of folic acid, the mother's body also suffers. A lack of vitamin provokes the development of anemia, toxicosis, and depression.
Why do you need folic acid during pregnancy planning?
Folic acid affects the structure of cell division, especially cells of the fetal nervous system. The baby's neural tube begins to form on the 16th day after conception. This is the period when most mothers do not yet know about conception.
Therefore, in many countries around the world, gynecologists recommend that women take folic acid in advance, that is, at the stage of planning pregnancy.
It is considered optimal if the expectant mother takes folic acid for at least 3 months before conception.
If a woman did not take folic acid before pregnancy and found out about her situation, for example, at 6-7 weeks of pregnancy, she still needs to start taking folic acid. Since during the entire first trimester the fetal neural tube undergoes further differentiation.
The preventive dose of folic acid during pregnancy planning and during the first trimester is 400 mcg per day. Otherwise – 0.4 mg.
Only a special group of expectant mothers (women at risk) are prescribed large doses of folic acid - 800-1000 mcg per day.
The risk group for having a child with congenital anomalies includes women who:
- there was a history of pregnancy that ended in the birth of a child with a pathology of the nervous system or other developmental defects, or fetal death;
- there are cases of hereditary diseases in the family (even among family members of a distant degree of kinship);
- there are serious diseases - diabetes mellitus, megaloblastic anemia, epilepsy, metabolic diseases, peptic ulcer, celiac disease, autoimmune diseases, severe toxicosis.
In the diseases listed above, the processes of absorption and breakdown of folic acid are disrupted.
And also medications used for such diseases (anticonvulsants, antacids, cytostatics, etc.) impair the absorption of folic acid.
A doctor observing a pregnant woman at risk can adjust the dose of folic acid based on the results of the examination. In some cases, it may be necessary to increase the dose to 2-3 mg of folic acid per day.
It is worth paying attention to the fact that most folic acid preparations contain 1 mg of the substance in one tablet. Therefore, if you are not at risk, you will have to divide the tablet. Or you need to choose a drug that contains a dose that is right for you.
The tablets should be taken orally after meals. It is also acceptable to take folic acid with meals if a woman feels nauseous after taking the pill after a meal.
How not to overdose the drug?
Many women are afraid of high doses of the drug and believe that taking 1000 mcg (1 mg) of folic acid can cause an overdose.
There's really no reason to worry. It is quite difficult to overdose on folic acid. This is a water-soluble vitamin, the excess of which is easily eliminated by the body.
However, you shouldn't get carried away. Long-term use of high doses of the drug can lead to malfunctions gastrointestinal tract, the appearance of a metallic taste in the mouth, sleep disturbances, irritability, anemia (as it leads to a deficiency of vitamin B 12).
Today, there are two opinions among doctors regarding the duration of taking folic acid during pregnancy.
Some believe that taking it for the first three months is enough. And in the future, the pregnant woman is recommended to take vitamin complexes containing folic acid and eat well.
Others recommend taking folic acid throughout pregnancy and continuing during pregnancy. breastfeeding. This is explained by the fact that throughout pregnancy and lactation the need for folic acid increases.
At the same time, a vitamin deficiency in the mother’s body that is not eliminated in time will lead to its deficiency in the baby’s body, since breast milk Vitamin B 9 will also not be enough.
What should you do? Trust your doctor and his opinion. Don't trust your doctor? Change it to someone you can trust.
Folic acid gets its name from the Latin word folium, meaning leaf. Because folic acid was first obtained from leafy greens.
The main sources of folic acid are green plants. This is spinach, wild garlic, parsley, lettuce, beans, lentils, beans, leeks, asparagus, Brussels sprouts, broccoli, green peas, avocado.
A significant amount of vitamin B 9 is found in whole grain flour (with bran), cereals with an unrefined grain shell, and yeast.
Folic acid is present in liver, meat, fish, and hard cheese, but heat treatment of such products reduces its amount significantly.
It is better to eat vegetables and herbs raw or steam them to preserve their folic acid as much as possible.
If you infrequently consume the above products, then, of course, you should take additional folic acid in tablets or take vitamin-mineral complexes.
Drinking large amounts of tea negatively affects the absorption of folic acid. Moreover, tea accelerates its elimination from the body.
On the pharmaceutical market there are monopreparations containing only folic acid, and drugs with a combined composition.
Regular folic acid tablets (single drug) are available in dosages of 400 mcg, 500 mcg, 1000 mcg (depending on the manufacturer of the drug). Most often this is a dosage of 1000 mcg.
Foliber is a drug containing folic acid (400 mcg) and vitamin B 12 (cyanocobalamin - 2 mcg). Prescribed for the prevention of heart disease and anemia. Can be prescribed to pregnant women in the first trimester or planning pregnancy.
The drug should be used with caution in patients with impaired absorption of glucose or galactose, galactosemia or lactase deficiency, since the drug contains 23 mg of lactose per tablet. Take one tablet once a day.
Folio. The drug contains 400 mcg of folic acid and 200 mcg of iodine. This drug contains two important elements for a pregnant woman in a prophylactic dose.
Folio according to the instructions should be taken once a day, preferably during a meal, one tablet. For diseases thyroid gland Before taking the drug, you need to adjust the dose of drugs already used (due to the iodine contained in the tablets).
Doppelhertz active Folic acid is a vitamin complex. Contains folic acid - 600 mcg, vitamin C - 300 mg, B 6 - 6 mcg, B 12 - 5 mcg, E - 36 mg.
The drug is prescribed for the prevention of heart disease, cerebrovascular accidents, and gynecological diseases. Suitable for the prevention of hypovitaminosis during pregnancy and lactation. Prescribed 1 tablet once a day with meals.
Folic acid with B 6 and B 12 (Evalar). The drug contains: folic acid - 600 mcg, vitamin B 12 - 5 mcg, vitamin B 6 - 6 mg. This is a biologically active food supplement.
Indications for use are the same as for the above drugs. The recommended course of treatment is 4-6 weeks. Take 1 tablet once a day, preferably with the first meal.
Multivitamin complexes such as Elevit Pronatal, Materna, Vitrum prenatal, etc. often prescribed to pregnant women with iron deficiency, deficiency of folic acid and other vitamins when carrying a child and breastfeeding.
Important: women with excess calcium in the blood should not take calcium-containing vitamin complexes for a long time.
Folic acid "9 months" and Mamifol contain 400 mcg of folic acid. Prescribed to prevent folic acid deficiency in women of childbearing age during pregnancy planning stages (1-3 months in advance) and to prevent the development of neural tube defects in the fetus. Take 1 tablet per day.
To treat established folic acid deficiency, Folacin or Apo-filik is used. The preparations contain 5 mg of folic acid per tablet.
There are also iron supplements that additionally contain folic acid. These are Maltofer, Hemoferon, Fenyuls Zinc.
These drugs are used mainly for iron deficiency, folate deficiency and iron deficiency anemia. They are not entirely suitable for the prevention of folic acid deficiency during pregnancy, since they contain a dose of folic acid lower than the preventive dose - 300 mcg.
Folic acid preparations are sold without a prescription and always remain affordable. However, a woman should not make her own decision regarding the intake and dosage of folic acid during pregnancy.
Always check with your doctor about the required dosage, duration of use, conditions for taking the drug, and the compatibility of the drug with other medications you are taking. Including vitamins.
Vitamins are also medicines, chemical substances, which, if not handled properly, can, in combination with other substances in your body, give such chemical reaction, which will cause irreparable harm to your body and the body of your child.
Be prudent and careful when using medications. Health to you and your children!
Health status expectant mother is one of the most important factors for a favorable pregnancy. A lack of vitamins and beneficial micro- and macroelements is very dangerous during pregnancy. Folic acid is vital during this time. We will talk about the features of this vitamin and its intake in an “interesting” position in this article.
General information about folic acid
This substance belongs to the B vitamins. In the body, folic acid, or vitamin B9 in other words, is produced in very small quantities, so most of it reaches a person with food.
You can often find the term “folate” in some sources. Some people believe that folic acid and folate are the same thing. But it is not so. Folate is a natural form of the vitamin that is found in natural form in food products. And folic acid is a synthetic substance, that is, a product of chemical manipulations by scientists in laboratories.
- parsley;
- spinach;
- salad;
- cabbage;
- beet;
- cucumbers;
- broccoli;
- spinach;
- peas;
- beans;
- lentils;
- oranges;
- bananas;
- apricots;
- wholemeal bread;
- meat;
- liver;
- eggs;
- leaves of black currant, raspberry, rose hips and some other products.
Dutch scientists have discovered a connection between folic acid and mental abilities person. In an experiment, it was proven that taking 0.4 mg of vitamin B9 daily preserves intelligence as you age.
When I was pregnant with my second son, I got a new local gynecologist. I was very surprised that she was against prescribing any synthetic vitamins unless absolutely necessary. To all my requests and questions regarding what I should drink from multivitamins, she answered that there is nothing better than a balanced diet. And only she treated folic acid differently and prescribed it in the first trimester of pregnancy. 
Vitamin B9 is found in a fairly large number of foods: vegetables, legumes, meat products, etc.
Unfortunately, the diet modern man often does not correspond to the concept of “balanced nutrition”. Therefore, it is not uncommon for certain substances in the body to be lacking. In addition to this, vitamin B9 is practically unstable to exposure environment. It quickly breaks down during storage and cooking.
There is also a category of people who lack the enzyme responsible for the absorption of folic acid. It is not absorbed from food at all, but taking pharmaceutical drugs can eliminate its deficiency.
Normally, in a healthy person, folic acid in the blood should be in an amount from 7 to 45 nmol/l. And although these indicators are very small, their slightest fluctuations up or down are fraught with health problems. The main symptoms of folic acid deficiency are constant fatigue, loss of appetite, severe irritability.
These signs are very similar to those experienced by a pregnant woman in the first months of pregnancy. Therefore, many people often have no idea about the lack of vitamin B9.
But if in normal conditions its lack is not so dangerous, then this problem becomes especially acute when a woman begins to carry a child under her heart. The body of the expectant mother at this time needs much more nutrients. And she needs especially a lot of vitamin B9, since it is involved in the process of DNA synthesis, growth and division of fetal cells, and the formation of the hematopoietic system.
Folic acid is essential for the development of a child’s nervous system. Its deficiency often leads to defects in the brain, neural tube of the embryo, etc. All these organs are formed already in the first weeks of pregnancy. Thus, in the first week after conception, the formation of the fetal neural tube occurs, which is responsible for the correct functioning of the entire body. This is why obstetricians and gynecologists recommend starting to take folic acid 3-4 months before the final decision to conceive is made.
Preparations with “folk”, as expectant mothers affectionately call it, are freely available in pharmacies. They are produced in tablet form. Vitamin B9 can be contained either in monopreparations with one active ingredient or included in complex remedy, combined, for example, with iodine, iron, other B vitamins and other substances.
Vitamin complexes for pregnant women usually contain a whole range of substances necessary for pregnancy. Some may contain folate, a substance obtained from natural foods. And in others - folic acid, which was synthesized artificially. It is believed that folates are absorbed better and faster by the body. 
Pharmaceutical factories produce folic acid in tablet form.
The single preparation contains only folic acid. Its name corresponds to the active substance. The auxiliary components are the following:
- lactose monohydrate (milk sugar);
- microcrystalline cellulose;
- povidone (polyvinylpyrrolidone);
- corn starch;
- magnesium stearate.
In the blood, vitamin B9 reaches its maximum value half an hour to an hour after administration. It accumulates in the liver and is excreted in the urine. Folic acid can penetrate to the fetus through the placenta and into breast milk.
Indications, contraindications and side effects
Indications for the use of Folic acid are:
- prophylactic use during pregnancy and lactation in order to prevent its deficiency in the body;
- treatment and prevention of folate deficiency anemia.
