Folic acid 800 mg for pregnant women. What should be the daily intake of folic acid for pregnant women? Folic acid deficiency, consequences

For women expecting a baby, the most important thing is to take care of their health. This includes a lot. In this case, nutrition is the basis. What, in addition to high-quality products, you need more, you will learn from this article.

Useful for everyone

Many people have probably heard of folic acid. It is extremely important for our body. It was obtained relatively recently (in 1941) from spinach leaves. And they synthesized it for the first time in 1946.

This acid is a capricious, unstable thing. About half of it disappears if the product is kept in the light for a long time. And if you boil or fry vegetables and herbs that contain folic acid, then it can be destroyed by 90%!

However (the second name of folic acid) is very necessary for a person, especially since inside the body it is almost not produced by itself. In any case, it is synthesized in such a small amount that the daily need cannot be covered by it.

What is the role of folic acid? It is easier to say which organs it does not participate in than to list where this substance is involved.

So, its role is important in the activity of the hematopoietic organs and intestines, as well as in the work of the liver. The acid perfectly supports the immune system, and also promotes transformations in redox processes and helps the functioning of blood cells (white and red). Necessarily participates in the biosynthesis of protein, has a great effect on the brain, its work, and so on.

And if there is a deficit?

Do not be surprised, because our organisms are rather complex physicochemical devices! And when B9 is not enough in them (and this is for almost everyone!), Then fatigue and insomnia, anxiety and loss of appetite, problems with breathing and memory begin. Add apathy with anemia, various abdominal pains and unpleasant nausea, mouth ulcers and general depression. There is even graying of hair, as well as hair loss. Not to mention dementia and birth defects in newborns.

These are some of the troubles (and sometimes grief) that small flat yellow pills can free us from, which we must drink regularly, but we do not do this, either out of ignorance, or from carelessness.

But the largest is observed in women who take hormonal medications and are addicted to alcohol.

By the way, the drug is sold without a prescription, and it will not ruin you at all. Folic acid is available in any pharmacy. The price will surprise you: from 27 to 35 rubles (for a package of 1 mg, 50 pieces, from different manufacturers).

Important for everyone

More recently, for some reason, B9 was considered a lady's vitamin. But fresh scientific data says that it will not harm the stronger sex, especially when they want to become fathers. And in general, for any of the adults, such pills are a good and simply obligatory help to strengthen the body.

In what other cases are these pills irreplaceable? badly needed. What is its use? It ensures the correct rate of growth and development of the expected baby. This substance is indispensable for cell division of cells, including blood cells. But the most valuable thing is that folic acid is very much needed in early pregnancy. Moreover, many experts advise taking it even when you are just planning to have a baby. So to speak, it is better to start strengthening your body in advance, because with a lack of vitamin B9, there will be a much higher risk of the appearance of a variety of congenital defects in the fetus.

Many experiments of scientists have proved that folic acid is a strong barrier that protects against abnormalities in the development of its neural tube in the fetus, which threaten with many pathologies, such as prematurity and malnutrition. And the latter is nothing more than a disorder (and chronic) of nutrition and digestion in general in young children. They begin to develop exhaustion, their immunity drops strongly, and many vital functions of a young organism are disrupted.

Therefore, you need to take your pregnancy very seriously! And then the baby will be born strong and healthy.

Grows in the garden

Of course, vitamin B9 can be consumed without going to the pharmacy, because it often grows in our garden. The same spinach is rich in them. Don't forget seeds, soybeans, beans, asparagus, kale, and even peanuts.

Most of all it is saturated with yeast, liver, both animals and birds. Herbs are good in this regard: basil, rosemary, parsley and other spices. Include all of this in your diet, if not daily, but at least once a week.

True, in order to provide yourself with the necessary amount of vitamin per day, you will have to absorb literally kilograms of vegetables. Yes, and it can cost a pretty penny today. Folic acid is always available in pharmacies. Its price is low, as mentioned above.

In some countries, by the way, a law has been passed on the mandatory fortification of flour products and bread with folic acid.

From the very first days

But, you say, if the products themselves contain natural B9, then why and how much to drink folic acid during pregnancy from the pharmacy? This must be done because part of the vitamin is destroyed at the time of preparation of meals. In addition, the range of foods rich in folic acid in our diet is not so great. And even if you have a super-complete food, it still will not cover the normal needs of the body for B9. And the availability of this substance of natural origin is low when compared with those tablets that are sold in pharmacies.

Many people drink the drug "Folic acid" during pregnancy. Reviews about him are only positive. It is advisable to take B9 to any expectant mother for prophylaxis (up to 12 weeks inclusive). And some people, according to the results of analyzes, are prescribed "shock" doses. The main thing is that all your actions should be directed precisely by doctors, specialists, and not by an acquaintance, girlfriend or even relatives.

What is the dose?

The question of how much to drink folic acid during pregnancy is decided by the gynecologist. Nowadays, the daily norm for those women who are expecting a baby has been established, and this is 0.4 mg. But there are cases - and there are many of them - when the dose can become much larger. For example, this applies to patients whose children have some developmental defects. Also, those who are already taking other medications are advised to increase the dosage to 4-5 mg (with daily intake). Further, the drug is prescribed based on the results of studying how the baby is formed.

But at the same time, as scientists have found out, in any case, an overdose of B9 can in no way harm the embryo in its development.

