Folic acid and pregnancy (need answer fast :-)

I know that women are advised to take folic acid supplements if they are planning to become pregnant, to reduce the chance of neural tube defects, and the usual recommendation is that they should start one month before they attempt conception. But I also understand that folic acid, compared to other micronutrients, is converted to serum folate and used by the body relatively quickly.

So I was wondering why the 30 day wait. Any expert insights?

It’s not necessarily that they recommend waiting until 30 days before. It’s more that since most women don’t know they are pregnant until they’ve actually been pregnant for a while, it’s a good idea to start taking it in advance so that the woman has adequate levels.

I kind of get that, but not completely. If a woman has just had her period, she knows she is not pregnant. So if you are aiming for the next fertile moment, do you still need to wait 30 days with the folic acid?

Strictly speaking, you don’t have to wait any time at all. Women get pregnant and have babies all the time without first taking a supplement. The “take folic acid for 30 days beforehand” is optimizing conditions. The “wait 30 days” is because not every woman has the same cycle, or even a consistent cycle.

Another possible reason is that folic acid is used for more than just making babies, so if a woman is deficient maybe it allow her body to build up to a better state before starting to make baby.

ETA: Also, women HAVE had their period while pregnant. It’s rare, but not unheard of. Having a period is a strong indication a woman isn’t pregnant, but not an absolute guarantee.

Folic acid is a water soluble vitamin, so any excess in the body is excreted in the urine.

Folic acid is cheap, easy to take, and not harmful or a big deal to the woman’s body.

It’s insurance.

Neural tube defects are debilitating and tragic. IMHO, every woman of childbearing age should be taking folic acid.

My wife has been taking folic acid for a week since her last period and is now ovulating. So I guess the question is whether she is ‘safe’ now in terms of protection by folic acid or whether we wait another month.

A normal diet should already be supplying sufficient folic acid, especially if she has been consuming fortified cereals, grains, breads, etc. and green leafy vegetables. One reason a lot of foods are fortified in the US is because not all pregnancies are planned, and since this fortification rates of neural tube defects in newborns have dropped significantly.

A neural tube defect isn’t the end of the world, but it’s not something you’d want your child to have, either. My spouse was born with a NTD and while he’s had a pretty good life there are definite issues of disability and chronic pain he’d be much happier without.

If your wife gets pregnant this month the odds are very much in favor of her having adequate folate levels and everything being OK. On the other hand, if there’s no pressing reason to hurry waiting until next month optimizes her nutritional status. That’s not a 100% guarantee everything will be OK, but it increases the odds for a good outcome.

If a woman has a folate insufficiency (much less a true deficiency), taking the supplements after she is already pregnant may be too late to prevent birth defects in her fetus (as well, insufficient folate has been linked to many other negative pregnancy outcomes for mother and baby). Your body has stores of most vitamins, and the fetus only gets whatever is left over once the mother’s needs are satisfied. 30 days give you a enough time that the fetus won’t find itself lacking at the most crucial stage of development.

IMO based on more recent research, women who want to conceive should be attempting to include lots of food rich in **folate **in their diets; folic acid supplements are not so important. Though if you don’t eat plenty of liver, legumes, and greens, by all means take the pills.

It’s just that folic acid is the synthetic form of the vitamin and has to undergo an enzymatic conversion to folate to be utilized - and many people’s bodies (as high as 30% to 50% of the population, according to some studies) aren’t particularly efficient at this. If this is the case and you supplement, high levels of circulating folic acid can prevent your body from utilizing what folate you do get from food, and you might be worse off than if you had never supplemented at all.

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