The drug should not be taken by persons who have the following health problems:
- individual intolerance to the components of the drug;
- anemia associated with vitamin B12 deficiency;
- lactose intolerance;
- lactase deficiency;
- glucose-galactase malabsorption (impaired absorption of glucose and galactose).
Also, the drug should not be taken by children under 3 years of age. Folic acid should be taken with extreme caution:
- in the presence of a folate-dependent malignant tumor;
- when taking dihydrofolate reductase inhibitors (drugs that slow down the activity of this enzyme).
Side effects may include:
- allergic reactions: rash, itching, erythema (severe redness of the skin due to dilation of capillaries), bronchospasm (narrowing of the bronchi), hyperthermia (fever), anaphylactic reactions;
- from the gastrointestinal tract: anorexia, nausea, bloating, bitterness in the mouth, diarrhea;
- from the nervous system: irritability, sleep disturbance.
With long-term use, there is a risk of developing hypovitaminosis B12.
Folic acid is not compatible with all medications, so you must consult a doctor before taking it. Reduces the absorption of folic acid:
- antacids (drugs that reduce gastric acidity);
- Cholestyramine;
- antimicrobial agents from the sulfonamide class (Arifon, Klopamide and others).
Reduce its effectiveness:
- Methotrexate;
- Pyrimethamine;
- Triamterene;
- Trimethoprim.
The connection between the absorption of zinc and the simultaneous intake of folic acid has not been proven. However, some scientists suggest that their combined use does not allow zinc to be properly absorbed.
Can there be an overdose?
Previously, it was believed that an overdose from taking folic acid could not happen. However, recent research has proven that this is possible. In those pregnant women who took it for a very long time or large quantities, children were born susceptible to frequent colds and bronchial asthma.
The health of a pregnant woman with uncontrolled intake of folic acid is also at risk, since an overdose is often not noticed for a very long time. And it can lead to vitamin B12 deficiency, as well as disruption of the central nervous system and gastrointestinal tract.
This is why you should not start taking folic acid supplements on your own. It is important to remember that only a person with a medical education and knowledge of the patient’s health condition can prescribe the correct dosage and duration of use of such drugs.
Features of application
According to the World Health Organization, a pregnant woman should receive 0.4 mg of folic acid per day. But each case is individual. And, based on the condition of the expectant mother, the doctor may prescribe a different dosage. It is possible to take 0.8 mg of the drug, and for anemia even 5 mg. Only a doctor can calculate the correct dose. It is he who prescribes the drug dosage regimen.
Usually a pregnant woman is prescribed to take 1 tablet per day with a concentration active substance 1 mg. But the doctor can make an appointment in a different way. For example, 2-3 tablets of 0.4 mg per day. If the expectant mother has been confirmed to have folate deficiency anemia, then she is prescribed a dosage of more than 5 mg. Typically, this condition is treated with the drug Folacin, which is no longer preventive, but remedy.
When purchasing a vitamin at a pharmacy, you should definitely pay attention to the concentration of the active substance, which varies.
It is better to drink folic acid after meals, as it increases the acidity of gastric juice. And in pregnant women, taking it before meals can cause vomiting. If you take a vitamin B9 tablet with meals, digestion of food will be difficult.
Unfortunately, not all doctors indicate when prescribing the drug the amount of active substance that should be in 1 tablet. This happened to me too. The gynecologist prescribed taking 1 tablet of Folic acid twice a day. Arriving at the pharmacy, I was extremely discouraged by the fact that the dosage could be different. The lack of necessary information led to the fact that I had to visit the doctor again so that she could clarify the amount of folic acid in the daily dose. 
For the treatment of folate deficiency anemia, the drug Folacin is prescribed.
At what stages of pregnancy can you take folic acid?
About the importance of taking vitamin B9 at the stage when the baby’s life has not yet begun, and early stage pregnancy was mentioned above. But the need for this vitamin does not disappear even after.
Thus, its lack throughout the entire period of pregnancy can lead to preeclampsia (a complication of its course, characterized by high blood pressure, edema and the appearance of protein in the urine). This condition is very dangerous for the fetus, as blood flow through the placenta is disrupted, which often leads to a delay in the physical development of the child. This pathology can also lead to premature birth and eclampsia, in which blood pressure becomes critically high, which is dangerous for the life of the mother and fetus.
In the last 3 months of pregnancy, folic acid is important element to prevent too early rupture of the amniotic membrane, as well as the onset of labor ahead of schedule.
Doctors usually prescribe folic acid supplementation in the first 3 months of pregnancy. Subsequently, as a rule, multivitamins are prescribed for pregnant women, which also contain it, but in a smaller dosage. In any case, the need to take any vitamins should be determined only by a doctor based on available data on the health status of the pregnant woman.
Analogues
Among the complete analogues of the monomedicine Folic acid, the following can be distinguished:
- Vitrum folicum. One tablet contains 0.4 mg of active substance. Indications, route of administration and dosage correspond to the original drug.
- Folacin. Contains 5 mg of active ingredient in 1 tablet. It is a therapeutic agent for the elimination of folate deficiency anemia.
Complex preparations that contain other beneficial substances besides folic acid include:
- Foliber. Also contains vitamin B12. Among the contraindications are individual intolerance to the components of Foliber, lactose intolerance, lactase deficiency, glucose-galactase malabsorption. The dosage of folic acid in 1 tablet is 0.4 mg, and cyanocobalamin (vitamin B12) is 0.002 mg, which is the minimum daily dosage.
- Elevit pronatal. This drug is a combination of vitamins and minerals necessary for the health of a pregnant woman and her baby. It contains 0.8 mg of folic acid. Contraindications to taking this vitamin complex are individual intolerance to the components, an excess of one or more substances of the drug in the body, kidney and liver diseases, impaired absorption and excretion of iron, problems with excessive excretion of calcium in the urine.
