Folic acid is one of the few supplements with genuinely strong evidence behind it. Taken before conception and through the first twelve weeks of pregnancy, it substantially reduces the risk of neural tube defects such as spina bifida.
The usual dose is 400 micrograms daily, ideally started before conception and continued until the end of the twelfth week.
A higher 5mg daily dose is prescribed for women at greater risk, including those who:
If any of these apply, ask your GP rather than assuming the standard tablet is enough.
Folic acid is also used to treat and prevent folate deficiency anaemia, alongside methotrexate to reduce its side effects, and in some blood disorders and dialysis patients.
When taken with methotrexate, follow the specific day instructions you have been given — it is usually taken on different days from the methotrexate.
Take it once daily, with or without food, at the same time each day. If you miss a dose, take it when you remember unless the next is nearly due.
Side effects are uncommon; occasional nausea, loss of appetite or bloating.
Folic acid can mask vitamin B12 deficiency, which is why B12 is usually checked before treating anaemia with folate alone. Tell your GP if you have unexplained tiredness, pins and needles or numbness.
If you are eligible for the Healthy Start scheme, vitamins including folic acid are provided free — worth checking.
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