Features of use

So when is the best time to start drinking folic acid during pregnancy? How many tablets are there per day? Women who are serious about the health of their unborn child should take them even before conception, exactly from the moment they wanted to give birth. The dose per day is 0.4 mg. And then, when pregnancy occurs, you do not need to stop taking it.

Why is it necessary to immediately go to the pharmacy at the first hint of pregnancy? Because you can miss the most active developmental phase of the neural tube embryo. And it ends in the sixth week.

Whether or not to consume all the vitamin sets that the doctor strongly recommends is up to every woman to decide for herself. This is, after all, her own business. But, as we know, not all ladies are obedient, and many are simply frivolous and neglect advice. Others believe that the opinion of experienced pregnant women is more important. And the doctors, they say, only need to prescribe more pills.

But to deny real facts means deliberately harming not only yourself personally, but also the future baby. And then you will cry that you did not listen to what the gynecologist said.

After all, it is not difficult at the first thought that you are a lady in an interesting position to rush to the clinic. And there they will already tell you how to take folic acid during pregnancy.

Tocopherol

If a woman finds out that she will have a child, she is registered with a doctor. And he immediately prescribes another drug for her. Because folic acid and vitamin E during pregnancy are two of the most essential things.

And again, some ladies do not want to follow the recommendations of a specialist. What for? They say they feel great. And doing so is actually very bad.

In general, tocopherol is the second. Translated from the Greek language, this means the following: "tokos" - birth, and "ferro" - wear, wear. In other words, the drug contributes to the very conception and bearing of the fetus, and even the birth of a baby. This is his triple invaluable mission.

Please note: it is equally useful for both mothers and their children. It is not enough to know how to take folic acid during pregnancy. This useful supplement is also needed. Which will now be proved by us.

Visible pluses

We present to the doubters a whole list of the positive properties of tocopherol. It prevents the risk of miscarriage, and this is the first thing. Then, he takes a significant part in creating the baby's respiratory system. It helps the placenta to ripen in a timely manner, protects the flexibility of blood vessels, prevents blood clots from forming, supports hormones, and also promotes the production of prolactin (it is he who "supplies" the mother with milk after the baby is born). As you can see, the question is not only about how much to drink folic acid during pregnancy.

Even without tocopherol, there would be a threat of leg cramps in a woman who is in position. Vitamin E also affects how her skin, hair and nails look, both during the period of carrying a baby and after childbirth. Finally, the drug begins to treat the same dysfunction of the female ovaries and more.

One minus

And that's why this important vitamin is always recommended in It's interesting. As it turned out, despite the great advantages, you cannot drink tocopherol for a long time. It has such a property as accumulation in tissues (fatty). Over time, an overabundance of this substance occurs, which leads to a very undesirable phenomenon. The muscles of a woman before childbirth become excessively elastic, and this is not at all necessary at such a crucial moment.

It was not proved yesterday that a person needs to take only 20 mg of tocopherol per day. But pregnancy is a special case! And here the dosage of the vitamin depends on many things: the condition of the gynecologist's ward, the results of fresh tests. Even the height and weight of the pregnant woman matter. So they usually prescribe this vitamin at 200-400 mg per day.

Rosehip and bran

Even women in a position should take into account the following: how the doctor prescribed tocopherol for them - alone or together with other trace elements.

And the most unexpected thing is that you don't have to drink vitamin E! In some, of course, individual situations and in contrast to the same folic acid. It is quite possible to get it just at the dinner table. Eat eggs more often, do not forget about seeds. Do not give up rosehip decoctions. Boil yourself buckwheat and oatmeal. Also, there is still a lot of tocopherol in the bran and wheat sprouts.

Be sensible. Be sure to find out how much folic acid to drink during pregnancy and how much tocopherol you need. Do not stop caring for yourself and your unborn child. This will allow you to give birth to wonderful babies and experience the real happiness of motherhood.

Folic acid (folacin) is a water-soluble B vitamin. Usually, folacin is produced in the body in the intestinal tract, so the main source of it is the natural microflora.

Folic acid deficiency is the most common cause of vitamin deficiency in pregnant women. During pregnancy, women have a significant increase in the need for vitamin B9.

The daily diet of an adult should contain foods that provide the body with a set of vitamins. Among the foods rich in high vitamin B9 content are:

• dark green vegetables (asparagus, parsley, Brussels sprouts, broccoli, spinach leaves, etc.);
• legumes (soybeans, green peas, lentils);
• some berries (watermelon) and fruits (oranges, peaches);
• eggs (yolk);
• beef liver;
• walnuts, sunflower seeds;
• rice, oatmeal and buckwheat;
• cottage cheese, kefir, cheese, milk powder;
• Wheat germ (sprouted), whole grain products, and wholemeal baked goods.

However, even a balanced diet of a pregnant woman is not able to fill the increasing daily requirement for vitamin B9, therefore, it becomes necessary to compensate for the lack of folic acid by taking additional pharmaceuticals.

According to medical statistics, folic acid deficiency is observed in almost every pregnant woman. Folacin is involved in important processes in the structure of DNA and RNA of newly formed fetal cells. Particularly critical in this regard are the 3rd and 4th weeks of embryonic development of the fetus, therefore, the lack of vitamin B9 provokes a serious delay in its development:

• the formation of pathologies of the nervous system (hydrocephalus, absence of the brain, various cerebral hernias, defects of the spine, etc.);
• disorders of the development of the cardiovascular system;
• congenital deformities (the appearance of a "cleft" lip);
• pathological formation of the placenta with the threat of its detachment, in the future (miscarriages, premature birth).

