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Folic acid supplements

Half of all pregnancies in the United States are unplanned. Therefore, clinicians should advise all women who are capable of pregnancy to take daily folic acid supplements. The critical period for supplementation starts at least 1 month before conception and continues through the first 2 to 3 months of pregnancy.

Who is at risk

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, many cases occur in the absence of any personal or family history.

Although all women of childbearing age are at risk of having a pregnancy affected by neural tube defects and should take folic acid supplementation, some factors increase their risk, including a personal or family history (first- or second-degree relative) of neural tube defects. Other risk factors include the use of particular anti-seizure medications (e.g., valproic acid or carbamazepine), maternal diabetes, obesity, and mutations in folate-related enzymes.

This recommendation applies to women who are planning or capable of pregnancy. It does not apply to women who have had a previous pregnancy affected by neural tube defects or who are at very high risk due to other factors (e.g., use of certain anti-seizure medications or family history). These women may be advised to take higher doses of folic acid.


You may have a deficiency if:

  • You frequently get sick.
  • You have chronic low energy.
  • You have issues like constipation, bloating, and IBS.
  • You are anemic.
  • You have canker sores and a tender, swollen tongue.
  • You have pale skin.
  • Your hair is prematurely graying.

What you can do

It is also used to fortify cereal grain products. Folate occurs naturally in foods such as dark green leafy vegetables, legumes, and oranges. However, most women do not receive the recommended daily intake of folate from diet alone.

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Women who are planning or capable of pregnancy

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 to 800 µg) of folic acid.

Why taking a supplement is important

Neural tube defects are major birth defects of the brain and spine that occur early in pregnancy due to improper closure of the embryonic neural tube, which may lead to a range of disabilities or death. The most common neural tube defects are anencephaly (an underdeveloped brain and an incomplete skull) and spina bifida (incomplete closing of the spinal cord).


Folic acid is the synthetic form of folate, a water-soluble B vitamin (B9). Folic acid is usually given as a multivitamin, prenatal vitamin, or single supplement.