EVERY WOMAN OF CHILDBEARING AGE NEEDS TO KNOW ABOUT FOLIC ACID
A pregnancy is not always planned, but the effects of a folic acid deficiency in a woman who becomes pregnant can be devastating – please read on and be prepared, even if you never plan on having children – sometimes these things just happen! Every woman at risk of becoming pregnant, planned or unplanned should take folic acid to help prevent an unborn child developing spine, brain and other disorders.
If you think it will never happen to you, you are wrong. Neural Tube Defects and other similar conditions are on the increase.
The normal dose of folic acid is not always enough either, so if you have a family history of spine, brain or skull malformations, blood or bowel disorders, or even epilepsy, then please consult your doctor prior to trying for a baby for a considerably higher dose of folic acid, and take extra care to prevent prevent an unplanned pregnancy.
The sciencey bit
Folic Acid is necessary for the production and maintenance of new cells. It is especially important during periods of rapid cell division and growth such as pregnancy.
Taking folic acid prior to pregnancy helps protect against a number of congenital malformations including neural tube defects (NTDs). NTDs result in malformations of the spine (spina bifida), skull, and brain (anencephaly). The risk of NTD is significantly reduced (95%) when folic acid is taken IN ADDITION to a healthy diet prior to and during the first month of pregnancy.
The protective effect of folic acid during pregnancy goes beyond NTDs. Taking folic acid has been shown to reduce the risk of congenital heart defects, cleft palate, limb defects, and urinary tract anomalies. A healthy diet containing the right level of folic acid in today’s society is very hard to achieve, so anyone planning pregnancy or at risk of an unplanned pregnancy needs to be taking a folic acid supplement.
Recent research has shown that it is also very important for men who are planning on fathering children, reducing chromosomal defects in their sperm.
What is a NTD?
During the first month of pregnancy the neural tube (the nerves inside the spine) form, and then the spine forms around it like a zip from head to toe. Spina bifida is when the spine traps some of these nerves (a bit like when your zip gets stuck). The damage caused depends on the level of the trapped nerves. It can be damage to anything from vital organs, to limbs to organ function. The majority of cases involving major organs do not make it to birth.
Those that do not miscarry tend to have varying levels of sensation loss, paralysis or malformation in the lower body and loss of control of bowels and bladder. There is a list as long as my arm of associated conditions which tend to go hand in hand, but most notably is hydrocephalus involving the inability to drain fluid from the brain causing the brain to be crushed. Hydrocephalus can never be cured, but is treatable by using a shunt (drain) - there will always be a major health risk and involve numerous brain surgeries throughout the person's life.
In addition, it is belived that up to 1 in 10 woman have a folic acid deficiency and will not absorb it sufficiently due to genetic issues, even when taking the over the counter dose. If you have a family history of bowel problems, spina bifida, miscarriages, birth defects, and blood disorders please speak to your doctor about a prescribed dose.
Why do I need folic acid?
Because it's very difficult to eat enough foods rich in the vitamin to supply the amount that experts recommend you take in pregnancy.
Folic acid, also known as folate or folacin, is one of the B group of vitamins, also known as B9. Your body needs it to produce red blood cells, as well as norepinephrine and seratonin (chemical components of the nervous system. It helps make DNA (the body's genetic material), which normalises the brain's functions, and is a critical component of spinal fluid. Folic acid is also one of the few nutrients known to prevent neural tube birth defects, such as spina bifida, which, according to The Association for Spina Bifida and Hydrocephalus (ASBAH), affects one in every 1,500 babies born in the United Kingdom.
The Department of Health recommends that every woman who is thinking about pregnancy or is in the first third (trimester) of pregnancy to take a daily supplement of 400 micrograms (mcg) of folic acid and eat a folate rich diet to reduce her baby's risk of getting some types of birth defects. Women who don't get enough may also increase their chance of miscarriage. Once you are into your second trimester (from week 13), you may wish to stop taking the supplements, although continuing to take them throughout pregnancy won't harm you or your baby either.
How much folic acid do I need?
Before you conceive, you'd be wise to take a daily folic acid supplement containing 400 micrograms (mcg) of folic acid. This is usually within most multivitims and pre-natal supplments.
Women who have had one child with a neural tube defect have a higher risk of having other children with the same disability. In this case, and for those who are prescribed certain medications, doctors will prescribe these women to take a much higher dose of folic acid -- a five milligram (mg) tablet -- starting one month before conception, if possible, and continuing through the first three months of pregnancy.
While experts recommend a daily supplement of 400 mcg folic acid, eating plenty of folate-rich foods is important, too. See below for suggestions on folate-rich food.
What are the best food sources?
Leafy green vegetables are a good source, so try to have a large bowl of salad daily. Other sources include:
• 11 Brussels sprouts: 127 mcg
• large jacket potato: 39 mcg
• 4 tbsp black eyed beans: 220 mcg
• 7 tbsp bran flakes: 113 mcg
• 25g / 1oz wheat germ: 100 mcg
• 4 spears steamed or boiled asparagus: 88 mcg
• medium sized papaya: 115 mcg.
• 2 spears steamed broccoli: 61 mcg
• large orange: 54 mcg
• large hard-boiled egg: 22 mcg
• 75g / 3oz tinned salmon: 17 mcg
FYI Delicate folic acid in foods is destroyed by overcooking, so cook in a covered pan with the minimum amount of boiling water. Try to eat vegetables lightly steamed, microwaved, or raw. What are signs of a deficiency?
Folate-deficiency anaemia and iron-deficiency anaemia can have similar symptoms of fatigue and weakness. A mild folate deficiency may also leave you grumpy or edgy.