What is folic acid?


Folic acid is a B vitamin. Like most vitamins, it cannot be made in the body, so it must be either taken as food or by means of a folic acid supplement in tablet form.


Who needs to take folic acid?


All women of child bearing age, especially if there is any possibility of becoming pregnant.


Why do I need folic acid?


Taking extra folic acid before becoming pregnant and during the first 12 weeks of pregnancy can help reduce the risk of your baby developing a neural tube defect (NTD).


What are neural tube defects?


NTDs are a major group of birth defects that occur when the brain, spinal cord or the covering of these organs has not developed properly. Anencephaly and spina bifida are the most common types of NTDs in Ireland.

Anencephaly is a fatal condition in which the upper end of the neural tube fails to close. In these cases, the brain either never completely develops or is totally absent. Pregnancies affected by anencephaly often result in miscarriages. Infants who are born alive die very soon after birth.

Spina bifida is more common than anencephaly and occurs when the lower end of the neural tube (which later becomes the spine and spinal cord) fails to close during the first 3 months of pregnancy. Thus, the spinal cord and back bones do not develop properly. Sometimes, a sac of fluid protrudes through an opening in the back, and a portion of the spinal cord is often contained in this sac. Children with spina bifida can have varying degrees of paralysis of their lower limbs – some children can be confined to a wheelchair, whereas others have almost no symptoms at all. Spina bifida can also cause bowel and bladder problems.


Are all babies at risk of neural tube defects?


Yes. It does not depend on:

•  your age
•  if you are a new mum
•  if you already have children
•  your health.

There is a higher risk if you have already have had a baby with an NTD. Women with an NTD themselves are also at a higher risk. A family history could also affect you too e.g. a sister or cousin with a child with an NTD or who have lost an NTD affected pregnancy.


How much folic acid do I need?


You need to take one 400 micrograms (400µg) folic acid supplement every day in addition to what you get from your diet.


Should I take a supplement?


Taking a tablet that contains only folic acid is the best way to be sure that you are getting enough folic acid to help reduce the risk of NTDs.


When should I start taking folic acid supplements?


Start taking folic acid today and everyday if there is any possibility of you becoming pregnant or if you are planning a pregnancy. It is important to take folic acid for at least two months before you become pregnant. Remember that a large proportion of pregnancies are unplanned and since you could be pregnant for a number of weeks before realising, it is recommended that all women of childbearing age should take a folic acid supplement.

If you are already pregnant, start now and continue to take the tablet until you go for your first check up at the hospital and then follow the instructions of your doctor.


Where can I buy folic acid supplements?


Folic acid supplements can be bought in any one of our Burkes pharmacies .  If you have a medical card, you can get them free of charge on prescription from your doctor.


Is there any particular supplement that is recommended?


The Department of Health and Children recommends that you take a supplement that contains only folic acid and not a multivitamin containing folic acid.


Can I get folic acid from food?


Yes. Foods that are naturally rich in foliate include some fruits, green leafy vegetables (such as broccoli), dried beans and legumes. However, the levels contained in the foods means that it can be very difficult to get enough folic acid from food alone to protect your baby as some natural foliate is lost through cooking and processing.


What is food fortification?


Food fortification means that vitamins or minerals are added to food at the processing stage. There are some foods that have already been fortified with folic acid, such as breakfast cereals, milk and bread. These foods have a logo on the packaging which says ‘with extra folic acid’ or ‘contains folic acid’.


If I eat food fortified with folic acid, is it enough?


There are currently only a limited number of foods that are fortified with folic acid, so it is very difficult to get enough folic acid from food alone. It is important when planning a pregnancy or if you are currently pregnant, that you have a varied and balanced diet. In order to be certain that you are taking in enough folic acid, the best approach would be to take folic acid supplements as well as fortified foods as part of your normal diet.


If I am taking supplements and eating food fortified with folic acid, could I be consuming too much of it?


The upper limit for safe intake of folic acid is extremely high; therefore there is practically no risk of getting too much folic acid through food and over-the- counter folic acid supplements when taken as directed. It is a B vitamin and the body will get rid of any it does not need.


What are other health benefits to taking folic acid?


Apart from NTDs, there is a considerable body of evidence that increasing folate status throughout the population may reduce the risk of heart disease and stroke, neuropsychiatric disorders – such as dementia and Alzheimer’s disease, and colon and other cancers. These issues are the subject of intensive ongoing research internationally. However, in contrast to the proven effect of folic acid in preventing NTDs, the evidence is as yet insufficient to conclude that folate status influences the development of these conditions. Further research is required to confirm these relationships.