Folic acid preparation for pregnant women. Folic acid for pregnant women: why is it needed, dosages. Where to get folic acid

Folic acid during pregnancy is a necessary substance for a woman's body and gestation.

Deficiency of folate compounds or vitamin B9 is dangerous and leads to changes in the composition of the blood in future mother and the child, disorders in the development of the placenta. The result is the birth of premature babies or children with developmental pathologies.

Significance for the body

Folic acid is found in foods:

• broccoli;
• green pea;
• carrot;
• bananas;
• citrus;
• leafy greens;
• yeast;
• bread products, etc.

A balanced diet is necessary to obtain the required amount of B9. But even in this case, the development of vitamin deficiency is possible.

The reason is the rapid destruction of folic acid during storage of products. Moreover, the body's need for a pregnant woman in the vitamin increases significantly.

Other causes of folic acid deficiency:

• low intake from food;
• genetic diseases (there are no enzymes in the body for the absorption and processing of folates);
• chronic diseases of the intestines or stomach (normal absorption of the substance is disturbed);
• passion for alcoholic beverages;
• the use of certain drugs - sulfonamides, oral contraception, anticonvulsants, antacids, anti-tuberculosis drugs.

folic acid during pregnancy

Vitamin B9 deficiency is a scourge among pregnant women these days. If the expectant mother has constant weakness, fatigue, anemia, dizziness and headaches, irritability - perhaps the reason is precisely the deficiency of folic acid.

The value of the vitamin in the body is enormous for the production of proteins and nucleic acids. It is necessary for the regeneration of cells and tissues, maintaining the normal state of all organs, and preventing the transformation of cells into cancerous ones.

An even greater role of folic acid during pregnancy. It ensures normal growth and development of the fetus.

Sufficient folate content is important in the 1st trimester. During these months, all the organs and systems of the embryo are laid, and most importantly, its nervous tissue and blood vessels of the placenta.

Why is a deficit dangerous?

The main danger of vitamin B9 deficiency during pregnancy is the insufficient development of the neural tube in the embryo.

This leads to such malformations:

• fading of pregnancy, that is, the death of the fetus in utero;
• hydrocephalus, or dropsy of the brain;
• anencephaly, that is, the embryo completely lacks a brain;
• spina bifida;
• hernia of the brain;
• impaired mental function;
• physical underdevelopment.

The importance of folic acid for the vascular system in the uterus is great. Consequences of a lack of a substance:

• premature detachment of the placenta;
• spontaneous abortion.

Folate deficiency affects the well-being of a pregnant woman. The manifestations are:

• toxicosis on early dates;
• rapid fatigue;
• weakness;
• loss of appetite;
• digestive disorders;
• headache and dizziness;
• leg cramps.

For this reason, doctors recommend drinking folic acid already at the planning stage of pregnancy. In fact, women often find out about conception for a period of 5-6 weeks, and it is during this period that the embryo is especially susceptible to vitamin deficiency.

Preparations

Folic acid is produced both in pure form and in the form of preparations:

• Folic acid tablets. Contains 1 mg of vitamin B9. For prevention, the recommended dosage is 1 tablet per day.
• Folio. Contains 400 micrograms of folate combined with 200 micrograms of iodine. Reception prevents the lack of B9 and iodine in the body of a pregnant woman.
• Folacin. Content active ingredient in a tablet high - 5 mg. Therefore, it is used not for prevention, but for the treatment of deficiency.
• Gendevit. Polevitamin in the form of a dragee. One contains 300 micrograms of folic acid.
• Compliment Mom. Multivitamin complex. One capsule contains 400 mcg of the vitamin.

Contraindications

Folic acid during pregnancy is contraindicated in the following cases:

• allergic reaction or individual intolerance to folic acid;
• oncological diseases in close relatives;
• vitamin B12 deficiency;
• chronic pyelonephritis;
• bronchial asthma.

Video about folic acid

Consequences of an overdose

An overdose of vitamin B9 during pregnancy is difficult to achieve, as it is a water-soluble substance. Its assimilation by the body occurs only in the right amount, and the excess is excreted through the kidneys.

However, the symptoms of a folic acid overdose are as follows:

• causeless irritability;
• disorders digestive system- nausea and vomiting, flatulence, diarrhea, lack of appetite;
• insomnia;
• dysfunction of the kidneys.

An overdose of folic acid is said to occur if a daily dose of more than 15 mg enters the body.

Folic acid during pregnancy is a vitamin necessary to maintain the body of the expectant mother and the proper development of the fetus. B9 deficiency leads to irreversible consequences in the form of defects in the embryo. To prevent complications, it is advisable to start taking folic acid already at the stage of pregnancy planning and continue up to 12 weeks, and even better until childbirth and the end of breastfeeding.

All information is presented for informational purposes. Do not self-medicate. At the first sign of disease, consult a doctor.

The health of the expectant mother is one of the most important factors for a favorable pregnancy. The lack of vitamins and useful micro and macro elements is very dangerous during childbearing. Folic acid is vital at this time. We will talk about the features of this vitamin and its intake in an “interesting” position in this article.

General information about folic acid

This substance belongs to the vitamins of group B. In the body, folic acid, or vitamin B9 in other words, is produced in very small quantities, so most of it gets to a person with food.
Often in some sources you can find the term "folate". Some people think that folic acid and folate are the same thing. But it is not so. Folate is a natural form of the vitamin that occurs naturally in foods. And folic acid is a synthetic substance, that is, a product of chemical manipulations by scientists in laboratories.

