Folic acid

About folic acid

Folic acid in anaemia

Vitamins are substances required by our bodies in small amounts for growth and general health. Our bodies do not store very much folic acid so we need to have a regular fresh supply. We can usually get the amounts we need from the food that we eat. Many foods contain folic acid, including spinach, sprouts, broccoli, green beans, peas, chickpeas, brown rice, kidney, liver and potatoes. Some people, for various reasons, may not receive enough from their diet alone. Folic acid is important for the production of red blood cells. A lack of it can lead to anaemia, which can cause tiredness and sometimes other symptoms. Folic acid deficiency is treated easily by taking a course of folic acid tablets for a few months.

Folic acid in pregnancy

Pregnant women in particular need a good supply of folic acid because it is used by the developing baby. It has been shown that taking folic acid supplements decreases the chance of spina bifida and other neural tube defects in the baby. The very early stages of pregnancy are crucial in the need for folic acid and this is why folic acid supplements are recommended for women planning a pregnancy.

Extra folic acid is advised for at least the first 12 weeks of pregnancy for all women - even if you are healthy and have a good diet. For most women, a supplement of 400 micrograms of folic acid a day from before conception until the twelfth week of pregnancy is recommended. It is best to start taking the extra folic acid before becoming pregnant. If the pregnancy is unplanned then start taking folic acid as soon as you know you are pregnant. You can buy tablets of folic acid at most health food shops or pharmacies.

If you have had a previous pregnancy affected by a neural tube defect or if there is a family history of such, a supplement of 5 mg (milligrams) of folic acid each day until the twelfth week is recommended. A supplement of 5 mg daily in pregnancy is also recommended with some medical conditions such as coeliac disease, diabetes, and sickle cell anaemia, and if you are taking medicines to treat epilepsy. This strength of folic acid tablet is not available to buy. Your doctor will prescribe the tablets for you.

Folic acid in other conditions

Folic acid is also used alongside methotrexate treatment in people with severe Crohn's disease, psoriasis, and arthritis. When it is used in these medical conditions, folic acid is taken on a different day of the week to methotrexate. It is taken to reduce the side-effects which can be caused by methotrexate.

How to take folic acid

• If you have bought folic acid tablets because you are planning to have a baby, read the manufacturer's printed information on the pack (or from inside it) before you start taking the tablets. Make sure you are clear about what dose to take - the recommended dose is 400 micrograms once daily. The 5 mg tablet has more than ten times as much folic acid as this. If you have any questions, ask a pharmacist to advise you.

• If you have been prescribed 5 mg folic acid tablets by a doctor, take them exactly as you are told to. Depending upon the reason for which you are taking folic acid, you may be asked to take one tablet every day, or one tablet only on certain days of the week. Try to take your doses at the same time of day each day that you take them, as this will help you to remember to take the tablets regularly. There will be more information about folic acid on the manufacturer's printed information leaflet from inside your pack.

• It is not important whether you take folic acid before or after meals.

• If you forget to take a tablet, take it as soon as you remember. If you do not remember until the following day, skip the forgotten dose. Do not take two doses at the same time to make up for a missed dose.

Getting the most from your treatment

• In addition to taking folic acid, try also to eat a healthy diet including foods rich in folic acid, such as spinach, sprouts, broccoli, green beans and potatoes. Lightly cook the vegetables, as the cooking process reduces the amount of folic acid they contain. Some bread and breakfast cereals are fortified with folic acid also.

Can folic acid cause problems?

Folic acid supplements are unlikely to cause any side-effects. The 5 mg tablets may, on rare occasions, cause mild upset stomach (loss of appetite, nausea, and a bloated feeling). If you experience any symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for advice.

How to store folic acid

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines