Getting Enough Folic Acid

Topic Overview

What is folic acid?

Folic acid is one of the B vitamins your body needs for good health. Getting enough of this vitamin prevents folic acid deficiency anemia. It also prevents certain birth defects.

The vitamin is also called folate, but there is a difference:

  • Folate is the natural form of this vitamin. It's found in food.
  • Folic acid is the man-made form. It's put into vitamin pills and fortified foods, such as fortified breakfast cereals.

Most people just say "folic acid" for either form of this vitamin.

What is the recommended daily amount of folic acid?

Most people can get the amount of folic acid they need by eating a well balanced diet.

Daily recommended folic acid:1
Category Age Daily amount of folic acid

Babies

0–6 months

65 mcg (micrograms)

7–12 months

80 mcg

Children

1–3 years

150 mcg

4–8 years

200 mcg

9–13 years

300 mcg

Older children and adults

Over 13 years

400 mcg

Do some women need more folic acid?

Although the recommended amount of folic acid for all adults is 400 mcg a day, many doctors recommend higher amounts for women who are able to get pregnant. This is because folic acid plays a big role in preventing birth defects.

Women who don't get enough folic acid before and during pregnancy are more likely to have a child born with a birth defect, such as:

Folic Acid Supplement Recommendations for Women
Category Daily amount of folic acid (folate)

Pregnant women2

600 mcg

Breast-feeding women2

500 mcg

Women who are able to get pregnant3

400 mcg to 800 mcg

If you're breast-feeding, getting this extra folic acid will make sure that your baby gets the folic acid he or she needs to stay healthy.

Here's an odd fact: The man-made form of this vitamin is actually absorbed better by our bodies than the natural form is. So even if a woman eats a well balanced diet, she may not get the extra folic acid she needs to prevent birth defects unless she also takes a supplement.

It can be hard for women to get extra folic acid from food. So experts say that all women who are able to get pregnant should take a daily supplement that has 400 to 800 mcg of folic acid.3

Some women need even higher doses.

  • Women who are pregnant with twins or more should take 1000 mcg a day.4
  • Women who have a family history of neural tube defects, who have already had a baby with a neural tube defect, or who are on medicines for seizures should take 4000 mcg a day. 5

Follow your doctor's advice about how to get higher amounts of folic acid. Don't just take more multivitamins. You could get too much of the other substances that are in the multivitamin.

What if you're not planning to get pregnant right now, or ever?

Even if you aren't planning to get pregnant, your doctor may recommend a daily supplement.

Many pregnancies aren't planned. And the birth defects that folic acid can prevent start to form in the first 6 weeks of pregnancy. This is often before a woman even knows she's pregnant.

So you can see why getting enough daily folic acid—even before you get pregnant—is so important. If you are pregnant and you have not been taking a vitamin containing folic acid, begin taking it right away.

What foods contain folic acid?

Foods high in folate include liver, citrus fruits, dark greens like spinach, and fortified breakfast cereals and breads. Read food labels to see how much folate the food contains.

Estimates of folic acid in certain foods6
Food Serving size Folic acid amount

Fortified (with 100% of daily requirement) breakfast cereal

1 cup

400 mcg or more

Spinach, cooked

1 cup

230 mcg

Beef liver, cooked

3 oz

215 mcg

Frozen peas, boiled

1 cup

94 mcg

Asparagus, boiled

4 spears

89 mcg

Enriched white rice, cooked

1 cup

154 mcg

Frozen broccoli, cooked

1 cup

168 mcg

Strawberries

1 cup

40 mcg

Orange

1 small

39 mcg

Lentils, cooked

1 cup

358 mcg

Enriched macaroni, cooked

1 cup

167 mcg

Folic acid tips

  • Breads, breakfast cereals, and pasta are often fortified with folic acid. Read labels for the folic acid amount.
  • Eat vegetables raw or lightly steamed. Cooking may destroy some of the folic acid found in food.
  • Multivitamins often contain folic acid.

References

Citations

  1. Food and Nutrition Board, Institute of Medicine (2011). Dietary reference intakes (DRIs): Recommended dietary allowances and adequate intakes, elements. Available online: http://iom.edu/Activities/Nutrition/SummaryDRIs/~/media/Files/Activity%20Files/Nutrition/DRIs/New%20Material/2_%20RDA%20and%20AI%20Values_Vitamin%20and%20Elements.pdf.
  2. Food and Nutrition Board, Institute of Medicine (2012). Dietary reference intakes (DRIs): Recommended dietary allowances and adequate intakes, vitamins. In LK Mahan et al., eds., Krause's Food and the Nutrition Care Process, 13th ed. St Louis: Saunders.
  3. U.S. Preventive Services Task Force (2009). Folic acid to prevent neural tube defects. Available online:
  4. Cunningham FG, et al. (2010). Multifetal gestation. In Williams Obstetrics, 23rd ed., pp. 859–889. New York: McGraw-Hill.
  5. Cunningham FG, et al. (2010). Prenatal care. In Williams Obstetrics, 23rd ed., pp. 189–214. New York: McGraw-Hill.
  6. Office of Dietary Supplements, National Institutes of Health (2010). Dietary Supplement Fact Sheet: Folate. Available online: http://ods.od.nih.gov/factsheets/Folate-HealthProfessional.

Other Works Consulted

  • Finer LB, Henshaw SK (2006). Disparities in rates of unintended pregnancy in the United States, 1994 and 2001. Perspectives on Sexual and Reproductive Health, 38(2): 90–96.
  • U.S. Department of Agriculture, Agricultural Research Service (2012). Nutrient data laboratory. USDA National Nutrient Database for Standard Reference, Release 25. Available online: http://ndb.nal.usda.gov.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Joseph O'Donnell, MD - Hematology, Oncology
Last Revised December 18, 2012

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