• parsley;
• spinach;
• salad;
• cabbage;
• beet;
• cucumbers;
• broccoli;
• spinach;
• peas;
• beans;
• lentils;
• oranges;
• bananas;
• apricots;
• wholemeal bread;
• meat;
• liver;
• eggs;
• leaves black currant, raspberries, rose hips and some other products.

Dutch scientists have identified a link between folic acid and human mental abilities. In the experiment, it was proved that taking 0.4 mg of vitamin B9 daily preserves intelligence as you age.

When I was pregnant with my second son, I got a new district gynecologist. I was very surprised that she was against prescribing any synthetic vitamins without special need. To all my requests and questions regarding what I would drink from multivitamins, she answered that there is nothing better than a balanced diet. And only she treated folic acid differently and prescribed it in the first trimester of pregnancy.
Vitamin B9 is found in a fairly large number of foods: vegetables, legumes, meat products, etc.

Unfortunately, the diet of a modern person often does not correspond to the concept of " balanced diet". Therefore, situations are not uncommon when certain substances in the body are not enough. In addition to this, vitamin B9 is practically unstable to the effects environment. It breaks down quickly during storage and cooking.
And there is also a category of people who lack the enzyme responsible for the absorption of folic acid. It is not absorbed from food at all, but taking pharmaceutical preparations can eliminate its deficiency.
Normal at healthy person folic acid in the blood should be in an amount of 7 to 45 nmol / l. And although these figures are very small, their slightest fluctuations up or down are fraught with health problems. The main symptoms of folic acid deficiency are constant fatigue, loss of appetite, and extreme irritability.

These signs are very similar to those that a woman feels in position in the first months of pregnancy. Therefore, many people often do not even know about the lack of vitamin B9.

But if in the normal state its lack is not so dangerous, then this problem becomes especially acute when a woman begins to carry a child under her heart. The body of the expectant mother at this time needs much more nutrients. And she needs especially a lot of vitamin B9, since it is involved in the process of DNA synthesis, growth and division of fetal cells, and the formation of the hematopoietic system.
Folic acid is essential for the development of the child's nervous system. Its deficiency often leads to defects in the brain, neural tube of the embryo, etc. All these organs are formed already in the first weeks of pregnancy. So, in the first week after conception, the neural tube of the fetus is formed, which is responsible for the correct functioning of the whole organism. This is why OB/GYNs recommend starting folic acid supplementation 3-4 months before the final decision to conceive is made.

Preparations with "folk", as future mothers affectionately call it, are freely available in pharmacies. They are produced in tablet form. Vitamin B9 can be contained both in monopreparations with one active ingredient, and be included in a complex remedy, combined, for example, with iodine, iron, other B vitamins and other substances.

Vitamin complexes for pregnant women usually contain a whole range of substances necessary for the course of pregnancy. Some may contain folate, a substance derived from natural foods. And in others - folic acid, which was synthesized artificially. It is believed that folate is better and faster absorbed by the body.
Pharmaceutical factories produce folic acid in the form of tablets

The monopreparation contains only folic acid. Its name corresponds to the active substance. Auxiliary components are the following components:

• lactose monohydrate (milk sugar);
• cellulose microcrystalline;
• povidone (polyvinylpyrrolidone);
• corn starch;
• magnesium stearate.

In the blood, vitamin B9 reaches its maximum value half an hour to an hour after ingestion. It accumulates in the liver and is excreted in the urine. Folic acid is able to penetrate to the fetus through the placenta and into breast milk.

Indications, contraindications and side effects

Indications for the use of folic acid are:

• prophylactic reception during childbearing and lactation in order to prevent its deficiency in the body;
• treatment and prevention of folic acid deficiency anemia.

The drug should not be taken by people who have the following health problems:

• individual intolerance to the components of the drug;
• anemia associated with vitamin B12 deficiency;
• lactose intolerance;
• lactase deficiency;
• glucose-galactase malabsorption (impaired absorption of glucose and galactose).

Also, the drug should not be taken by children under 3 years of age. Folic acid should be taken with extreme caution:

• in the presence of a folate-dependent malignant tumor;
• when taking inhibitors of dihydrofolate reductase (drugs that slow down the activity of this enzyme).

As side effects may be observed:

• allergic reactions: rash, itching, erythema (severe reddening of the skin due to capillary expansion), bronchospasm (narrowing of the bronchi), hyperthermia (fever), anaphylactic reactions;
• from the gastrointestinal tract: anorexia, nausea, bloating, bitterness in the mouth, diarrhea;
• from the nervous system: irritability, sleep disturbance.

With prolonged use, there is a risk of developing hypovitaminosis B 12 .

Folic acid is not compatible with all medications, so it is imperative to consult a doctor before taking it. Reduce the absorption of folic acid:

• antacids (drugs that reduce the acidity of gastric juice);
• Colestyramine;
• antimicrobial agents from the sulfonamide class (Arifon, Clopamid and others).

Reduce its effectiveness:

• Methotrexate;
• Pyrimethamine;
• Triamterene;
• Trimethoprim.

The relationship of zinc absorption with the simultaneous intake of folic acid has not been proven. However, some scientists suggest that their combined use does not allow adequate absorption of zinc.

Can there be an overdose

It used to be thought that an overdose from taking folic acid could not happen. However, recent studies have proven that it is possible. Those pregnant women who took it for a very long time or in large quantities gave birth to children prone to frequent colds and bronchial asthma.
The health of a pregnant woman with uncontrolled intake of folic acid is also at risk, since an overdose is often not noticed very much. long time. And it can lead to vitamin B12 deficiency, as well as disruption of the central nervous system and gastrointestinal tract.

