From the Guidelines
Folic Acid Definition and Importance
Folic acid, also known as vitamin B9, is a crucial nutrient that plays a significant role in various bodily functions, including cell growth and development. It is particularly important for pregnant women, as it helps prevent birth defects of the brain and spine, such as neural tube defects 1.
Recommended Dosage and Timing
The recommended dosage of folic acid for pregnant women is 400-800 micrograms per day, starting at least one month before conception and continuing through the first trimester 1. Women with certain health risks, such as epilepsy, insulin-dependent diabetes mellitus, or obesity, may require a higher dosage of 4-5 mg of folic acid daily 1.
Benefits and Risks
The benefits of folic acid supplementation include a reduced risk of neural tube defects by nearly 75% 1. The risks associated with folic acid supplementation are minimal, with no serious harms reported at usual doses 1.
Clinical Considerations
Clinicians should advise all women who are capable of pregnancy to take folic acid supplements, as most pregnancies in the United States are unplanned 1. The effective amount of additional folic acid supplementation in settings where food is fortified with folic acid is unclear 1.
Key Points
- Folic acid is essential for preventing birth defects of the brain and spine
- Recommended dosage: 400-800 micrograms per day for pregnant women
- Higher dosage (4-5 mg) may be required for women with certain health risks
- Folic acid supplementation reduces the risk of neural tube defects by nearly 75%
- Minimal risks associated with folic acid supplementation at usual doses
From the FDA Drug Label
Folic acid, N-[ρ-[[(2-amino-4-hydroxy-6-pteridinyl) methyl]-amino]benzoyl]-L-glutamic acid, is a B complex vitamin containing a pteridine moiety linked by a methylene bridge to para-aminobenzoic acid, which is joined by a peptide linkage to glutamic acid. Folic acid is a B complex vitamin that is necessary for nucleoprotein synthesis and erythropoiesis. It is a precursor to tetrahydrofolic acid, which is involved in the biosynthesis of purines and thymidylates of nucleic acids.
- Folic acid is also known as a pteridine moiety linked to para-aminobenzoic acid and glutamic acid.
- It is found in foods such as liver, kidneys, yeast, and leafy green vegetables. 2 2
From the Research
Definition of Folic Acid
- Folic acid is the synthetic form of vitamin B9, found in supplements and fortified foods, while folate occurs naturally in foods 3, 4, 5, 6.
- It is crucial for homeostatic function of the biological system and is not endogenously produced 4, 5, 6.
Importance of Folic Acid
- Folic acid is extremely important in the synthesis of nucleic acids (DNA and RNA) and different proteins 3.
- It acts as a coenzyme for the transfer of 1 carbon in the biosynthesis of purine, pyrimidine, and amino acids 3.
- Folic acid is critically important in rapidly proliferating tissues, including fetus and trophoblastic tissue to prevent neural tube defect (NTD) 3.
- It plays a very important role in the prevention of neural tube defects and megaloblastic anemia, the proper functioning of the nervous system, as well as reducing the risk of developing certain cancers 5, 6.
Health Benefits of Folic Acid
- Folic acid supplementation is recommended for pregnant women to prevent neural tube defects, maternal anaemia, puerperal sepsis, low birthweight, and preterm birth 3, 7.
- It is also important for the prevention of megaloblastic anemia, various cardiovascular diseases, obstetrical complications, neuropsychiatric diseases, and tumors 6.
- Folic acid has a preventive effect in many diseases, including neural tube defects, megaloblastic anemia, and certain cancers 5, 6.
Folic Acid Deficiency
- Decreased blood folic acid levels can inhibit DNA replication, repair, RNA synthesis, histone and DNA methylation, methionine production, and homocysteine remethylation reactions, leading to neural tube defects and other health problems 3.
- Folate deficiency can lead to genetic, epigenetic, and metabolic changes, and is related to the development of megaloblastic anemia, cardiovascular diseases, and neuropsychiatric diseases 6.