5 questions about ... folic acid

1. What is folic acid and why is it so important to take extra folic acid if you want to become pregnant? When should you start and how often should you take it? HealthNet asked Martina Cornel, professor of 'community genetics and public health genomics' at the VU medical center (VUmc) in Amsterdam.

1. What is Folic Acid?

1. Folic acid is an essential vitamin (B11) for your body. It aids in the production of red blood cells in the bone marrow. Normally you get enough folic acid from a healthy and varied diet. But during pregnancy, the body needs extra folic acid. Folic acid is very important for cell division and the development of the nervous system of the unborn child.

2. Why take extra folic acid during pregnancy?

1. Even before your pregnancy, sufficient folic acid in your blood is important. Folate is necessary for cell division. Research shows that the risk of congenital abnormalities such as a spina bifida is significantly reduced by taking extra folic acid. You can improve the folic acid level by taking extra folic acid four weeks before a pregnancy starts.

3. When is the best time to start with extra folic acid tablets?

1. It takes a while before the folic acid level is up to standard. My advice is to start taking extra folic acid as soon as you prepare for a pregnancy or as soon as you can become pregnant. Start at least a month before possible conception, so for example during the last month that you take the contraceptive pill. The advice is to take extra folic acid in the first ten weeks of pregnancy. It is sufficient to take one 400 microgram tablet daily.

4. What do you advise parents-to-be about folic acid and pregnancy?

1. If you are preparing for a pregnancy and you stop using contraceptives, for example, start with a tablet of folic acid every day. In addition, eat varied and sufficient green vegetables and fruit daily. Oranges, for example, contain a lot of folic acid. A tip that I always give is: take a folic acid tablet at a fixed time, then you will not forget it.

5. Can it hurt to take folic acid for a long time? For example, if you want to have children, but don't get pregnant and have been taking folic acid for ten years.

1. If you take the normal dose (one tablet per day with 0.4-0.5 mg folic acid), that won't hurt. Folic acid is water soluble, so you urinate too much. If there is a recurrence risk of a child with a neural tube defect, 5mg per day is recommended, talk to your doctor about whether blood checks are needed. Even if colon cancer occurs in your family at a young age, it is wise to consult your doctor. Martina Cornel is a professor at the VU medical center. She is a doctor and epidemiologist, and obtained her PhD in 1993 on 'Registration and prevention of congenital anomalies'. In recent years she has been involved in research on genetic screening criteria, a pilot study offering prior pregnancy screening for cystic fibrosis and hemoglobinopathy, research on genetics education and the international database for rare diseases.

2. If you take the normal dose (one tablet per day with 0.4-0.5 mg folic acid), that won't hurt. Folic acid is soluble in water, so you urinate too much. If there is a recurrence risk of a child with a neural tube defect, 5mg per day is recommended, talk to your doctor about whether blood checks are needed. Even if colon cancer occurs in your family at a young age, it is wise to consult your doctor. Martina Cornel is a professor at the VU medical center. She is a doctor and epidemiologist, and obtained her PhD in 1993 on 'Registration and prevention of congenital anomalies'. In recent years she has been involved in research on genetic screening criteria, a pilot study offering prior pregnancy screening for cystic fibrosis and hemoglobinopathy, research on genetics education and the international database for rare diseases.