That is why you should not start taking folic acid supplements on your own. It is important to remember that only a person with medical education and knowledge of the patient's state of health can prescribe the correct dosage and duration of taking such drugs.

Application features

According to the World Health Organization, a pregnant woman should receive 0.4 mg of folic acid per day. But each case is individual. And, based on the condition of the expectant mother, the doctor may prescribe a different dosage. It is possible to take 0.8 mg of the drug, and with anemia even 5 mg. Only a doctor can calculate the correct dose. It is he who prescribes the regimen for taking the drug.

Usually, a pregnant woman is prescribed 1 tablet per day with an active ingredient concentration of 1 mg. But the doctor may prescribe an appointment in a different way. For example, 2-3 tablets of 0.4 mg per day. If the expectant mother has confirmed folic acid deficiency anemia, then she is prescribed a dosage of more than 5 mg. Usually, the treatment of this condition is carried out with the drug Folacin, which is no longer a preventive, but a therapeutic agent.

When purchasing a vitamin in a pharmacy, be sure to pay attention to the concentration of the active substance, which can be different.

It is better to drink folic acid after meals, as it increases the acidity of gastric juice. And in pregnant women, taking it before meals can cause vomiting. If you take a vitamin B9 tablet with a meal, the digestion of food will be difficult.

Unfortunately, not all doctors indicate when prescribing the drug the amount of active substance that should be in 1 tablet. It happened to me as well. The gynecologist prescribed to take Folic acid 1 tablet twice a day. Arriving at the pharmacy, I was extremely discouraged by the fact that the dosage can be different. Absence necessary information led to the fact that I had to visit the doctor again so that she clarified the amount of folic acid in the daily dose.
Folacin is prescribed for the treatment of folic acid deficiency anemia.

At what stage of pregnancy can you take folic acid

The importance of taking vitamin B9 at the stage when the life of the baby has not yet begun, and the early stage of pregnancy, was mentioned above. But the need for this vitamin does not disappear even after.

So, its lack throughout the entire period of pregnancy can lead to preeclampsia (a complication of its course, characterized by high blood pressure, edema and the appearance of protein in the urine). This condition is very dangerous for the fetus, as the blood flow through the placenta is disturbed, which often leads to a lag in the physical development of the child. Also, this pathology can lead to premature birth and eclampsia, in which arterial pressure becomes critically high, which is dangerous for the life of the mother and fetus.

In the last 3 months of pregnancy, folic acid is an important element to prevent too early rupture of the amniotic membrane, as well as early onset of labor.

Doctors usually prescribe folic acid in the first 3 months of pregnancy. Subsequently, as a rule, multivitamins are prescribed for women in position, in which it is also present, but in a lower dosage. In any case, the need to take any vitamins should be determined only by a doctor based on the available data on the health status of a pregnant woman.

Analogues

Among the complete analogues of the monopreparation Folic acid, the following can be distinguished:

1. Vitrum Folikum. One tablet contains 0.4 mg of the active substance. Indications, method of administration and dosage correspond to the original drug.
2. Folacin. Contains 5 mg of active ingredient in 1 tablet. It is a remedy for the elimination of folic acid deficiency anemia.

To complex preparations that have in their composition and other useful material, in addition to folic acid, include:

1. Foliber. Also contains vitamin B12. Among the contraindications are individual intolerance to the components of Foliber, lactose intolerance, lactase deficiency, glucose-galactase malabsorption. The dosage of folic acid in 1 tablet is 0.4 mg, and cyanocobalamin (vitamin B12) - 0.002 mg, which is the minimum daily dosage.
2. Elevit pronatal. This drug is a combination of vitamins and minerals necessary for the health of a pregnant woman and her baby. Folic acid is contained in it in an amount of 0.8 mg. Contraindications to taking this vitamin complex are individual intolerance to the components, an excess of one or more substances of the drug in the body, kidney and liver diseases, impaired absorption and excretion of iron, problems with excessive excretion of calcium in the urine.
3. Alphabet Mom's health. The uniqueness of this vitamin complex lies in the fact that all the substances contained in it (namely, 13 vitamins with folic acid together, 11 minerals and taurine) are distributed over three tablets in such a way that they do not interfere with the absorption of each other. Vitamin B9 is contained in two tablets of 0.3 mg each. Contraindications include sensitivity to the components of the drug, as well as hyperfunction of the thyroid gland. The manufacturer recommends taking each tablet separately throughout the day. But it is also possible to take all three tablets at the same time. But the effectiveness of taking the drug is reduced.
4. Folio. The drug contains folic acid in the amount of 0.4 mg and 0.2 mg of iodine in 1 tablet. Contraindications include individual intolerance to the components. Caution should be taken by women with thyroid disease.

In both my first and second pregnancies, I took regular Folic Acid until 12 weeks pregnant. The gynecologist did not prescribe a further intake of multivitamins for expectant mothers. In my opinion, with a full-fledged varied diet, the body does not require additional sources of vitamins and minerals, even when a woman is in an “interesting” position.

Photo gallery: analogues of the drug Folic acid

Foliber, in addition to folic acid, contains vitamin B12 Vitamin complex Alphabet Mom's health is distributed between 3 tablets Vitrum Folicum is a complete analogue of Folic acid Folacin contains is prescribed only for folic acid deficiency anemia confirmed by analyzes Elevit pronatal includes a complex necessary for a pregnant woman
Folio is an additional source of folic acid and iodine for expectant mothers

A woman who is preparing to become a mother must carefully prepare for a responsible mission. A healthy lifestyle, parting with bad habits are common truths known to everyone. But few people know how important it is during pregnancy. This is one of the main tools that a future mother needs to use.

