Folic acid. The need for water-soluble B vitamins increases by a full 83% during pregnancy. This gives you a good idea of the huge role folic acid plays in the development of new life. However, women who are only in the planning phase when it comes to babies should also ensure they have a sufficient supply of the water-soluble B vitamin. Find out here what folic acid is needed for, where it is found – and much more.
Folic acid (also: vitamin B9, or more rarely: vitamin B11) is a water-soluble vitamin that belongs to the B vitamin family. The form of the vitamin that occurs naturally in the body or in food is called folate, the form used in food is called folic acid. Many women who are on their way from wanting to have children to having a baby are familiar with this vitamin. But folic acid is not just for family planning! Find out what else the vitamin can do in our blog:
Folic acid, also known as the "maternal or pregnancy vitamin", is essential for us humans from the very first moment of our existence. Through its role in the body's own cell division, the vitamin ensures that new life grows and thrives and also contributes to the growth of maternal tissue during pregnancy.
In the matter of growth, folic acid is a must. So it’s no wonder that the water-soluble vitamin is immensely important for the mother-child team throughout the entire pregnancy. This is also reflected in the official recommendations of the DGE (Deutsche Gesellschaft für Ernährung [German Nutrition Society]), which increases from 300 μg for adults to 550 μg for pregnant women. Moreover, the folic acid requirement during the entire pregnancy is increased by a full 83%, and the recommendations also increase accordingly. Since this additional requirement cannot be reliably covered by diet, mothers-to-be should use a high-quality folic acid preparation as a precaution.
Not only does the baby grow during pregnancy, the mother's tissue also gains mass. What the uterus achieves here makes even bodybuilders green with envy: its muscle mass increases from 50 to up to 1500 grams by the end of the pregnancy. At the same time, the glandular tissue of the breast also increases. Folic acid is involved in all these growth processes.
However, the water-soluble B vitamin not only supports maternal tissue growth, it also contributes to the normal function of the immune system, to the reduction of tiredness and fatigue and to normal haematopoiesis. Folic acid is particularly important for the latter during pregnancy. After all, the mother's blood volume increases by around 40 percent during the 40 weeks - from 4-5 litres at the beginning to 6-7 litres towards the end of pregnancy.
Cell division is probably the most important process for the growth of new life. Among other things, this is also dependent on an adequate supply of folic acid. Particularly in the first few days after conception, the foetus grows rapidly and craves folic acid. The supply of folic acid between the 22nd and 28th day of pregnancy is particularly critical for the child's development, as the neural tube, the precursor of the spinal column, closes during this time - a time when the pregnancy is often not even known.
Expectant mothers need more. This is also reflected in the folic acid requirement, which increases from 300 µg to 550 µg per day during pregnancy. In order to meet this additional requirement, expectant mothers should ideally supplement folic acid from the time they wish to have children until the end of their pregnancy.
In the event of pregnancy, doctors recommend supplementing folic acid in addition to a healthy and balanced diet. Although numerous foods, especially plant-based foods, provide significant amounts of folic acid (= dietary folate), on average only 50% of dietary folate can be utilised by our body. In addition, the vitamin reacts sensitively to external influences such as heat, light and oxygen and therefore often falls victim to preparation processes and prolonged storage.
Women should start to prepare their "inner nest" for a possible pregnancy as soon as they feel a more concrete desire to have children by - among other things - making sure they have a sufficient supply of folic acid.
The supply of folic acid for the development of the neural tube is considered to be particularly critical. As the neural tube of the foetus closes between the 22nd and 28th day - i.e. at a time when many women are not even aware that they are expecting - the folic acid depot should already be well filled before conception.
To be on the safe side, experts recommend starting to take a suitable folic acid supplement (400 µg folic acid daily) in addition to a folate-rich diet at an early stage - ideally at least four weeks before conception.
If the pregnancy occurs unexpectedly, it is usually recommended to take a double dose of folic acid; the medical staff treating you will advise you on this.
Folic acid is not only a leading pregnancy vitamin, studies have shown that it can also bridge the gap between the desire to have children and the desired child. The water-soluble vitamin helps the female body to produce high-quality eggs. Male fertility also benefits from a good folic acid supply (according to studies, especially in combination with zinc) with healthier sperm.
Women who are using contraception should ideally start taking 400 µg of folic acid daily in addition to a folate-rich diet immediately after stopping the contraceptive. As it takes a while for folic acid levels to build up, folic acid should have been taken for at least 4 weeks before conception, ideally even 3 months before.
Not every pregnancy is planned. Women who unexpectedly start a pregnancy should start taking a higher-dose folic acid supplement (800 µg daily) as soon as they find out about it. In such a case, the healthcare professional treating you will advise you and determine the appropriate individual dose, which depends on the duration and course of the pregnancy.
It is only 20 centimetres, yet it is one of the toughest competitions of all: the distance that sperm have to travel to reach the egg. The more sperm that compete and the more "vital" they are, the better the chances of success. Folic acid - especially in combination with zinc - is considered to be a strategy to make male sperm fit for the competition. Studies show that men who take both micronutrients produce healthier sperm.
