Folic acid
Folic acid is a form of folate (a B vitamin) that everyone needs. If you can get pregnant or are pregnant, folic acid is especially important. Folic acid protects unborn babies against serious birth defects. You can get folic acid from vitamins and fortified foods, such as bread, pasta, and cereals. Folate is found naturally in foods such as leafy green vegetables, oranges, and beans.
What are folic acid and folate?
Folic acid and folate help the body make healthy new red blood cells. Red blood cells carry oxygen to all the parts of your body. If your body does not make enough red blood cells, you can develop anemia. Anemia happens when your blood cannot carry enough oxygen to your body, which makes you pale, tired, or weak. Also, if you do not get enough folate, you could develop a type of anemia called folate-deficiency anemia.
Why do women need folic acid?
- Before and during pregnancy. Folic acid protects unborn children against serious birth defects called neural tube defects. These birth defects happen in the first few weeks of pregnancy, often before a woman knows she is pregnant. Folate might also help prevent other types of birth defects and early pregnancy loss (miscarriage). Since about half of all pregnancies in the United States are unplanned1, experts recommend all women get enough Folate even if you are not trying to get pregnant.
- To keep the blood healthy by helping red blood cells form and grow. Not getting enough folic acid can lead to a type of anemia called folate-deficiency anemia. Folate-deficiency anemia is more common in women of childbearing age than in men.
How do I get folic acid?
- Through the foods, you eat. Folate is found naturally in some foods, including spinach, nuts, and beans. Folic acid is found in fortified foods (called "enriched foods"), such as bread, pasta, and cereals. Look for the term "enriched" on the ingredients list to find out whether the food has added folate.
- As a vitamin. Most multivitamins sold in the United States contain 400 micrograms, or 100% of the daily value, of folic acid. Check the label to make sure.
How much folic acid do women need?
Some women may need more folate each day. See the chart to find out how much folic acid you need.
If you:
|
Amount of folic acid you may need daily
|
|---|---|
| Could get pregnant or are pregnant | 400–800 micrograms. Your doctor may prescribe a prenatal vitamin with more. |
| Had a baby with a neural tube defect (such as spina bifida) and want to get pregnant again | 4,000 micrograms. Your doctor may prescribe this amount. Research shows taking this amount may lower the risk of having another baby with spina bifida. |
| Have a family member with spina bifida and could get pregnant | 4,000 micrograms. Your doctor may prescribe this amount. |
| Have spina bifida and want to get pregnant | 4,000 micrograms. Your doctor may prescribe this amount. Women with spina bifida have a higher risk of having children with the condition. |
| Take medicines to treat epilepsy, type 2 diabetes, rheumatoid arthritis, or lupus | Talk to your doctor or nurse. Folic acid supplements can interact with these medicines. |
| Are on dialysis for kidney disease | Talk to your doctor or nurse. |
| Have a health condition, such as inflammatory bowel disease or celiac disease, that affects how your body absorbs folic acid | Talk to your doctor or nurse. |
Are some women at risk for not getting enough folic acid?
Yes, certain groups of women do not get enough folate each day.
Women who can get pregnant need more folate (400 to 800 micrograms). Nearly one in three African-American women does not get enough folic acid each day.
- Spanish-speaking Mexican-American women often do not get enough folate. However, Mexican-Americans who speak English usually gets enough folic acid.
Not getting enough folate can cause health problems, including folate-deficiency anemia, and problems during pregnancy for you and your unborn baby.
What can happen if I do not get enough folic acid during pregnancy?
Neural tube defects are serious birth defects that affect the spine, spinal cord, or brain and may cause death. These include:
- Spina bifida. This condition happens when an unborn baby's spinal column does not fully close during development in the womb, leaving the spinal cord exposed. As a result, the nerves that control the legs and other organs do not work. Children with spina bifida often have lifelong disabilities. They may also need many surgeries.
- Anencephaly. This means that most or all of the brain and skull does not develop in the womb. Almost all babies with this condition die before or soon after birth.
Do I need to take folic acid every day even if I'm not planning to get pregnant?
- Your birth control may not work or you may not use birth control correctly every time you have sex. In a survey by the Centers for Disease Control and Prevention, almost 40% of women with unplanned pregnancies were using birth control.
- Birth defects of the brain and spine can happen in the first few weeks of pregnancy, often before you know you are pregnant. By the time you find out you are pregnant, it might be too late to prevent the birth defects.
- You need to take folic acid every day because it is a water-soluble B-vitamin. Water-soluble means that it does not stay in the body for a long time. Your body metabolizes (uses) folate quickly, so your body needs folic acid each day to work properly.
What foods contain folate?
- Spinach and other dark green, leafy vegetables
- Oranges and orange juice
- Nuts
- Beans
- Poultry (chicken, turkey, etc.) and meat
- Whole grains
What foods contain folic acid?
- Breakfast cereals (Some have 100% of the recommended daily value — or 400 micrograms — of folic acid in each serving.)
- Bread and pasta
- Flours
- Cornmeal
- White rice
How can I be sure I get enough folic acid?
If you are at risk for not getting enough folic acid, your doctor or nurse may recommend that you take a vitamin with folic acid every day. Most U.S. multivitamins have at least 400 micrograms of folic acid. Check the label on the bottle to be sure. You can also take a pill that contains only folic acid.
If swallowing pills is hard for you, try a chewable or liquid product with folate.
What should I look for when buying vitamins with folic acid?
Ask your pharmacist for help with selecting a vitamin or folic acid-only pill. If you are pregnant and already take a daily prenatal vitamin, you probably get all the folate you need. Check the label to be sure.
Vitamin label
Check the "Supplement Facts" label to be sure you are getting 400 to 800 micrograms (mcg) of folic acid.
Can I get enough folic acid from food alone?
Some women, especially women who could get pregnant, may not get enough folic acid from food. African-American women and Mexican Americans are also at higher risk for not getting enough folic acid each day. Talk to your doctor or nurse about whether you should take a vitamin to get the 400 micrograms of folic acid you need each day.
What is folate-deficiency anemia?
The symptoms of folate-deficiency anemia include:
- Fatigue
- Headache
- Pale skin
- Sore mouth and tongue
If you have folate-deficiency anemia, your doctor may recommend taking folic acid vitamins and eating more foods with folate.
Can I get too much folic acid?
You should not get more than 1,000 micrograms of folic acid a day unless your doctor prescribes a higher amount. Too much folic acid can hide signs that you lack vitamin B12, which can cause nerve damage.
Do I need folic acid after menopause?
Yes. Women who have gone through menopause still need 400 micrograms of folic acid every day for good health. Talk to your doctor or nurse about how much folic acid you need.