Determination of folic acid

Otherwise, it is called vitamin B9. There is also a generalized name - folates, these are vitamin derivatives. It is them that a person receives from food, and tablets are a synthetic agent that turns into folates inside the body.

Any derivatives of vitamin B9 are very important for the hematopoietic system, namely, in the formation of new blood cells. Due to their deficiency, anemia develops.

Role in the body

The main functions that folic acid performs during pregnancy should be highlighted:

• Participates in the formation of cell DNA, that is, the carrier of hereditary information.
• Stimulates blood formation.
• Participates in the formation of the placenta.
• Blocks the formation of cancer cells.
• Restores muscle tissue.
• Participates in the laying and subsequent development of the nervous tissue of the fetus.

Why is it important to get folate during pregnancy?

To the question, doctors cannot answer in detail within the framework of a quick appointment, so it is worth explaining its significance. In the early stages, its consumption increases sharply. There is an increased division of embryonic cells to form full-fledged tissues. The baby's tissue is the most difficult to transform. That is why it is worth taking folic acid.

Deficiency can occur for various reasons:

• Insufficient vitamin intake from food.
• Malabsorption - occurs in chronic diseases of the stomach, intestines.
• Genetic disorders in the folate cycle. It very rarely happens when the body does not have the necessary enzymes. Because of this, folic acid is not converted to folate. Accumulation of intermediate metabolic products occurs, leading to diseases of cardio-vascular system, infertility and inability to bear a fetus. In this case, drink folic acid derivatives.
• Taking oral contraceptives, barbiturates, sulfa drugs and alcoholic beverages reduces the level of the substance in the blood. If a woman took any of the above before conception, additional methods are required so that the norm of folic acid for pregnant women remains within its boundaries.

Required dosage

The ideal option is to drink a vitamin before pregnancy three months before conception and throughout gestation. Usually women are advised to drink 400 mcg per day. Sometimes the dosage needs to be increased. If the future mother has diabetes mellitus or epilepsy, then for her the daily norm is 1 mg. If children with a neural tube defect have previously been born, the dose of folic acid during pregnancy will be 4 mg. But the exact decision can only be made by a doctor after an examination.

Recommendations regarding the use of folic acid in women during pregnancy are being disseminated in many countries. So, American women who are at the planning stage take 400-800 mcg per day a month before conception and for three months of gestation.

A blood test for vitamin B9 levels should be taken by anyone who has anemia or homocysteinemia. Healthy pregnant women do not need such an examination.

What is the best way to take it?

Pharmaceutical companies offer a wide range of products that contain folate. Their main difference is in quantity, dosage and cost.

Some of the medicines that are available in tablets have a dosage of 1 mg, which is inconvenient. You have to break it in half so that the norm of folic acid during pregnancy is not exceeded. It is desirable to find a form that will contain 400-500 mcg. This is the standard dosage of folic acid required during pregnancy.

There is another option - complexes (, etc.). But they should be used by those who live in an unfavorable climate and have a poor diet.

Three components are enough for a modern woman:

1. Folic acid during pregnancy at a dosage of 400 mcg.
2. Iodine preparations when in an area with its deficiency.
3. If you have anemia, you need to take iron supplements.

Taking drugs with a multicomponent composition can be called inappropriate. It is sufficient to take folic acid during pregnancy, because this drug is safe. Its effectiveness has been proven through numerous studies. When asked how much folic acid a particular woman should drink during pregnancy, a specialist should answer.

Extract from the instructions

Indications include the prevention of neural tube defects and vitamin B9 deficiency. Contraindications - childhood, pernicious anemia, cobalomin deficiency, the presence of malignant tumors, sensitivity to components.

According to the instructions for use, the established daily dose of folic acid for pregnant women is 400 mcg. Among side effects- itching, rash, hyperthermia, bronchospasm, bitterness in the mouth, erythema, loss of appetite, nausea and bloating. If you take folic acid for a long time, hypovitaminosis B12 may develop.

There are also special instructions. To prevent vitamin B9 deficiency, a balanced diet is necessary. The diet should contain green vegetables, legumes, beets, cheese, fresh liver, nuts, eggs.

If large doses are allowed and treatment becomes prolonged, a decrease in B12 concentration may develop. In the case where it seems that the doctor has overdone the appointment, you need to consult with another. Drink the amount that will be agreed with different experts.

An overdose of folic acid during pregnancy is possible, but only in those taking 25-30 tablets per day. In other cases, the excess is excreted from the body.

What else you need to know about vitamin B9:

• Folic acid is prescribed for pregnant women, since during this period it is more quickly excreted from the body.
• If a woman drank strong tea, the vitamin will be excreted from the body faster.
• Reception of some medicines increases the need for vitamin B9.
• It is important to remember that when taking folic acid during pregnancy, it is imperative to monitor the reaction - an allergy is possible.
• In addition to the fact that the vitamin is necessary for the creation of the nerve cells of the baby, it goes to "repair" about 70 trillion of the mother's cells, because they are constantly updated.
• Be sure to drink folic acid, as its deficiency is transmitted to the fetus and affects the quality of breast milk.
• In order for an important element to be preserved in products, they must be eaten raw or steamed.

A woman may not notice that she lacks a vitamin. But already in the first trimester, the appearance of irritability, loss of appetite, fatigue is permissible. Be sure to drink folic acid so that all these symptoms do not interfere with a successful pregnancy. As a rule, doctors, when asked how to take vitamin B9, answer that 1 tablet per day is enough. In some cases, the specialist increases the dosage, but this is strictly individual. Therefore, before you start taking even such a harmless drug, you should ask your gynecologist how much to drink vitamin B9 and for how long. This will create optimal conditions for the health of the baby and mother. It would also be useful to clarify, . Vitamin must be supplied to the body and from natural sources.

