From the Guidelines
The recommended daily folate supplement is 0.4 to 0.8 mg (400 to 800 μg) for women planning or capable of pregnancy, as recommended by the USPSTF with a Grade A recommendation 1. This recommendation is based on the evidence that folic acid supplementation in the periconceptional period reduces the risk for neural tube defects in offspring. The USPSTF found further observational evidence that supports the hypothesis that supplementation with 0.4 to 0.8 mg (400 to 800 μg) of folic acid in the periconceptional period reduces the risk for neural tube defects in offspring 1. Some key points to consider when taking folate supplements include:
- Folate supplements are typically available as folic acid, which is the synthetic form that's better absorbed than natural folate found in foods.
- When taking folate supplements, look for products labeled as folic acid or methylfolate (a more bioavailable form beneficial for those with certain genetic variations).
- It's best to take folate with water, and it can be taken with or without food.
- Folate is essential for DNA synthesis, cell division, and preventing neural tube defects in developing fetuses.
- While many people get sufficient folate from fortified foods and a balanced diet, supplements are particularly important for women of childbearing age, pregnant women, those with malabsorption conditions, and individuals taking certain medications that deplete folate 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION ... The usual therapeutic dosage in adults and children (regardless of age) is up to 1 mg daily. ... Daily doses greater than 1 mg do not enhance the hematologic effect, and most of the excess is excreted unchanged in the urine. The daily folate supplement dose should not exceed 1 mg.
- The maintenance level should be:
- 0.1 mg for infants
- up to 0.3 mg for children under 4 years of age
- 0.4 mg for adults and children 4 or more years of age
- 0.8 mg for pregnant and lactating women 2
From the Research
Daily Folate Supplement
The daily folate supplement can vary depending on the individual's needs and health status.
- For women with a previous pregnancy affected by a neural tube defect (NTD), a daily dose of 4000 micrograms of supplemental folic acid is recommended when planning a subsequent pregnancy 3.
- For those without a history of NTD, a daily dose of 400 micrograms of supplemental folic acid is recommended to prevent the occurrence of NTDs 3, 4.
- A daily dose of 650 micrograms of supplemental folic acid can help normalize elevated plasma homocysteine levels, which is a risk factor for cardiovascular diseases 3.
- The minimum effective dose of folic acid for food fortification to prevent neural-tube defects is estimated to be around 200 micrograms daily 4.
- For women of childbearing age, a daily folate intake of 400 micrograms is recommended for the prevention of NTDs, and a multiple vitamin containing folic acid can be a practical solution to meet this recommendation 5.
Folate Intake and Food Sources
- The mean daily folate intake in the US population is around 242 micrograms, with major food sources including orange juice, white bread, dried beans, green salad, and ready-to-eat breakfast cereals 6.
- Folate deficiency can be associated with anticonvulsant drugs and psychiatric morbidity, and supplementation with folic acid or folinic acid may improve cognitive performance and well-being in individuals with folate deficiency 7.