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Folate vs folic acid vs folinic acid and role of each
Penny found 20 sources
with relevant information
5 peer-reviewed research articles
5 professionally-backed sources
3 articles from healthcare institutions
Overview
Folate, folic acid, and folinic acid are all forms of vitamin B9, which is essential for healthy pregnancy, especially for the development of the baby’s brain and spine. Each form has unique properties, sources, and roles in the body.
Key Points
Folate
What it is:
- The natural form of vitamin B9 found in foods like leafy greens, legumes, and some fruits.
- Required for DNA synthesis, cell division, and normal growth and development, especially during pregnancy.
Role in Pregnancy:
- Supports the rapid cell growth needed for fetal development.
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Deficiency is linked to neural tube defects (NTDs), anemia, and other complications for both mother and baby.
The Critical Role of Folate in Prenatal Health and a Proposed Shift from Folic Acid to 5-Methyltetrahydrofolate Supplementation | Published in Georgetown Medical ReviewMenezo Y, Elder K, Clement A, Clement P. FolicAcid, FolinicAcid, 5 Methyl TetraHydroFolate Supplementation for Mutations That Affect Epigenesis through the Folate and One-Carbon Cycles. Biomolecules. 2022;12(2):197.Folic Acid Supplementation and Pregnancy: More Than Just Neural Tube Defect Prevention - PMCFolate (vitamin B9) is an essential ... and vitamin metabolism. Demands for folate increase during pregnancy because it is also required for growth and development of the fetus....Read full articleSource: PubMed CentralFolic Acid for a Healthy Baby | Johns Hopkins MedicineThe developing baby needs folate to make healthy new cells, and to make DNA and RNA (genetic material). These are cell-building blocks. Folate also is essential to form normal red blood cells and certain amino acids. These are important functions during pregnancy and infancy.Folate vs. Folic Acid: What's the Difference?For people of all ages, it can be hard to maintain adequate B9 levels and meet the recommended daily amount without taking supplements. People who are pregnant or those planning to conceive need folic acid to reduce the risk of birth defects of the brain and spine (neural tube defects). The terms ...Read full articleSource: Cleveland Clinic
Absorption:
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Folate from food is less stable and less efficiently absorbed than synthetic forms.
Folic Acid for a Healthy Baby | Johns Hopkins MedicineThe developing baby needs folate to make healthy new cells, and to make DNA and RNA (genetic material). These are cell-building blocks. Folate also is essential to form normal red blood cells and certain amino acids. These are important functions during pregnancy and infancy.Folic Acid: Facts for Clinicians | Folic Acid | CDCFolic acid is more stable than folates found naturally in food. It is used in supplements and fortified foods, such as bread, pasta, some breakfast cereals, and some corn masa flour. A woman needs adequate folate in early pregnancy to properly form the neural tube, which becomes a baby's brain ...Folate vs. Folic Acid: What's the Difference?For people of all ages, it can be hard to maintain adequate B9 levels and meet the recommended daily amount without taking supplements. People who are pregnant or those planning to conceive need folic acid to reduce the risk of birth defects of the brain and spine (neural tube defects). The terms ...Read full articleSource: Cleveland Clinic
Folic Acid
What it is:
- The synthetic form of vitamin B9 used in supplements and fortified foods (like cereals and bread).
- More stable and better absorbed than natural folate.
Role in Pregnancy:
- Proven to reduce the risk of neural tube defects (NTDs) when taken before conception and during early pregnancy.
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Recommended daily intake for people who could become pregnant is 400 micrograms (mcg), starting at least one month before conception and continuing through the first trimester.
Folic Acid: Facts for Clinicians | Folic Acid | CDCFolic acid is more stable than folates found naturally in food. It is used in supplements and fortified foods, such as bread, pasta, some breakfast cereals, and some corn masa flour. A woman needs adequate folate in early pregnancy to properly form the neural tube, which becomes a baby's brain ...About Folic Acid | Folic Acid | CDCIt is the only form of folate that's been shown to help prevent serious birth defects called neural tube defects (NTDs). NTDs are major birth defects of the baby's brain (such as anencephaly) and spine (such as spina bifida). NTDs happen in the first few weeks of pregnancy, often before you ...Nutrition During Pregnancy | ACOGDuring pregnancy you need folic acid, iron, calcium, vitamin D, choline, omega-3 fatty acids, B vitamins, and vitamin C. See the below table for recommended amounts. ... Folic acid, also known as folate, is a B vitamin that is important during pregnancy.Folic acid | Office on Women's HealthEveryone needs folicacid to be healthy. But it is especially important for women: Before and during pregnancy. Folicacid protects unborn children against serious birth defects called neural tube defects. These birth defects happen in the first few weeks of pregnancy, often before a woman ...How and when to take folic acid - NHSNHS medicines information on dosage for folic acid, how to take it and what to do if you miss a dose or take too much.Read full articleSource: nhs.ukPrenatal Vitamins: Folate vs. Folic Acid and the MTHFR MutationWomen in intermediate- to high-risk ... risk and the appropriate level of folic acid supplementation. ... While often used interchangeably, folate and folic acid differ slightly....
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Higher doses (up to 4,000 mcg) may be recommended for those with higher risk factors (e.g., previous NTD-affected pregnancy, certain medical conditions).
About Folic Acid | Folic Acid | CDCIt is the only form of folate that's been shown to help prevent serious birth defects called neural tube defects (NTDs). NTDs are major birth defects of the baby's brain (such as anencephaly) and spine (such as spina bifida). NTDs happen in the first few weeks of pregnancy, often before you ...Prenatal Vitamins: Folate vs. Folic Acid and the MTHFR MutationWomen in intermediate- to high-risk ... risk and the appropriate level of folic acid supplementation. ... While often used interchangeably, folate and folic acid differ slightly....
Folinic Acid (and L-methylfolate)
What it is:
- Folinic acid (also called 5-formyltetrahydrofolate) and L-methylfolate (5-methyltetrahydrofolate) are active forms of folate used in the body.
