Folic acid (vitamin B9) is one of those vitamins that, once in the body, dissolves. The body does not make its own reserves of folic acid, which is why it is so important to get it from food and sometimes from supplements.

But what does it have to do with pregnancy, and how does it help your baby? And if it is so beneficial, when and why can it have negative effects? We tell you everything about how folic acid deficiency occurs, what are the consequences and why it is recommended to take folic acid during pregnancy, in this article.

What is folic acid?

In nature, there are many foods that contain vitamin B. Sources vary from plant-based foods (broccoli, spinach, kale, citrus fruits) to animal-based foods (eggs, liver, etc.). This natural form of vitamin B9 is called folate.

Well, because sometimes the body doesn't get enough vitamin B9 from food, it needs help with supplements. Vitamin B9 is also added to foods such as flour, cereals or bread. So we also need a synthetic form of vitamin B, and this is called folic acid.

Folic acid is the synthetic form of water-soluble vitamin B9, which you only find in nutritional supplements. It is an essential nutrient for your body, which contributes to the optimal functioning of the body and to the prevention of complications generated by folic acid deficiency.

The role of folic acid

One of the main roles of folic acid is to contribute to the production and repair of DNA and RNA in the body, especially when there is rapid growth of cells and tissues. That is why it is especially recommended for babies, teenagers and pregnant women.

Folic acid along with vitamin B12 supports red blood cell production and optimal iron function to prevent anemia. Other important roles include:

• Energy production

• Production of certain types of protein

• Metabolism of carbohydrates

• Optimal cell growth, division and function

• Regulation of the functioning of the nervous system

• Prevention of fetal problems at birth

On the other hand, a low level of folic acid can lead to various health problems, including anemia, increased risk of heart problems, and problems with the development of the fetus in pregnancy. This is also why folic acid supplementation is so important in pregnant women.

Folic acid - The main benefits

Folic acid is often recommended in the form of supplements to support several body functions.

Both synthetic folic acid and folate (natural folic acid) are found in these supplements. Although both are forms of vitamin B9, the body metabolizes them differently and thus can produce more beneficial effects.

If you were wondering what folic acid does, here are the main benefits.

Folic acid prevents birth defects and pregnancy complications

Folic acid is recommended during pregnancy to support the normal and uncomplicated development of the fetus, but also to prevent health risks for the mother. Thus, folic acid supplementation during pregnancy can prevent:

• Birth defects of the fetus: especially neural tube defects such as spina bifida (when the baby's brain, meninges or spine do not fully develop) and anencephaly (when the baby's skull and bones are not fully formed before birth).

• Complications during pregnancy: such as preeclampsia (high blood pressure and excess protein in the urine after the 20th week of pregnancy).

Treats folate deficiency

Lack of folic acid in the body, or folate deficiency, can have many negative effects. Anemia, mental impairment, decreased immunity, depression and fetal development problems during pregnancy are some of the most common.

Folic acid supplementation can regulate folate levels in the body, thus restoring balance and preventing complications.

Folic acid keeps the brain healthy

Because folate deficiency is associated with an increased risk of dementia and problems with mental functioning, folic acid supplements may support brain health. Statistics show that an optimal consumption of folate can also protect you from Alzheimer's.

Folic acid helps treat mental disorders

Lack of folate has also been associated with schizophrenia, depression and other mental disorders because it affects the production of neurotransmitters. Thus, recent studies suggest that taking folic acid can improve the symptoms of problems such as:

• Bipolar disorder

• Schizophrenia, including when administered with antipsychotics

• Postpartum depression, including when administered with antidepressants

Folic acid reduces risk factors for heart disease

One of the known benefits of folic acid is that it lowers blood levels of homocysteine, an amino acid that in turn contributes to an increased risk of heart problems. A low level of folic acid is often associated with a high level of homocysteine.

By metabolizing this amino acid and improving the function of resistance vessels, folic acid supports heart health. According to studies, it prevents by 10% the risk of heart attack and by 4% the risk of other cardiovascular diseases.

  Folic acid can help keep blood sugar at an optimal level

In people with diabetes, folate and folic acid supplements can balance blood sugar and reduce insulin resistance. Women suffering from diabetes are recommended to consume approx. 400 mcg of folic acid before pregnancy.

Folic acid supplements reduce inflammation

There are many theories that folic acid reduces inflammation, some of which have been confirmed by studies. Vitamin B9 supplements can reduce markers of inflammation such as CRP (C-Reactive Protein) in women with PCOS (Polycystic Ovary Syndrome).

Folic acid helps reduce the side effects of medications

Methotrexate, for example, is a treatment that suppresses the activity of the immune system to treat conditions such as psoriasis or rheumatoid arthritis. Because it supports important body functions, folic acid can reduce the side effects caused by such drugs.

Folic acid helps to reduce kidney failure

Homocysteine can build up when the kidneys are not functioning optimally and filtering the blood. This is precisely why approximately 85% of people with chronic kidney failure have high levels of homocysteine in their blood.

Folic acid can help lower homocysteine and prevent heart disease in these people.

Causes of folic acid (vitamin B9) deficiency

Folic acid deficiency can occur for several reasons. Vitamin B is water-soluble and dissolves in the body, so no reserves remain stored in the body. Folate and folic acid must be administered and absorbed constantly in the body, through a balanced diet and correct supplementation.

