Pre-Natal Peace of Mind:
And Other Benefits of Folic Acid
By: Nancy Webster
After massaging countless pairs of names to prepare for the birth of our twins, my husband and I had settled on Grace and Rachel if we were blessed with two girls. Whoever came out first would be Grace. But when Greg held “Twin A,” the name “Rachel” felt more right to him. Within a few days we would realize why “Twin B” would need an extra measure of God’s grace.
After the Friday morning birth, I spent the weekend reveling in the wonder of having delivered the twins that I had prayed for nine months before. My husband spent the weekend secretly studying books and online sources about infant abnormalities. When he first held Twin B, he thought he saw something different about her eyes.
What he saw was Down syndrome. The midwife attending the birth had missed it. Our delivering obstetrician hadn’t noticed and none of the nurses at the hospital detected anything different about Grace. But at the twins’ Monday morning post-natal check-up, our pediatrician confirmed Greg’s suspicion.
Now 13, our twins are a delightful pair, if strikingly different from one another. Rachel rides pony trails and climbs mountains while Grace tours the zoo in a wheelchair, because severely flat feet make her legs and hips ache after much walking. Rachel catches on quickly while simple, often-repeated activities frustrate Grace into blank stares. Rachel’s alto contributes handsomely to classical performances of the local children’s community choir, while Grace can only attend performances.
Of course, Grace would not be Grace if she didn’t have her Down syndrome. Without her, we would miss out on the mysterious, masking-taped presents of a toilet paper tube, a rock, or utensil from the kitchen–accompanied by her standard card, a crayoned picture of a multi-layered cake with candles, signed “GRCE.” And we might take for granted her mastery of reading a new word.
Still, if there was something I could have done to prevent her Down syndrome, I would have done it. There’s no denying life is harder–and maybe burdened with a few more inexpressible disappointments—for Grace.
At the time Grace and Rachel were conceived, I was homeschooling four children, ages two to eight. My oldest daughter needed speech and occupational therapy, which meant hauling the entire crew back and forth to tri-weekly sessions. One son suffered gastrointestinal problems, which entailed specialist visits and many home treatments.
Although by the time I’d learned quite a bit about healthy eating, life was so huge that fish sticks and tater tots made their way onto our table far too often. I knew we should do better with our eating, but Real Life was so overwhelming, it couldn’t happen as I wanted. I didn’t even remember to start taking pre-natal vitamins until four or five months into the twin pregnancy.
The Folic Acid Connection
Researchers have found that nearly 60% of mothers of children with Down syndrome have a genetic mutation that impairs the mother’s ability to metabolize folic acid. “Maternal non-disjunction” occurs before conception and is responsible for 95% of all Down syndrome cases. Mothers of babies with neural tube defects like spina bifada and anencephaly have a similar problem metabolizing folic acid.
Folic acid is the synthetic version of folate, vitamin B9. Found naturally in leafy greens, citrus, liver, tuna, eggs, and legumes, among other foods, folate is necessary for synthesis of DNA, RNA and proteins, and for the production and maintenance of all new cells. The body’s requirement for this vitamin increases during periods of rapid growth, such as pregnancy and fetal development. As a result, since 1992, the U. S. Public Health Service recommends that all women who might become pregnant should take a minimum of 400 micrograms of folic acid supplement per day. Studies suggest that if all women did this, the risk of neural tube defects would be reduced by up to 70%.
Waiting until you’re expecting a baby is not good enough. It takes up to a year to build up reserve of this vitamin, and the lack of folic acid at conception may result in brain and spinal cord damage as the fetus develops. Folic acid supplements taken for at least a year before conceiving is also associated with a 70% reduction in premature births between 20 and 28 weeks and a 50% reduction between 28 and 32 weeks. Another benefit of folic acid is protection against congenital cleft lip (with or without a cleft palate). It is estimated that 1/3 of facial clefts can be avoided with the help of folic acid.
Dads are not off the hook here, either. There’s a connection between folic acid and chromosomal abnormalities in men’s sperm. Men who consume high levels of folate or folic acid tend to have fewer sperm in which a chromosome is lost or gained. Extra or missing chromosomal material causes genetic abnormalities like Down, Turner’s, and Klinefelter’s syndromes. As with moms, future dads should consume at least 400 micrograms of folic acid per day for a minimum of three months prior to conception.
You are more at risk of preclampsia, placental abruption, fetal growth restriction, or even fetal death if you take medicines for epilepsy, mood disorders, hypertension, or infections because these medications are folic acid “antagonists.” You may require more than the usual recommendation of folic acid to counteract these bad effects.