- Folinic acid is available as a supplement and is sometimes used in medical settings, especially for people with specific metabolic or absorption issues.
Role in Pregnancy:
-
Folinic acid and L-methylfolate can be used by the body without needing conversion by the MTHFR enzyme, which is important for people with certain genetic variations (MTHFR mutations) that reduce their ability to process folic acid efficiently.
Folic Acid Supplementation and Pregnancy: More Than Just Neural Tube Defect Prevention - PMCFolate (vitamin B9) is an essential ... and vitamin metabolism. Demands for folate increase during pregnancy because it is also required for growth and development of the fetus....Read full articleSource: PubMed CentralFolic acid in pregnancy - ScienceDirectFolate (vitamin B9) is one of thirteen vital vitamins and is found in dietary products, while folic acid is the synthetic supplement used to fortify f…Read full articleSource: sciencedirect.comMultivitamin Supplementation During Pregnancy: Emphasis on Folic Acid and l-Methylfolate - PMCIncreased plasma homocysteine is ... adverse pregnancy outcomes. In a study by Lamers and colleagues,1 healthy women were randomly assigned to consume 400 µg of folicacid, 416 µg of Lmethylfolate (the bioequivalent dose of folicacid), and 208 µg of l-methylfolate (half dose). Each group experienced increases in plasma folate and decreases ...Read full articleSource: PubMed CentralActive Folate Versus Folic Acid: The Role of 5-MTHF (Methylfolate) in Human Health - PMCWhile implementing specific ... the absorption of folate is much more effective with fortified foods and supplements, such as 5-MTHF/folate and folic acid. In fact, in the last decades, the main form of folate supplementation has been FA. Prescription of FA to women in the preconception period ...Read full articleSource: PubMed Central
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However, only folic acid supplementation has been proven in large studies to prevent neural tube defects. There is not enough evidence to recommend folinic acid or L-methylfolate as a replacement for folic acid for the general population.
Prenatal Vitamins: Folate vs. Folic Acid and the MTHFR MutationWomen in intermediate- to high-risk ... risk and the appropriate level of folic acid supplementation. ... While often used interchangeably, folate and folic acid differ slightly....
How They Work in the Body
Conversion and Activation
- Folic acid must be converted in the body to its active form (L-methylfolate) through several steps, including one that uses the MTHFR enzyme.
- Folate from food is also converted to active forms, but less efficiently.
-
Folinic acid and L-methylfolate are already in active forms and can be used directly by the body, which is why they may be considered for people with MTHFR mutations.
Folic acid in pregnancy - ScienceDirectFolate (vitamin B9) is one of thirteen vital vitamins and is found in dietary products, while folic acid is the synthetic supplement used to fortify f…Read full articleSource: sciencedirect.comMultivitamin Supplementation During Pregnancy: Emphasis on Folic Acid and l-Methylfolate - PMCIncreased plasma homocysteine is ... adverse pregnancy outcomes. In a study by Lamers and colleagues,1 healthy women were randomly assigned to consume 400 µg of folicacid, 416 µg of Lmethylfolate (the bioequivalent dose of folicacid), and 208 µg of l-methylfolate (half dose). Each group experienced increases in plasma folate and decreases ...Read full articleSource: PubMed CentralActive Folate Versus Folic Acid: The Role of 5-MTHF (Methylfolate) in Human Health - PMCWhile implementing specific ... the absorption of folate is much more effective with fortified foods and supplements, such as 5-MTHF/folate and folic acid. In fact, in the last decades, the main form of folate supplementation has been FA. Prescription of FA to women in the preconception period ...Read full articleSource: PubMed Central
Summary
- Folate is the natural form in foods; folic acid is the synthetic, stable, and well-absorbed form in supplements and fortified foods; folinic acid and L-methylfolate are active forms sometimes used for people with absorption or genetic issues.
- Folic acid supplementation before and during early pregnancy is the only intervention proven to reduce the risk of neural tube defects.
- Most guidelines recommend 400 mcg of folic acid daily for anyone who could become pregnant, as it is difficult to get enough from food alone.
- Folinic acid or L-methylfolate may be considered in special cases, but are not standard for NTD prevention in the general population.
If you have questions about which form is best for your individual needs—especially if you have a known MTHFR mutation or other health concerns—it might be beneficial to discuss this with your OB/GYN, who can work with you on your personal course of care.
References:
The Critical Role of Folate in Prenatal Health and a Proposed Shift from Folic Acid to 5-Methyltetrahydrofolate Supplementation | Published in Georgetown Medical Review
Menezo Y, Elder K, Clement A, Clement P. FolicAcid, FolinicAcid, 5 Methyl TetraHydroFolate Supplementation for Mutations That Affect Epigenesis through the Folate and One-Carbon Cycles. Biomolecules. 2022;12(2):197.
Folic Acid: Facts for Clinicians | Folic Acid | CDC
Folic acid is more stable than folates found naturally in food. It is used in supplements and fortified foods, such as bread, pasta, some breakfast cereals, and some corn masa flour. A woman needs adequate folate in early pregnancy to properly form the neural tube, which becomes a baby's brain ...
Folic Acid Supplementation and Pregnancy: More Than Just Neural Tube Defect Prevention - PMC
Folate (vitamin B9) is an essential ... and vitamin metabolism. Demands for folate increase during pregnancy because it is also required for growth and development of the fetus....
Read full article
Source:
PubMed Central
Folic Acid for a Healthy Baby | Johns Hopkins Medicine
The developing baby needs folate to make healthy new cells, and to make DNA and RNA (genetic material). These are cell-building blocks. Folate also is essential to form normal red blood cells and certain amino acids. These are important functions during pregnancy and infancy.
Folate vs. Folic Acid: What's the Difference?
