Folic acid: It's not just for your baby’s health

It’s felt that if all women of reproductive age were to take 400 micrograms of folic acid, the incidence of this birth defect would decrease by 36 percent. In addition, estimates are that 4000 micrograms (4 milligrams) a day would decrease spina bifida by 82 percent. 

The CDC has recommended that all women who have had a pregnancy complicated by a neural tube defect take 4 milligrams a day of folic acid, and continue this through the first trimester in their next pregnancy.

What do women get with the typical prenatal vitamins?
These usually contain 1000 micrograms of folic acid (and a specific prescription is usually required to purchase them). Many doctors recommend that women who may get pregnant start prenatal vitamins before conception. It is not recommended to take a double dose (or more) of regular over-the-counter multivitamins to get the higher folic acid dose — these may contain too much vitamin A, a potential disaster, since doses of A higher than 5000 units can cause birth defects if taken during early pregnancy.

Can we get high-dose folic acid over the counter?
As noted, doses of 1000 micrograms or more usually require a prescription.  However, you can get the 400 microgram pills; they’re small, and if you take one or two of these and one multivitamin, your total dose (with appropriate diet), will then be at least 1000 micrograms. 

Bottom-line, how much folic acid should women take?
Once a woman becomes sexually active, she should take a multivitamin.  I suggest adding at least 400 micrograms of folic acid.  If she is trying to conceive (or is not sure of her contraception) she should talk to her doctor about adding much higher doses, up to 4000 micrograms.  If pregnancy is not (or no longer) an option, she should probably maintain a total dose of 1000 micrograms of folic acid.   That’s what I do.  Actually, I take one multivitamin and a tablet of 400 micrograms folic acid every day. 

Only on TODAY.MSNBc.com! Dr. Judith Reichman addresses your questions about women's health. LAST WEEK: Will removing my ovaries prevent cancer? GO TO ALL HEALTH TUESDAY COLUMNS

After menopause, her doctor should check her homocysteine levels, and if it’s high, her B-12 levels should also be checked, and if necessary, B-12 should be supplemented. Increasing doses of folic acid should be prescribed in order to get her homocysteine levels down to normal limits.

Folic acid is a vitamin supplement that, together with good nutrition and exercise, can help us maintain our health and the health of our progeny. 

Dr. Judith Reichman, the “Today” show's medical contributor on women's health, has practiced obstetrics and gynecology for more than 20 years. You will find many answers to your questions in her latest book, "Slow Your Clock Down: The Complete Guide to a Healthy, Younger You," which is now available in paperback. It is published by William Morrow, a division of HarperCollins.

PLEASE NOTE: The information in this column should not be construed as providing specific medical advice, but rather to offer readers information to better understand their lives and health. It is not intended to provide an alternative to professional treatment or to replace the services of a physician.

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