What is folic acid?

Folic acid, or folate, is a B vitamin. The word folate comes from folium, the Latin word for leaf. Folate happens naturally in food, particularly in dark, green leafy vegetables. Folic acid is the synthetic form supplied in multivitamins and foods fortified with folic acid. Researchers discovered folate’s importance in preventing anemia about 70 years ago. But only in recent years have they learned of the link between folate deficiency and certain birth defects.

Why is folic acid important?

Most people have heard about the importance of folic acid for people during their childbearing years. But what’s all the fuss about? Getting enough folic acid can reduce the risk for neural tube defects (NTDs). Folic acid only helps, however, if it’s taken before getting pregnant and during the first trimester of pregnancy.

What is the role of folic acid in preventing birth defects?

A critical period of fetal development happens during the early weeks of pregnancy, often before a person is aware they are even pregnant.

One of the earliest structures to form is the neural tube. This structure is flat at first. But it rolls into a tube by only 1 month after conception to become the brain and spinal cord.

Without enough folic acid, the cells in this structure can’t function or grow correctly and the tube doesn’t close. The spine, skull, and brain can be affected, with open or closed abnormalities.

Two of the most common types of NTDs are spina bifida and anencephaly. Spina bifida is a condition in which a part of the spinal cord and the surrounding structures develops outside the body, instead of inside it. Anencephaly is a condition in which the brain and skull bones don't form correctly. This results in most of the brain being absent.

Researchers have found that the risk for NTDs is significantly lowered when a person gets extra folic acid in addition to a healthy diet from 1 month before conception through 2 to 3 months after becoming pregnant.

What are the sources for folic acid?

Folate happens naturally in many foods. These include dark, leafy green vegetables, legumes (dried beans and peas), and fruits (oranges, bananas, melons, and most berries). But often it’s not enough. To help people get the amount they need, the FDA requires folic acid to be added to enriched breads, breakfast cereals, pastas, rice, and other grains.

The developing fetus needs folate to make healthy new cells, and to make DNA and RNA (genetic material). These are cell-building blocks. Folate also is vital to form normal red blood cells and certain amino acids. These are important functions during pregnancy and infancy. This is a time when cells rapidly divide and grow.

How much folic acid is advised for people of childbearing age?

People who may become pregnant should take a supplement with 400 mcg of folic acid. To help reduce your risk, take the folic acid supplement in addition to eating foods naturally rich in folate and those fortified with folic acid. Some people will need additional folic acid. So it’s important to talk with your healthcare provider about the amount that is right for you.