For people of all ages, it can be hard to maintain adequate B9 levels and meet the recommended daily amount without taking supplements. People who are pregnant or those planning to conceive need folic acid to reduce the risk of birth defects of the brain and spine (neural tube defects). The terms ...
Read full article
Source:
Cleveland Clinic
About Folic Acid | Folic Acid | CDC
It is the only form of folate that's been shown to help prevent serious birth defects called neural tube defects (NTDs). NTDs are major birth defects of the baby's brain (such as anencephaly) and spine (such as spina bifida). NTDs happen in the first few weeks of pregnancy, often before you ...
Nutrition During Pregnancy | ACOG
During pregnancy you need folic acid, iron, calcium, vitamin D, choline, omega-3 fatty acids, B vitamins, and vitamin C. See the below table for recommended amounts. ... Folic acid, also known as folate, is a B vitamin that is important during pregnancy.
Folic acid | Office on Women's Health
Everyone needs folicacid to be healthy. But it is especially important for women: Before and during pregnancy. Folicacid protects unborn children against serious birth defects called neural tube defects. These birth defects happen in the first few weeks of pregnancy, often before a woman ...
How and when to take folic acid - NHS
NHS medicines information on dosage for folic acid, how to take it and what to do if you miss a dose or take too much.
Read full article
Source:
nhs.uk
Prenatal Vitamins: Folate vs. Folic Acid and the MTHFR Mutation
Women in intermediate- to high-risk ... risk and the appropriate level of folic acid supplementation. ... While often used interchangeably, folate and folic acid differ slightly....
Folic acid in pregnancy - ScienceDirect
Folate (vitamin B9) is one of thirteen vital vitamins and is found in dietary products, while folic acid is the synthetic supplement used to fortify f…
Read full article
Source:
sciencedirect.com
Multivitamin Supplementation During Pregnancy: Emphasis on Folic Acid and l-Methylfolate - PMC
Increased plasma homocysteine is ... adverse pregnancy outcomes. In a study by Lamers and colleagues,1 healthy women were randomly assigned to consume 400 µg of folicacid, 416 µg of Lmethylfolate (the bioequivalent dose of folicacid), and 208 µg of l-methylfolate (half dose). Each group experienced increases in plasma folate and decreases ...
Read full article
Source:
PubMed Central
Active Folate Versus Folic Acid: The Role of 5-MTHF (Methylfolate) in Human Health - PMC
While implementing specific ... the absorption of folate is much more effective with fortified foods and supplements, such as 5-MTHF/folate and folic acid. In fact, in the last decades, the main form of folate supplementation has been FA. Prescription of FA to women in the preconception period ...
Read full article
Source:
PubMed Central
Providing feedback helps us improve Penny's responses.
What made this response need improvement?
How robust is the evidence on folic acid supplementation?
Penny found 20 sources
with relevant information
7 peer-reviewed research articles
7 professionally-backed sources
Overview
The evidence supporting folic acid supplementation for the prevention of neural tube defects (NTDs) in pregnancy is considered extremely robust. This conclusion is based on decades of research, including large randomized controlled trials, systematic reviews, and ongoing recommendations from major health organizations.
Key Points
Strength of Evidence for Neural Tube Defect Prevention
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Convincing and Consistent Results:
Multiple large-scale randomized controlled trials and systematic reviews have shown that taking 400–800 micrograms (mcg) of folic acid daily before conception and during early pregnancy reduces the risk of NTDs (such as spina bifida and anencephaly) by at least 50% or more.Recommendation: Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication | United States Preventive Services TaskforceNearly half of all pregnancies ... of food suggests that an over-the-counter multivitamin with between 0.4 mg (400 μg) (the generally available dose) and 0.8 mg (800 μg) of folic acid daily reduces the risk for neural tube defects.10,12 Clinical practice guidelines ...Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement - PubMedImportance: Neural tube defects ... 3000 pregnancies affected each year. Many of these neural tube defects are caused by low folate levels in the body. Objective: The US Preventive Services Task Force (USPSTF) commissioned a reaffirmation evidence update on the benefits and harms of folicacidsupplementation...Read full articleSource: PubMedTask Force Recommends Folic Acid to Prevent Neural Tube Defects | Patient CareBecause NTDs happen early in pregnancy, ... to help prevent NTDs. ... The updated recommendation statement reaffirms the task force’s January 2017 statement on the topic, which also had an “A” grade. After conducting an evidence review that included results from a handful of new studies, the task force said there was convincing evidence that supplements containing 0.4 to 0.8 mg of folicacid, taken during the periconceptional period, reduce the risk for neuraltubedefects...Folic Acid Supplementation for the Prevention of Neural Tube Defects: Recommendation Statement | AAFPWomen who have a personal or family history of a pregnancy affected by a neural tube defect are at increased risk of having an affected pregnancy. However, most cases occur in the absence of any personal or family history. The USPSTF found convincing evidencethatfolicacidsupplementation in the ...Final Recommendation Statement: Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication | United States Preventive Services TaskforceIn 2017, the USPSTF reviewed the evidence on the benefits of folicacid supplementation to preventneuraltubedefects and found convincing evidence that the benefits of supplementation were significant. Three fair-quality observational studies (reported in 4 publications) published since the ...About Folic Acid | Folic Acid | CDCFolicacid is a form of folate that is used in supplements (vitamins) and fortified foods, such as breakfast cereals. Keep Reading FolicAcid: Sources and Recommended Intake · If you could become pregnant, the U.S. Public Health Service recommends that you get 400 mcg of folicacid daily to help prevent NTDs.1 · In addition, this recommendation is supported by the Institute of Medicine and the US Preventive Services Task Force. If you had a previous pregnancy ...Folic Acid for the Prevention of Neural Tube Defects: Recommendation Statement | AAFPAlthough a personal or family history ... an affected pregnancy, most cases occur in the absence of any positive history. Benefits of preventive medication. The USPSTF found convincing evidencethatsupplements containing 0.4 to 0.8 mg (400 to 800 mcg) of folicacid in the ...Folic Acid for the Prevention of Neural Tube Defects | Pediatrics | American Academy of PediatricsThe American Academy of Pediatrics endorses the US Public Health Service (USPHS) recommendation that all women capable of becoming pregnant consume 400 μg of folicacid daily to preventneuraltubedefects (NTDs). Studies have demonstrated that periconceptional folicacid supplementation can ...Folic Acid Supplementation for the Prevention of Neural Tube Defects: US Preventive Services Task Force Recommendation Statement - PubMedThe USPSTF recommends that all women who are planning or capable of pregnancy take a daily supplement containing 0.4 to 0.8 mg (400-800 µg) offolicacid. (A recommendation).Read full articleSource: PubMed -