The lack of folic acid also affects the pregnant woman's body.

Deficiency of vitamin B9 is accompanied by severe toxicosis, the occurrence of depressive conditions in a woman, and anemia develops.

The most common folic acid supplements are folic acid tablets. 1 tablet contains 1000 mcg (1 mg) of folic acid. When taking 1 tablet per day, overdose is impossible.

With a pronounced deficiency of folacin (folic acid) in the body of a pregnant woman, doctors recommend taking a stronger drug. This is "Folacin" or "Apo-folic", the tablets of which contain up to 5000 μg (5 mg) of folic acid, which already indicates the intake of corrective therapeutic doses.

As part of complex vitamin preparations, "pregnant" vitamin is also contained in the required amount. For example, the composition of the drug "Folio" contains up to 400 mcg of folic acid, and in the preparations "Elevit Pronatal" and "Materna" - up to 1000 mcg. Further, "Vitrum Prenatal Forte" - a dose of 800 mcg of folic acid, "Multi-tabs" - up to 400 mcg, and "Pregnavit" - up to 750 mcg of vitamin B9.

Taking any of the above drugs eliminates the need for additional "care" about the level of folate in the body. As an additional measure, the attending physician may prescribe a biochemical analysis for the content of folic acid in the blood, which will help establish the body's real need for this vitamin.

The only contraindication to taking vitamin B9 is individual intolerance to the constituent components of the drug.

Despite the fact that folic acid is completely non-toxic to humans, there is also a danger of overdose with prolonged use of B9-vitamin-containing preparations.

Hypervitaminosis (excess) of folic acid contributes to a significant decrease in the content of another vitamin in the blood - B12, which leads to:

• the development of anemia;
• increased nervous excitability;
• the occurrence of changes in the gastrointestinal tract, disorders of the digestive function;
• functional changes in the excretory system - impaired renal function.

The above symptoms are typical for women who take 10-15 mg of folic acid per day for 3 months. With the termination of the intake of synthetic folic acid, the condition will return to normal, since the body itself is able to cope with the excess content of folacin.

To prevent an overdose of vitamin preparations containing folic acid, one should not self-medicate. It is necessary to obtain qualified advice from a specialist and strictly adhere to his clear recommendations.

The average daily intake of vitamin B9 is at least 200 mcg "dietary folate equivalent" (0.2 mg). However, this dosage is clearly not enough for women planning or already carrying a pregnancy.

During pregnancy, the need for folic acid in women increases significantly - up to 400 μg (0.4 mg). If a pregnant woman is listed in a risk group, as evidenced by an obvious, laboratory-proven vitamin B9 deficiency, then the daily dose increases from 800 μg (0.8 mg) to 5 mg of folacin.

To mitigate the effect of these factors, the pregnant woman is prescribed folic acid preparations. Only 1 mcg of natural folic acid consumed with food is equal to a dose of 0.6 mcg of folacin obtained in tablet form.

A woman may not always know about her pregnancy. If we consider that the neural tube in the embryo is formed for up to 30 days from the moment of conception, then the elimination of folic acid deficiency becomes an especially important measure.

Future mothers begin to take care of their baby even before his birth. Correct, fresh air, rejection of addictions - everything is aimed at ensuring that he appears on time and is healthy. A prerequisite for this is the intake of folic acid during pregnancy.

Read in this article

What it is

A must-have for all nutrients will be incomplete without folate or vitamin B9. Women are convinced that it provides beauty and health to hair, skin, nails. Many foods contain derivatives of this substance - folate. But during pregnancy there are too few of them. Therefore, folic acid preparations are useful for all expectant mothers.

Artificial vitamin B9 plays a vital role in the creation of blood cells. It is also absorbed in the body to form folate. Its deficiency means the occurrence of anemia, in which there is a shortage of red blood cells, or they do not function. And this is a reason not only for poor health, but also for serious problems with other systems of the body, which will experience oxygen starvation, and many metabolic processes are disrupted.

Another important role of folate is to stimulate the formation of DNA and RNA, which are present in all cells of the body, being their main component. That is, their normal division and tissue renewal without vitamin B9 are excluded. Therefore, its importance during pregnancy, especially at its early stage, can hardly be overestimated.

Why folic acid for pregnant women

Folic acid is involved in many processes during early pregnancy. The most important role belongs to it in the formation of the embryo and the tissues that ensure its viability, therefore, at this stage, a lot of substance is consumed for:

• Bookmarks and development of the baby's nervous system;
• Vascular growth of the placenta;
• Bone and connective tissue formation;
• Sufficient mental development of the child;
• Restoration of muscle tissues in the mother's body and blocking their transformation into cancerous ones;
• Normal gestation.

The most essential amount of folate is required in the construction of the fetal nervous system. Cell division occurs with duplication of DNA strands in the nucleus of each. For it to be complete, anyone must receive the complete human genome. And only folic acid can provide this. A similar division continuously occurs not only in the nervous, but in all systems of the fetus. The number of cells at an early stage increases weekly. Ensuring the quality of the process is possible only with sufficient blood supply to the embryo and surrounding tissues.

