Pregnant! Are You Already Taking Folic Acid?

This is probably one of the first questions you’re asked when you visit your midwife for the first time. But why is that? And what if your body cannot properly absorb, convert, or process folic acid at all?

What Is Folic Acid and Why Do You Need It?

Folic acid is essential for the development of a healthy baby because it helps prevent neural tube defects. The neural tube is a structure in the embryo from which the spinal cord and brain develop early in pregnancy. When there is a neural tube defect, the spine or skull does not form properly, which can result in spina bifida or an open skull. The neural tube develops within the first 28 days of pregnancy. For this reason, it is recommended that all women who are trying to conceive take folic acid starting three months before conception.

Folic acid also reduces the risk of certain heart defects, cleft lip, and cleft palate. In addition, it lowers the risk of anemia, miscarriage, preterm birth, and low birth weight.

Vitamin B9

Folic acid is a form of vitamin B9. The human body cannot produce vitamin B9 on its own, but it does need it. We therefore depend on food and supplements to obtain enough folic acid, especially during pregnancy. The recommended daily intake of folic acid for adults is 400 micrograms (µg). For women who are pregnant or planning to become pregnant, it is advised to consume 400 to 1,000 µg of folic acid or folate daily. But what exactly is folate?

Folate

Folate, like folic acid, is a form of vitamin B9. Folic acid is the synthetic version often used in processed foods and supplements. However, folic acid is not directly absorbed into the cells because the body does not recognize it. It must first be converted into folate. This conversion process involves several steps, and only about half of the population can perform this conversion effectively. In addition, the process is often inefficient. Research has shown that due to a genetic mutation, 25–60% of the population cannot properly convert folic acid. This mutation negatively affects the body’s ability to process folic acid.

(Methyl)folate is the active and natural form of vitamin B9 that can be absorbed directly by the cells. Vitamin B9 is a water-soluble vitamin, meaning that folate requires water for absorption. Folate is therefore absorbed much more easily and efficiently than folic acid.

Folic acid must be converted in the body via an enzyme pathway into L-methylfolate (also known as 5-MTHF). Once MTHF is produced, it can help nourish tissues and the brain. Successful conversion of folic acid to MTHF depends on an enzyme known as MTHFR.

MTHFR and Homocysteine

A defect in the MTHFR gene can lead to elevated homocysteine levels, which are associated with an increased risk of miscarriage. Homocysteine is an amino acid produced during the breakdown of proteins in the body. Low levels of homocysteine are normal and harmless, but high levels can increase blood clotting (hypercoagulability).

Pregnant women with elevated homocysteine levels have a higher risk of miscarriage, pre-eclampsia, and preterm birth. This is likely due to the increased clotting tendency caused by elevated homocysteine levels.

Folate, B12, and B6

Always take folate as part of a combination supplement that also contains vitamins B12 and B6, as these vitamins work together. Long-term use of folate or folic acid as a single supplement can lead to a decrease in vitamin B12 levels in the body. A vitamin B12 deficiency is linked to miscarriages and other issues such as fatigue and depressive symptoms (including postnatal depression).

This is also why it is advised not to take folate/folic acid throughout the entire pregnancy and then stop abruptly after delivery. After the first trimester of pregnancy, you can stop taking this supplement.

A supplement such as folate can never replace a healthy diet. Supplements should therefore always be used as an addition to a balanced and nutritious diet.

Choosing a Good Supplement

If you want to take a high-quality supplement, look for one of the following terms on the label under vitamin B9 / vitamin B11 or folic acid:

• Folate

• 5-methyltetrahydrofolate

• 5-MTHF

• L-methylfolate

Not sure which option is right for you? At Mirasoon Curaçao, folate drops from VitaminFit are available.

Foods Rich in Folate or Folic Acid

In addition to supplements, you can also obtain folate or folic acid from your diet, especially during pregnancy. Folate occurs naturally in a variety of foods, and it is essential to follow a diet rich in this vitamin to support a healthy pregnancy. Examples of folate-rich foods include:

Animal Products: Eggs, liver (such as beef liver, in limited amounts due to its high vitamin A content)

Green Leafy Vegetables: Spinach, kale, romaine lettuce, broccoli, Brussels sprouts

Fruit: Avocado, oranges, papaya, bananas, strawberries

Legumes: Lentils, chickpeas, black beans, pinto beans, soybeans

Nuts and Seeds: Sunflower seeds, flaxseed, almonds, walnuts

Whole Grains: Whole wheat bread, whole wheat pasta, oats, quinoa, brown rice

Folic acid and/or folate therefore play a major role in the development of a healthy baby and in preventing certain birth defects, while also helping to reduce the risk of other pregnancy-related complications. Combining a healthy diet with the right supplements ensures that you and your baby get the best possible start.

Pregnancy Without Worries

If you have questions about which supplements are right for you, don’t hesitate to contact us. We’re happy to help guide you toward a healthy and happy pregnancy!