Why is Folic Acid important before and during Pregnancy?

If you are thinking about pregnancy or in the first trimester of pregnancy you are advised to take a daily supplement of 400 micrograms (mcg) of folic acid and eat a diet rich in folates. This will protect your baby that helps a baby's neural tube- the part of the embryo that becomes the brain and spinal cord-  develop properly. It is critical to start taking it before conception and to continue taking it through the third month of pregnancy, when the baby's neural tube is developing, to prevent birth defects in the spine and skull. 

You will also find it in fortified breakfast cereals; citrus fruits and juices; dried peas and beans; and green, leafy vegetables such as spinach, collard and turnip greens, and broccoli. From birth defects, and reduce your risk of miscarriage. 

You should start taking a folic acid supplement as soon as you decide to try for a baby, up to three months before you conceive. Carry on taking it (along with iron supplements) throughout pregnancy and for the first six months of breastfeeding.

If you have had a child with a NTD (Neural Tube Defects), your doctor may prescribe a much higher daily dose of folic acid. This is because you are at greater risk of having further children with a NTD.

What is Folic Acid?

Folic acid (also known as vitamin B₉, vitamin B_c or folacin) is one of the B vitamins. It occurs naturally as folate in foods like pulses (daals) and green vegetables. 

Vitamin B₉ (folic acid and folate inclusive) is essential to numerous bodily functions. The human body needs folate to synthesize DNA (the body's genetic material), repair DNA, and methylate DNA as well as to act as a cofactor in biological reactions involving folate. It is especially important in aiding rapidcell division and growth, such as in infancy and pregnancy. Children and adults both require folic acid to produce healthy red blood cells and prevent anemia. Folic acid is also important for the brain, nervous system and spinal fluid. It can prevent your baby from developing a neural tube defect (NTD) such as spina bifida. 

Folate and folic acid derive their names from the Latin word folium (which means "leaf"). Leafy vegetables are a principal source, although in Western diets fortified cereals and bread may be a larger dietary source

Take folic acid before you're pregnant

Folic acid can help prevent neural tube defects. However, folic acid only works if taken before getting pregnant and during the first few weeks of pregnancy, often before a woman may even know she is pregnant. Since nearly half of all pregnancies in the U.S. are unplanned, it's important that all women of childbearing age (even if they're not trying to get pregnant) get the recommended daily amount of folic acid. 

The best way to get enough folic acid is to take a multivitamin with at least 400 micrograms of folic acid in it and eat a healthy diet. You also can get folate (the natural form of folic acid) in your diet, but most women don't get the recommended amount of folate or folic acid from diet alone.

If all women took adequate folic acid before getting pregnant and during early pregnancy, up to 70 percent of neural tube defects could be prevented. 

Folic acid in natural foods

Vegetables: Leafy green vegetables are a good source, so try to have fenugreek (methi) or raddish leaves or spinach daily. Other folate-rich vegetables are peas, corn, cauliflower, green pepper, beetroot, mustard greens and ladyfinger. 

Nuts such as almonds, cashew nuts, peanuts, walnuts and sesame seeds.

Legumes such as soya bean, lobhia, kidney beans, dried peas, chickpeas and lentils.

Fruits such as strawberries, honeydew or cantaloupe melons, bananas, pineapple, papaya, oranges and raspberries. 

Grains Whole grain flour and pasta, wholemeal bread and oats. 

Other sources

1. A large orange (contains 54mcg of folate)
2. A large hard-boiled egg (22mcg)
3. A medium papaya (115mcg)
4. 1/2 cup of chickpeas or chole (140mcg)
5. 1/2 cup of cooked spinach (130mcg)
6. 3/4 cup of cooked white rice (60mcg)
7. 1 cup of tomato juice (50mcg)
8. 1/2 cup of lentils, cooked (175mcg)
9. 1 cup of noodles, cooked (160mcg)
10. Four tablespoons of black-eyed beans (220mcg)
11. 1/2 cup of kidney beans or rajma (115mcg)
12. Seven tablespoons of bran flakes (113mcg)
13. 25g/1oz of wheat germ (100mcg)
14. Two spears of steamed broccoli (61mcg)
15. A large jacket potato (39mcg)

As well as taking a supplement, you could make a few small changes to your diet:

• Include orange juice at breakfast or chopped fruit with your breakfast cereal.
• Choose a bowl of fruit salad at snack time.
• Include a serving of stir-fried vegetables in sesame oil at dinner time.

Folic acid deficiency anemia?

Folic acid deficiency anemia happens when your body does not get enough folic acid. Folic acid is one of the B vitamins, and it helps your body make new cells, including new red blood cells. Your body needs red blood cells to carry oxygen. If you don't have enough red blood cells, you have anemia, which can make you feel weak and tired. So it's important that you get enough folic acid every day.

Most people get enough folic acid in the food they eat. But some people either don't get enough in their diet or have trouble absorbing it from the foods they eat. Talk to your doctor about whether you should take a daily vitamin with folic acid.

Pregnant women who do not get enough folic acid are more likely to have babies with very serious birth defects.

Symptoms

Anemia may make you

• Feel weak and tired.
• Feel lightheaded.
• Be forgetful.
• Feel grouchy.
• Lose your appetite and lose weight.
• Have trouble concentrating.

Causes of folic acid deficiency anemia

• If you don't eat enough foods that contain folic acid. These include citrus fruits, leafy green vegetables, and fortified cereals.
• If you have a greater need for folic acid. This might happen if you are pregnant or have some medical problems, such as sickle cell disease.
• If your body doesn't absorb enough folic acid. This might happen if you drink too much alcohol or have severe kidney problems that require blood-cleaning procedures.
• If you take certain medicines, such as some used for cancer, rheumatoid, and seizures.

Treatment
It is important to see your doctor and get tested so you can get the right treatment. Being treated for a shortage of folic acid when your anemia is caused by something else can be dangerous.

To treat the anemia, you can take folic acid pills each day to bring your folic acid level back up.

After your folic acid levels are normal, eat foods rich in folic acid so you don't get anemia again. These foods include fortified breads and cereals, citrus fruits, and dark green, leafy vegetables.

Beware of Folic Acid Supplements

It is common knowledge that folic acid supplements in their natural form are

 especially required by pregnant women for the healthy development of the 

growing fetus.The problem is that folic acid is chemically different from 

dietary folate, which results in differences in uptake and processing of these 

two substances by the cells in the intestinal wall. Some folic acid is

 chemically modified to be more similar to natural folate, but the intestinal 

cells are limited in how much folic acid they can modify – folic acid often 

enters the circulation unmodified. Scientists do not yet know the implications

 of circulating synthetic folic acid. Many Americans, through multivitamin use

 and consumption of fortified foods, are taking in excessive amounts of folic

 acid, and thus may have unmodified folic acid circulating in their blood – this 

could contribute to cancer-promoting effects.

Folate is abundant in all green vegetables. We do not need synthetic folic 

acid supplements to meet our daily folate requirements