Global Health Guidelines:
The U.S. Preventive Services Task Force (USPSTF), World Health Organization (WHO), and other major health authorities give an “A” grade (highest certainty and benefit) to the recommendation that all people who could become pregnant take a daily folic acid supplement.Recommendation: Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication | United States Preventive Services TaskforceNearly half of all pregnancies ... of food suggests that an over-the-counter multivitamin with between 0.4 mg (400 μg) (the generally available dose) and 0.8 mg (800 μg) of folic acid daily reduces the risk for neural tube defects.10,12 Clinical practice guidelines ...Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement - PubMedImportance: Neural tube defects ... 3000 pregnancies affected each year. Many of these neural tube defects are caused by low folate levels in the body. Objective: The US Preventive Services Task Force (USPSTF) commissioned a reaffirmation evidence update on the benefits and harms of folicacidsupplementation...Read full articleSource: PubMedTask Force Recommends Folic Acid to Prevent Neural Tube Defects | Patient CareBecause NTDs happen early in pregnancy, ... to help prevent NTDs. ... The updated recommendation statement reaffirms the task force’s January 2017 statement on the topic, which also had an “A” grade. After conducting an evidence review that included results from a handful of new studies, the task force said there was convincing evidence that supplements containing 0.4 to 0.8 mg of folicacid, taken during the periconceptional period, reduce the risk for neuraltubedefects...Folic Acid Supplementation for the Prevention of Neural Tube Defects: Recommendation Statement | AAFPWomen who have a personal or family history of a pregnancy affected by a neural tube defect are at increased risk of having an affected pregnancy. However, most cases occur in the absence of any personal or family history. The USPSTF found convincing evidencethatfolicacidsupplementation in the ...Final Recommendation Statement: Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication | United States Preventive Services TaskforceIn 2017, the USPSTF reviewed the evidence on the benefits of folicacid supplementation to preventneuraltubedefects and found convincing evidence that the benefits of supplementation were significant. Three fair-quality observational studies (reported in 4 publications) published since the ...Folic Acid for the Prevention of Neural Tube Defects: Recommendation Statement | AAFPAlthough a personal or family history ... an affected pregnancy, most cases occur in the absence of any positive history. Benefits of preventive medication. The USPSTF found convincing evidencethatsupplements containing 0.4 to 0.8 mg (400 to 800 mcg) of folicacid in the ...Daily iron and folic acid supplementation during pregnancyDeficiencies in iron and folicacidduringpregnancy can potentially negatively impact the health of the mother, her pregnancy, as well as fetal development. Evidence has shown that the use of iron and folicacidsupplements is associated with a reduced risk of iron deficiency and anaemia in ...Read full articleSource: who.int -
Population Impact:
Countries that have implemented folic acid supplementation and food fortification have seen significant declines in the rates of NTDs.Folic Acid for the Prevention of Neural Tube Defects | Pediatrics | American Academy of PediatricsThe American Academy of Pediatrics endorses the US Public Health Service (USPHS) recommendation that all women capable of becoming pregnant consume 400 μg of folicacid daily to preventneuraltubedefects (NTDs). Studies have demonstrated that periconceptional folicacid supplementation can ...
Evidence for Other Pregnancy Outcomes
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Other Outcomes Less Clear:
While folic acid is essential for maternal health and fetal development, evidence for benefits beyond NTD prevention—such as reducing the risk of preterm birth, low birth weight, or preeclampsia—is less consistent or conclusive. Some studies and meta-analyses suggest possible benefits, but results are mixed and not as robust as for NTD prevention.Folic acid supplementation during pregnancy for maternal health and pregnancy outcomes - PMCA review on folic acid supplementation during pregnancy by Charles et al (Charles 2005b) that included results from large randomised controlled trials found no conclusive evidence of benefit for folic acid supplementation in pregnant women.Read full articleSource: PubMed CentralEffect of folate intake on health outcomes in pregnancy: a systematic review and meta-analysis on birth weight, placental weight and length of gestation - PMCOur aims were to systematically review randomizedcontrolledtrials (RCTs) investigating the effect of folate supplementation on birth weight, placental weight and length of gestation and to assess the dose–response relationship between folate intake (folicacid plus dietary folate) and health outcomes. The MEDLINE, EMBASE and Cochrane Library CENTRAL databases were searched from inception to February 2010 for RCTs in which folate intake and health outcomes in pregnancy ...Read full articleSource: PubMed CentralDaily iron and folic acid supplementation during pregnancyDeficiencies in iron and folicacidduringpregnancy can potentially negatively impact the health of the mother, her pregnancy, as well as fetal development. Evidence has shown that the use of iron and folicacidsupplements is associated with a reduced risk of iron deficiency and anaemia in ...Read full articleSource: who.intSupplementation of folic acid in pregnancy and the risk of preeclampsia and gestational hypertension: a meta-analysis - PMCIn total, 13 cohort studies and 1 randomizedcontrolledtrial study was included, containing 160,562 and 149,320 women with and without folicacidsupplementationduringpregnancy. Pooled results showed that risk of gestational hypertension was not associated with the supplementationoffolicacid.Read full articleSource: PubMed CentralFolic acid supplementation in pregnancy to prevent preterm birth: a systematic review and meta-analysis of randomized controlled trials - PubMedThe aim of this systematic review ... of folicacidsupplementationduringpregnancy to prevent preterm birth (PTB). The research protocol was designed a priori, defining methods for searching the literature in electronic databases, including and examining articles, and extracting and analyzing data. We included all randomizedtrials (RCTs) of asymptomatic singleton gestations without prior PTB who were randomized to prophylactic treatment with either FA supplementationorcontrol (placebo or ...Read full articleSource: PubMed