Any woman who plans to soon become pregnant and become a mother should consciously and carefully prepare for this new status. And if everyone knows about a healthy lifestyle, parting with bad habits and walking in the fresh air, then future mothers often ignore taking certain vitamins and medicines before pregnancy. One such remedy is folic acid.

What is folic acid?

Folic acid is vitamin B9. Often you can hear the generalized name - folates, they are derivatives of this vitamin. We must understand that we get them from food, and folic acid tablets are a synthetic agent that is already converted into folates inside the body.

All derivatives of vitamin B9 play an important role in hematopoiesis, that is, the formation of new blood cells. Therefore, the lack of these substances leads to anemia - a condition in which red blood cells are not enough, or they have irregular shape and do not perform their functions.

Folates have another very important feature: they stimulate the formation of nucleic acids (DNA and RNA), which are the basis of all body cells. Therefore, it is folic acid that is necessary for all rapidly dividing human tissues, including embryonic tissues.

The role of folic acid:

• participates in the formation of DNA of all cells, that is, the source of hereditary information
• stimulates hematopoiesis
• indirectly blocks the formation of cancer cells
• restores muscle tissue
• during pregnancy:
  • plays a role in the laying and development of the nervous tissue of the embryo
  • participates in the formation of placental blood vessels

Why is folate needed during pregnancy?

During pregnancy, especially in the early stages, the consumption of folate increases dramatically. All cells of the embryo are intensively dividing in order to eventually form full-fledged tissues. The nervous tissue of the future man is transformed especially quickly and difficultly. And it is she who requires a large amount of folic acid.

Folic acid deficiency during pregnancy can occur for the following reasons:

• Insufficient dietary folate intake
• Folate malabsorption (in chronic inflammatory diseases of the stomach and intestines)
• Genetic disorders of the folate cycle. In rare cases, a woman's body lacks the necessary enzymes (MTHFR). As a result, folic acid is not converted to folates, and they do not perform the necessary functions. Intermediate metabolic products accumulate in the body, which can lead to cardiovascular diseases, tumor processes, infertility, etc. In the presence of such a mutation, it is recommended to take folic acid derivatives, for example, Metafolin. It is absorbed faster and in greater volume.
• Taking certain anti-epilepsy drugs and hormonal drugs dramatically reduces the level of folate in the blood:
  • oral contraceptives (see)
  • barbiturates, diphenylhydantoin
  • sulfa drugs (for example,), which inhibit the synthesis of vitamin B9 by intestinal microflora
  • drinking alcohol also lowers their levels

How does the body get folic acid?

3 sources of folic acid:

• From food - as folate
• A small amount of vitamin B9 is synthesized by the body itself (intestinal microflora) during the normal functioning of the gastrointestinal tract - in the form of 5-methyltetrahydrofolate
• Chemical folic acid - from vitamin supplements

Folates were first isolated from spinach leaves. Subsequently, it turned out that they are present in large quantities in almost all leafy vegetables. Other sources of folate include citrus fruits, green peas, bread, liver, nutritional yeast, cheeses, eggs, and cottage cheese.

If there are so many foods that contain folate, then why do you need to take folic acid tablets during pregnancy?

• technological progress and market economy causes producers of plant and animal products to accelerate the growth of animals on the farm and the cultivation of greens and vegetables in the greenhouse, respectively, less of the natural isomer of folic acid accumulates in products. As a result, reference information from old printed publications on the content of folates in various products is not relevant and overestimated today.
• The main disadvantage of "natural" folates is the rapid destruction during heat treatment. Cooking, frying and stewing destroy almost 90% of the vitamin. But even eating raw foods does not guarantee that the right amount will enter the bloodstream. Moreover, vitamin B9 is sensitive to conditions and shelf life:
  • when boiling an egg, 50% of vitamin B9 is destroyed
  • after 3 days, the greens lose it up to 70%
  • in meat after heat treatment - up to 95%
• The presence of a person with chronic diseases of the intestines, stomach does not allow the vitamin to be absorbed in full.

Therefore, about 60% of the population suffers from folate deficiency, and the body of a healthy pregnant woman receives a little more than 50% of the daily folic acid from food.

However, numerous studies by scientists have established that the body recognizes how folic acid enters the body and its absorption directly depends on this. Of course, intake from natural sources is better absorbed in the gastrointestinal tract, even with metabolic disorders and gastric acidity, and therefore has serious advantages in comparison with synthetic folic acid.

The body's own synthesized folic acid in the form of 5-methyltetrahydrofolate does not interact as strongly with other drugs and does not mask the hematological signs of vitamin B12 deficiency as synthetic folic acid. In addition, it excludes the possible negative consequences of an excess of unreacted vitamin B9 in peripheral vessels.

But in order to provide the body of a pregnant woman with folates (and the need for them increases by 50 percent), you need to eat a huge amount of the above foods daily. AT modern conditions this is impossible, and given the decrease in its amount in modern products, it is ineffective. Modern drugs folic acid contain the required amount, are safe for a pregnant woman in the recommended dosage and are quite well studied.

Consequences of folic acid deficiency during pregnancy

Maternal pathologies:

• violation of hematopoiesis in a woman: anemia, low resistance to infections and a tendency to form blood clots.
• reduced tolerance for physical and mental stress

These symptoms are characteristic of women with a hereditary defect in the genes responsible for the folate cycle. Usually, symptoms of vitamin deficiency occur even before pregnancy, combined with iron deficiency anemia and diseases of the cardiovascular system. In case of gene disorders, it is necessary to take large doses of folic acid with the obligatory control of a blood test, only under the constant supervision of a specialist.

