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Folic Acid While Trying to Conceive
Theresa Halvorsen (ICCE)0 Comments | Add Comment
Q: I went for my annual exam last wed and told the doctor that we were close to trying to conceive and that I had been on prenat vitamins since June, he wrote me out a prescription for folic acid and said to take it in addition to the prenatal. I don't really have any health issues other than IBS. Is this still safe? And is it ok to take them both together at night before bed? Thank you :) A: Great question!
First, let's talk about folic acid. Folic acid or folate is a B vitamin (B9) that aids in cell growth and the building of DNA. It's in green leafy vegetables (like spinach), orange juice, and fortified grains (read the labels of your breads, pastas and breakfast cereals). Many people in the United States don't get enough folate in their diets and need supplements.
So how does folic acid relate to pregnancy? In pregnancy, a folic acid deficiency can cause neural tube birth defects such as spina bifida, anencephaly or encephalocele. With spina bifida babies are born with incomplete spinal cords usually resulting in some form of paralysis. In anencephaly babies' brains aren't fully formed and in encephalocele the skull doesn't close completely. Obviously, these are very severe birth defects. One of the most difficult things about these birth defects is they often occur even before the woman knows she's pregnant. This is why doctors recommend women trying to conceive (TTC) take extra folic acid. According to the FDA, adults should take 400mcg (micrograms) of folic acid and pregnant, breastfeeding or women trying to get pregnant should take between 400 and 600mcg of folic acid. The CDC reports that women who take the recommended dosage of folic acid reduce their likelihood of having a baby with neural tube defects by 50 to 70 percent.
You asked why your doctor is recommending a folic acid supplement even though you're already on prenatal vitamins. Prenatal vitamins do have a great deal of folic acid in them, but amounts vary, which is why some doctors recommend taking an additional folic acid supplement. In addition, your doctor knows your medical history. If you have any neural tube defects in your family history, or a past history of miscarriages (sometimes women miscarry babies with severe neural tube defects) your doctor may be extra cautious and recommend even more folic acid. Your doctor also knows about your diet and because of it may have recommended a supplement (very few Americans get enough folic acid in their diets).
You also asked about overdosing on folic acid. Interestingly, folic acid is a water soluble vitamin. This means that your body will flush out any extra it can't absorb. Because of this you're unlikely to overdose on it--though most doctors recommend not taking more than 1000mcg a day. In addition, some people on certain medications shouldn't take extra folic acid. I'd definitely check your prenatal vitamins to see how much folic acid is in them and bring up the topic of overdose with your doctor. Because you have IBS (irritable bowel syndrome), you may be on medications that might interfere with the absorbtion of folic acid. You should bring this topic up with your doctor since IBS is out of my area of expertise.
Usually with vitamins it helps with absorption if you take them with food. You may absorb more of the folic acid if you take your prenatal vitamin in the morning with your breakfast and the folic acid supplement with dinner or before bed with a light snack. I'm a little concerned that if you take both vitamins at the same time you may not absorb as much folic acid as you could if you take the vitamins at different times. Basically, your body can only absorb so much folic acid at one time.
Bottom line, you should discuss this information up with doctor and ask if you're on prenatal vitamins why they prescribed you a supplement. Good luck and I hope you conceive soon!
Thanks for the great questions and keep them coming!
Theresa Halvorsen is a certified childbirth educator (ICCE) and teaches pregnancy, childbirth, newborn care and breasfeeding classes at two California hospitals. Over the course of a week, she may see over a hundred different couples. She enjoys sharing her expertise and answering lots of questions.Before she became a childbirth educator, Theresa was a certified doula or professional labor coach and attended over fifty births providing couples with physical, emotional and informational support during their births. She also holds a BA in psychology and a minor in biology.
In addition to being a childbirth educator, Theresa is also a writer and her book for men about supporting a laboring woman is due out soon. Theresa is also the mother of twin boys. She lives in California with her husband, their sons and too many pets to count.