Safety and Harms
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Safety Profile:
Folic acid supplementation at recommended doses (400–800 mcg daily) is not associated with serious harms to the mother or baby. High-quality studies have found no increased risk of autism, cancer, or other major adverse effects at these doses.Recommendation: Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication | United States Preventive Services TaskforceNearly half of all pregnancies ... of food suggests that an over-the-counter multivitamin with between 0.4 mg (400 μg) (the generally available dose) and 0.8 mg (800 μg) of folic acid daily reduces the risk for neural tube defects.10,12 Clinical practice guidelines ...Task Force Recommends Folic Acid to Prevent Neural Tube Defects | Patient CareBecause NTDs happen early in pregnancy, ... to help prevent NTDs. ... The updated recommendation statement reaffirms the task force’s January 2017 statement on the topic, which also had an “A” grade. After conducting an evidence review that included results from a handful of new studies, the task force said there was convincing evidence that supplements containing 0.4 to 0.8 mg of folicacid, taken during the periconceptional period, reduce the risk for neuraltubedefects...Folic Acid Supplementation for the Prevention of Neural Tube Defects: Recommendation Statement | AAFPWomen who have a personal or family history of a pregnancy affected by a neural tube defect are at increased risk of having an affected pregnancy. However, most cases occur in the absence of any personal or family history. The USPSTF found convincing evidencethatfolicacidsupplementation in the ...Final Recommendation Statement: Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication | United States Preventive Services TaskforceIn 2017, the USPSTF reviewed the evidence on the benefits of folicacid supplementation to preventneuraltubedefects and found convincing evidence that the benefits of supplementation were significant. Three fair-quality observational studies (reported in 4 publications) published since the ...
Limitations and Research Gaps
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Beyond NTDs:
There is inadequate evidence to support benefits of folic acid supplementation for outcomes other than NTD prevention, and more research is needed in these areas.Folic acid supplementation during pregnancy for maternal health and pregnancy outcomes - PMCA review on folic acid supplementation during pregnancy by Charles et al (Charles 2005b) that included results from large randomised controlled trials found no conclusive evidence of benefit for folic acid supplementation in pregnant women.Read full articleSource: PubMed CentralEffect of folate intake on health outcomes in pregnancy: a systematic review and meta-analysis on birth weight, placental weight and length of gestation - PMCOur aims were to systematically review randomizedcontrolledtrials (RCTs) investigating the effect of folate supplementation on birth weight, placental weight and length of gestation and to assess the dose–response relationship between folate intake (folicacid plus dietary folate) and health outcomes. The MEDLINE, EMBASE and Cochrane Library CENTRAL databases were searched from inception to February 2010 for RCTs in which folate intake and health outcomes in pregnancy ...Read full articleSource: PubMed CentralFolic Acid Supplementation for the Prevention of Neural Tube Defects: Recommendation Statement | AAFPWomen who have a personal or family history of a pregnancy affected by a neural tube defect are at increased risk of having an affected pregnancy. However, most cases occur in the absence of any personal or family history. The USPSTF found convincing evidencethatfolicacidsupplementation in the ...Daily iron and folic acid supplementation during pregnancyDeficiencies in iron and folicacidduringpregnancy can potentially negatively impact the health of the mother, her pregnancy, as well as fetal development. Evidence has shown that the use of iron and folicacidsupplements is associated with a reduced risk of iron deficiency and anaemia in ...Read full articleSource: who.intFolic acid supplementation in pregnancy to prevent preterm birth: a systematic review and meta-analysis of randomized controlled trials - PubMedThe aim of this systematic review ... of folicacidsupplementationduringpregnancy to prevent preterm birth (PTB). The research protocol was designed a priori, defining methods for searching the literature in electronic databases, including and examining articles, and extracting and analyzing data. We included all randomizedtrials (RCTs) of asymptomatic singleton gestations without prior PTB who were randomized to prophylactic treatment with either FA supplementationorcontrol (placebo or ...Read full articleSource: PubMed -
Optimal Dose and Timing:
Most evidence supports starting supplementation at least one month before conception and continuing through the first trimester. There is less clarity about benefits of continuing supplementation later in pregnancy for other outcomes.Folic Acid Supplementation for the Prevention of Neural Tube Defects: Recommendation Statement | AAFPWomen who have a personal or family history of a pregnancy affected by a neural tube defect are at increased risk of having an affected pregnancy. However, most cases occur in the absence of any personal or family history. The USPSTF found convincing evidencethatfolicacidsupplementation in the ...Folic Acid for the Prevention of Neural Tube Defects: Recommendation Statement | AAFPAlthough a personal or family history ... an affected pregnancy, most cases occur in the absence of any positive history. Benefits of preventive medication. The USPSTF found convincing evidencethatsupplements containing 0.4 to 0.8 mg (400 to 800 mcg) of folicacid in the ...
Summary
- The evidence that folic acid supplementation prevents neural tube defects is extremely strong, consistent, and forms the basis for global health recommendations.
- The benefit is greatest when supplementation starts before conception and continues through the first trimester.
- Folic acid supplementation is safe at recommended doses, and no serious harms have been identified.
- Evidence for benefits beyond NTD prevention is less robust and remains an area for further research.
Recommendation: Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication | United States Preventive Services Taskforce
Nearly half of all pregnancies ... of food suggests that an over-the-counter multivitamin with between 0.4 mg (400 μg) (the generally available dose) and 0.8 mg (800 μg) of folic acid daily reduces the risk for neural tube defects.10,12 Clinical practice guidelines ...
Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement - PubMed
Importance: Neural tube defects ... 3000 pregnancies affected each year. Many of these neural tube defects are caused by low folate levels in the body. Objective: The US Preventive Services Task Force (USPSTF) commissioned a reaffirmation evidence update on the benefits and harms of folicacidsupplementation...
Read full article
Source:
PubMed
Task Force Recommends Folic Acid to Prevent Neural Tube Defects | Patient Care
Because NTDs happen early in pregnancy, ... to help prevent NTDs. ... The updated recommendation statement reaffirms the task force’s January 2017 statement on the topic, which also had an “A” grade. After conducting an evidence review that included results from a handful of new studies, the task force said there was convincing evidence that supplements containing 0.4 to 0.8 mg of folicacid, taken during the periconceptional period, reduce the risk for neuraltubedefects...
Folic Acid Supplementation for the Prevention of Neural Tube Defects: Recommendation Statement | AAFP
Women who have a personal or family history of a pregnancy affected by a neural tube defect are at increased risk of having an affected pregnancy. However, most cases occur in the absence of any personal or family history. The USPSTF found convincing evidencethatfolicacidsupplementation in the ...
Final Recommendation Statement: Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication | United States Preventive Services Taskforce
In 2017, the USPSTF reviewed the evidence on the benefits of folicacid supplementation to preventneuraltubedefects and found convincing evidence that the benefits of supplementation were significant. Three fair-quality observational studies (reported in 4 publications) published since the ...
About Folic Acid | Folic Acid | CDC
Folicacid is a form of folate that is used in supplements (vitamins) and fortified foods, such as breakfast cereals. Keep Reading FolicAcid: Sources and Recommended Intake · If you could become pregnant, the U.S. Public Health Service recommends that you get 400 mcg of folicacid daily to help prevent NTDs.1 · In addition, this recommendation is supported by the Institute of Medicine and the US Preventive Services Task Force. If you had a previous pregnancy ...
Folic Acid for the Prevention of Neural Tube Defects: Recommendation Statement | AAFP
Although a personal or family history ... an affected pregnancy, most cases occur in the absence of any positive history. Benefits of preventive medication. The USPSTF found convincing evidencethatsupplements containing 0.4 to 0.8 mg (400 to 800 mcg) of folicacid in the ...
Folic Acid for the Prevention of Neural Tube Defects | Pediatrics | American Academy of Pediatrics
The American Academy of Pediatrics endorses the US Public Health Service (USPHS) recommendation that all women capable of becoming pregnant consume 400 μg of folicacid daily to preventneuraltubedefects (NTDs). Studies have demonstrated that periconceptional folicacid supplementation can ...
Folic Acid Supplementation for the Prevention of Neural Tube Defects: US Preventive Services Task Force Recommendation Statement - PubMed
The USPSTF recommends that all women who are planning or capable of pregnancy take a daily supplement containing 0.4 to 0.8 mg (400-800 µg) offolicacid. (A recommendation).
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PubMed
Daily iron and folic acid supplementation during pregnancy
Deficiencies in iron and folicacidduringpregnancy can potentially negatively impact the health of the mother, her pregnancy, as well as fetal development. Evidence has shown that the use of iron and folicacidsupplements is associated with a reduced risk of iron deficiency and anaemia in ...
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Peer-Reviewed Research
Published, peer-reviewed scientific studies from journals or databases.
Maternal folic acid and multivitamin supplementation: International clinical evidence with considerations for the prevention of folate-sensitive birth defects - ScienceDirect
More evidence is available for maternal intake, absorption, distribution, tissue specific concentrations, and pregnancy outcomes with folicacid (fortification/supplementation) during preconception – first trimester.
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sciencedirect.com
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The Critical Role of Folate in Prenatal Health and a Proposed Shift from Folic Acid to 5-Methyltetrahydrofolate Supplementation | Published in Georgetown Medical Review
Menezo Y, Elder K, Clement A, Clement P. FolicAcid, FolinicAcid, 5 Methyl TetraHydroFolate Supplementation for Mutations That Affect Epigenesis through the Folate and One-Carbon Cycles. Biomolecules. 2022;12(2):197.
Folic Acid Supplementation and Pregnancy: More Than Just Neural Tube Defect Prevention - PMC
Indirect evidence suggests that folate may indeed be important in the timing of labor. In observational studies, a shorter duration of pregnancy has been associated with low serum folate levels6,28 and with the absence of folicacidsupplementationduringpregnancy.29
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PubMed Central
2
Folic Acid Supplementation and Pregnancy: More Than Just Neural Tube Defect Prevention - PMC
Folate (vitamin B9) is an essential ... and vitamin metabolism. Demands for folate increase during pregnancy because it is also required for growth and development of the fetus....
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PubMed Central
2
Folic Acid Supplementation to Prevent Neural Tube Defects: US Preventive Services Task Force Reaffirmation Recommendation Statement - PubMed
Importance: Neural tube defects ... 3000 pregnancies affected each year. Many of these neural tube defects are caused by low folate levels in the body. Objective: The US Preventive Services Task Force (USPSTF) commissioned a reaffirmation evidence update on the benefits and harms of folicacidsupplementation...
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PubMed
Folic acid supplementation in pregnancy and implications in health and disease | Journal of Biomedical Science | Full Text
Kennedy D, Koren G: Identifying ... acidinpregnancy. Can Fam Physician. 2012, 58: 394-397. ... Wald NJ, Law MR, Morris JK, Wald DS: Quantifying the effect of folicacid. Lancet. 2001, 358: 2069-2073. ... Fowler B: The folate cycle and disease in humans. Kidney Int Suppl. 2001, 78: S221-S229. ... Crider KS, Yang TP, Berry RJ, Bailey LB: Folate and DNA methylation: a review of molecular mechanisms and the evidence for folate's ...
