Pharmacological action of Folic acid
Folic acid is part of the B group of vitamins. It is synthesized by intestinal microflora and also enters the human body with food. In the body, folic acid is reduced to tetrahydrofolic acid, which is a coenzyme necessary for many metabolic processes: the formation of pyrimidines, purines, amino and nucleic acids. It is necessary for choline metabolism, differentiation and maturation of megaloblasts, and takes part in erythropoiesis.
Taking this vitamin during pregnancy reduces the risk of teratogenic effects on the fetus.
The drug has a pronounced antianemic effect.
Folic acid activates the process of formation of leukocytes, increases physical and mental performance, memory, intelligence, improves the functioning of the nervous system, stimulates the production of hydrochloric acid in the stomach, improves fat metabolism, strengthens the intestinal walls, normalizes the hormonal levels of the female body, prevents the occurrence of cancer, has a beneficial effect on the condition of the skin. Vitamin B9 is also necessary for the development of the immune and cardiovascular systems.
An adult should receive at least 200 mcg of vitamin B9 daily, and pregnant and lactating women need 2 times more.
A lack of this vitamin can lead to impaired maturation of red blood cells and the occurrence of folate deficiency anemia.
Vitamin B9 deficiency during pregnancy can lead to fetal development defects and spontaneous miscarriages.
Folic acid, after entering the stomach, combines with intrinsic factor and is absorbed in the duodenum. Then it enters the blood, and then into the tissues, after which it is partially decomposed in the liver and is excreted in the urine in the form of metabolites.
Use during pregnancy and lactation
How to take vitamin B9 for pregnant women: dosage of Folic acid during pregnancy?
The minimum folate requirement for an adult is 50 mcg per day. However, during pregnancy the rate increases.
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Only a doctor can determine how much folic acid a pregnant woman needs. The optimal daily dosage for pregnant women who do not show signs of vitamin B9 deficiency is 400 mcg. However, according to the instructions, the dose can vary from 100 to 800 mcg/day.
Since vitamin deficiency is considered the most dangerous in early pregnancy, doctors recommend starting to take folic acid when planning - at least three months before conception.
A standard tablet contains one milligram of the active substance; multivitamin complexes, which include all the vitamins and minerals a pregnant woman needs, contain from 300 mcg. Thus, one tablet f. An acid or multivitamin preparation is usually enough not only to meet the daily folate requirement, but also to cover it by 100 and sometimes 200%.
This dose is considered completely safe during pregnancy.
Why and why do pregnant women increase the dose of vitamin B9?
For therapeutic purposes, the dose is sometimes increased to 5 mg/day. The course usually lasts 3-4 weeks.
High doses before pregnancy and for pregnancy are also indicated for women whose previous pregnancies ended in the birth of children with developmental defects associated with insufficient intake of f.acid.
Indications for use of Folic acid
According to the instructions, Folic acid is prescribed:
to prevent a lack of vitamin B9 in the body (including during pregnancy and lactation);
with acrocytic hyperchromic anemia caused by a lack of folic acid;
as part of combination therapy:
- leukopenia and anemia caused by ionizing radiation and drugs;
- chronic gastroenteritis;
- intestinal tuberculosis;
- sprue;
- anemia associated with gastric resection.
Contraindications for use and possible side effects
Folic acid is one of the B vitamins (B9), a component necessary for the functioning of the body. As a building material, folic acid has an irreplaceable effect on metabolism in the body, especially on protein metabolism.
Vitamin B9 affects the genetic apparatus, promoting DNA synthesis, and also participates in the formation of amino acids. Vitamin B9 is especially important for a woman during pregnancy and her child, because it is necessary for growing tissues, especially nervous tissue.
With a deficiency of folic acid, a strong deterioration in the quality of life and general well-being of a person is noticed. Weakness, irritability, and fatigue may develop. With a long-term lack of vitamin B9, there is a risk of megaloblastic anemia. With this pathology, nausea, loss of appetite, and periodic pain in the abdominal area often occur. This is why it is so important to take folic acid.