The DGE recommends a daily dose of 300 μg folic acid for adult men. However, more concentrated quantities are generally used when planning to have children. It is best to consult your doctor to find out which dosage is the right one for your individual case.
Once the new mum finally holds her baby in her arms after approx. 40 weeks, i.e. 10 long months, she shouldn’t give up her supplements but should stick to her daily folic acid supplementation at least during breastfeeding. After all, folic acid is ingested by the baby via the breast milk – along with many other nutrients – and this is required for its growth. And what the female body gives to her offspring should also be replenished accordingly. According to the DGE, the recommended intake for breastfeeding women is 450 μg folate equivalents daily.
Would you like to know more about topics relating to the desire to have children? Then continue reading here:
The German Nutrition Society (DGE) recommends that women who wish to have children start folic acid supplementation (400 μg folic acid daily) at least four weeks before conception and continue with it until the end of the third trimester of pregnancy.
Specially developed pregnancy preparations often provide higher doses (800 μg folic acid per daily dose) for safety reasons, in order to provide the mother-child team adequately with folic acid even at lower baseline values if necessary. Experts also suggest that expectant mothers should extend their folic acid intake over the entire pregnancy, as folic acid requirements are greatly increased throughout this time.
Women who want precise details about their folic acid balance can ask for a laboratory blood test. The following normal values apply:
|
Laboratory value folic acid |
Findings |
|
> 5,38 ng/ml |
Normal range of folic acid |
Table: Laboratory values according to Biogena Diagnostics
Folic acid from food supplements is an absolute must-have for expectant mums and those planning a baby. Covering the additional requirement via pure nutrition is difficult and therefore too uncertain in this special phase of life, which is why the DGE also recommends a supplementary intake.
Whether it’s a expectant mum, a woman who wants to have children or a breast-feeding mum: In every life situation, folic acid should be on the menu daily in sufficient quantities. Particularly greens such as kale, spinach and broccoli contain large amounts, especially if freshly harvested and enjoyed raw. But it’s not just these veg! You can find out which other foods contain a lot of folic acid here.
Preparations with activated folic acid compounds (5-methyltetrahydrofolate) are particularly recommended if you wish to have children and during pregnancy. These compounds are particularly easy to absorb. In addition, they are directly available to the organism, since they do not first have to be converted into the active form.
Both folic acid and folate have advantages and disadvantages: Folate is the natural form of the vitamin found in the body and in food. How well the food folate can be absorbed by us humans depends on the compounds contained. Folate is an umbrella term for all folate-effective compounds that can be present with a different number of glutamate residues. While industrially produced folic acid has only one glutamate residue and can be almost completely absorbed, the absorption rate for folate variants with more than one glutamate residue is approx. 20%. According to the experts, on average only about 50% of food folate can be reasonably exploited. However, folate can become active immediately once it has been ingested in our body.
The artificially produced folic acid, on the other hand, is much more stable and almost 100% usable by the body on an empty stomach. Once it has reached the body, it must first be converted into active folate. Special brand raw materials (Quatrefolic® and Extrafolate-S®) now also supply folic acid in activated form: as easily absorbable 5-Methyltetrahydrofolate.
Tablets, capsules or liquid? Women who would like to support their pregnancy with a folic acid preparation are spoiled for choice. However, the purity and quality of the product is much more important than the pharmaceutical form, especially for pregnant women.
Folic acid capsules or tablets have the advantage that they are practical, tasteless and can be dosed precisely in the application. While folic acid tablets contain production-related additives, capsule products manufactured according to the pure substance principle do not contain unnecessary additives.
For pregnant women who have a difficulty swallowing or for those who may wish for a product with a taste, folic acid is available in liquid form. However, a careful eye should always check the additives list for these products. This should show as few additives as possible. Alternatively, capsule products can be opened and the powder consumed directly.
Not only folic acid, but also many other nutrients are increasingly needed during pregnancy. The good news is that folic acid is a vitamin that can easily be combined with other nutrients. This means that there is nothing that prevents the combination with vitamin B12, vitamin D, iodine, iron, zinc or the omega 3 fatty acid DHA – and this is even recommended during pregnancy in the form of a well thought-out micronutrient combination that provides the mother and her growing child with important nutrients.
No matter what stage you are at between your wish to have children and holding your child in your arms, our Nutrifem® Basic perfectly supports you when creating your “inner nest” with its customised micronutrient formula. Adapted to the latest scientific knowledge, it naturally also contains 800 μg folic acid – 400 μg of which are in activated form (Quatrefolic®).
If you have too low a folic acid level and are looking for a pure folic acid preparation, our Folsäure 800 aktiviert could be just the thing for you. The brand raw materials Quatrefolic® and Extrafolate-S® contained in Folsäure 800 aktiviert contain folic acid in activated form (5-methyltetrahydrofolate). These compounds can therefore be absorbed particularly easily and are directly available to the organism, since they do not first have to be converted into the active form.
