When should you start and stop taking folic acid during pregnancy? [Doctor-supervised]

What kind of nutrient is folic acid?

Folic acid is one of the B vitamins. It was named “folic acid” because it was discovered in spinach, and as the name suggests, it is found in large amounts in green leafy vegetables.

Its main function is known to be involved in the formation of red blood cells together with vitamin B12, and it is sometimes called the hematopoietic vitamin.

Folic acid is also an essential nutrient for synthesizing nucleic acids such as DNA and RNA, and proteins. Proper DNA synthesis promotes cell division, and metabolism and growth are normal.

Adequate intake of folic acid contributes to healthy fetal and infant development, as well as healthy skin and mucous membranes.

What is the difference between folic acid and folate?

Pregnant women sometimes ask, “Which is more effective, folic acid or folate?”

Folic acid is an artificial compound. The form found in dietary supplements is considered to be “folic acid.” Folate, on the other hand, is found in vegetables and fruits.

Since the amount of folate in vegetables is reduced by heating during cooking, it is unlikely that you will consume too much no matter how many vegetables you eat. It is important to use cooking methods that do not use heat, and if you are deficient in folic acid, you should take appropriate supplements such as nutritional supplements.

The effect of folic acid on your baby

Reduce the risk of neural tube defects

One of the main reasons why folic acid intake is recommended during pregnancy is to reduce the risk of neural tube defects in the baby.

As mentioned above, folic acid is a nutrient involved in DNA synthesis. If you are deficient in folic acid, you may be at higher risk of DNA synthesis not working properly and cell division failing.

The early stages of pregnancy are an especially important time for the formation of the neural tube, which develops into the baby’s brain and spinal cord.

If cell division fails and the neural tube becomes closed, it can lead to disabilities such as paralysis of the lower body, miscarriage, and stillbirth. By consciously taking folic acid during this period, the risk of neural tube defects can be reduced as much as possible.

Promotes baby’s growth

During pregnancy, the baby’s cells are actively dividing inside the mother’s womb. Folic acid promotes the division of the baby’s cells and supports healthy growth.

However, a lack of folic acid can cause cell division to be disrupted, often resulting in underdeveloped babies. Folic acid is an important nutrient not only during fetal development but also during infancy, so it is important to actively take in folic acid not only before and during pregnancy, but also during the breastfeeding period after birth.

Can folic acid prevent Down Syndrome?

Many mothers who have given birth to a child with Down syndrome say, “I took folic acid supplements during pregnancy, but my child still had Down syndrome .”

Because folic acid reduces the risk of birth defects such as neural tube defects, some may wonder if it could also prevent the onset of Down Syndrome .

However , Down syndrome is said to be caused by a trisomy in which there is an extra copy of chromosome 21. For these reasons, it cannot be said that taking folic acid will prevent the cause of Down syndrome .

However, in recent years, research reports have been submitted suggesting that there may be a relationship between neural tube defects and the onset of Down’s syndrome . According to a study by Hokkaido University, women who have given birth to a baby with a neural tube defect are about five times more likely to give birth to a child with Down’s syndrome than women who have not.

At this point, it cannot be said with certainty that folic acid can prevent Down syndrome itself. However, it may be possible to say that appropriate intake of folic acid can “reduce the risk of neural tube defects, which are thought to be related to Down syndrome .”

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Effects of folic acid on the body of pregnant women

Folate deficiency

During pregnancy, the nutrients in your blood are used to help your baby grow, which makes your blood thinner and more likely to cause anemia. Anemia can cause dizziness and falls, which are very dangerous for both you and your baby. Folic acid, along with vitamin B12, is responsible for the production of red blood cells.

In addition, a lack of folic acid often leads to folate deficiency, which can be prevented and improved by taking in enough folic acid.

Main Symptoms of Folate Deficiency

• Mild: Anemia, dizziness, shortness of breath, fatigue, etc.
• Severe: glossitis, taste disorder, diarrhea, depression, dementia, etc.
• Pregnant women: Neural tube defects in the fetus, which increase the risk of birth defects of the spinal cord and brain

Compared to the United States, where there are many foods fortified with folic acid, Japan has a low blood folate concentration. Make an effort to actively consume foods that are high in folic acid.

Prevents arteriosclerosis and reduces the risk of pregnancy-related hypertension

Folic acid converts the amino acid homocysteine ​​into methionine and cysteine. Homocysteine ​​is known to be a risk factor for blood clots, and a lack of folic acid can lead to increased levels of homocysteine ​​in the blood, which can cause arteriosclerosis. Taking folic acid to prevent arteriosclerosis can also reduce the risk of pregnancy-induced hypertension.

Brings mental stability

During pregnancy, you may feel mentally unstable, as you may not be able to move as you want and you may feel anxious about childbirth. This may also be due to the large changes in hormone balance caused by pregnancy.

It has been confirmed that taking folic acid increases the secretion of serotonin, also known as the “happiness hormone.” It can also be expected to reduce stress and calm your mood.

How to get folic acid from your diet?