- Alphabet Mom's health. The uniqueness of this vitamin complex is that all the substances contained in it (namely 13 vitamins with folic acid together, 11 minerals and taurine) are distributed among three tablets in such a way that they do not interfere with the absorption of each other. Vitamin B9 is contained in two tablets of 0.3 mg each. Contraindications include sensitivity to the components of the drug, as well as hyperfunction of the thyroid gland. The manufacturer recommends taking each tablet separately throughout the day. But it is also possible to take all three tablets at the same time. But the effectiveness of taking the drug decreases.
- Folio. The drug contains folic acid in the amount of 0.4 mg and 0.2 mg of iodine in 1 tablet. Contraindications include individual intolerance to the components. Should be taken with caution by women with thyroid diseases.
In both my first and second pregnancies, I took regular Folic acid until the 12th week of pregnancy. The gynecologist did not prescribe me any further multivitamins for expectant mothers. In my opinion, with a nutritious, varied diet, the body does not require additional sources of vitamins and minerals, even when a woman is in an “interesting” position.
Photo gallery: analogues of the drug Folic acid
Foliber, in addition to folic acid, contains vitamin B12. Complex of vitamins Alphabet Mom's Health is distributed between 3 tablets. Vitrum Folikum is a complete analogue of Folic acid. Folacin contains. It is prescribed only for test-confirmed folic deficiency anemia. Elevit pronatal includes a complex necessary for a pregnant woman. 
Folio is additional source folic acid and iodine for expectant mothers
Folic acid during pregnancy is an essential substance for a woman’s body and pregnancy.
A deficiency of folate compounds or vitamin B9 is dangerous and leads to changes in the blood composition of the expectant mother and child, and disturbances in the development of the placenta. The consequence is the birth of premature babies or children with developmental pathologies.
Importance for the body
Folic acid is found in foods:
- broccoli;
- green pea;
- carrot;
- bananas;
- citrus;
- leafy greens;
- yeast;
- bread products, etc.
A balanced diet is required to receive the required amount of B9. But even in this case, the development of vitamin deficiency is possible.
The reason is the rapid destruction of folic acid during food storage. Moreover, a pregnant woman’s body’s need for the vitamin increases significantly.
Other causes of folic acid deficiency:
- low dietary intake;
- genetic diseases (the body does not have enzymes for the absorption and processing of folate);
- chronic diseases of the intestines or stomach (normal absorption of the substance is disrupted);
- passion for alcoholic drinks;
- the use of certain medications - sulfonamides, oral contraception, anticonvulsants, antacids, anti-tuberculosis drugs.
Folic acid during pregnancy
Lack of vitamin B9 is a scourge among pregnant women these days. If the expectant mother has constant weakness, increased fatigue, anemia, dizziness and headaches, irritability - perhaps the reason is a deficiency of folic acid.
The importance of the vitamin in the body is enormous for the production of proteins and nucleic acids. It is necessary for the regeneration of cells and tissues, maintaining the normal state of all organs, and preventing the transformation of cells into cancer.
An even greater role of folic acid during pregnancy. It ensures normal growth and development of the fetus.
Adequate folate levels are important in the 1st trimester. During these months, all organs and systems of the embryo are formed, and most importantly, its nervous tissue and placental vessels.
Why is deficiency dangerous?
The main danger of vitamin B9 deficiency during pregnancy is insufficient development of the neural tube in the embryo.
This leads to the following developmental defects:
- fading of pregnancy, that is, fetal death in utero;
- hydrocephalus, or dropsy of the brain;
- anencephaly, that is, the embryo completely lacks a brain;
- spina bifida;
- brain herniation;
- impaired mental function;
- physical underdevelopment.
The importance of folic acid for vascular system in the uterus. Consequences of a lack of substance:
- premature placental abruption;
- spontaneous termination of pregnancy.
Folate deficiency affects the well-being of a pregnant woman. The manifestations are:
- toxicosis in the early stages;
- rapid fatigue;
- weakness;
- decreased appetite;
- digestive disorders;
- headache and dizziness;
- leg cramps.
For this reason, doctors recommend drinking folic acid already at the stage of pregnancy planning. In reality, women often find out about conception at 5-6 weeks, and it is during this period that the embryo is especially susceptible to vitamin deficiency.
How to use?
Folic acid is available in tablet form in pure form or in combination with cyanocobalamin (vitamin B12) or ascorbic acid. They also produce vitamin complexes and biological supplements containing B9.
The tablets are taken without chewing and washed down with plain water. Take regardless of food.
When to start?
It is better to start taking folic acid before conception. This will prevent possible pathologies.
WHO - The World Health Organization recommends that all pregnant women take folic acid and iron supplements. The dosage is prescribed by the doctor managing the pregnancy. The woman’s medical history must be taken into account, the presence of any chronic diseases.
Until when should you drink it?
Folic acid during pregnancy is especially important in the first trimester, that is, from conception to 12 weeks.
Then you can stop taking the drug, provided that there are no manifestations of its insufficiency. In some cases, a woman is prescribed a vitamin and then in the 2nd and 3rd trimesters.
It is advisable to start taking folic acid when planning pregnancy, then before childbirth and the end of breastfeeding.
The dosage varies depending on the timing:
- The period of planning conception – 400 mcg daily.
- First trimester of pregnancy – 600 – 800 mcg.
- From the 13th week until the end of pregnancy - 800 mcg per day.
- During breastfeeding - 400 - 600 mcg per day.
If necessary, the gynecologist can increase the daily dose:
- For miscarriages, fetal death, birth of children with developmental defects - 4 mg per day.
- For diabetes or epilepsy in a woman - 1 mg.
- When taking certain medications - 800 mcg - 4 mg per day (anticonvulsants, sulfonamides, alcohol-based medications, anti-tuberculosis, etc.).
Drugs
Folic acid is produced both in pure form and in the form of preparations:
- Folic acid tablets. Contains 1 mg vitamin B9. For prevention, the recommended dosage is 1 tablet per day.
- Folio. Contains 400 mcg folate combined with 200 mcg iodine. Taking it prevents the lack of B9 and iodine in the body of a pregnant woman.
- Folacin. The content of the active substance in the tablet is high – 5 mg. Therefore, it is used not for prevention, but for the treatment of deficiency.