If she's missing

Any failure caused by a lack of folic acid responds with irreparable defects in the baby, the most likely of which are:

• Defects of the brain, in particular, the absence of some of its lobes. This forces the woman to terminate the pregnancy, for such a newborn would not be viable. A defect in the bones of the skull is also possible, in which the membrane of the brain or its part extends beyond their limits;
• Anomalies in the formation of the spine, when many of its components simply do not exist. The spinal cord remains fully or partially open. The vitality of the newborn depends on the degree of the defect. Most of the babies die, others remain disabled, have difficulties with the urinary system and independent movement when they grow up;
• Uncompensated intellectual and mental underdevelopment. And this is due to oxygen starvation of the brain due to a lack of folic acid at the initial stage of fetal development. Due to its involvement in cell division, it takes part in the formation of the placenta that provides it with nutrition.

Lack of vitamin B9 in a woman makes it more possible for premature birth and early termination, fetal death in the womb due to oxygen deficiency. So the answer to the question of whether folic acid can be ignored in early pregnancy is obvious. There is no substitute for this substance. And most importantly, not all fetal defects arising from vitamin B9 deficiency can be traced at an early stage of its development.

In a pregnant woman, at the initial stage of the situation, a lack of folic acid provokes:

• A noticeable decrease in immunity, which is fraught with viral diseases, problems with the skin and mucous membranes;
• Increased toxicosis;
• Depression or increased nervousness.

What leads to a deficiency of the substance

A woman's diet and her inherent bad habits can seriously affect the amount of folic acid. The absence or small amount of fresh vegetables and fruits in the diet, an excess of sugar, does not contribute to the filling of cells with it. In thermally processed foods, vitamin B9 is practically absent, since it does not tolerate high temperatures and is destroyed.

The drugs used by the woman, which interfere with her assimilation, contribute their share:

• Antibiotics The preparations, together with the pathogenic flora, destroy the beneficial bacteria in the intestine, which prevents the absorption of beneficial elements, including vitamin B9. Sulfonamides do not allow the intestinal mucosa to synthesize folic acid, which is characteristic of the body in normal conditions;
• Hormonal drugs, including contraceptives, lower its concentration;
• Antiepileptic drugs, as most of them are potentially toxic.

There are also genetic features that are quite rare, but interfere with the formation of folate. We are talking about the lack of essential enzymes in the body, which provokes heart problems, the development of tumors and miscarriage. Then taking large quantities of folic acid preparations will not help either. But even in this almost unique case, the situation is not hopeless, because there are means that can replenish the amount of folate in the tissues.

How to fill a vitamin deficiency

It is advisable to find out how much folic acid is necessary during pregnancy in the early stages even before conception. Then the woman will have the opportunity to prepare for everything that awaits her, that is, to include in the diet:

• Spinach, other fresh herbs;
• Carrots, beets;
• Rye bread;
• Nutritional yeast;
• Eggs;
• Cottage cheese, cheeses;
• Green vegetables;
• Beef liver;
• Citrus.

And do not use, in large quantities, which reduce the concentration of B9 in the tissues of the body. Another enemy is smoking. Largely due to the effect on folic acid volume, experts urge not to become pregnant immediately after stopping the use of birth control pills and antibiotics. This will be a good prevention of a deficiency of the substance, it will restore its synthesis by the intestines. This preparation will take at least 3 months. But even with adequate nutrition, the amount of folic acid obtained with it during early pregnancy is not enough. It is necessary to continue the use of products containing it, supplement them with appropriate preparations. And to do this immediately after the establishment of pregnancy, since the nervous system of the embryo is formed very early.

Preparations containing folic acid, and the rules for their intake

The use of synthesized vitamin B9 is obligatory due to the 50% increase in the need for a pregnant woman's body in it. With all the desire to get an adequate amount from food will not work.

How to drink folic acid in the early stages is largely determined by the presence of diseases in the expectant mother. Serious neurological ailments and high blood sugar dictate the need to increase the daily amount to 1 mg and 4 mg, respectively. Diseases of the liver and urinary system in the mother are forced to reduce the amount of vitamin and monitor the woman's condition by specialists. In such circumstances, exceeding a safe amount of a substance can cause the same negative effect as a deficiency.

The dosage of folic acid in early pregnancy in healthy women is usually 400-800 mcg per day. This does not include the amount that the expectant mother should receive with food. There are several pharmaceuticals that are used to replenish stocks of a substance:

• Valent;
• Blomin V9;
• Solgar;
• Nature Bounty.

There are also many preparations of domestic and Belarusian manufacturers, produced under the general name Folic acid. The difference between them is only in the volume of the substance in each tablet. It has already been mentioned how important the dosage of folic acid is in the early stages under different circumstances, so it is very important to monitor this in the mentioned diseases.

If a woman has a genetic indigestibility of vitamin B9, drugs are prescribed that contain its derivatives, in particular metafoline. This is a well-known preparation Fembion, manufactured in capsules and tablets. With the above peculiarities of the body, the dose of folic acid in the early stages of pregnancy cannot exceed one piece per day in the morning meal. There are other B vitamins in a 400 mcg folate tablet.

Who needs folic acid bolus doses?

In addition to the already mentioned problems with blood glucose, neurological ailments, an increased dose of vitamin B9 is required by the body of those expectant mothers who previously had:

• Miscarriages;
• Premature birth;
• Not the only one;
• Children with previously described developmental disabilities.