According to the Japanese Dietary Reference Intakes, the recommended daily intake of folate for adult men and women is 200 µg, with 240 µg recommended. With a well-balanced diet and appropriate food intake, there is no need to worry about extreme folic acid deficiency or overconsumption.

However, women who are trying to become pregnant or are in the early stages of pregnancy are recommended to take an additional 240 µg. This is equivalent to about one bunch of raw spinach per day. If you have not eaten many vegetables or fruits up until now, it would be a good idea to actively consume foods that are high in folic acid and review your current diet.

In addition to folic acid, there are many other nutrients necessary to maintain health. It is important to check nutrition survey reports from the National Health and Nutrition Survey, which show trends in nutrient intake, and to maintain a healthy diet.

Foods high in folic acid

• Spinach *boiled (110µg/100g)
• Broccoli *boiled (120µg/100g)
• Asparagus *boiled (180µg/100g)
• Edamame beans (boiled) (260µg/100g)
• Avocado (84µg/100g)
• Strawberry (90µg/100g)
• Chicken liver (1300µg/100g)
• Beef liver (1000µg/100g)
• Pork liver (810µg/100g)
• Natto (120µg/100g)
• Roasted seaweed (1900µg/100g)

See the Standard Tables of Food Composition in Japan.

As the character “leaf” indicates, folic acid is found in abundance in green vegetables in general. Folic acid is a water-soluble vitamin that is sensitive to heat, so it is said that most of its components are reduced when heated for a long time. The best way to get the most folic acid is to eat vegetables and fruits raw, such as in a salad. If you boil or fry them, try to cook them for as short a time as possible. You can also make soup out of them and eat the broth to ensure that no nutrients are lost.

Liver is also a food that is rich in folic acid, but at the same time, it is also characterized by its high content of vitamin A. It is also known that excessive intake of vitamin A during pregnancy increases the possibility of causing fetal malformations. If you eat liver, you should limit it to one slice and be careful not to eat it too frequently. It is also better to choose beef liver, which has a relatively low content of vitamin A.

Roasted seaweed is an excellent food that is rich in folic acid even in small amounts. You can eat it on rice or as a salad topping, so if you keep it on hand, you can efficiently consume folic acid in your daily meals.

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What happens if you take too much folic acid?

According to the Ministry of Health, Labor and Welfare, the upper limit of folic acid intake per day is 1000 µg. If you have a well-balanced diet, there is little need to worry about taking in too much folic acid.

However, there are now many folic acid supplements on the market, and there is a lot of false information on the Internet, such as “folic acid supplements recommended for pregnant women,” “taking folic acid makes it easier to get pregnant,” and “taking lots of folic acid supplements before and during pregnancy prevents Down’s syndrome .” However, taking more than the recommended intake amount can result in an overdose of folic acid.

Folic acid is a water-soluble vitamin, so if you take more than you need, it will be excreted in your urine, so there is no need to worry about taking in too much.

On the other hand, it has been suggested that continuing to take more than the daily upper limit of folic acid through supplements that do not contain vitamin B12 may delay the diagnosis of vitamin B12 deficiency.

Pernicious anemia, which is caused by a lack of vitamin B12, can be improved by taking folic acid. However, if left untreated, the other symptom, neurological symptoms, may not improve and may continue to progress, so caution is required.

In addition, according to a study by an Australian university, taking more than 1,000 µg of folic acid per day in the late stages of pregnancy through supplements increased the risk of developing childhood asthma in the offspring by about 26%. Because folic acid is more easily absorbed in supplements than in food, it is important to strictly adhere to the recommended intake amount.

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Adequate folic acid intake for your and your baby’s health

Folic acid is an important nutrient that is needed before, during, and after pregnancy, as well as during the lactation period. If you get folic acid from natural foods such as vegetables and fruits, there is no need to worry about overdosing. If you are deficient in folic acid, it is important to supplement your intake with supplements or nutritional supplements. Also, if you are experiencing morning sickness or other health problems, it is best not to force yourself to take folic acid supplements.

Hiro Clinic NIPT: Early detection of Down syndrome in the fetus

Down syndrome is a congenital disease caused by chromosomal abnormalities. Appropriate intake of folic acid promotes cell division in babies and is important for healthy growth, but it cannot be said to prevent Down syndrome . There is no established method for preventing or treating chromosomal abnormalities in current medical practice. However, it is possible to know early on the risk of a baby having a congenital disease caused by chromosomal abnormalities.

Hiro Clinic NIPT (New Prenatal Testing) is a screening test that can be performed by taking a blood sample from about the 6th week of pregnancy (when pregnancy is confirmed by ultrasound). It is considered a highly accurate prenatal test with a sensitivity and specificity of 99.9% for Down syndrome .

In addition, chromosomal abnormalities in the baby often cause miscarriage. Checking the baby’s health condition in the early stages of pregnancy is important for a healthy pregnancy and birth.

At Hiro Clinic NIPT, we offer not only single tests for Down syndrome, but also plans to test all chromosomes. Please feel free to consult us about anything you don’t understand or are worried about, such as NIPT (new type prenatal testing) or Down syndrome . Doctors and staff who are well versed in NIPT (new type prenatal testing) will provide you with full support.

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