8 Times You Need to Be Taking Folic Acid

Folic acid is a man-made form of folate, a B vitamin (B9, to be exact). Folic acid is found in fortified cereals, pasta, bread, and of course supplements. Folate is plentiful in such whole foods as leafy vegetables, eggs, and citrus fruits. Folic acid and folate confer health benefits throughout your life, but you especially need to make folic acid a priority if:

You could become pregnant

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All women of childbearing age should get 400 micrograms (mcg) of folic acid daily along with food with folate from a varied diet, according to the Centers for Disease Control and Prevention (CDC). “This helps prevent neural tube birth defects such as spina bifida and anencephaly,” says Diane Young, MD, an obstetrician/gynecologist at the Cleveland Clinic in Ohio. It’s important to start at least one month before you become pregnant. “Most women aren’t aware that they are pregnant in the early days and most birth defects occur in the first three to four weeks of pregnancy.” The March of Dimes notes that taking folic acid before and during pregnancy may help prevent up to 7 in 10 neural tube defects.

You are pregnant

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Getting enough folic acid is one of the ways to prevent birth defects before and during pregnancy. If you are pregnant, you may need more than 400 mcg of folic acid, the US Office on Women’s Health states. This number can range from 400 to 800 micrograms per day. “Pregnant women who have had a previous baby with neural tube defect should take a higher dose,” Dr. Young says. The CDC recommends that these women get up to 4,000 mcg of folic acid every day for a month prior to becoming pregnant and through the first three months of pregnancy. “Moms who are pregnant with multiples should take double the dose,” Dr. Young says. The good news is that unlike larger prenatal vitamins which can be hard to take, ” folic acid is a tiny pill with no taste,” says Jennifer Wu, MD, an obstetrician/gynecologist at Lenox Hill Hospital in New York City. “You can crush it up and take it in apple sauce or chew it. It’s a very different formulation than prenatal vitamins,” she says. Discuss your risk factors and pregnancy with your obstetrician for personal recommendations on how much folic acid you will need during pregnancy.

You are breastfeeding

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Keep taking your folic acid while you are breastfeeding, Dr. Young advises. “This will help ensure your baby gets enough folic acid,” Dr. Young says. Talk to your doctor about how much you might need—some groups recommend raising the amount you take to 500 mcg of folic acid a day. Here are some expert-approved ways to increase your milk supply when breastfeeding,

You are anemic

If you don’t consume enough folic acid, you are at risk for folate-deficient anemia. Folate and folic acid help generate the red blood cells that carry oxygen to all parts of your body. Folate-deficiency anemia is most common during pregnancy, but may also occur if you are an alcoholic or take certain medications to treat seizures, anxiety, or arthritis, explains the U.S. Office on Women’s Health. Symptoms may include fatigue, headache, weakness, paleness, sore mouth, and tongue. Discuss any symptoms with your doctor to see if you are anemic, says Dr. Young. These are some silent signs of anemia that should you never ignore.

You are in menopause

It’s true: Women who have gone through menopause still need 400 micrograms of folic acid every day. Dr. Wu cautions that experts do not recommend folic acid to treat menopausal symptoms such as hot flashes and night sweats. These are 15 signs that may suggest menopause is near.

You have this genetic mutation

Some people are born with a genetic flaw that interferes with your body’s ability to convert folic acid into folate. “Individuals with a methylene-tetrahydrofolate reductase (MTHFR ) gene mutation have a hard time processing folic acid and may need to take additional amounts of this B vitamin,” explains Dr. Young says. Talk to your doctor about your folic acid needs.

You are at risk for heart disease or stroke

Folic acid helps to lower levels of homocysteine, an amino acid that has been linked to heart disease and stroke when it is present in abundance, according to the American Heart Association. That said, the group does not recommend widespread use of B vitamin supplements to reduce this risk—at least not yet. Instead, the group advises eating a healthy diet rich in fruits and vegetables, whole grains, and lean protein as the best way to lower your risk for heart disease and stroke.

You are facing certain mental health problems

B vitamins—including folic acid—may help maintain concentration skills among people experiencing a first episode of psychosis, according to a study that was published in Biological Psychiatry. In the study, people with schizophrenia who got a B-vitamin supplement that included folic acid performed better at concentration and attention tasks than their counterparts who were given fake pills.

You can get too much of good thing

Folic acid and folate are essential for good health, but it is possible to overdo it. Don’t take more than 1,000 mcg of folic acid a day unless your doctor prescribes it, warns the US Office on Women’s Health. Too much folic acid can mask a vitamin B12 deficiency, which can cause nerve damage.

It would be difficult to overdo it on folate, but fortified foods and supplements can push you over the limit if you don’t watch your diet. For example, many fortified breakfast cereals have 100 percent of the recommended daily value or 400 mcg of folic acid in each serving.