All of the above are signs of a persistent deficiency of a substance in the body. With him, folic acid during pregnancy in the early stages is significantly more needed than other women. Deficiency can be detected using a blood test (the norm of the substance is 3-17 ng / ml). Then it will become clear that you should start replenishing vitamin B9 stores at least 12 weeks before the expected pregnancy. Women with such a history are prescribed:

• Folacin, which has an increased volume of the substance. There is a package in which 1 tablet contains 5 mg of folic acid. Taking Folacin significantly reduces the risk of termination of pregnancy and premature resolution from it;
• Folio. In addition to vitamin B9, the drug contains iodine, which is no less important for a pregnant woman with a deficiency of nutrients.

Can folic acid harm?

The probable risk of folate overdose in early pregnancy has been studied more than once, but in each case the results are controversial. It was believed, and some experts continue to be confident that regularly exceeding the accepted amount entails the risks of diabetes and obesity for the newborn, as well as the likelihood of developing allergic and asthmatic manifestations in him.

At present, it is indisputable only that folic acid is soluble in water, therefore, excreted in the urine. Therefore, women who have problems in this area should be especially attentive to the dosage of vitamin products.

Some also need to drink and other medications during the early stages of pregnancy and later. Therefore, the amount of funds with folic acid in specific circumstances is selected by a specialist, and may exceed average values ​​even in the absence of its deficiency. But those for whom vitamin B9 is prescribed in prophylactic doses should not increase them arbitrarily. The body will assimilate exactly as much as it needs. The rest, if it does not bring any noticeable harm, will turn into money wasted and make you feel unpleasant symptoms:

• Metal taste in the mouth and bitterness;
• Increased irritability, insomnia;
• Strengthening the manifestations of toxicosis;
• Skin rashes;
• Difficulty breathing due to bronchospasm.

Carrying a child is not an easy and responsible job. He has not yet been born, but already so much is needed: micro- and macroelements, minerals, many organic acids. Folic acid during early pregnancy can generally decide its fate. But in reality, taking vitamins and monitoring your health are not such big sacrifices for the opportunity to have a healthy baby.

Before using any drugs, you should consult a specialist doctor. There are contraindications.

Most often, folate deficiency is due to three reasons:

• Insufficient food intake. It should be borne in mind that heat treatment destroys up to 90% of the folic acid contained in raw food, but nevertheless, it is not difficult to ensure sufficient folic acid from food. In addition to the leaves of garden greens, it is also found in the liver, meat, cheese, caviar, egg yolk, legumes, tomatoes, sunflower seeds,
• Increased need. The need for this substance increases when rapid growth and tissue renewal prevails: during the period of rapid growth in young children and adolescents, with severe oncological diseases, anemia, skin diseases, etc. The need for folic acid in pregnant women increases with the growth of the fetus. During breastfeeding, the need for this vitamin is also increased, as well as the need for other vitamins.
• Violation of absorption of folic acid in the intestine. Diseases of the stomach and small intestine can lead to deficiency due to insufficient absorption, while with a normal composition of the intestinal microflora, the body can synthesize folic acid on its own.

Folic acid contained in medicines is absorbed much better than its natural counterpart.

The mechanism of action of folic acid

As you know, in order for any living cell to enter the process of division, its genetic material, enclosed in a DNA helix, must double. It is in the process of DNA doubling that folic acid takes an active part. In addition, it participates in the synthesis of RNA (ribonucleic acid), amino acids, and promotes better absorption of iron.

Accordingly, the deficiency of this factor is especially dangerous for actively multiplying cells, folic acid is necessary for the growth and development of all organs and tissues, the normal development of the embryo, and the processes of hematopoiesis. In the early stages of pregnancy, this is especially important, because already at the 2nd week from conception in the embryo, it is possible to determine the part from which the brain begins to develop. It was during this period, despite the fact that the woman still does not suspect about her pregnancy, even a short-term deficiency of folic acid is fraught with the development of defects in the development of the nervous system in the fetus.

In addition to participating in the creation of fetal cells, this vitamin is consumed to replace cells in the body of a pregnant woman, since human cells are constantly being renewed. Folic acid takes part in the formation of all blood cells. In addition, it provides a good mood, participating in the metabolism of biologically active substances serotonin and adrenaline, which significantly affect the state of the nervous system, stimulates appetite when eating food, participating in the production of hydrochloric acid in the stomach,

During pregnancy, a deficiency of folic acid leads to the formation of neural tube defects: the absence of the brain, hydrocephalus (dropsy of the brain), the formation of cerebral hernias, spina bifida. In addition, the formation of malformations of the cardiovascular system and cleft lip and palate (cleft lip and cleft palate). With a lack of this vitamin, the formation of the placenta is disrupted, the likelihood of miscarriage, partial placental abruption, stillbirth, and fetal growth retardation increases. Studies have shown that about 75% of these defects can be prevented if women start taking folic acid supplements before pregnancy.

It is important to continue using folic acid during breastfeeding, when the need for it even exceeds the need for a pregnant woman. Folic acid deficiency has a significant effect on the formation of postpartum depression, apathy, weakness, and causes a decrease in the amount of milk. In addition, the deficiency of this vitamin in a nursing mother leads to its low content in breast milk and, as a result, to its deficiency in the child. In children with a deficiency of folic acid, in addition to anemia, there is a lag in weight, a delay in psychomotor development, a decrease in immunity, and a disruption in the functioning of the intestines.