Regardless of whether you are still in the planning phase, were surprised by the positive pregnancy test, are already happily pregnant or now hold your baby in your arms – the mother vitamin – folic acid – is an absolute must-have. To be on the safe side in terms of supply, it is best to use folic acid from the moment you start planning your baby to breast-feeding. Specially developed pregnancy preparations not only support you in replenishing your folic acid as a precaution, they also supply you with other important nutrients.
A good folic acid supply in the first weeks of pregnancy (22nd - 28th day of pregnancy) is particularly important, since the paediatric neural tube closes during this time, but the increased need remains throughout the entire pregnancy and also during breastfeeding.
That’s not so serious. As long as you don’t make a habit of forgetting, it is not necessary to take a double dose on the following day.
Since the folic acid requirement is greatly increased throughout the entire pregnancy, the additional intake of a folic acid preparation is safe.
Folic acid increases fertility in both women and men. In women, folic acid contributes to the production of higher quality eggs. In men, ingestion (especially in combination with zinc) improves the quality of sperm.
Since it takes a little time for the folic acid level to build up in the body, women who want to have children should have supplemented folic acid for at least 1 month, preferably for 3 months, before actually becoming pregnant.
Physicians recommend that women take folic acid when they want to have children, as a good vitamin intake is critical – especially in early pregnancy – at a time when many women are still unaware of their changed state.
Folic acid is especially important during pregnancy. In addition, the need for vitamins is increased throughout the entire pregnancy. For this reason, experts recommend an additional intake of a folic acid preparation for expectant mothers.
Since the strongly increased folic acid requirement during pregnancy is difficult to cover via normal nutrition, experts and the German Society for Nutrition urgently recommend the concomitant intake of folic acid for every expectant mother.
Since every woman starts pregnancy with varying levels of folic acid, this question cannot be answered in a general form. However, if you are concerned, it is important that you seek advice in advance from gynaecological specialists in your individual case.
Further reading
Van Gool J.D. et al. 2018. Folic acid and primary prevention of neural tube defects: A review. Reprod Toxicol. 2018 Sep:80:73-84. doi: 10.1016/j.reprotox.2018.05.004. Epub 2018 May 16.
Chitayat D. et al. 2016. Folic acid supplementation for pregnant women and those planning pregnancy: 2015 update. J Clin Pharmacol J Clin Pharmacol. 2016 Feb;56(2):170-5. doi: 10.1002/jcph.616. Epub 2015 Nov 5.
Kanasaki K., Kumagai A. 2021. The impact of micronutrient deficiency on pregnancy complications and development origin of health and disease. J Obstet Gynaecol Res. 2021 Jun;47(6):1965-1972. doi: 10.1111/jog.14770. Epub 2021 Mar 29.
Molly A.M. et al. 2008. Effects of folate and vitamin B12 deficiencies during pregnancy on fetal, infant, and child development. Food Nutr Bull. 2008 Jun;29(2 Suppl):S101-11; discussion S112-5.
Ferrazzi E. et al. 2020. Folic acid versus 5- methyl tetrahydrofolate supplementation in pregnancy.
Eur J Obstet Gynecol Reprod Biol. 2020 Oct:253:312-319. doi: 10.1016/j.ejogrb.2020.06.012. Epub 2020 Jun 13.
Valentin M. et al. 2018. Acid folic and pregnancy: A mandatory supplementation. Ann Endocrinol (Paris). 2018 Apr;79(2):91-94. doi: 10.1016/j.ando.2017.10.001. Epub 2018 Feb 9.
Gröber, U. Orthomolekulare Medizin. Ein Leitfaden für Apotheker und Ärzte, 3. Auflage. Stuttgart: Wissenschaftliche Verlagsgesellschaft, 2008.
Elmadfa, I. et al. Österreichischer Ernährungsbericht 2008, 1. Auflage. Wien: Bundesministerium für Gesundheit, 2009.
Hahn, A. et al. Ernährung: Physiologische Grundlagen, Prävention, Therapie, 2. Auflage. Stuttgart: Wissenschaftliche Verlagsgesellschaft, 2006.
Gröber, U. Mikronährstoffe. Metabolic Tuning – Prävention – Therapie, 3. Auflage. Stuttgart: Wissenschaftliche Verlagsgesellschaft, 2011
Wilcox, A. J. et al. 2007. Folic acid supplements and risk of facial clefts: national population based case-control study. BMJ. 334(7591):464.
Irani, M. et al. 2017. The Effect of Folate and Folate Plus Zinc Supplementation on Endocrine Parameters and Sperm Characteristics in Sub-Fertile Men: A Systematic Review and Meta-Analysis. Urol J. 2017 Aug 29;14(5):4069-4078.
Deutsche Gesellschaft für Ernährung, 2023. https://www.dge.de/gesunde-ernaehrung/faq/folat/, und https://www.dge.de/wissenschaft/referenzwerte/folat/ Zugriff: 24.06.2024.
https://ivi-fruchtbarkeit.de/blog/folsaure-schwangerschaft/#:~:text=Ganz%20allgemein%20erh%C3%B6ht%20Fols%C3%A4ure%20die,Voraussetzungen%20f%C3%BCr%20eine%20Befruchtung%20geschaffen. Zugriff: 22.06.2024.