The lack of such a balanced diet is one of the main sources of vitamin B9 deficiency, along with causes such as:

Insufficient intake of folate-rich foods

Pregnancy and breast-feeding

Dialysis

Hemolytic anemia

Achlorhydria (lack of stomach acid) or hypochlorhydria (a low level of stomach acid)

Surgery or disorders that affect the body's ability to absorb folate (eg gastric bypass surgery or celiac disease)

Medicines that decrease folate absorption (eg methotrexate or sulfasalazine)

Excessive alcohol consumption

Symptoms of folic acid deficiency

When a sufficient amount of folate is not present in the body, a deficiency occurs that can cause megaloblastic anemia, that is, insufficient red blood cells in the blood. This is the main symptom of the deficiency, and manifests itself through symptoms such as:

• Fatigue

• Concentration problems

• Headaches

• The feeling of weakness and difficult breathing

• Weight loss

• States of irascibility

• Heart palpitations

• Pain inside the mouth and on the tongue

• Change in the color of the skin, nails and hair

• Depressive states

• The appearance of certain allergies

• Memory loss

How to take folic acid (vitamin B9) - recommended doses

Although it is important that the diet is balanced and rich in sources of folate, it has been confirmed that the body absorbs folic acid better from supplements and foods enriched with vitamin B9. Thus, both sources are important, and a total consumption of:

65 mcg: for babies aged 0 to 6 months

80 mcg: for babies aged 7 to 12 months

150 mcg: for children aged 1 to 3 years

200 mcg: for children aged 4 to 8 years

300 mcg: for adolescents aged 9 to 13 years

400 mcg: For youth ages 14 to 18

400 mcg: for adults, after age 19

400-800 mcg: during pregnancy

500 mcg: while breastfeeding

Theoretically, studies confirm that a dose of folic acid not exceeding 1mg/day is generally safe for any healthy person. Basically, it is always good to follow the doctor's recommendation, even more so for babies, children, during pregnancy and in the postpartum period.

Adverse effects may occur if the dose of 1 mg per day is exceeded, and some studies suggest that too high doses of folic acid taken long-term, for example 0.8-1.2 mg/day, may increase the risk of cancer or heart attack in people who have heart problems. Folic acid reactions can also occur with various treatments. So always seek expert advice before using such supplements.

The importance of folic acid in pregnancy

During fetal formation, the spine is among the first parts of the body to develop from the embryo. After that, the baby's brain is also formed. A deficient amount of folic acid in the mother's body can affect the development of the spine and neural tube (brain and spine), so supplementation is very important.

Also, folic acid in pregnancy has an important role in the prevention of premature birth and heart disorders, contributing to the normal development of the fetus. If you want to read more about the natural development of the baby in each trimester of pregnancy, I have told you everything you need to know HERE .

How long to take folic acid during pregnancy

• general details

In general, folic acid supplementation is very important in the first trimester of pregnancy and doctors recommend a daily dose of approx. 400-800 mcg until week 12.

You can take folic acid even before you get pregnant and you can continue while breastfeeding with about 500 mcg per day.

But this amount varies for each woman and must be adjusted according to her own state of health. So always take only the doses your doctor recommends.

Foods containing folic acid

There are fortified sources of folic acid such as bread, pasta, flour, cereals, crackers and baked goods fortified with vitamin B12. But in addition to these, foods that naturally contain folate include:

• Asparagus and artichoke

• Green and red beans

• Spinach, kale and lettuce

• Brussels sprouts

• Broccoli and Cauliflower

• Peas

• Artichoke

• Avocado

• Peanuts

• Sunflower seeds

• Oranges

• Grapefruit

• Papaya

• BANANAS

• Cantaloupe

• Eggs

• Beef liver

Excess folic acid - manifestations

Not only the deficiency of folic acid has negative effects, but also the excess. Too much vitamin B12 consumption can lead to the accumulation of unmetabolized folic acid in the blood and a number of side effects. Such an excess is manifested by:

Weakening of the immune system

Disorders of brain functions

Abdominal cramps

Diarrhea, nausea and other digestive problems

Sleep disorders

Confusion and irritability

Epilepsy

Also, taking too much folic acid during pregnancy can negatively affect the development of the fetus's brain and increase the risk of autism.

The good news is that because vitamin B9 is water-soluble (it dissolves in water), it is easily eliminated from the body through urine. So it is quite rare to get to the situation where there is too much folic acid in the blood.

Side effects and contraindications of folic acid administration

One of the common side effects of taking folic acid is that it can mask another deficiency. For example, in the case of anemia. You may think folic acid is helping, but the source of your anemia may be something else, such as iron or B12 deficiency.

In the case of B12 deficiency, lack of proper treatment can lead to complications such as nerve damage. So it's very important to get a doctor's visit and a series of blood tests to determine exactly whether or not you need folic acid and other supplements.

Also, make sure you only take vitamin B9 as directed by your doctor and avoid excess to avoid the complications discussed above and possible negative reactions with other medications.

Folic acid vs folate. What is the difference between the two?

The main difference is the type of vitamin: synthetic vs. natural. Although folate and folic acid are often used interchangeably and are forms of the same vitamin (B9), they have different origins.

Folate refers to all forms of vitamin B9, including folic acid and 5-MTHF, a derivative of folic acid. Folate is also called the natural form of vitamin B9, as it is found in foods such as liver, green vegetables or citrus fruits.

Folic acid is the synthetic form of folate, with a different structure and slightly different effects on the body. This is the form of vitamin B9 added to fortified foods, multivitamins, and other supplements.

Frequently asked questions about folic acid

When should folic acid be taken in the morning or in the evening?

You can take folic acid at any time during the day, both in the morning and in the evening. It is not the time of day that is important, but when it should be administered in relation to meal times. Vitamin B9 is water-soluble, which means it is best taken with a glass of water just before a meal for complete and optimal absorption.

How many folic acid pills to take per day?

The recommended dose of folic acid depends on many factors such as age, health status, whether the patient is pregnant or breastfeeding, etc. Also, the number of pills recommended depends on their folic acid concentration. Always take folic acid exactly as your doctor recommends, both in terms of dose and when to take it.