Folic acid dosage during pregnancy

The minimum daily requirement for folic acid in the normal state is 50 mcg, but with an increase in requirements, for example, during pregnancy, it can increase several times. In Russia, it is believed that the need for folic acid in pregnant women without signs of deficiency of this vitamin is 400 mcg per day. For nursing mothers, this need is 600 mcg per day. Considering that folic acid deficiency is especially dangerous in the first weeks of pregnancy, this vitamin is recommended to be taken in preparation for pregnancy (at least three months), as well as during the entire period of gestation. A standard folic acid tablet contains 1 mg, and the folate content in multivitamins ranges from 300 mcg to 1 mg. Thus, taking one tablet of folic acid per day or multivitamins containing, among others, this vitamin, covers the daily need for it by 100-200%. Taking such doses of folic acid is safe.

In women for therapeutic purposes, the dose may be increased to 5 mg per day. The course of treatment is 20-30 days. High doses of folic acid during preparation for pregnancy and in the first third of it are also prescribed to women who have already had cases of giving birth to children with folate-dependent malformations.

Folic acid safety

Folic acid is not toxic to humans. There are studies on the long-term use of 15 mg of folic acid per day (exceeding the daily dosage by 40 times), which have not revealed any toxic effects of this drug. However, long-term use (over 3 months) of high doses of folic acid can reduce the content of vitamin B 12 in the blood, which can lead to anemia. Large doses of folic acid sometimes cause gastrointestinal disorders, increased nervous excitability, and functional changes in the kidneys.

Contraindications to the use of folic acid are cases of an individual allergic reaction to the drug.

It is important to take folic acid regularly. However, given that any folic acid supplement will cover your daily requirement, you shouldn't be alarmed if you miss your next dose. Just take the drug when you think about it.

Many medicines can affect the absorption, utilization, and storage of folate in the body. It is better to take folic acid together with vitamins B 12 and C. Supplementary intake of bifidobacteria helps to increase the synthesis of folic acid in the large intestine.

On the contrary, when taking alcohol, antacids (drugs that neutralize hydrochloric acid - ALMAGEL, MAALOX etc.), sulfonamides, antiepileptic drugs, the absorption of folic acid in the intestine is significantly reduced. Reception ASPIRINA in high doses, nitrofuran drugs (prescribed for urinary tract infections), oral contraceptives, corticosteroid hormones reduces the concentration of folic acid in the blood.

Checked: no risk!

In the United States, there is a law requiring manufacturers to add fairly high doses of folic acid to flour in order to prevent a deficiency of this vitamin in the population. In addition, in the United States, the prophylactic dosage of folic acid is 2 times higher than in Russia. No negative effects on the genotype of folic acid doses used in Russia have been identified.

Any woman planning to soon become pregnant and become a mother should consciously and carefully prepare for this new status. And if everyone knows about a healthy lifestyle, parting with bad habits and walking in the fresh air, then expectant mothers often ignore the intake of certain vitamins and medications before pregnancy. Folic acid is one of these agents.

What is folic acid?

Folic acid is a vitamin B9. You can often hear a generic name - folates, they are derivatives of this vitamin. We must understand that we get them from food, and folic acid tablets are a synthetic agent that turns into folates already inside the body.

All derivatives of vitamin B9 play an important role in hematopoiesis, that is, the formation of new blood cells. Therefore, a lack of these substances leads to anemia - a condition in which there are not enough red blood cells, or they have an irregular shape and do not fulfill their functions.

Folate has another very important feature: it stimulates the formation of nucleic acids (DNA and RNA), which are the basis of all cells in the body. Therefore, it is folic acid that is necessary for all rapidly dividing human tissues, including the tissues of the embryo.

Role of folic acid:

• participates in the formation of DNA of all cells, that is, a source of hereditary information
• stimulates hematopoiesis
• indirectly blocks the formation of cancer cells
• restores muscle tissue
• during pregnancy:
  • plays a role in the establishment and development of the nervous tissue of the embryo
  • participates in the formation of blood vessels of the placenta

What is folate used for during pregnancy?

During pregnancy, especially in the early stages, folate consumption increases dramatically. All cells of the embryo are intensively dividing in order to form full-fledged tissues over time. The nervous tissue of the future man is especially quickly and difficult to transform. And it is she who requires a large amount of folic acid.

Folic acid deficiency during pregnancy can occur for the following reasons:

• Inadequate dietary folate intake
• Folate malabsorption (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 to folate and does not function properly. The body accumulates intermediate metabolic products that can lead to cardiovascular diseases, tumor processes, infertility, etc. In the presence of such a mutation, it is recommended to take folic acid derivatives, for example, Metafolin. It is absorbed faster and in greater volume.
• Taking some anti-epilepsy drugs and hormonal agents dramatically reduces blood folate levels:
  • oral contraceptives (see)
  • barbiturates, diphenylhydantoin
  • sulfa drugs (for example) that inhibit the synthesis of vitamin B9 by the intestinal microflora
  • drinking alcohol also lowers their levels

How does the body get folic acid?

