Folic acid(according to lat. Acidumfolicum), which has the trade name "Folacin", is a biologically inactive, water-soluble vitamin from group B (namely B9). It was discovered in 1930. The drug was originally named after the scientist who discovered it - "Wils Factor". Later, B9 was isolated from spinach leaves and named folic acid (in Latin folium - leaf, leaf).

Pharmacological properties

Folacin for medical purposes is produced artificially and sold in the form of tablets, dragees or capsules. Vitamin B9 is poorly absorbed in the human body, it is synthesized only in a very small amount in the large intestine. When consumed, folates are converted by cells into a biologically active form called tetrahydrofolate. It is thanks to him that the body produces the amino acids that a person needs.

Information about vitamin B9

Folates are found in fresh vegetables and fruits. People who prefer fresh herbs in their diet never complain about the lack of vitamin B9.

This vitamin contains plants such as:

Rich in vitamin B9 and fruits:

• citrus;
• bananas;
• apricots.

There are fewer folates in dairy or animal products, but in order for the body to receive them in sufficient quantities, it is worth consuming:

• liver;
• eggs (yolk);
• meat;
• fish;
• cottage cheese.

Vitamin B9 contains:

• beans;
• nuts;
• yeast;
• cereals (buckwheat, oatmeal);
• millet;
• wholemeal flour.

naturally occurring folate poorly absorbed by the body. That is why people who need them should take it in the form of medicines. Especially such vitamin medicines are shown:

• women planning a pregnancy;
• in the first trimester of pregnancy;
• people suffering from epilepsy;
• patients with diabetes;
• patients with bowel disease.

Indications for the use of folic acid

According to the instructions, B9 is prescribed for men and women suffering from iron deficiency anemia, as well as:

Children are prescribed vitamin B9 in the following cases:

• its deficiency in the child's body;
• in the treatment of anemia.

Folic acid intake by pregnant women

The benefits of vitamin B9 have been known for a long time, but only for the last ten years, doctors have prescribed folate for preventive purposes for pregnant women:

Sometimes, to enhance the effect of B9, they are prescribed together with other vitamins: B12, ascorbic acid. Such multicomponent preparations are more profitable to buy than several vitamins separately.

Folic acid contraindications

B9 preparations are not prescribed to patients:

• with increased sensitivity to the components;
• with oncology;
• in case of malabsorption of B vitamins;
• with a deficiency of cobalamin (vitamin B12);
• with hemosiderosis (impaired metabolism of iron-containing components).

In some cases, the following side effects folic acid:

• vomit;
• nausea;
• bitterness in the mouth;
• bloating;
• allergic reaction in the form of rash and itching.

The use of vitamin B9

Folates are poorly absorbed from foods prepared in their pure form. For example, to provide the body with a daily dose of vitamin B9, it is necessary to consume about 20 stalks of fresh asparagus. In artificial form, this vitamin is absorbed better, and it is quite inexpensive. You can take the drug long time- an overdose is unlikely, the component does not accumulate in the cells and is well excreted from the body.

Dosage of the drug

Vitamins B9 render g homeopathic effect on the human body and are available in the following dosage form:

• in the form of a powder - a dose of 1 mg;
• in drops - a bottle with a dosage of 30 ml;
• tablets - 25, 30, 60, 50 or 90 pcs. in a blaster, dosage of 1-2 mg;
• in the form of a dragee of 1 mg, used to prevent vitamin B9 deficiency in children;
• in injections - 1 ampoule contains 400 mcg of the active substance.

Indications for taking vitamin B9 and its daily doses prescribed for prophylactic purposes:

In the treatment of certain conditions caused by a lack of vitamins B9, it is necessary to adhere to strict doctor's prescriptions:

• with atherosclerosis in elderly patients;
• with celiac disease (digestion disorder);
• with gum disease, gingivitis, bad breath;
• with ulcerative lesions of the epidermis (folates are prescribed in combination with phenolic acid);
• during depression.

Preparations with folates and analogues with their content are indicated for use by all age categories. Here are some more recommendations for their use:

Description

Flat-cylindrical tablets from pale yellow to yellow color, with chamfer and risk. The presence of blotches of a darker and lighter color is allowed.

Compound

Each tablet contains active substance: folic acid - 1 mg; Excipients: powdered sugar, potato starch, stearic acid.

Pharmacotherapeutic group

Antianemic agents. Folic acid and its derivatives.
ATX code: B03BB01.

Pharmacological properties

Pharmacodynamics
Vitamin B group (vitamin B9) can be synthesized by the intestinal microflora. In the body, folic acid is reduced to tetrahydrofolic acid, which is a coenzyme involved in various metabolic processes. It is necessary for the normal maturation of megaloblasts and the formation of normoblasts. Stimulates erythropoiesis, participates in the synthesis of amino acids (including glycine, methionine), nucleic acids, purines, pyrimidines, in the metabolism of choline, histidine.
Pharmacokinetics
Folic acid, prescribed as a drug, is well and completely absorbed in the gastrointestinal tract, mainly in the upper
departments of the duodenum (even in the presence of malabsorption syndrome against the background of tropical sprue, at the same time, food folates are poorly absorbed in malabsorption syndrome). Intensively binds to plasma proteins. Penetrates through the BBB, the placenta and into breast milk. TCmax - 30 - 60 min.
It is deposited and metabolized in the liver with the formation of tetrahydrofolic acid (in the presence of ascorbic acid under the action of dihydrofolate reductase).
Excreted by the kidneys mainly as metabolites; if the accepted dose significantly exceeds the daily requirement for folic acid, then it is excreted unchanged.
Excreted by hemodialysis.

Indications for use

Treatment of macrocytic (folic acid deficiency) anemia.
Treatment of folic acid deficiency: a) with malabsorption syndrome (non-tropical and tropical sprue; celiac disease, subject to the impossibility of observing a gluten-free diet); b) in violation of the metabolism of folate against the background of the use of certain drugs (antiepileptics, combined oral contraceptives, cytostatics), with liver diseases and insufficient intake of folic acid (for example, alcohol dependence, malnutrition); c) with increased excretion of folic acid (for example, against the background of alcohol dependence, hemolytic anemia).
In pregnant women to prevent the development of defects in the formation of the neural tube in the fetus.

Contraindications

Hypersensitivity to the components of the drug (LS).
Pernicious anemia and other conditions associated with vitamin B12 deficiency, due to the fact that folic acid monotherapy can accelerate the onset of subacute degenerative changes in the spinal cord in this case. Taking folic acid as monotherapy for more than 3 months in such individuals leads to the development of cobalamin neuropathy. Shorter courses do not cause this complication. In the elderly, therefore, cobalamin absorption should be assessed before initiating folic acid therapy.
Folate-dependent neoplasms, unless severe megaloblastic or macrocytic anemia is a complication of ongoing anticancer therapy.

