How much folic acid is enough folic acid?
December 19, 2017 1:09 PM   Subscribe

My husband and I have decided to start trying for a baby soon. Yay! I've read that women who are trying to get pregnant should take folic acid even before conception. I've already been taking a multivitamin for general health purposes for about a month now. It says it has 600 mcg of folate (150% of the RDA). Compare this to a prenatal vitamin which says it has 1 mg of folate.

YANMD, but: do I switch to prenatals now? Or when there's a confirmed pregnancy?

I'd rather finish this bottle of multis before I go buying more vitamins, but of course, I will pick up a bottle of prenatal vitamins if that's what is better (and to that end, I am also looking for recommendations for vegetarian prenatals, preferably a brand that's available on Amazon).

Thank you.
posted by spicytunaroll to Health & Fitness (18 answers total) 3 users marked this as a favorite
1mg is 1000 mcg. the multivitamin has just over half the folate that the prenatal does. you can probably buy folic acid to supplement if you want that boost before you run out.
posted by koroshiya at 1:26 PM on December 19, 2017

Hi there,

The CDC recommends 400 micrograms of folic acid per day for women who are capable of becoming pregnant. They also recommend a diet rich in folate (beans, peas and lentils, oranges and orange juice, asparagus and broccoli, and dark leafy green vegetables such as spinach, and mustard greens.) If you have a family history of neural tube defects or have had a previous pregnancy with a neural tube defect, you should see a doctor who will tell you to take 4000 micrograms (or 4 mg) of folic acid per day. 1 mg is the maximum recommended dose for women with no history of neural tube defects.

Thus, it seems that 600 mcg/.6 mg is in excess of the CDC recommendation in terms of folate and you should be fine. However, I'm one of those overly prepared people and vitamins aren't that expensive so I would probably switch to prenatals. I don't have any recommendations for vegetarian prenatals in particular, but my wife found gummy prenatals to be much more palatable than the 'giant horse pills'.

As per the CDC page you are supposed to switch to prenatals as soon as you start trying because the neural tube will form before you know for sure you are pregnant.

Anyway, good luck with all of this! If you don't trust some random dude off the internet, you'll probably need to find an OB/GYN soon anyway, and you can always ask him or her ...
posted by Comrade_robot at 1:29 PM on December 19, 2017 [4 favorites]

Mayo Clinic says "Adult women who are planning pregnancy or could become pregnant should be advised to get 400 to 800 mcg of folic acid a day." so you are probably getting enough in your multivitamin to decrease your chances of the birth defects affected by folic acid deficiency.

That said, you might want to switch to prenatals sooner than later because some people don't tolerate them super well, so you might want accustom yourself or try different brands before you're also dealing with morning sickness.
posted by vunder at 1:32 PM on December 19, 2017 [3 favorites]

Yes, you switch to prenatals now.
posted by DarlingBri at 1:34 PM on December 19, 2017

If you are worried, you could always add a 400mg folic acid supplement like this one -- folic acid-only pills are super cheap. I personally did not switch to a prenatal-specific multivitamin until after I found out I was pregnant, although I did supplement with extra folic acid. I talked to my doctor about it, and she said the folic acid is the only thing that's really important to be taking before you find out you are pregnant. But prenatal multivitamins are expensive and you could be trying for a while (it took us 7 months), so it seemed like a waste to do the entire multivitamin for that whole time when the folic acid-only version is way more affordable.
posted by rainbowbrite at 2:01 PM on December 19, 2017

I think our doctor told my wife to start taking prenatal vitamins even before we started trying to conceive. Maybe give the regular multvitamins to your husband?
posted by any portmanteau in a storm at 2:01 PM on December 19, 2017 [1 favorite]

Oh and I see you’re asking for recommendations: I used Rainbow Light One.
posted by vunder at 2:47 PM on December 19, 2017

I like Gummy Vites prenatal or the equivalent generic from Target. Surprisingly tasty. I am not in front of the bottle so I don't know if they are vegetarian. You can definitely take them pre-pregnancy.
posted by radioamy at 3:08 PM on December 19, 2017