However, this vitamin has some contraindications and can also cause adverse reactions in the body. For example, it is prohibited to prescribe folic acid to people who have hypersensitivity to the vitamin, as well as to additional substances included in the tablets. For example, lactose or sucrose.
The use of folic acid is not recommended for cancer patients and for patients who have impaired absorption of B vitamins.
It is not recommended to take vitamin B9 uncontrollably if there is a lack of cobalamin – vitamin B12 – in the body. In this case, a blood test can give an improved result, but will hide neurological ailments.
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For the same reason, in case of low hemoglobin, as well as in case of any changes in blood test parameters, a full examination is required before starting a course of taking folic acid. Only when the test result confirms the need to take vitamin B9 should you start taking pills. Adverse reactions are especially noticeable in children. This may include itchy skin, nausea, bitter taste in the mouth, bloating, or a rash. If such a reaction occurs, you must stop taking the medication. Long-term use of the drug leads to a disease such as vitamin B12 hypovitaminosis.
Interaction with other drugs
When using vitamin B9 simultaneously with sulfasalazine and antacids, the absorption of folic acid may decrease.
Pyrimethamine, methotrexate, trimethoprim, triamterene inhibit dihydrofolate reductase and reduce the effect of the drug.
When used concomitantly with oral contraceptives, plasma folic acid levels may decrease.
When using the drug simultaneously with primidone, phenytoin, phenobarbital, the concentration of the latter in plasma may decrease, and the anticonvulsant activity may decrease.
The absorption of vitamin B9 is reduced when used with neomycin, chloramphenicol, tetracyclines, and polymyxins.
Medical instructions for use
Folic acid in the treatment of acute and severe stages of vitamin B9 deficiency is taken 5 mg daily. The duration of vitamin therapy is 21-30 days. To prevent hypovitaminosis, it is prescribed to take 20-50 mcg during the day. The dose of the drug for chronic diseases should be greater than the standard dose, determined individually by the attending physician.
- For babies up to 6 months, the recommended daily dose is 25 mcg, from 6 months. and up to one year – 35 mcg.
- For children from one to three years of age, the recommended dose is 50 mcg daily.
- From 3 to 6 years the drug is used in a dosage of 75 mcg, 7-10 years - 100 mcg, 10-14 years - 150 mcg, children from 15 years old - 200 mcg.
special instructions
According to reviews of Folic acid, in order to prevent hypovitaminosis B9, it is most preferable to adhere to a balanced diet and eat foods rich in this vitamin - spinach, lettuce, carrots, tomatoes, fresh liver, beets, legumes, eggs, nuts, cheese, cereals.
The drug is not used for the treatment of pernicious, normocytic, aplastic anemia, anemia refractory to treatment. In pernicious anemia, vitamin B9 masks neurological complications. Until pernicious anemia is excluded, the drug in a dosage of more than 0.4 mg per day is not prescribed (with the exception of periods of pregnancy and breastfeeding).
Hemodialysis patients require increased amounts of Folic acid.
In the presence of pernicious anemia, vitamin B9 is used only with cyanocobalamin.
Long-term use of the drug is not recommended due to the increased risk of reducing the level of cyanocobalamin in the blood.
When taking Folic acid therapy, it is better to take antacids 2 hours after taking this drug, and cholestyramine - an hour after or 4-6 hours before taking it.
Taking antibacterial drugs may distort the results of microbiological analysis of the concentration of Folic acid in plasma and red blood cells.
When taking high doses of vitamin B9, or long-term therapy with it, the concentration of vitamin B12 in the body may decrease.
Release form and composition
Folic acid tablets have a yellow (pale yellow is allowed) color, a round flat-cylindrical shape. The main active compound of the drug is folic acid, its content in one tablet is 1 or 5 mg. The tablet also contains auxiliary components, which include:
- Stearic acid.
- Sucrose.
- Talc.