3 sources of folate:

• From food - as folate
• A small amount of vitamin B9 is synthesized by the body itself (intestinal microflora) during normal functioning of the gastrointestinal tract - in the form of 5-methyltetrahydrofolate
• Chemical Folic Acid - From Vitamin Supplements

Folate was first isolated from spinach leaves. Subsequently, it turned out that they are present in large quantities in almost all leafy vegetables. Other sources of folate include citrus fruits, green peas, bread, liver, nutritional yeast, cheese, eggs, and cottage cheese.

If there are so many foods that contain folate, why should you take folic acid tablets during pregnancy?

• Technological progress and the market economy are forcing 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. As a result, the background information from old print media on the folate content in various products is not up-to-date and overstated today.
• The main disadvantage of "natural" folate is its rapid degradation during heat treatment. Boiling, frying and braising destroys almost 90% of the vitamin. But even eating raw foods does not guarantee that the right amount will enter the bloodstream. Moreover, vitamin B9 is sensitive to conditions and shelf life:
  • when boiling eggs, 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 slightly more than 50% of the daily value of folic acid from food.

However, numerous studies by scientists have found 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 in the gastrointestinal tract even with metabolic and gastric acidity disorders 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 so strongly with other drugs and does not mask hematological signs of vitamin B12 deficiency as does synthetic folic acid. In addition, it excludes the possible negative consequences of an excess of unreacted vitamin B9 in peripheral vessels.

But in order to provide the body of a pregnant woman 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 amount in modern products, it is ineffective. Modern preparations of folic acid contain the required amount, are safe for pregnant women in the recommended dosage, and are well studied.

Consequences of Folic Acid Deficiency During Pregnancy

Maternal pathologies:

• violation of hematopoiesis in a woman: 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. Symptoms of vitamin deficiency usually occur 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 the obligatory control of a blood test, only under the constant supervision of a specialist.

Fetal pathologies:

• 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 can 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, it is recommended to terminate the pregnancy.
• A cephalocele is a cleft in the skull through which the meninges or the brain itself can swell. Depending on the degree of tissue swelling, the prognosis can vary from lethal to successful.
• Spina bifida is the most common neural tube defect. Through the defect in the vertebrae, the spinal canal is exposed, and the membranes of the spinal cord bulge out. Depending on the level of vertebral lesion and the degree of bulging, the prognosis also depends: a quarter of children die in the first days of life, most of them become disabled, and only a small percentage of babies do not have problems with urination and movement in the legs in the future.

Not all of the consequences of folate deficiency can be found during pregnancy or immediately after childbirth. Minimal disturbances in nerve tissue make themselves felt in adulthood with difficulties in learning and concentration. Scientists at the University of Cambridge have conducted a number of studies proving the link between B9 deficiency and emotional disorders in children.

In perfectly healthy women who eat a full 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 at 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 for the prevention of fetal malformations should be started at the stage of preparation for pregnancy, at least three months before the intended conception. That is why pregnancy should be planned. If conception happened unexpectedly, then you need to start taking the drug as soon as it became known.

Reasons for taking folate during pregnancy planning:

• With an unbalanced diet, a woman may have a decrease in folic acid levels, so it takes time to replenish its reserves. This usually takes three to four months.
• The neural tube of the embryo is laid at such an early stage that a woman may not even be aware of the pregnancy that has happened, especially with a long menstrual cycle.
• Folate deficiency can make pregnancy difficult.

Folic acid dosage during pregnancy

In most cases, 400 mcg of folic acid per day should be taken three months before conception and throughout pregnancy. In some cases, it is advised to increase the dosage:

• up to 1 mg per day for epilepsy and diabetes mellitus
• up to 4 mg per day if there have been children with neural tube defects in the past

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.

So, in the United States, all women planning a pregnancy should take the drug at a dose of 400-800 mcg per day one month before conception and within 3 months of pregnancy. Moreover, these recommendations exist together with the enrichment of food with folates (for example, adding them to pasta), which is not observed in our country. And rightly so! Why add a vitamin to the product, which is destroyed after further 10 minutes of cooking? If you take synthetic folic acid, it is better in tablet form!

Effects of excess folic acid

Vitamin B9 belongs to water-soluble substances, therefore all its excess is successfully excreted by the kidneys. It is very difficult to arrange an overdose of folic acid during pregnancy, when the vitamin becomes toxic and has an adverse effect on the fetus. This vitamin must be used with caution when:

• severe liver and kidney pathology in a pregnant woman
• hereditary defects in the gene responsible for the exchange of folate. Excess folate can further disrupt the balance in this cycle, with the same consequences for the fetus as vitamin deficiency. The intake of this substance in such patients should be monitored by a physician.
• 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 have noted cases of the birth of children with altered folate cycle genes from mothers taking this drug. That is, for the processing of external folic acid, nature "invented" a new gene. All would be fine, but some human diseases may be associated with this gene.

These studies were not widely disseminated, since the theory was not confirmed in practice. But the decrease in the incidence of malformations of embryos in mothers taking folic acid has been confirmed by numerous studies around the world. The incidence of spina bifida dropped by a quarter after widespread initiation of folic acid supplementation.

In the early 90s, in the United States, they even tried to enrich 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 more than usual. Considering that mainly flour, high-calorie foods 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 in the child in the future, as well as a tendency to allergies, bronchial asthma, and can lead to impaired immunity. But these are only assumptions, there are no convincing studies confirming such risks.