- Gendevit. Polevitamine in the form of dragees. One contains 300 mcg of folic acid.
- Mom is complimentary. Multivitamin complex. One capsule contains 400 mcg of vitamin.
Contraindications
Folic acid during pregnancy is contraindicated in the following cases:
- allergic reaction or individual intolerance to folic acid;
- cancer in close relatives;
- vitamin B12 deficiency;
- chronic pyelonephritis;
- bronchial asthma.
Video about folic acid
Consequences of overdose
An overdose of vitamin B9 during pregnancy is difficult to achieve, since it is a water-soluble substance. Its absorption by the body occurs only in the required quantity, and the excess is excreted through the kidneys.
However, the symptoms of folic acid overdose are as follows:
- causeless irritability;
- disorders digestive system– nausea and vomiting, flatulence, diarrhea, lack of appetite;
- insomnia;
- impaired renal function.
An overdose of folic acid is said to occur when a daily dose of more than 15 mg enters the body.
Folic acid during pregnancy is a vitamin necessary to maintain the body of the expectant mother and the proper development of the fetus. B9 deficiency leads to irreversible consequences in the form of defects in the embryo. To prevent complications, it is advisable to start taking folic acid already at the stage of pregnancy planning and continue until the 12th week, and even better until childbirth and the end of breastfeeding.
One of essential vitamins is folic acid, which during pregnancy must be in the diet of the expectant mother. Without exaggeration, the development of the fetus depends on this, since scientists have proven that meeting the daily requirement for folic acid allows the neural tube to develop without defects or defects.
Many people have not encountered the concept of folic acid or vitamin B9 during their lives, and therefore information awareness on this issue often tends to zero. That is why in this article we will give answers to all the questions related to vitamin B9 that a future mother may have.
Folic acid: what, why and for what?
Folic acid or “B9” is a vitamin that belongs to the group of water-soluble vitamins and has a vital role in the human body in general, but especially for expectant mothers. B9 controls many processes in the body that are vital. This vitamin controls protein metabolism and the synthesis of nucleic acids, which are directly related to the life of cells (growth, division, etc.). And since the process of fetal development is directly related to the process of cell division and growth, vitamin B9 is indispensable for a pregnant woman.
Folic acid is practically not synthesized by the human body
Unfortunately, our body practically does not synthesize folic acid on its own. An extremely small amount is synthesized within the colon by its microflora, but this amount does not cover the daily requirement for vitamin B9 even by half. Therefore, a person has to compensate for the deficiency of this component on his own by consuming foods high in it.
Do I need to take additional medications?
The daily norm of folic acid is quite high, and we should also not forget that the norm threshold for pregnant women is higher than for ordinary women, since most of the vitamin is used by the body specifically for the development of the baby. Especially in the first trimester.
Folic acid should be consumed by pregnant women, especially in the first trimester, when the baby’s organs are forming
For this reason, it would be advisable to use special vitamin complexes containing an amount of B9 equal to or slightly higher than the daily requirement. If you are still not sure about the need to take additional medications, then we will give two convincing arguments:
- Taking folic acid during pregnancy is a proven and used worldwide prevention of malformations of the neural tube in the fetus, from which the full development of the central nervous system will later occur.
- Many foods containing folic acid are not eaten raw. And during the heat treatment of food, most of the acid is destroyed, which reduces the body’s receipt of the vitamin from natural products to a minimum.
Medicinal vitamin complexes in in this case will be more effective, since one capsule or tablet will contain the full daily requirement. This way, you will save yourself from unnecessary headaches and guarantee the normal development of the fetus. The best option Of course, there will be a combination of eating natural sources of folic acid and using vitamin complexes. It has been scientifically proven that an overdose of B9 does not cause any harm. embryonic development, in contrast to its disadvantage.
Deficiency B9: symptoms and meaning
Folic acid affects many functions in the body, which can be affected by its deficiency and cause disruption in the entire harmonious functioning of the body.
For example, vitamin B9 prevents the liver from excess fat, which reduces its performance and subsequently leads to the development of fatty liver hepatosis.
If you don't have enough folic acid, a pregnant woman may experience serious illness
Folic acid is also involved in the process of hematopoiesis, namely in the synthesis of red blood cells - erythrocytes. Their deficiency can lead to the development of moderate or severe iron deficiency anemia. These degrees of anemia are always accompanied by immunodeficiency, which can be especially dangerous for the body of a pregnant woman, since the treatment of any minor disease is complicated by a ban on taking medications.
Folic acid has an effect on the central nervous system, as it is directly related to neurotransmitters. Irritability and memory impairment are characteristic manifestations of vitamin B9 deficiency on the part of the nervous system.
If you find yourself matching the list of such symptoms, then you clearly have a lack of folic acid in your body:
- constant weakness;
- headaches and dizziness;
- frequent fainting;
- weight loss;
- unhealthy pallor (as a manifestation of anemia).
How much is needed?
As a medicine, B9 has the form of a yellow powder consumed in capsules. It is easily excreted from the body along with urine, so an overdose of folic acid is impossible.
It is also important to explain how much and for how long you take folic acid during pregnancy.
According to scientists, the recommended dose of this vitamin during pregnancy is 600-650 mcg per day, and for nursing mothers – 500 mcg per day.
The World Health Organization writes that a slightly smaller amount of folic acid is sufficient to cover the daily requirement, but a slight excess will be harmless. Scientists recommend starting to take folic acid at the planning stage of pregnancy, for all nine months and during breastfeeding.
In what foods can you find folic acid?
The word “folium”, from which “folic” comes, is literally translated from Latin as “leaf”, and therefore it is quite logical that the largest amount of vitamin B9 is found in greens and leaves. You can find this essential component in spinach, lettuce and onions. Even parsley contains small amounts of the vitamin. On average, about 51.5-51.7 mcg per 50 grams of parsley.
There is also a lot of vitamin B9 in various vegetables and fruits, but most of all in cabbage, legumes, carrots, corn, avocado, tomatoes and even watermelon.
