Folic acid is a water-soluble vitamin also known as folate. It is essential for healthy cell production and replication of genetic material, so is especially important during the early stages of pregnancy when the baby is developing extremely quickly.
Why you may need folic acid
Neural tube defects (NTDs) such as spina bifida can be reduced by increasing folic acid intake at least one month before falling pregnant and during the first three months of pregnancy.
Megaloblastic anaemia – is a type of anaemia where there are immature, large and dysfunctional red blood cells due to improper cellular maturation and division. Red blood cells contain haemoglobin, which have the primary function of transporting oxygen throughout our body.
Cardiovascular disease is associated with elevated plasma homocysteine levels – studies have found low folic acid, vitamin B6 and vitamin B12, with folic acid showing the strongest link. Homocysteine is associated with oxidative damage, increased clot formation, which can place extra demand on your cardiovascular system.
Alzheimer’s disease – studies have also found low blood levels of folic acid and vitamin B12 increase the risk of conditions such as Alzheimer’s. The folic acid and vitamin B12 work together to lower homocysteine levels which are a risk factor in this condition.
Abnormal cervical cells (pap smear) – low folic acid is linked to abnormal pap smears.
How much do you need?
Recommended Daily Intake (RDI)
Adults (over 19 years): 400mcg folate equivalents daily
Pregnancy: 600mcg folate equivalents daily
Breastfeeding: 500mcg folate equivalents daily
Children 9-13 years: 300mcg folate equivalents daily
Children 14-18 years: 400mcg folate equivalents daily
Note: 1mcg dietary folate equivalent = 1 mcg food folate
Symptoms of deficiency
Just remember ‘cell division’ when you think about folic acid. Folic acid deficiency leads to reduction of cell division and it is mainly seen in tissues with a high turnover rate such as red blood cells. Therefore the main deficiency symptom is megaloblastic anaemia.
Other symptoms to look for include digestive upsets such as heartburn, diarrhoea and constipation, weight loss, poor appetite, recurrent infections, smooth red tongue, fatigue, forgetfulness, depression, skin disorders and impaired growth in children.
The best dietary sources of folic acid include green leafy vegetables, asparagus, broccoli, cabbage, brewer’s yeast, mushrooms and beef liver.
Other reasons why you may need more
A deficiency or excess of a single B vitamin may cause problems in the metabolism of other B group vitamins.
Fresh is best with folic acid – it is unstable to heat, acid, light and when cooking, you will lose up to 65 per cent.
You may need to keep tab of your intake if you have a malabsorption disorder such as coeliac disease. Folic acid along with many other nutrients, are at risk of reduced absorption.
Alcoholism also affects absorption of folic acid thus increasing your demand for folic acid.
We can’t emphasise the huge importance of folic acid during pregnancy and even breastfeeding. There is plenty of cell division going on during these periods.
Long term use of certain medications can lead to folate deficiency such as phenytoin (anticonvulsant), aspirin, methotrexate and the oral contraceptive pill.
- Folic acid is well tolerated at recommended doses.
- Large doses of folic acid can cause gastrointestinal problems, such as abdominal cramps and diarrhoea.
- Large doses of folic acid (>1000mcg) can mask a vitamin B12 deficiency. If you are vitamin B12 deficient, folic acid will improve vitamin B12 associated anaemia, but it will allow the neurologic abnormalities and potentially irreversible neurological damage to progress.
- Before taking high doses of folic acid, you should check with your healthcare professional about testing vitamin B12 status.