Dosage and administration

inside. Before eating. It is allowed to crush the tablet before taking it for children and persons who have difficulty swallowing.
Adults (including the elderly):
With a medical deficiency of folic acid - 5 mg per day for 4 months; with malabsorption - it is possible to use up to 15 mg daily.
For the prevention of anemia in chronic hemolytic status: 5 mg every 1 to 7 days, depending on the exacerbations of the disease.
Children with hemolytic anemia and metabolic disorders
In children under the age of 4 years, it is allowed to use tablets in a pre-crushed form in the form of a powder. Doses of folic acid in children are: at the age of up to 1 year 0.5 mg / kg (½ tablet per 1 kg of body weight) 1 time per day, but not more than 5 mg / day, at the age of 1 to 12 years - 2, 5 - 5 mg / day; over 12 years old - 5 - 10 mg / day 1 time per day.
For the treatment of macrocytic (folic acid deficiency) anemia, the following is prescribed: for adults and children of any age, the initial dose is up to 1 mg / day (1 tablet). Daily doses of more than 1 mg do not enhance the hematological effect, and most of the excess folic acid is excreted unchanged in the urine. In resistant cases, higher doses may be required. Initial doses are used for about 14 days or until a hematological and clinical response is obtained, then they are switched to maintenance treatment. The total duration of therapy can be about 4 months.
Maintenance treatment: for children under 4 years old: for infants - 0.1 mg / day, for children under 4 years old - up to 0.3 mg / day; children over 4 years old and adults - 0.5 mg (½ tablet), during pregnancy and lactation - 1 mg / day, but not less than 0.1 mg / day.
For established folic acid deficiency during pregnancy: 5 mg daily throughout pregnancy. For the prevention of neural tube defects in the presence of a history of malformations: 4-5 mg daily 1 month before the planned conception and for 3 months after it. In the absence of a history of neural tube defects (or other predisposing factors): 0.5 mg (½ tablet) daily for 10 to 12 weeks after the last menstrual period. During pregnancy, the appointment of folic acid in doses above 0.4 mg / day can be carried out only after malignant (pernicious) anemia associated with vitamin B12 deficiency has been excluded.
The duration of folic acid intake is not precisely defined, sometimes a multi-month course of taking the drug is required to resume and maintain normal hematopoiesis. In the case of elimination of the main causes of vitamin deficiency, improvement of the diet or elimination of concomitant diseases, the use may be terminated ahead of schedule. With concomitant alcoholism, hemolytic anemia, chronic infectious diseases, concomitant use of anticonvulsant drugs, after removal of the stomach, malabsorption of nutrients, liver failure, cirrhosis, stress, the dose of the drug should be increased and longer treatment may be required.

Side effect

Reactions from the immune system: rarely (from 1/1000 to 1/10000 cases) - skin rash, pruritus, urticaria, bronchospasm, erythema, hyperthermia, anaphylactic reactions (including shock).
From the gastrointestinal tract: rarely (from 1/1000 to 1/10000 cases) - loss of appetite, nausea, bloating and flatulence.
From the side of hematopoiesis: may mask manifestations of B12 deficiency anemia.
From the side nervous system: when taken in doses of more than 15 mg / day, sleep disturbance, problems with concentration, irritability, excitability, depression, confusion are possible. In people with epilepsy, an increase in the frequency of seizures is possible.

Precautionary measures

The drug is not intended for the prevention of hypo- and beriberi in children (due to the discrepancy between the daily requirement and dosage of drugs).
For the prevention of hypovitaminosis B9, a balanced diet is most preferable. Foods rich in vitamin B9 - green vegetables (lettuce, spinach), tomatoes, carrots, fresh liver, legumes, beets, eggs, cheese, nuts, cereals.
Folic acid is removed by hemodialysis, this should be taken into account in persons with severe renal insufficiency.
During treatment, the therapeutic effect should be monitored by laboratory tests and the diagnosis should be reconsidered in the absence of the expected effect. Serum potassium and iron/ferritin levels should be monitored.
Cobalamin metabolism should be established in all cases of pernicious anemia (not only during pregnancy).
Folic acid should not be used routinely in patients with coronary stents.
Caution should be exercised when prescribing folic acid to patients who may have folic acid-dependent tumors.
Folic acid at doses above 0.1 mg daily may mask pernicious anemia by improving haematological parameters, while neurological manifestations will progress. In this regard, folic acid is not used to treat B12-deficient (pernicious), normocytic and aplastic anemia, as well as anemia refractory to therapy. Until pernicious anemia is excluded, the appointment of folic acid in doses exceeding 0.1 mg / day is not recommended (with the exception of pregnancy and lactation).
When using large doses of folic acid, as well as therapy for a long period, it is possible to reduce the concentration of vitamin B12 (cyanocobalamin) in the blood. Long-term use of folic acid is recommended to be combined with vitamin B12 intake.
During treatment, folic acid should be taken 2 hours after taking antacids, as well as 1 hour before or 4 hours after taking cholestyramine.
It should be borne in mind that antibiotics can distort (deliberately underestimate) the results of microbiological assessment of the concentration of folic acid in plasma and erythrocytes.
The drug contains sucrose, which should be taken into account in patients with congenital fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase deficiency.