Fruits and vegetables that contain folic acid
Among grains and legumes, you should give preference to beans and lentils, which on average contain about 150-190 mcg (almost a third of the daily requirement!) of folic acid per 100 grams of product. Different types Cabbage also contains plenty of vitamins, although the amount, depending on the type, ranges from 15 mcg to 35 mcg per 100 grams of product. These vegetables are among the most accessible in our region and at the same time the richest in folic acid.
You can also find this vitamin in carrots and beets, which are good source fiber necessary for good intestinal motility and prevention of constipation. For pregnant women, this issue is especially relevant due to the fact that in almost a third of pregnant women, regular constipation leads to the development of hemorrhoids.
Watermelons and tomatoes contain about 40-60 mcg of folic acid per 100 grams of product. But they are also sources of vitamin C, without which the absorption of cyanocobalamin (B12) and pyridoxine (B6) is impossible. These two vitamins also have great importance in the functioning of the body. With a lack of cyanocobalamin, one of the subtypes of anemia develops, and pyridoxine is involved in the formation of protein bonds.
Corn is a rich source of vitamins in general and B9 in particular. There are about 25 micrograms of folic acid per 100 grams of corn grains. The most useful thing, of course, will be to eat corn during the season, since canned corn does not contain as many useful elements.
You can reach your daily folic acid requirement by introducing apples, pears, strawberries, currants, grapes, bananas, etc. into your diet.
Oranges, lemons and other citrus fruits are also a real vitamin bomb, so you need to approach their use with care. Especially if you are prone to allergic reactions. A medium-sized orange contains almost 20% of the daily requirement of the vitamin.
It wouldn’t hurt to include several types of nuts in your diet, since today the food market offers big choice. Folic acid can be found in almost all types of nuts: almonds, hazelnuts, hazelnuts, peanuts and others. For reference, 100 grams of hazelnuts contain about 70-75 mcg of vitamin B9, and peanuts - 230-245 mcg.
A large amount of vitamin B9, as well as E and B6, is found in flax, pumpkin, and sunflower seeds. They can be eaten raw or fried. This addition, by the way, will make any salad of greens and vegetables more appetizing and rich.
So do not forget that folic acid is also found in animal products. One of these foods rich in B9 is the liver of various animals. For example, in normal chicken liver 100 grams contain 235-250 mcg of vitamin, pork contains about 230 mcg.
However, heat treatment destroys most of the folic acid, so the best option There will be an introduction of several types of liver into the diet.
If you prefer fish, then cod liver is an excellent choice. It contains a large amount of vitamins B9, A, E and D. Plus, such a liver, even after heat treatment, contains enough fats and proteins necessary for a balanced diet for the expectant mother.
A significant amount of folic acid is found in eggs, especially raw ones. However, in order to protect yourself from salmonellosis, which you can carry chicken eggs, scientists offer an incomparable option for pregnant women - quail eggs. These eggs are hypoallergenic and cannot transmit the causative agent of salmonellosis, and therefore can be consumed without shame even by pregnant women.
Any woman planning to get pregnant and become a mother soon should consciously and carefully prepare for this new status. And if oh healthy way Everyone knows about life, parting with bad habits and walks in the fresh air, then expectant mothers often ignore taking certain vitamins and medications before pregnancy. One of these remedies is folic acid.
What is folic acid?
Folic acid is vitamin B9. You can often hear the general name - folates; they are derivatives of this vitamin. We must understand that we get them from food, and folic acid tablets are a synthetic product that is already converted into folates inside the body.
All derivatives of vitamin B9 play an important role in hematopoiesis, that is, the formation of new blood cells. Therefore, the lack of these substances leads to anemia - a condition in which red blood cells insufficient, or they are of the wrong shape and do not perform their functions.
Folates have another very important feature: They stimulate the formation of nucleic acids (DNA and RNA), which are the basis of all cells in the body. Therefore, folic acid is necessary for all rapidly dividing human tissues, including fetal tissues.
The role of folic acid:
- participates in the formation of DNA in all cells, that is, the source of hereditary information
- stimulates hematopoiesis
- indirectly blocks the formation of cancer cells
- restores muscle tissue
- during pregnancy:
- plays a role in the formation and development of neural tissue of the embryo
- participates in the formation of blood vessels of the placenta
Why do you need folate during pregnancy?
During pregnancy, especially in the early stages, folate consumption increases sharply. All cells of the embryo rapidly divide in order to form full-fledged tissues over time. The nervous tissue of the future human being transforms especially quickly and complexly. And it is precisely this that requires large amounts of folic acid.
Folic acid deficiency during pregnancy can occur for the following reasons:
- Insufficient intake of folate from food
- Impaired absorption of folates (in chronic inflammatory diseases of the stomach and intestines)
- Genetic disorders of the folate cycle. In rare cases, a woman's body lacks essential enzymes (MTHFR). As a result, folic acid is not converted into folates, and they do not perform the necessary functions. Intermediate metabolic products accumulate in the body, which can lead to cardiovascular diseases, tumor processes, infertility, etc. If such a mutation is present, it is recommended to take folic acid derivatives, for example, Metafolin. It is absorbed faster and in greater volume.
- Taking certain drugs against epilepsy and hormonal drugs sharply reduces the level of folate in the blood:
- oral contraceptives (see)
- barbiturates, diphenylhydantoin
- sulfonamide drugs (for example), inhibiting the synthesis of vitamin B9 by intestinal microflora
- drinking alcohol also reduces their levels
How does the body get folic acid?
3 sources of folic acid:
- From food - in the form of folates
- A small amount of vitamin B9 is synthesized by the body itself (intestinal microflora) when normal functioning Gastrointestinal tract - in the form of 5-methyltetrahydrofolate
- Chemical folic acid - from vitamin supplements
Folates were first isolated from spinach leaves. Subsequently, it turned out that they are present in large quantities in almost all leafy vegetables. Other sources of folic acid include citrus fruits, green peas, bread, liver, nutritional yeast, cheeses, eggs and cottage cheese.
If there are so many foods containing folate, then why do you need to take folic acid tablets during pregnancy?