Fetal pathologies:

• neural tube defects in the fetus
• miscarriage:) and intrauterine fetal death
• defective placenta and, as a result, oxygen starvation fetus

Neural tube defects in the fetus

Already in the third week after conception, a tube with a thickening at the end is formed in the embryo - the future spinal cord and brain. Under the influence of adverse factors, including folic acid deficiency, the construction of this neural tube may be disturbed or stopped. As a result, very serious, sometimes incompatible with life, malformations of the fetus are formed.

• Anencephaly is the absence of most of the brain. The defect is incompatible with life, therefore, after confirming the diagnosis with the help of ultrasound, termination of pregnancy is recommended.
• A cephalocele is a split in the skull through which the meninges or the brain itself can bulge. Depending on the degree of tissue swelling, the prognosis may vary from lethal to favorable.
• Spina bifida is the most common neural tube defect. Through the defect of the vertebrae, the spinal canal is exposed, and the membranes of the spinal cord bulge. Depending on the level of damage to the vertebrae and the degree of bulging, the prognosis also depends: a quarter of children die in the first days of life, most become disabled, and only a small percentage of babies do not have problems with urination and movement in the legs in the future.

Not all the consequences of folic acid deficiency can be detected during pregnancy or immediately after childbirth. Minimal disorders of the nervous tissue make themselves felt in adulthood by difficulties in learning and concentration. Scientists at the University of Cambridge have conducted a number of studies proving the connection between B9 deficiency and emotional disorders in children.

In perfectly healthy women who eat a full and varied diet, a lack of folic acid may not affect their well-being. First of all, the fetus and placenta will suffer, and already in the very early stages. Therefore, drinking folic acid during pregnancy means taking care of the health of the unborn baby.

At what stage of pregnancy should you take folic acid supplements?

Folic acid intake in order to prevent fetal malformations should be started even at the stage of preparation for pregnancy, at least three months before the intended conception. That is why pregnancy should be planned. If conception occurred unexpectedly, then you need to start taking the drug as soon as it became known.

Reasons for taking folates at the stage of pregnancy planning:

• With an unbalanced diet, a woman can have a reduced level of folic acid, so it takes time to replenish her reserves. It usually takes three to four months.
• The neural tube of the fetus is laid at such an early stage that a woman may not even be aware of the pregnancy, especially with a long menstrual cycle.
• Folate deficiency can make pregnancy difficult.

Dosage of folic acid during pregnancy

In most cases, three months before conception and throughout pregnancy, you need to take 400 micrograms of folic acid per day. In some cases, the dosage is advised to increase:

• up to 1 mg per day for epilepsy and diabetes
• up to 4 mg daily if there have been children with neural tube defects in the past

Increased doses of folate can only be prescribed by a doctor after a thorough examination.

The dose of folic acid during pregnancy remains the same.

So, in the USA, all women planning a pregnancy should take the drug at a dose of 400-800 mcg per day a month before conception and during 3 months of pregnancy. Moreover, these recommendations exist in conjunction with the enrichment of food products with folates (for example, adding them to pasta), which is not observed in our country. And right! Why add a vitamin to the product, which is destroyed during further 10 minutes of cooking? If you take synthetic folic acid, it is better in tablet form!

Consequences of excess folic acid

Vitamin B9 belongs to water-soluble substances, so all of its excess is successfully excreted by the kidneys. It is very difficult to arrange an overdose of folic acid during pregnancy, when the vitamin becomes toxic and has an adverse effect on the fetus. This vitamin should be used with caution when:

• severe pathology of the liver and kidneys in a pregnant woman
• hereditary defects in the gene responsible for folate metabolism. An excess of folic acid can further disrupt the balance in this cycle, leading to the same consequences for the fetus as vitamin deficiency. The intake of this substance in such patients should be monitored by a physician.
• allergic reactions to synthetic vitamins

The effect of folic acid on fetal development has been studied for a very long time and everywhere. Scientists from Newcastle University have noted cases of children born with altered folate cycle genes from mothers who took this drug. That is, for the processing of external folic acid, nature "invented" new gene. Everything would be fine, but some human diseases can be associated with this gene.

These studies were not widely disseminated, since the theory was not confirmed in practice. But the reduction in the incidence of malformations of embryos in mothers taking folic acid has been confirmed by numerous studies around the world. The number of cases of spina bifida after the widespread introduction of folic acid has decreased by a quarter.

In the early 90s, in the United States, they even tried to enrich food with this vitamin, which did not lead to the desired results, since the dosage of folic acid during pregnancy should be at least 2 times more than usual. Considering that mainly flour, high-calorie foods were enriched with vitamins, the target audience (pregnant and lactating women) tried to avoid them.

There are suggestions that an overdose of folic acid during pregnancy can lead to an increase in the body weight of the child, an increase in the risk of developing obesity and diabetes in the child in the future, as well as a tendency to allergies, bronchial asthma, and can lead to impaired immunity. But these are only assumptions, there are no convincing studies confirming such risks.

Conclusion: there is no convincing evidence of a negative effect of the standard dosage of folic acid on a healthy pregnant woman. There have been studies that have confirmed that taking even 15 mg per day is non-toxic. But like any synthetic substance, this the drug must be used strictly in the required dosage. Especially since positive effect on the nervous tissue of the fetus at a dosage of 400 mg and 4 mg differs slightly. Therefore, the doctor decides how much folic acid during pregnancy each woman should take.