Use during pregnancy

The drug is used according to indications during pregnancy and lactation. Daily intake of folic acid for early dates pregnancy can prevent fetal neural tube defects (anencephaly, spina bifida). If the drug is started after the fourth week of pregnancy, folic acid is not effective in preventing neural tube defects.
Deficiency of the vitamin or its metabolites may also be associated with spontaneous abortions and intrauterine growth retardation.

Lactation

Folic acid is actively excreted in breast milk. The accumulation of folates in milk prevails over the needs of the mother's body in folic acid. Folic acid levels are relatively low in colostrum, but as lactation increases, the concentration of the vitamin increases. Adverse effects have not been observed in breastfed infants whose mothers received folic acid.
The total amount of folic acid in breast milk meets the needs of the child, although additional doses of folic acid may be needed for children with low birth weight, those who are breastfed by mothers with folic acid deficiency (50 mcg per day), or in children with prolonged infectious diarrhea.

There are several reasons why women need folic acid. Vitamin is important for the functioning of the nervous system, the condition of the skin, hair and nails. Folic acid is also essential for correct formation organs of the unborn child during pregnancy.

Vitamin characteristics

Folic acid belongs to the B vitamins. Its second name is vitamin B9. daily requirement healthy body in this trace element - 0.2-0.4 mg. The active metabolite of folic acid is tetrahydrofolate. It is involved in metabolic reactions, hematopoiesis, the formation of sex hormones. In the embryo, folic acid is responsible for the formation of the nervous system.

Why do women need folic acid - for healthy nerves and a successful pregnancy

What is useful acid for a woman

Vitamin is involved in ensuring the normal functioning internal organs. Without it, the formation of red blood cells is disrupted - anemia develops. Folic acid stimulates the formation of lymphocytes. These are the main cells of the human immune system. Vitamin provides protection against viruses, bacteria and fungi.

An important property of folic acid for women is to improve the functioning of the nervous system. Increases resistance to stress factors, normalizes the emotional background. There is a production of serotonin, which improves mood and reduces the risk of developing depression.

Participation in the functioning of the cardiovascular system is the normalization of cholesterol metabolism. Folic acid prevents the formation of atherosclerotic plaques, reduces the likelihood of developing a heart attack and stroke. Vitamin ensures the constancy of the normal intestinal microflora. This improves digestion and the functioning of the gastrointestinal tract.

Folic acid ensures normal growth and division of cells, being a preventative measure. oncological diseases and genetic disorders.

An important property of vitamin B9 for women is to improve the condition of the skin, hair and nails. It regulates the function of the sebaceous glands, preventing the formation of acne. By participating in the formation of keratin, folic acid makes the nail plate strong and prevents hair loss. Vitamin B9 is especially important for maintaining youth and health in women after 40 years.

Folates are part of the sex hormones. They provide regularity menstrual cycle, improve reproductive properties. Without folic acid, the maturation of the egg and its release from the ovary is impossible.

Reasons for deficiency

Folic acid deficiency occurs when it is not taken in enough from the outside, increased consumption, insufficient absorption. The reasons for this are the following conditions:

• strict diets;
• pregnancy;
• diseases of the gastrointestinal tract;
• alcohol abuse;
• oncological diseases.

In all these conditions, the body requires an increased amount of vitamin B9.

The body lacks folic acid in case of its insufficient intake with food or in violation of absorption

Manifestations of folic deficiency

The lack of folic acid first affects the condition of the skin and nervous system. A woman becomes irritable, reacts more sharply to stress factors. The quality of sleep suffers, which leads to increased fatigue, frequent headaches, and decreased ability to work.

Chronic stress causes depression. The skin becomes dry and dull, wrinkles, age spots appear. Hair also grows dull, begins to fall out quickly. Nails peel and break.

With a prolonged deficiency of folic acid, dysbacteriosis occurs due to a change in the composition of the intestinal microflora.

This is manifested by a violation of the digestion of food, nausea, stool disorder. Nutrients and vitamins are no longer absorbed, which also affects the appearance of a woman.

Due to a violation of cell metabolism, the risk of developing malignant tumors increases. The process of formation of sex hormones is disturbed. Because of this, there are failures of the menstrual cycle, gynecological diseases develop. The probability of getting pregnant is reduced up to secondary infertility.