- Dextrose monohydrate.
Folic acid tablets are packaged in blister packs of 10 pieces or contained in a polymer jar in the amount of 50 pieces. A cardboard pack may contain 2, 5 or 10 blister packs or 1 polymer jar with the appropriate number of tablets.
They also produce the above product called “Folic acid 9 months”. One tablet of this drug contains 400 mcg of active substance. They sell the medicine in 30, 60 and 90 tablets per box.
Vitamin B9 for planning conception and when expecting a baby
Women who dream of becoming mothers should start taking healthy vitamin supplements six months before the important date of conception in order to strengthen the body. The standard dosage for expectant mothers is 0.8 mg per day. This dose is enough to prevent many pathologies of the baby’s nervous system, blood vessels and heart muscle.
At different stages of pregnancy, the concentration of vitamin acid is different, so only a gynecologist can prescribe the correct concentration of the vitamin. The instructions indicate that in the 1st trimester you should take approximately 0.4 mg per day. In the second, 0.6 mg per day is sufficient, and in the third – 0.8 mg.
Increased dosages are indicated if there is a threat of miscarriage or a risk of dangerous pathologies according to ultrasound examination.
During lactation, doctors also often recommend taking folic acid. The average dosage per day is 300 mcg, but you should first consult a physician.
Why does the body need vitamin B9?
Many people simply do not wonder what folic acid does for women. And in vain, because this vitamin is so important for the body, and at the same time it is practically not produced in it. It comes from certain foods or vitamin supplements. Doctors recommend that all women of childbearing age constantly take such supplements, as well as properly plan their diet.
So, let's look at what functions vitamin B9 performs:
- mitosis and proper DNA replication;
- successful pregnancy, as well as the correct formation of the child’s internal organs, especially with regard to the formation of the neural tube;
- folic acid is also involved in the process of blood formation and improves overall metabolism;
- Regular use of this vitamin will significantly increase the level of the immune system and protect the heart and blood vessels from various pathological processes.
What do the reviews say?
Reviews about Folic acid tablets are positive. All patients who took this vitamin noted a significant improvement in their overall well-being, mood and digestive processes. In addition, the drug is indispensable for hair and nails.
Taking vitamin B9 during pregnancy - reviews are proof of this - can improve the course of pregnancy and prevent the occurrence of malformations in the child. Women who take the drug not only for 9 months, but also after childbirth, are less susceptible to postpartum depression.
Infants who get enough folate gain better weight and develop well.
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What dosage should you take folic acid during pregnancy?
Almost all women during pregnancy are prescribed folic acid, since this component is necessary during planning and at the initial stage of fetal development. Even active opponents of any medications view this remedy favorably. It is important that the dosage of folic acid during pregnancy is correct and does not exceed the permissible limit. The fact is that a lack of this vitamin provokes negative consequences. Folic acid plays a role in DNA synthesis, as well as in the process of cell growth and division. It is vital for the development of the fetal nervous system. Thanks to this element, it is possible to prevent the appearance of defects in the brain, neural tube, etc.
Why do pregnant women need folic acid?
This component belongs to the B vitamins. It is also called vitamin B9. This is an important component for the human body, but it is often lacking. The deficiency is especially common in pregnant women and young children. Initially, this may not be noticeable, but over time, loss of appetite occurs, fatigue, irritability, diarrhea, vomiting appear, the mouth becomes covered with ulcers, and hair falls out. In advanced cases, megaloblastic anemia occurs, most often leading to death.
Folic acid, which is found in foods, breaks down quickly when exposed to sunlight and heat treatment, so it is often prescribed in tablet form. The daily dose of folic acid for pregnant women should be determined by a doctor.
Why is its use so important? The explanation consists of several points:
- It is involved in DNA synthesis. Without it, cell division is impossible. In other words, this vitamin is a necessary element that is responsible for the development of tissues and organs. This is especially important for the formation of the embryo.
- Important for hematopoiesis. Participates in the formation of blood elements such as red blood cells, leukocytes and platelets.