With regard to the intake of folic acid by non-pregnant women, in high doses and for a long time, a constant overdose can lead to sad consequences. Exceeding the recommended dose may result in:

• men are 2 times more likely to develop
• taking folic acid in a non-pregnant woman at a dosage of 500-850 mcg per day increases the risk of breast adenocarcinoma by 20%, more than 850 mcg - by 70%
• in the elderly, long-term overdose causes a disorder of psycho-social functions

Symptoms of an overdose of folic acid:

• metallic taste in the mouth
• irritability, irritability, sleep disturbance (see)
• gastrointestinal disorders: vomiting, nausea, diarrhea, (but similar symptoms also accompany toxicosis of the 1st trimester)
• kidney disorders
• one of the serious consequences of an overdose is zinc deficiency, vitamin B12 deficiency

Tests to determine the level of folic acid

A blood test for the level of folic acid is prescribed for patients with anemia to determine its cause or for patients with homocysteinemia. Healthy pregnant women do not need such an analysis, since when taking folate, the level of this substance in the blood will be higher than normal in any case. And it is absolutely physiological. Folic acid when planning pregnancy is prescribed regardless of its initial amount in the body.

How to take folic acid?

The modern pharmaceutical industry offers a huge selection of drugs containing folates. Most of them differ only in dosage and price.

Many folic acid tablets come in the inconvenient 1mg dosage and have to be broken in half. It is better to find folic acid in the dosage of 400-500 micrograms needed for most pregnant women. How to take the drug for pregnant women with homocysteinemia is determined by the attending physician.

The pharmaceutical market in recent years offers big choice multivitamin complexes created specifically for pregnant women. Such funds should be taken only by people living in extremely unfavorable conditions and having a poor diet. Modern woman for a successful and healthy pregnancy needed:

• folic acid in the amount of 400 mcg per day
• (potassium iodide) in deficient areas
• with the appearance of anemia - iron supplements

The use of multivitamin complexes to compensate for folate deficiency can be considered inappropriate. Folic acid is one of the few medicines, the effectiveness and safety of which during pregnancy has been proven in numerous studies. Taking just one tablet a day is a simple, inexpensive and reliable way to reduce the risk of serious illnesses in your baby and give him a full life!

Dosage of folic acid

What are the best folic acid supplements to take?

9 months Folic acid (Valenta) 400 mcg. 30 pcs. 120 rub.	Folic acid (Valenta) 1000 mcg. 50 pcs. 40 rub. half a tablet a day	Folic acid from OZONE 1000 mcg. 50 pcs. 25-30 rub. (half a tablet)	Blagomin B9 (OOO VIS) 200 mcg. 90 caps. 110 rub. 2 tab. in a day
Folic Acid by Solgar 400 mcg. 100 pieces. 500 rub.	Folic Acid from Natures Bounty 400 mcg. 100 pieces. 300 rub.	Folic acid (Borisov plant, Belarus) 1000 mcg. 50 pcs. 25-30 rub. (half a table per day)	Folic acid (MARBIOPHARM) 1000 mcg. 50 pcs. 30 rub. (half a table per day)
Instructions for use of folic acid Indications: prevention of development in the 1st trimester of pregnancy in the fetus of neural tube defects (1-3 months before the planned pregnancy and in the first trimester), as well as in folic acid deficiency. Contraindications: children with pernicious anemia with cobalamin deficiency malignant neoplasms hypersensitivity to drug components Dosage: during pregnancy 400-800 mcg in the 1st trimester, with folic acid deficiency - 400 mcg once a day. Side effect: itching, skin rash, bronchospasm, hyperthermia, erythema, bitterness in the mouth, nausea, loss of appetite, bloating, with prolonged use, hypovitaminosis B12 may develop. Interaction with other drugs: taking anticonvulsants, analgesics, oral contraceptives, estrogens increase the need for folic acid. Sulfonamines, antacids, cholestyramine, reduce the absorption of vitamin B9. Pyrimethamine, methotrexate, triamterene, trimethoprim reduce the effect of folic acid (patients are shown not folic acid, but calcium folinate). With the simultaneous administration of folic acid with tetracyclines, chloramphenicol, polymyxins, the absorption of folic acid is reduced. Special instructions: To prevent vitamin B9 deficiency, a balanced diet is preferable - green vegetables (tomatoes, carrots, lettuce, spinach), beets, legumes, fresh liver, cheese, cereals, eggs, nuts. Folic acid is not used for normocytic, B12-deficient and aplastic anemia. With B12-deficiency (pernicious) anemia, vitamin B9 masks neurological complications, improving hematological parameters. Until B12 deficiency anemia has been ruled out, doses greater than 100 mcg/day of folic acid are not recommended (except during pregnancy and lactation). With simultaneous treatment - antacids are taken 2 hours after folic acid, cholestyramine - 1 hour or 4-6 hours before taking folic acid. Antibiotics can distort the results of microbiological assessment of the concentration of erythrocytes and plasma folic acid. When taking large doses and long-term treatment with folic acid, a decrease in the concentration of vitamin B12 is possible.

Frequently asked questions about folic acid

In the previous 5 years I had 3 pregnancies that ended at 10 weeks. What dosage of folic acid do I need?

Three or more missed pregnancies are a reason for examining a married couple. After it, the doctor will most likely prescribe 4 mg of folic acid per day.

The doctor prescribed 1 mg of folic acid per day. It turned out that I was allergic to her. What should I do?

allergic reaction in this case associated with the components of tablets (dyes, sweeteners). You can try changing the drug or switching to injections.

