If you would like to download a copy of our folic acid self-care aware fact sheet, click on the image.
This fact sheet is for women who are planning to have children. It will help you understand what folic acid is, why it is important and how to eat enough of this essential nutrient.
What is folic acid?
‘Folate’ is a naturally occurring, water-soluble vitamin also known as folacin or vitamin B9. (1)
‘Folic acid’ is the manufactured version of folate that is used in most supplements and in fortified food.
They both work in a similar way. Folate is needed to make red blood cells and the genetic material DNA (2) allowing cells to replicate. It is also important for nerve function. Everyone needs enough folic acid, but more is needed before and during pregnancy because requirements are increased.
Why is folic acid important?
Folic acid and folate are measured in micrograms. The symbol for micrograms looks like this: μg.
The World Health Organization and most governments advise women who are planning to become pregnant to take 400μg of folic acid for 3 months before pregnancy, and for at least the first 3 months of pregnancy. This helps to protect the unborn child from birth defects which are caused by the neural tube not forming correctly (neural tube defects or NDT) resulting in a spinal malformation called spina bifida.
The neural tube is where the brain and spinal cord develop. It starts as an open tube in the first 4 weeks of pregnancy when most women don’t even know they are pregnant. Without enough folic acid the neural tube cannot close properly. The open tube can leave the baby’s brain and spinal cord exposed at birth and this can only be closed with surgery.(3)
Which foods contain folic acid?
Folate is naturally found in a wide variety of foods, and some foods are fortified with folic acid. Good sources include:(1)
- Green leafy vegetables including: broccoli, brussel sprouts, cabbage, kale, spring greens, spinach.
- Beans and legumes including: chickpeas (eg hummus), kidney beans, peas, lentils, blackeye beans, edamame beans.
- Fortified foods including: breakfast cereals fortified with folic acid (check the label)
- chickpeas and kidney beans
- Beef and yeast extracts eg marmite
- Eggs
- Orange juice and oranges
- Wheat bran and other wholegrain foods
- Poultry, pork, shellfish and liver.
Because folate is water soluble it is lost from food if boiled in water. Steaming and microwaving reduces this loss. Always cook for minimum time needed or eat the food raw.
You may have greater risk if:
-you or the baby’s biological father have a neural tube defect or a family history of neural tube defects
-you have had a previous pregnancy affected by a neural tube defect
-you have diabetes
-you take anti-epilepsy medicine
-you take anti-retroviral medicine for HIV
-you have sickle-cell disease, thalassaemia or thalassaemia trait (in which case you should take 5mg throughout your pregnancy)
-you have a BMI of over 30
-you have inflammatory bowel disease
If any of these applies to you, talk to a health care professional soon. They can prescribe the higher dose of folic acid.
200-400μg supplements are widely available from pharmacies, supermarkets and health food shops.
Eating a varied well-balanced diet with plenty of fruit and vegetables every day should provide the amount recommended for the general population 200μg. Folate is not stored in the body so these foods should be eaten regularly and frequently.
Food fortification with folic acid
In November 2024 the UK government introduced legislation which will mean all non-wholemeal wheat flour is fortified with folic acid from the end of December 2026.
This legislation is designed to reduce the occurrence of neural tube defects. Approximately half of all pregnancies in the UK are unplanned (5) so the women do not know to take the recommended supplements. Food fortification of a commonly eaten ingredient (wheat flour) will increase everyone’s folic acid intake and make sure women of childbearing age have a higher level of folate at conception, better protecting their unborn child.
The recommendations outlined above to consume more folic acid before and during pregnancy will remain.
Can I take too much folic acid?
Because folic acid is a water soluble vitamin it is a very safe substance. It is safe with a daily intake of up to 1,000μg (or 1 milligram) is safe. (7) (8)
The main risk is that high intakes of folic acid may mask vitamin B12 deficiency anaemia. The higher doses which may be prescribed for people at high risk of neural tube defects (up to 5mg) should be monitored by a health professional.
If you have vitamin B12 deficiency you should not take a folic acid supplement unless advised by your doctor.
We review our health information every two years and this information is due to be updated in October 2028.
Here are references used in producing the folic acid fact sheet
- Hoffbrand A.V. (2001) The History of Folic Acid; British Journal of Haematology; 579-589
- British Dietetic Association; Folic Acid Fact Sheet, 2016.
- Yi Y., Lindermann M., Colligs A., Snowball C. (2011) Economic burden of neural tube defects and impact of prevention with folic acid: a literature review. European Journal of Pediatrics 170(11): 1391–1400 doi: 10.1007/s00431-011-1492-8
- Public Health England, NDNS results from years 7-8 (combined). Accessed December 2018.
- Scientific Advisory Committee on Nutrition (2017) Paper for discussion: timing of folic acid supplementation for prevention of neural tube defects (NTDs). London: Scientific Advisory Committee on Nutrition.
- NICE, Maternal and Child Nutrition Public Health Guideline 2014. Accessed December 2018.
- Safe upper levels of vitamins and minerals 2003; Expert Group on Vitamins and Minerals. Food Standards Agency. Accessed January 2019
- Field M.S, Stover P.J. (2018) Safety of Folic Acid. Annals of the New York Academy of Sciences 1414(1):59-71 doi: 10.1111/nyas.13499
Further references
- Hibbard B. M., Hibbard E.D., Jeffcoate T. N. A. (1965) Folic Acid and Reproduction, Acta Obstetricia et Gynecologica Scandinavica, 44:3, 375-400, DOI: 10.3109/00016346509155874
- Wald N., Sneddon J. (1991) Prevention of neural tube defects: Results of the Medical Research Council Vitamin Study. The Lancet Vol. 338 Issue 8760, p131
- Action Medical Research for Children; accessed December 2018
- SHINE: Prevention, Folic Acid. Accessed December 2018