- Necessary for the creation of nucleic acids involved in the transmission of hereditary characteristics.
- Participates in the formation of the fetal brain and neural tube.
Folic acid is removed from the body of a pregnant woman faster than usual. Taking certain medications increases the need for this component, for example, estrogens, antacids, anticonvulsants and zinc preparations. In addition to the fact that the vitamin is involved in the creation of cells of the nervous system, it is necessary to replace approximately 70 trillion mother cells, because they are constantly renewed. Its deficiency can be passed on to the child during pregnancy and breastfeeding.
In many countries, a mandatory condition in preparation for conception is to take this important vitamin during pregnancy planning and for three months upon pregnancy. This recommendation is also combined with dietary folate supplementation. Studies have shown that mothers who follow these tips have a reduced risk of having children with birth defects.
There is one drawback to folic acid, due to which it is prescribed only in the early stages of pregnancy. The point is its ability to accumulate in fatty tissues. As a result of long-term use, the component may be contained in excess in the body, causing the muscles to become very elastic, and this is an undesirable effect before childbirth. Read more about taking folic acid during pregnancy →
What medications contain folic acid?
Some foods contain some folic acid. But the problem is that when cooking, a significant part of it is destroyed. Because of this, you should resort to a medicinal method of administering the drug.
There are several types of medicines that include this component:
- Folic acid tablets. They contain 1 mg of the substance. This is the best option, because the cost of the tablets is affordable for everyone. There folic acid is contained in the dose required during pregnancy. In other drugs it is higher. For a woman to get the norm, one tablet per day is enough. During the planning period and the first trimester of pregnancy, the doctor prescribes 2-3 tablets per day. It is believed that such an overdose cannot happen; the consequences of a deficiency are much worse.
- Folacin. It contains 5 mg of the substance. But in this form, folic acid during pregnancy can cause an overdose. There will be no harm to the body, but no more harm either, since the excess amount will be excreted.
- Apo-filik. It contains 5 mg of the substance. This dosage is not preventive, but therapeutic. That is why folic acid for pregnant women in this dosage is prescribed only in case of obvious deficiency.
- Folio. It contains 40 mcg of folic acid, as well as 200 mcg of iodine. This is why the drug is convenient - it contains two important elements at once. This folic acid is indicated for pregnant women as a preventive dosage. It will meet the needs of mother and child if there is no deficiency.
- Multivitamin complexes such as Elevit, Materna, Vitrum prenatal, etc. All of them contain a preventive dosage. If there is no deficiency, it is enough to take complexes where folic acid is present in the dosage required during pregnancy.
Foods with folic acid
The main source is wholemeal flour. There is a lot of vitamin in spinach, green peas, parsley, lettuce and beans. Significant amounts are also found in citrus fruits, avocados and asparagus. Among animal products, the richest is liver. Folic acid is present in small quantities in meat, fish and cheese. Despite the fact that vegetarians do not eat meat, they do not have a deficiency. After all, they eat a sufficient amount of plant products, including greens. If you do not take them in large quantities, then you need to supplement your diet with folic acid in tablet form. In this case, it is difficult to meet the daily requirement with food. This is especially true for the cold season.
To retain enough folic acid in vegetables, you need to eat them raw. You can also steam it. The intake of this vitamin through the consumption of natural products prevents the risk of developing cancer and affects the transmission of hereditary information into DNA.
If a person’s microflora is in order, then folic acid can be independently synthesized in small quantities. But strong tea removes it from the body.
Dosage during pregnancy
Doctors say that every second pregnant woman needs vitamin B9. Therefore, it is so important to know what dose of folic acid for pregnant women is indicated for a particular mother. The daily dose increases during pregnancy. The minimum dosage of folic acid in the first trimester of pregnancy is 400 mcg per day. But in most cases, twice as much is required - 800 mcg. If, as a result of the tests, it turns out that the deficiency is severe, then the dosage of folic acid during pregnancy in tablets reaches 5 mg.