I accidentally drank 2 folic acid tablets of 500 mcg, that is, 1 mg per day. Is it dangerous?

This dose is not toxic and will not harm you or your baby. Continue taking 1 tablet daily.

I am 39 years old, we have been planning a pregnancy for six months. The doctor prescribed 4 mg of folic acid, as at my age there is a risk of its deficiency and termination of pregnancy. Is such a large dose necessary?

The risk of interruption in your case increases somewhat due to age, and not due to folate deficiency. Therefore, such an increase in the dosage of the drug is impractical.

(vitamin B9) is a vital vitamin. It is involved in metabolic processes, including DNA synthesis, is responsible for the formation of blood cells, is necessary for the formation of immunity, and improves the functioning of the gastrointestinal tract. The vitamin is especially important for pregnant women., because it is involved in the formation of the neural tube of the fetus, preventing malformations of its development. In addition, folic acid plays an important role in the formation of the placenta.

Folic acid deficiency does not always show visible symptoms. But at the same time, studies have shown that vitamin B9 deficiency is observed in 20-100% of the population, depending on the region. This is one of the most common vitamin deficiencies.. At the same time, even in the absence of any clinical manifestations, the risk of heart attacks and strokes increases, immunity decreases.

First of all, with a deficiency of folic acid, anemia occurs. With this type of anemia, not only the number of red blood cells decreases, but their function is also impaired, since most of them leave the bone marrow immature. If this deficiency is not corrected, symptoms such as loss of appetite, irritability, fatigue occur, followed by vomiting, diarrhea, and hair loss. Skin changes, painful sores in the mouth and throat may appear.

Folic acid deficiency during pregnancy primarily affects nervous system fetus, increases the risk of developing hydrocephalus, anencephaly (absence of the brain), cerebral hernia, delayed mental and physical development of the unborn child. There is a high risk of defects in the spinal column, for example, its non-closure ("open back"). In addition, a deficiency of this vitamin can cause premature termination of pregnancy, placental insufficiency.

The need for a vitamin in an adult is 200 mcg per day, in pregnant women - 400 mcg per day.

What foods contain folic acid:

The main source of the vitamin is wholemeal flour. This vitamin is also abundant in spinach, parsley, lettuce, green peas, beans. Relatively large amounts of folic acid are present in citrus fruits and their juices, in asparagus and avocados. Of animal products, it is the richest liver. In a much smaller amount, it is present in fish, meat, cheeses.

Vegetarians are not usually deficient in folic acid, as they eat a lot of plant foods, including greens. But if you do not use them constantly in large quantities, then you need to additionally take folic acid in the form of tablets and as part of vitamins, since in this case it is enough it is difficult to meet the body's need for folic acid only through food especially during the cold season.

With a normal composition of the intestinal microflora, a small amount of folic acid can be synthesized by the body on its own.

Accelerates the excretion of the drug from the body strong tea. In addition, some drugs increase the need for folic acid: oral contraceptives, antacids (400 mcg, in Pregnawit- 750 mcg. That is, in all preparations there is a sufficient prophylactic dose, so the dose of folic acid should be selected taking into account its preparation in a multivitamin complex. If you are not deficient in folic acid, you do not need to take additional folic acid if you are taking any prenatal vitamins.

When should the drug be taken?

The drug is most important during pregnancy. The need for pregnancy is 400 mcg (according to some sources, 800 mcg) per day, but if there is a vitamin deficiency in the body, a large dose is required to compensate for this deficiency. The neural tube begins to form on the 16-28th day after conception. These days, a woman may not be aware of her pregnancy, and may not start taking folic acid on time. That's why the drug is prescribed at the stage of pregnancy planning. The most important thing is to take the drug in the first 12 weeks pregnancy.

Some women are afraid of an overdose of the drug. An overdose of the drug is extremely rare., only if you take the drug in doses hundreds of times higher than the body's need (20-30 tablets per day). In other cases, the excess of the drug is simply excreted from the body (during pregnancy, the excretion of the drug from the body is accelerated), without adversely affecting it. However, as with all medicines, allergic reactions can occur.

The drug should be taken at breastfeeding at a dose of 300 mcg per day (can be in the composition of multivitamins). This prevents the development of deficiency in both mother and baby. If you take the drug in about In larger doses (for example, one tablet of folic acid, that is, 1000 mcg), then the excess will simply be excreted from the mother's body, without adversely affecting either her or the child.

The drug must be taken at a dose exceeding the prophylactic dose, firstly if there are symptoms of a deficiency of this vitamin (in this case, the dose is selected individually, additional consultation with the therapist is required), and secondly, if there are factors that increase the intake of folic acid or accelerate its excretion. This is taking oral contraceptives before pregnancy, taking Almagel or Phosphalugel, anticonvulsants at the planning stage and during pregnancy, protein diet before pregnancy, lack of plant foods in the diet, problems with gastrointestinal tract, vomiting in pregnant women. If you have any of the above factors, then when planning pregnancy and in the first 12 weeks, the drug should be taken 2-3 tablets per day. Besides, increase the dose of folic acid if there is a high risk of developing neural tube defects. This risk is increased in women with epilepsy, with diabetes, and if there are any malformations in relatives.

Folic acid is the only vitamin whose importance during pregnancy is not denied even by ardent opponents of artificial vitamins and drugs in general. Therefore, even if you do not want to take any "extra" drugs during pregnancy, do not refuse to take folic acid at least in preventive doses, and this will save you and your baby from many problems. Although sometimes it does not hurt to compare the dose that you will be prescribed with the body's needs for this vitamin.