Folic acid needs to be supplemented, but excessive intake is not advisable

Folic acid needs to be supplemented, but excessive intake is not advisable

Author: Yu Hong, Deputy Director and Pharmacist of the Pharmacy Department of Dalian Women and Children's Medical Center Group Sports New City Campus

One day, a pregnant woman came to the window to get iron supplements, compound ferrous sulfate folic acid tablets. The pregnant woman asked the pharmacist: The iron supplement prescribed by the doctor contains folic acid. I am taking Kingsleyan. Can I take it at the same time? After some inquiries, the pharmacist learned that the patient was not a folic acid deficiency patient. The folic acid content in Kingsleyan was 0.4mg. The pharmacist then suggested that Kingsleyan be discontinued and that only compound ferrous sulfate tablets be taken to ensure the daily requirement of folic acid.

As we all know, folic acid plays an important role in preventing neurospinal malformations for pregnant women and those preparing for pregnancy. However, people often know very little about the dosage of folic acid supplementation, and excessive supplementation may be risky. Let's discuss this together today.

How much folic acid should pregnant women take?

In view of the low level of folic acid in women of childbearing age in my country and the risk of folic acid deficiency during pregnancy, my country has formulated a folic acid supplementation reference plan suitable for the Chinese population. The "Guidelines for Peri-conception Folic Acid Supplementation to Prevent Neural Tube Defects (2017)" provides corresponding folic acid supplementation recommendations for different populations:

For women without high-risk factors: It is recommended to supplement 0.4 mg or 0.8 mg of folic acid daily starting from the time of possible pregnancy or at least 3 months before pregnancy until the 3rd month of pregnancy. The supplementation dose for women with risk factors is as follows:

In this prescription, compound ferrous sulfate and folic acid tablets are a compound preparation, each tablet contains 1 mg of folic acid. The Kingsleyan used by the patient daily contains 0.4 mg of folic acid. For pregnant women who normally supplement folic acid, the folic acid content in compound ferrous sulfate and folic acid tablets is sufficient. If used at the same time, it will cause duplication of medication, so the pharmacist does not recommend taking Kingsleyan at the same time.

What are the risks of taking too much folic acid?

When taking large amounts of folic acid, urine may turn yellow. In addition, oral administration of large doses of folic acid may affect the absorption of the trace element zinc. The "Chinese Multidisciplinary Expert Consensus on Rational Clinical Folic Acid Supplementation (2020)" states that the effective and safe dose of folic acid supplementation for the general population is 0.4-1.0 mg/d. It should be noted that long-term large-dose (> 1 mg/d) folic acid supplementation (including folic acid-fortified foods) may pose health risks, such as increasing the risk of certain cancers (such as colorectal cancer and prostate cancer), masking the early manifestations of vitamin B12 deficiency, aggravating degenerative lesions of the nervous system, interfering with other drugs, affecting zinc absorption, reducing folic acid absorption rate, and reducing immunity.

From this point of view, although folic acid is indispensable for pregnant women, excessive intake is not advisable. You can also supplement folic acid in your daily diet by consuming some foods containing folic acid, such as green leafy vegetables, animal liver, lean meat, eggs, soy products, etc.