Conclusion: There is no conclusive evidence of a negative effect of standard dosage of folic acid on 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 should be taken during pregnancy for each particular woman.

As for the intake of folic acid by non-pregnant women, in high doses and for a long time, a constant overdose can lead to sad consequences. Exceeding the recommended dose may result in:

• in men, the risk of developing
• taking folic acid in 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 the elderly, prolonged overdose causes a disorder of psycho-social functions

Folic acid overdose symptoms:

• metallic taste in the mouth
• increased excitability, irritability, sleep disturbance (see)
• gastrointestinal disorders: vomiting, nausea, diarrhea, (but similar symptoms accompany toxicosis of the 1st trimester)
• impaired renal function
• one of the serious consequences of an overdose is zinc deficiency, vitamin B12 deficiency

Folic acid tests

A blood test for the level of folic acid is prescribed for patients with anemia to find out its cause or for patients with homocysteinemia. Healthy pregnant women do not need such an analysis, 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.

How to take folic acid?

The modern pharmaceutical industry offers a huge selection of products containing folate. Most of them differ only in dosage and price.

Many folic acid tablets have an inconvenient 1mg dosage and have to be broken in half. It is better to find folic acid at a dosage of 400-500 mcg, which is necessary for most pregnant women. How to take the drug for pregnant women with homocysteinemia is determined by the attending physician.

In recent years, the pharmaceutical market has been offering a large selection of multivitamin complexes designed specifically for pregnant women. Such funds should be taken only by people living in extremely 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
• with the onset of anemia - iron supplements

The use of multivitamin complexes to replenish folate deficiency can be considered inappropriate. Folic acid is one of the few medicines, the effectiveness and safety of which during pregnancy has been proven in the course of numerous studies. Taking just one tablet a day is a simple, inexpensive and reliable way to reduce your baby's risk of serious illness and give him a fulfilling life!

Folic acid dosage

What are the best folic acid supplements to take?

9 months Folic acid (Valenta) 400 mcg. 30 pcs. 120 RUB	Folic acid (Valenta) 1000 mcg. 50 pcs. RUB 40 half a tablet a day	Folic acid from OZONE 1000 mcg. 50 pcs. RUB 25-30 (half a tablet)	Blomin V9 (VIS LLC) 200 mcg. 90 caps. 110 RUB 2 tab. in a day
Folic acid from Solgar 400 mcg. 100 pieces. RUB 500	Folic Acid from Nature Bounty 400 mcg. 100 pieces. RUB 300	Folic acid (Borisov plant, Belarus) 1000 mcg. 50 pcs. RUB 25-30 (half table per day)	Folic acid (MARBIOPHARM) 1000 mcg. 50 pcs. RUB 30 (half table per day)
Folic acid instructions Indications: 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 with a deficiency of folic acid. Contraindications: children with pernicious anemia and cobalamin deficiency malignant neoplasms hypersensitivity to drug components Dosage: during pregnancy 400-800 mcg in 1 trimester, with folic acid deficiency - 400 mcg 1 time per day. Side effect: itching, skin rash, bronchospasm, hyperthermia, erythema, bitterness in the mouth, nausea, loss of appetite, bloating, with prolonged use, hypovitaminosis B12 may develop. Interaction with other drugs: taking anticonvulsants, analgesics, oral contraceptives, estrogens increase the need for folic acid. Sulfonamines, antacids, cholestyramine, reduce the absorption of vitamin B9. Pyrimethamine, methotrexate, triamterene, trimethoprim reduce the effect of folic acid (patients are shown not folic acid, but calcium folinate). With the simultaneous administration of folic acid with tetracyclines, chloramphenicol, polymyxins, the absorption of folic acid decreases. Special instructions: To prevent vitamin B9 deficiency, a balanced diet is preferable - green vegetables (tomatoes, carrots, lettuce, spinach), beets, legumes, fresh liver, cheese, cereals, eggs, nuts. Folic acid is not used for normocytic, B12-deficient and aplastic anemia. In case of B12-deficiency (pernicious) anemia, vitamin B9 masks neurological complications, improving hematological parameters. Until B12 deficiency anemia is ruled out, prescribing doses of more than 100 mcg / day of folic acid is not recommended (except during pregnancy and lactation). With simultaneous treatment - antacids are taken 2 hours after folic acid, cholestyramine - after 1 hour or 4-6 hours before taking folic acid. Antibiotics can distort the results of microbiological evaluation of plasma red blood cell and folate concentrations. When taking large doses and long-term treatment with folic acid, a decrease in the concentration of vitamin B12 is possible.

Frequently asked questions about folic acid

In the previous 5 years I have had 3 pregnancies frozen at 10 weeks. What dosage of folic acid do I need?

Three or more frozen pregnancies are a reason for examining a married couple. After that, 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 was allergic to it. What should I do?

An allergic reaction in this case is associated with the components of the tablets (dyes, sweeteners). You can try to change the drug or switch to injections.

I accidentally drank 2 tablets of folic acid, 500 mcg each, that is, I got 1 mg per day. Is it dangerous?

This dose is non-toxic and will not harm you or your baby. Continue taking 1 tablet daily.

I am 39 years old, we 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 termination of pregnancy. Do you need such a large dose?

Your risk of interruption is somewhat increased by age and not by folate deficiency. Therefore, such an increase in the dosage of the drug is impractical.