The most common tablets are those in which folic acid, necessary during pregnancy, is contained in a dosage of 1 mg. One such tablet per day may be enough. In this case, an overdose cannot occur.
If a woman has a pronounced deficiency, then she will need stronger drugs - for example, Folacin or Apo-folic. One such tablet contains a therapeutic dose of folic acid for pregnant women - 5 mg.
Different vitamin complexes contain different amounts of folic acid. If a woman takes at least one of them, this amount of vitamin is usually enough. Folic acid prescribed during pregnancy at the required dosage is accompanied by instructions in which you can see the content of the substance per 1 tablet. Read more about instructions for taking folic acid →
How to prevent an overdose?
You should clearly know in what dosage to take folic acid for pregnant women in order to prevent an overdose, although it is not toxic to humans. An overdose can only occur if the drug is taken in a dose one hundred times higher than the normal dose. For example, 25-30 tablets per day. Long-term use of high doses can be harmful for both mother and baby. There is a decrease in vitamin B12 in the blood, which causes anemia. Disturbances in the gastrointestinal tract may appear, kidney function changes, and nervous excitability increases. This can happen if you take 10-15 mg of the drug daily for three months or more.
Overdose symptoms:
- The appearance of a metallic taste and bitterness in the mouth.
- Increased excitability, sleep disturbance and irritability.
- Gastrointestinal disorders - nausea, vomiting, diarrhea, flatulence.
- Kidney disorders.
- Deficiency of zinc and vitamin B 12.
Scientists from Norway conducted an experiment showing that women with a high content of vitamin B9 were 1.5 times more likely to have children who were prone to asthmatic diseases. But scientists were unable to name the dosage that leads to such consequences.
It is important to know that pregnancy and folic acid are inseparable, but the dosage should only be determined by a doctor. Already at the first consultation with a gynecologist, the expectant mother is introduced to this element. Some people believe that it should only be taken for the first three months. Next you should switch to a vitamin complex. Other experts are confident that it is necessary to take folic acid in the early stages of pregnancy in the prescribed dosage, but also at other times. It has been proven that even representatives of the stronger sex who are preparing to become fathers benefit from the use of this substance. Read more about folic acid for men →
The drug is sold in any pharmacy and always remains affordable. The cost may vary depending on the manufacturer and form of release. Before purchasing, you should check with your doctor what dosage of folic acid during pregnancy is required in your individual case. You should not make a decision about taking this drug on your own. Despite all its benefits, it is important that the doctor himself determines the required dosage for a pregnant woman. It is important to take your situation seriously, then the baby will be born absolutely healthy!
Author: Irina Levchenko, doctor specially for Mama66.ru
Useful video about folic acid and pregnancy planning
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Determining the correct dosage
It is very important to determine the correct daily intake of folic acid for women. Please note that this element is quite poorly absorbed by the body if it enters our body through food. For example, to replenish daily reserves, a woman should eat about twenty to twenty-five stalks of asparagus daily. Despite the benefits of food, moderation is still needed in everything. In addition, proper nutrition is not cheap. Folic acid from vitamin supplements is much better absorbed by the body and is available in the required dosages.
Please note: excessive consumption of alcohol-containing drinks, hormonal medications, and oral contraceptives contributes to the rapid removal of vitamin B9 from the body.
The dosage of this element should be selected only by the attending physician, based on the individual characteristics of your body. It is very important that the dosage is chosen correctly. Most often, doctors recommend that women take 0.1 grams of this substance per day. However, if there is a deficiency of vitamin B9, then its amount can be increased to 1 gram. However, please note that only the attending physician can decide to increase the dosage. Do not self-medicate under any circumstances, as you can cause very serious harm not only to your health, but also to the health of your unborn baby.
It is very important to understand how to take folic acid for women. Depending on the dosage, as well as the purpose of use, the tablet should be taken two to three times a day after meals. Take the product with plenty of water.