Folic acid: influence on the outcome of pregnancy - PubMed
The periconceptional use of folicacid-containing supplements reduces the first occurrence, as well as the recurrence, of neural tube defects. Women of populations in which adverse pregnancy outcomes are prevalent often consume diets that contain a low density of vitamins and minerals, including ...
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PubMed
8
Folic Acid for the Prevention of Neural Tube Defects | Pediatrics | American Academy of Pediatrics
The American Academy of Pediatrics endorses the US Public Health Service (USPHS) recommendation that all women capable of becoming pregnant consume 400 μg of folicacid daily to preventneuraltubedefects (NTDs). Studies have demonstrated that periconceptional folicacid supplementation can ...
Folic acid supplementation during pregnancy for maternal health and pregnancy outcomes - PubMed
Selection criteria: All randomised, cluster-randomised and cross-over controlledtrials evaluating supplementationoffolicacid alone or with other micronutrients versus no folicacid (placebo or same micronutrients but no folicacid) inpregnancy.
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PubMed
9
Folic Acid Supplementation for the Prevention of Neural Tube Defects: US Preventive Services Task Force Recommendation Statement - PubMed
The USPSTF recommends that all women who are planning or capable of pregnancy take a daily supplement containing 0.4 to 0.8 mg (400-800 µg) offolicacid. (A recommendation).
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Source:
PubMed
11
Folic acid supplementation during pregnancy for maternal health and pregnancy outcomes - PMC
A review on folic acid supplementation during pregnancy by Charles et al (Charles 2005b) that included results from large randomised controlled trials found no conclusive evidence of benefit for folic acid supplementation in pregnant women.
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PubMed Central
11
Folic acid in pregnancy - ScienceDirect
Folate (vitamin B9) is one of thirteen vital vitamins and is found in dietary products, while folic acid is the synthetic supplement used to fortify f…
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sciencedirect.com
12
Effect of folate intake on health outcomes in pregnancy: a systematic review and meta-analysis on birth weight, placental weight and length of gestation - PMC
Our aims were to systematically review randomizedcontrolledtrials (RCTs) investigating the effect of folate supplementation on birth weight, placental weight and length of gestation and to assess the dose–response relationship between folate intake (folicacid plus dietary folate) and health outcomes. The MEDLINE, EMBASE and Cochrane Library CENTRAL databases were searched from inception to February 2010 for RCTs in which folate intake and health outcomes in pregnancy ...
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PubMed Central
12
Multivitamin Supplementation During Pregnancy: Emphasis on Folic Acid and l-Methylfolate - PMC
Increased plasma homocysteine is ... adverse pregnancy outcomes. In a study by Lamers and colleagues,1 healthy women were randomly assigned to consume 400 µg of folicacid, 416 µg of Lmethylfolate (the bioequivalent dose of folicacid), and 208 µg of l-methylfolate (half dose). Each group experienced increases in plasma folate and decreases ...
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PubMed Central
Folic acid supplementation in pregnancy and implications in health and disease | Journal of Biomedical Science | Full Text
In addition, studies in humans, also reported to have found higher blood folate concentration of unmetabolized FA and naturally occurring folates [78]. To gain a better understanding if maternal supplementation of FA modulates pregnancy related outcomes, much focus has been given to reveal the role ...
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Supplementation of folic acid in pregnancy and the risk of preeclampsia and gestational hypertension: a meta-analysis - PMC
In total, 13 cohort studies and 1 randomizedcontrolledtrial study was included, containing 160,562 and 149,320 women with and without folicacidsupplementationduringpregnancy. Pooled results showed that risk of gestational hypertension was not associated with the supplementationoffolicacid.
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PubMed Central
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Active Folate Versus Folic Acid: The Role of 5-MTHF (Methylfolate) in Human Health - PMC
While implementing specific ... the absorption of folate is much more effective with fortified foods and supplements, such as 5-MTHF/folate and folic acid. In fact, in the last decades, the main form of folate supplementation has been FA. Prescription of FA to women in the preconception period ...
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PubMed Central
14
Folic acid supplementation in pregnancy to prevent preterm birth: a systematic review and meta-analysis of randomized controlled trials - PubMed
The aim of this systematic review ... of folicacidsupplementationduringpregnancy to prevent preterm birth (PTB). The research protocol was designed a priori, defining methods for searching the literature in electronic databases, including and examining articles, and extracting and analyzing data. We included all randomizedtrials (RCTs) of asymptomatic singleton gestations without prior PTB who were randomized to prophylactic treatment with either FA supplementationorcontrol (placebo or ...
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PubMed
Intestinal absorption of folic acid - new physiologic & molecular aspects - PMC
3). [Reprinted with permission from John Wiley & Sons Ltd., UK: Eur J Haematol2006; 76: 200-5]. In order to maintain an adequate folate status, the intake of folates/folic acid should be appropriate and the absorption processes of folates/folic acid in the small intestine should function properly.
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PubMed Central
Continuous supplementation of folic acid in pregnancy and the risk of perinatal depression–A meta-analysis - ScienceDirect
The current meta-analysis is the first to assess the association of depression risk during pregnancy with blood folate levels and folate intake. This meta-analysis provides evidence that folic acid supplement is negatively associated with the risk of depression during pregnancy.
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sciencedirect.com
Biological Role of Folic Acid in Pregnancy and Possible Therapeutic Application for the Prevention of Preeclampsia - PMC
In the pathogenesis of preeclampsia ... play a key role. Increased blood levels of homocysteine during pregnancy are associated with the risk of preeclampsia. Moreover, hyperhomocysteinemia has been proposed to be an independent risk factor for preeclampsia. Folate supplementation ...
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PubMed Central
Folic acid supplementation during pregnancy for maternal health and pregnancy outcomes - PMC
The role of folate deficiency in increasing the risk of spontaneous abortion and birth outcomes such as low birthweight, preterm birth, and perinatal mortality is unclear (Bukowski 2009; Scholl 2000). Hence, the aim of this review is to assess the effect of folicacid supplementation alone in pregnant women on haematological and biochemical parameters, adverse events during pregnancy...
