The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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How much to take?
Supplemental folic acid has been found to be even more important for women who already have had an NTD-affected pregnancy. Research shows that a much larger dose of folic acid — 4,000 micrograms, or 4 milligrams — taken daily beginning a month before conception reduces recurrences by 71 percent. But such a large dose requires a prescription: Simply taking 10 times the usual number of multivitamins could lead to an overdose of some vitamins. Women who are candidates for the higher dose should also be screened for pernicious anemia, a condition that can be masked by large amounts of folic acid.
The best advice is to check your diet to make sure you’re getting both synthetic folic acid and naturally occurring folate. “I tell my clients to pick a ‘Folate Friday’ and do a mini-check to see how much they’re getting,” says Edith Howard Hogan, R.D., L.D., a dietitian in Washington, D.C., and spokeswoman for the American Dietetic Association. “They should take a multivitamin, but they also need to check the nutrition panel on the foods they’re eating.” Hogan recommends folate-rich snacks like hummus on a whole-wheat pita, orange juice and lentils, which can be enjoyed in soup or as a salad in the summer. “I tell my clients to drink a cup of orange juice with their lentil salad, and they’re getting a two-fer,” she adds.
Adding folic acid to your diet may have other health benefits as well. “Folic acid is vital for the production of new and healthy red blood cells,” says Hogan. And new research suggests that folic acid may help prevent other health risks, such as heart disease and certain cancers. So pour yourself another glass of orange juice — and put lentils on the shopping list.