- Technological progress and market economy forces producers of plant and animal products to accelerate the growth of animals on the farm and the cultivation of greens and vegetables in the greenhouse, respectively, less of the natural isomer of folic acid accumulates in products. Consequently, reference Information from old printed publications on the folate content in various products today is not relevant and is overestimated.
- The main disadvantage of “natural” folates is their rapid destruction during heat treatment. Cooking, frying and stewing destroy almost 90% of the vitamin. But even eating raw foods does not guarantee intake. required quantity into the blood. Moreover, vitamin B9 is sensitive to storage conditions and shelf life:
- When boiling an egg, 50% of vitamin B9 is destroyed
- after 3 days the greens lose it up to 70%
- in meat after heat treatment - up to 95%
- The presence of chronic diseases of the intestines and stomach in a person does not allow the vitamin to be absorbed in full.
Therefore, about 60% of the population suffers from folate deficiency, and the body of a healthy pregnant woman receives a little more than 50% of the daily requirement of folic acid from food.
However, numerous studies by scientists have established that the body recognizes how folic acid enters the body and its absorption directly depends on this. Of course, intake from natural sources is better absorbed into the gastrointestinal tract even with metabolic disorders and gastric acidity and therefore has serious advantages over synthetic folic acid.
Folic acid synthesized by the body itself in the form of 5-methyltetrahydrofolate does not interact as strongly with other medications and does not mask the hematological signs of vitamin B12 deficiency as synthetic folic acid. In addition, it eliminates the possible negative consequences of an excess of unreacted vitamin B9 in peripheral vessels.
But in order to provide a pregnant woman’s body with folates (and the need for them increases by 50 percent), you need to eat a huge amount of the above foods every day. In modern conditions this is impossible, and given the decrease in its quantity in modern products, it is ineffective. Modern drugs folic acid contain the required amount, are safe for pregnant women in the recommended dosage and have been studied quite well.
Consequences of folic acid deficiency during pregnancy
Pathologies on the mother's side:
- impaired hematopoiesis in women: anemia, low resistance to infections and a tendency to form blood clots.
- reduced tolerance to physical and mental stress
These symptoms are typical for women with a hereditary defect in the genes responsible for the folate cycle. Typically, symptoms of vitamin deficiency occur even before pregnancy, combined with iron deficiency anemia and diseases of the cardiovascular system. In case of gene disorders, it is necessary to take large doses of folic acid with mandatory monitoring of blood tests, only under the constant supervision of a specialist.
Pathologies from the fetus:
- neural tube defects in the fetus
- miscarriage: ) and intrauterine fetal death
- defective placenta and, as a result, oxygen starvation of the fetus
Neural tube defects in the fetus
Already in the third week after conception, a tube with a thickening at the end is formed in the embryo - the future spinal cord and brain. When exposed to unfavorable factors, including folic acid deficiency, the construction of this neural tube may be disrupted or stopped. As a result, very serious, sometimes incompatible with life, fetal malformations are formed.
- Anencephaly is the absence of most of the brain. The defect is incompatible with life, therefore, after confirming the diagnosis using ultrasound, termination of pregnancy is recommended.
- A cephalocele is a split in the skull through which the meninges or the brain itself may protrude. Depending on the degree of tissue bulging, the prognosis can vary from fatal to favorable.
- Spina bifida is the most common case of neural tube defect. Through the vertebral defect, the spinal canal is exposed and the membranes of the spinal cord bulge. The prognosis depends on the level of damage to the vertebrae and the degree of bulging: a quarter of children die in the first days of life, most become disabled, and only a small percentage of children do not have problems with urination and movement in the legs in the future.
Not all consequences of folic acid deficiency can be detected during pregnancy or immediately after childbirth. Minimal disorders of the nervous tissue make themselves felt in adulthood with difficulties in learning and concentrating. Scientists at the University of Cambridge have conducted a number of studies proving the connection between B9 deficiency and emotional disorders in children.
In completely healthy women who eat a nutritious and varied diet, a lack of folic acid may not affect their well-being. First of all, the embryo and placenta will suffer, and already in the very early stages. Therefore, drinking folic acid during pregnancy means taking care of the health of the unborn baby.
At what stage of pregnancy should you take folic acid supplements?
Taking folic acid to prevent fetal malformations should begin at the stage of preparation for pregnancy, at least three months before the expected conception. This is why pregnancy must be planned. If conception occurs unexpectedly, then you should start taking the drug as soon as it becomes known.
Reasons for taking folate during pregnancy planning:
- With an unbalanced diet, a woman may have a reduced level of folic acid, so it takes time to replenish its reserves. This usually takes three to four months.
- The neural tube of the embryo is formed at such early that a woman may not yet suspect that pregnancy has occurred, especially with a long menstrual cycle.
- Folate deficiency can make it difficult to get pregnant.
Folic acid dosage during pregnancy
In most cases, you should take 400 mcg of folic acid per day three months before conception and throughout pregnancy. In some cases, it is recommended to increase the dosage:
- up to 1 mg per day for epilepsy and diabetes
- up to 4 mg per day if there has been a history of children with neural tube defects
Increased doses of folate can only be prescribed by a doctor after a thorough examination.
The dose of folic acid during pregnancy remains the same.
Thus, in the USA, all women planning a pregnancy must take the drug at a dose of 400-800 mcg per day a month before conception and during 3 months of pregnancy. Moreover, these recommendations exist in conjunction with the fortification of food products with folates (for example, adding them to pasta), which is not observed in our country. And rightly so! Why add a vitamin to a product that is destroyed during further 10-minute cooking? If you take synthetic folic acid, it is better in tablet form!
Consequences of excess folic acid
Vitamin B9 is a water-soluble substance, so all its excess is successfully excreted by the kidneys. It is very difficult to overdose on folic acid during pregnancy, when the vitamin will become toxic and have an adverse effect on the fetus. This vitamin should be used with caution when:
- severe pathology of the liver and kidneys in a pregnant woman
- hereditary defects of the gene responsible for folate metabolism. Excess folic acid can further disrupt the balance in this cycle, leading to the same consequences for the fetus as a deficiency of the vitamin. The use of this substance in such patients should be monitored by a doctor.
- allergic reactions to synthetic vitamins
The effect of folic acid on fetal development has been studied for a very long time and everywhere. Scientists from the University of Newcastle noted cases of children born with altered folate cycle genes from mothers taking this drug. That is, to process external folic acid, nature “invented” a new gene. Everything would be fine, but some human diseases may be associated with this gene.
These studies were not widespread, since the theory was not confirmed in practice. But the reduction in the incidence of embryonic malformations in mothers taking folic acid has been confirmed by numerous studies around the world. The number of cases of spina bifida fell by a quarter after the widespread introduction of folic acid supplementation.
In the early 90s in the USA they even tried to fortify food with this vitamin, which did not lead to the desired results, since the dosage of folic acid during pregnancy should be at least 2 times higher than usual. Considering that it was mainly flour, high-calorie foods that were enriched with vitamins, the target audience(pregnant and lactating women) tried to avoid them.
There are suggestions that an overdose of folic acid during pregnancy can lead to an increase in the child’s body weight, an increased risk of obesity and diabetes mellitus in the child in the future, as well as a tendency to allergies, bronchial asthma, can lead to immunity disorders. But these are only assumptions; there are no convincing studies confirming such risks.
Conclusion: convincing evidence negative influence There is no standard dosage of folic acid for a healthy pregnant woman. There have been studies that have confirmed that taking even 15 mg per day is non-toxic. But like any synthetic substance, this the drug must be used strictly in the required dosage. Moreover, the positive effect on the nervous tissue of the fetus at a dosage of 400 mg and 4 mg differs slightly. Therefore, the doctor decides how much folic acid each individual woman needs to take during pregnancy.
As for taking folic acid by non-pregnant women, in high doses and for a long time, a constant overdose can lead to dire consequences. Exceeding the recommended dose may lead to:
- in men the risk of developing
- Taking folic acid by a non-pregnant woman at a dosage of 500-850 mcg per day increases the risk of breast adenocarcinoma by 20%, over 850 mcg - by 70%
- in older people, long-term overdose causes disorders of psycho-social functions
Symptoms of folic acid overdose:
- metallic taste in the mouth,
- increased excitability, irritability, sleep disturbance (see)
- gastrointestinal disorders: vomiting, nausea, diarrhea (but similar symptoms also accompany 1st trimester toxicosis)
- kidney dysfunction
- one of the serious consequences of overdose is zinc deficiency, vitamin B12 deficiency
Tests to determine folic acid levels
A blood test for folic acid levels is prescribed for patients with anemia to determine its cause or for patients with homocysteinemia. Healthy pregnant women do not need such a test, since when taking folate the level of this substance in the blood will be higher than normal in any case. And this is absolutely physiological. When planning pregnancy, folic acid is prescribed regardless of its initial amount in the body.
In what form should you take folic acid?
The modern pharmaceutical industry offers huge selection medications containing folates. Most of them differ only in dosage and price.
Many folic acid tablets have an inconvenient dosage of 1 mg; such tablets have to be broken in half. It is better to find folic acid in the dosage of 400-500 mcg, which is required for most pregnant women. How to take the drug for pregnant women with homocysteinemia is determined by the attending physician.
Pharmaceutical market in last years offers a large selection of multivitamin complexes created specifically for pregnant women. Such drugs should only be taken by people living in extreme conditions. unfavorable conditions and having a meager diet. For a successful and healthy pregnancy, a modern woman needs:
- folic acid in the amount of 400 mcg per day
- (potassium iodide) in areas with its deficiency
- if anemia occurs, use iron supplements
The use of multivitamin complexes to compensate for folate deficiency may not be considered appropriate. Folic acid is one of the few medicines, the effectiveness and safety of which during pregnancy has been proven in numerous studies. Taking just one tablet a day is simple, inexpensive and reliable way reduce the risk of serious illnesses for your baby and give him a full life!
Folic acid dosage
Which folic acid supplements are best to take?
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400 mcg. 30 pcs. 120 rub. |
1000 mcg. 50 pcs. 40 rub. half a tablet a day |
1000 mcg. 50 pcs. 25-30 rub. (half a tablet) |
200 mcg. 90 caps. 110 rub. 2 tables each in a day |
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400 mcg. 100 pieces. 500 rub. |
400 mcg. 100 pieces. 300 rub. |
1000 mcg. 50 pcs. 25-30 rub. (half a tablet per day) |
1000 mcg. 50 pcs. 30 rub. (half a tablet per day) |
Instructions for use of folic acidIndications: prevention of the development of neural tube defects in the fetus in the 1st trimester of pregnancy (1-3 months before the planned pregnancy and in the first trimester), as well as in case of folic acid deficiency.
Dosage: during pregnancy 400-800 mcg in the 1st trimester, with folic acid deficiency - 400 mcg once a day. |
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Frequently asked questions about folic acid
Over the course of the previous 5 years, I had 3 pregnancies that miscarried at 10 weeks. What dosage of folic acid do I need?
Three or more frozen pregnancies are a reason to examine a married couple. After this, the doctor will most likely prescribe 4 mg of folic acid per day.
The doctor prescribed 1 mg of folic acid per day. It turned out that I am allergic to it. What should I do?
The allergic reaction in this case is associated with the components of the tablets (dyes, sweeteners). You can try changing the drug or switching to injections.
I accidentally took 2 tablets of folic acid, 500 mcg each, that is, I got 1 mg per day. Is it dangerous?
This dose is not toxic and will not harm you or your baby. Continue taking the drug 1 tablet per day.
I am 39 years old and have been planning a pregnancy for six months. The doctor prescribed 4 mg of folic acid, since at my age there is a risk of its deficiency and miscarriage. Is such a large dose necessary?
The risk of interruption in your case increases slightly due to age, and not due to folate deficiency. Therefore, such an increase in the dosage of the drug is inappropriate.