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PubMed Central
Clinical Guidelines & Professional Sources
Clinical recommendations from government, public health organizations, or professional medical provider associations.
1
Recommendation: Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication | United States Preventive Services Taskforce
Nearly half of all pregnancies ... of food suggests that an over-the-counter multivitamin with between 0.4 mg (400 μg) (the generally available dose) and 0.8 mg (800 μg) of folic acid daily reduces the risk for neural tube defects.10,12 Clinical practice guidelines ...
3
Task Force Recommends Folic Acid to Prevent Neural Tube Defects | Patient Care
Because NTDs happen early in pregnancy, ... to help prevent NTDs. ... The updated recommendation statement reaffirms the task force’s January 2017 statement on the topic, which also had an “A” grade. After conducting an evidence review that included results from a handful of new studies, the task force said there was convincing evidence that supplements containing 0.4 to 0.8 mg of folicacid, taken during the periconceptional period, reduce the risk for neuraltubedefects...
4
Folic Acid Supplementation for the Prevention of Neural Tube Defects: Recommendation Statement | AAFP
Women who have a personal or family history of a pregnancy affected by a neural tube defect are at increased risk of having an affected pregnancy. However, most cases occur in the absence of any personal or family history. The USPSTF found convincing evidencethatfolicacidsupplementation in the ...
5
Folic Acid: Facts for Clinicians | Folic Acid | CDC
Folic acid is more stable than folates found naturally in food. It is used in supplements and fortified foods, such as bread, pasta, some breakfast cereals, and some corn masa flour. A woman needs adequate folate in early pregnancy to properly form the neural tube, which becomes a baby's brain ...
5
Final Recommendation Statement: Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication | United States Preventive Services Taskforce
In 2017, the USPSTF reviewed the evidence on the benefits of folicacid supplementation to preventneuraltubedefects and found convincing evidence that the benefits of supplementation were significant. Three fair-quality observational studies (reported in 4 publications) published since the ...
6
About Folic Acid | Folic Acid | CDC
It is the only form of folate that's been shown to help prevent serious birth defects called neural tube defects (NTDs). NTDs are major birth defects of the baby's brain (such as anencephaly) and spine (such as spina bifida). NTDs happen in the first few weeks of pregnancy, often before you ...
Periconceptional folic acid supplementation to prevent neural tube defects
This periconceptional period is ... positive pregnancy outcomes. Birth defects, or congenital malformations, are structural or functional abnormalities present from birth and can be caused by a number of factors, including micronutrient deficiencies. Neural tube defects such as spina bifida are one of the most common congenital malformations. Current evidence suggests that folicacidsupplementation in the ...
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6
About Folic Acid | Folic Acid | CDC
Folicacid is a form of folate that is used in supplements (vitamins) and fortified foods, such as breakfast cereals. Keep Reading FolicAcid: Sources and Recommended Intake · If you could become pregnant, the U.S. Public Health Service recommends that you get 400 mcg of folicacid daily to help prevent NTDs.1 · In addition, this recommendation is supported by the Institute of Medicine and the US Preventive Services Task Force. If you had a previous pregnancy ...
7
Nutrition During Pregnancy | ACOG
During pregnancy you need folic acid, iron, calcium, vitamin D, choline, omega-3 fatty acids, B vitamins, and vitamin C. See the below table for recommended amounts. ... Folic acid, also known as folate, is a B vitamin that is important during pregnancy.
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Folic Acid for the Prevention of Neural Tube Defects: Recommendation Statement | AAFP
Although a personal or family history ... an affected pregnancy, most cases occur in the absence of any positive history. Benefits of preventive medication. The USPSTF found convincing evidencethatsupplements containing 0.4 to 0.8 mg (400 to 800 mcg) of folicacid in the ...
Pregnancy, breastfeeding and fertility while taking folic acid - NHS
NHS medicines information on folic acid and whether you can take it while pregnant or breastfeeding.
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nhs.uk
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Folic acid | Office on Women's Health
Everyone needs folicacid to be healthy. But it is especially important for women: Before and during pregnancy. Folicacid protects unborn children against serious birth defects called neural tube defects. These birth defects happen in the first few weeks of pregnancy, often before a woman ...
Vitamins, minerals and supplements in pregnancy - NHS
Find out about vitamins, minerals and supplements in pregnancy, including why you should take a folic acid supplement.
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nhs.uk
9
How and when to take folic acid - NHS
NHS medicines information on dosage for folic acid, how to take it and what to do if you miss a dose or take too much.
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nhs.uk
10
Daily iron and folic acid supplementation during pregnancy
Deficiencies in iron and folicacidduringpregnancy can potentially negatively impact the health of the mother, her pregnancy, as well as fetal development. Evidence has shown that the use of iron and folicacidsupplements is associated with a reduced risk of iron deficiency and anaemia in ...
Read full article
Source:
who.int
Medical & Academic Institutions
Information from hospitals, research institutions, or academic medical centers known for clinical expertise and research contributions.
3
Folic Acid for a Healthy Baby | Johns Hopkins Medicine
The developing baby needs folate to make healthy new cells, and to make DNA and RNA (genetic material). These are cell-building blocks. Folate also is essential to form normal red blood cells and certain amino acids. These are important functions during pregnancy and infancy.
4
Folate vs. Folic Acid: What's the Difference?
For people of all ages, it can be hard to maintain adequate B9 levels and meet the recommended daily amount without taking supplements. People who are pregnant or those planning to conceive need folic acid to reduce the risk of birth defects of the brain and spine (neural tube defects). The terms ...
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Cleveland Clinic
10
Prenatal Vitamins: Folate vs. Folic Acid and the MTHFR Mutation
Women in intermediate- to high-risk ... risk and the appropriate level of folic acid supplementation. ... While often used interchangeably, folate and folic acid differ slightly....