Folic Acid- Mixed Reviews
In cancer research, there’s good news and bad about folic acid. On the good side: It counteracts cancer by strengthening chromosomes. Folic acid helps prevent colon cancer in men, and a study at Harvard Medical School found it can reduce women’s colon cancer rates by 75 percent.
However, too much folic acid can be a problem. While maintenance levels seem to offer protection against prostate cancer, too much folic acid may actually increase chances of prostate cancer. In other mixed news, studies show that people who get sufficient folic acid reduce their risk of developing colorectal cancer and precancerous polyps by 40 to 60 percent. On the other hand, one researcher estimates that ingesting too much folic acid may cause an extra 15,000 cases of colorectal cancer each year in the US and Canada.
Folic Acid intertwines with vitamin B12 in many body processes, including synthesis of DNA, red blood cells, and the myelin sheath which insulates nerve cells and helps conduct signals throughout the nervous system. But, again, too much folic acid in the interaction can worsen a vitamin B12 deficiency. This problem is common in older patients and causes dementia and other complications like depression, apathy, withdrawal, and lack of motivation. Taking a combination of the two vitamins protects against this problem.
Vegetarians, whose diets tend to be especially high in folate-rich green vegetables and folic-acid fortified grains, are prone to vitamin B12 deficiencies. Because the body stores a good amount of B12 in the liver, though, there may be a delay of 5 to 10 years between the start of a vegetarian diet and the onset of deficiency symptoms.
Folic acid supplements offer good news to people over 50 through improved mental performance and memory. A study of adults age 50 to 70 who had low levels of folate were given folic acid supplements for three years with the result that memory, reaction speeds, information processing, and overall thinking tested similar to that of people two to five years younger.
In addition, a folate deficiency elevates homocysteine levels which contribute to heart disease and stroke. Folic acid supplementation is beneficial in preventing these cardiovascular problems. But too much folic acid throws these levels off in the other direction.
Allergy sufferers will likewise want to be sure their folic acid intake is good. Patients consuming higher levels had fewer antibodies that trigger immune responses such as allergies and asthma.
Folic Acid– The Sources
Since 1996, the USDA has required cereals and grains to be fortified with folic acid to ensure folks get an adequate amount of this vital nutrient. Although this has show a reduced incidence of babies born with neural tube defects, it’s wise for prospective parents to supplement with folic acid as extra insurance– especially mothers who already have a child or two (or more!) and may be depleted.
So how much should you take? Because folic acid is a water-soluble vitamin, it is hard to overdose. The ideal dosage is between 400-800 micrograms per day for all populations. This will be safe for you unless your favorite daily snack is liver, which contains 170-190 micrograms for every three ounces!
Healthy bodies seem only able to process a maximum of 1000 mcg/day. Above this, some people report itchiness and rarely, gastrointestinal discomfort or insomnia. Sometimes doctors prescribe up to 4000 micrograms per day of folic acid supplementation for special cases, like a jump-start in healing certain anemias, or for mothers planning another pregnancy when they’ve borne a child with a neural tube defect. The folks at Beeyoutiful urge medical supervision before consuming mega-doses.
The Weston A. Price Foundation recommends getting the necessary pre-natal nutrition (also good for people of any age!) from properly prepared, nutrient-dense foods. This includes organic liver and other organ meats, seafood, eggs, and the best quality butter, cream and fermented (preferably raw) milk products you can find. Organic meats, vegetables, grains, and legumes should round out the diet, with a special emphasis on leafy green vegetables. (For more about the ideal way to prepare and eat foods, I’ll recommend yet again the excellent book by Sally Fallon, Nourishing Traditions, available from Beeyoutiful.)
Healthy meal preparation too often collides with Real Life making a thoroughly healthy diet difficult to achieve regularly–which is where the importance of using the right supplements come in. For those in their child-bearing years, the elderly, allergy sufferers, heart patients, and people taking medicine for epilepsy and mood disorders, supplemental folic acid intake is essential. You can get it through Beeyoutiful’s SuperMom and SuperDad vitamins as well as Beeyoutiful’s separate Folic Acid tablets which contain an ample 800 mcg. of folic acid, plus 25 mg. of B12. Whatever your stage of life, knowing you’re getting the rewards of proper folic acid intake will add to your peace of mind.
Nancy Webster is a free-lance writer, homeschool mother of eight, and an avid researcher on health and nutrition. She lives with her family on their partially working farm in Tennessee. Nancy and her husband Greg’s sixth child Grace (smiling atop their old Belgian horse) is a big sister to a brother and sister who do not have Down syndrome or neural tube defects. The Websters believe siblings are the best gift you can give your child with Down syndrome. Nancy has recently started the Southern Middle Tennessee chapter of the Weston A. Price Foundation (see Nourishing Traditions in the Beeyoutiful book section for more about the WAP Foundation.)