Take the prenatals. The others will still be good after you've had the baby. Any pharmacist can tell you which brand to take. Also, prenatal vites usually have the iron you will need. And you will need it.
posted by Enid Lareg at 3:56 PM on December 19, 2017

for what it's worth, all the number-tossing above being what it may, my fertility doctor told me to switch to prenatal vitamins as soon as we started, and the main reason was that the 400mcg of folic acid wasn't enough. so I'd switch now and save the others for After.
posted by acm at 3:58 PM on December 19, 2017 [1 favorite]

Huh. We are in a similar state, my gyno said using up my multis first was fine. Especially since prenatals make me nauseated. Y'all having me doubt myself now.
posted by St. Peepsburg at 4:38 PM on December 19, 2017

If you're interested in a vegetarian prenatal vitamin because you're a vegetarian, you should probably switch sooner rather than later for the iron supplementation offered in prenatal formulations, too. (Note: Gummy prenatal vitamins rarely contain iron.)
posted by Iris Gambol at 5:17 PM on December 19, 2017

Firstly, IANAN (I am not a nutritionist), and recommend checking with your care provider(s) about your options.

Folic acid is a synthetic form of folate. Some people (there is some disagreement about the % of the population) possess a MTHFR gene mutation (a methylation fault) which causes them to be unable to turn folic acid into folate because they do not produce enough dihydrofolate reductase -- folic acid is not a good fit for these folks. There are a limited number of seats on the "folate schoolbus" -- if folic acid is taking up those seats, and your body can't process it, there's no room left for active folate from folate-rich foods or other supplements.
I suggest you look into prenatal vitamins containing natural folate supplements, which are derived from nonsynthetic sources. Look for products that list 5-methyltetrahydrofolate, or 5-MTHF, on the label. Thorne Research Basic Prenatal is popular, vegetarian, and available on Amazon, in addition to containing 5-MTHF.
posted by sutureselves at 6:31 PM on December 19, 2017

Thorne is also nice because the serving size is 3 capsules, rather than one large tablet (see "giant horse pill" reference above, a real downside to some prenatal vitamins).
posted by Iris Gambol at 6:39 PM on December 19, 2017

Anecdata: my gyno recommends taking folic acid as soon as you decide to start trying, says it helps to conceive. I have no idea about the validity of that claim, but I was taking folic and got pregnant on the first try, soooo...
posted by gakiko at 11:49 PM on December 19, 2017

Thanks, MeFi! I wasn't expecting the response to be so overwhelmingly on the "start the prenatals now" side. I was thinking it'd be perfectly okay to finish out the multivitamins first, but hey, you learn something new everyday.

Just happened to be close to a drugstore yesterday, and was able to pick up some vegetarian prenatals which are chewable so yay for no horse pills - I would prefer gummies as well, but they don't make those vegetarian AFAIK.

We've basically decided to wait a couple of months to actively start trying anyway, but open to any happy accidents that may occur between now and then, so bring on that extra 400 mcg, I say.

It's funny because just a month ago, I was contemplating buying some prenatal vitamins solely for the purposes of getting better hair and nails, and I read then that they're not recommended for women who aren't trying to get pregnant, and well, I wasn't at that time, so that's when I just opted for a multi.

FWIW, not actually vegetarian, but have religious dietary restrictions surrounding gelatin.
posted by spicytunaroll at 6:52 AM on December 20, 2017

If the religious dietary restriction happens to be needing a kosher product, there are kosher prenatal gummy vitamins (one example -- folic acid rather than folate, unfortunately).

There are pre-conception supplements recommended for hopeful dads, too, to improve sperm quality and motility -- vitamin C and zinc are the ones that I'm aware of; depending on your husband's age, co-enzyme q10 (as ubiquinol) may be another. He could consult his healthcare provider while you're in this planning stage. Best wishes.
posted by Iris Gambol at 11:05 AM on December 20, 2017

FYI, if you are in the US, prenatal vitamins/folic acid supplements are almost certainly 100% covered by your health insurance (thanks, Obama!). YMMV as to whether getting a prescription and getting your vitamins refilled at the pharmacy is worth saving the few bucks vs. grabbing the same generic drugstore vitamins off the shelf.
posted by teditrix at 3:13 PM on December 20, 2017

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