Deficiency Diagnostics

The diagnosis of folic deficiency cannot be made on the basis of subjective complaints and external manifestations. A woman should undergo a comprehensive examination, which includes:

• general and biochemical blood tests;
• determining the level of hormones;
• coprogram;
• feces for dysbiosis.

A blood test for vitamin content helps confirm folic deficiency.

Replenishment rules

A person receives folic acid from food. Vitamin B9 is found in:

• meat by-products;
• beef;
• green vegetables and fruits;
• sea ​​fish;
• nuts and seeds;
• greens;
• buckwheat;
• rye bread.

If a woman eats properly, is not fond of strict diets, she will receive a sufficient amount of folic acid. Under such conditions, vitamin deficiency does not develop if there are no conditions that violate its absorption. It is enough to take a monthly course of multivitamins once a year to ensure the normal content of folates.

During heat treatment, vitamin B9 is destroyed. Therefore, whenever possible, vegetables, fruits and herbs should be eaten raw.

Vitamin B9 is absorbed only in the presence of a healthy intestinal microflora. If a person has dysbiosis, folate will not be absorbed from either food or medicines. Therefore, it is recommended to take it together with probiotics.

Folic acid is found in medicines and dietary supplements. The former are recommended to be taken for serious illnesses, and dietary supplements - for nutritional or age-related deficiency. You can take a pure folic acid preparation only as prescribed by a doctor, if vitamin deficiency is confirmed by tests.

An additional source of folate is needed for teenage girls, pregnant women, and women over 40. They are recommended to use multivitamins with high content folic acid or pure preparations with a dose of 0.2 mg. In the presence of diseases that impair the absorption of folate, the dosage is determined individually. Usually it is 0.3-0.4 mg, that is, the average daily dose.

If a woman eats properly, the use of drugs with folic acid is not required.

Features in pregnant women

Folic acid is especially important for pregnant women and those who are just planning a pregnancy. It is recommended to take the drug for three months before conception. Vitamin B9 reduces the risk of developing genetic disorders at the time of fertilization, improves ovarian function and increases the likelihood of conception. When planning pregnancy, the recommended dose of the vitamin is 0.8 mg per day.

When a woman becomes pregnant, vitamin B9 is needed for the proper laying and formation of the fetal nervous system. This happens in the first trimester of pregnancy. Also, folic acid in the early stages prevents miscarriages, pregnancy fading, malformations.

Folate is important for the proper formation of the placenta.

The norm of folic acid during pregnancy is 0.4 mg per day. It must be taken throughout the first trimester. If a woman has already had children with neurological disorders, it is recommended to take the drug throughout the pregnancy.

Folic acid - a water-soluble vitamin of group B - takes part in the synthesis of immune blood cells, activates metabolism, and contributes to the normalization of the function of the digestive tract.

Vitamin B9 is involved in the synthesis of DNA and RNA molecules, in which genetic information is stored. Its presence in the body is also necessary for protein biosynthesis.

With an insufficient level of vitamin B9, the likelihood of malformations in the fetus increases significantly.

Folic acid is also essential for the female reproductive system. It is especially important for pregnant women, as it is involved in the formation of the nervous system of the fetus. In addition, it is necessary for the normal formation and functioning of the placenta.

With the participation of folic acid, cell division occurs, in addition, the following benefits for the body are noted:

• positive impact on brain function;
• normalization of homocysteine ​​levels;
• improving the appearance of hair, nails;
• improved skin regeneration;
• the production of a sufficient amount of methionine, norepinephrine, glycine, serotonin, thereby reducing the likelihood of developing anemia and depression.

As a rule, folic acid is prescribed for additional intake when planning pregnancy and during gestation. For an adult, a deficiency of this important element can be avoided with a daily intake of 200 mg of the drug. For pregnant and lactating women, the dose should be increased to 400-600 mcg.

Folic acid is usually combined with vitamin B12.

Signs of a folic acid deficiency

Signs of vitamin B9 deficiency can be symptoms that are often attributed to other diseases:

• depression, irritability;
• memory impairment;
• headache;
• general weakness and poor appetite;
• discomfort and impaired sensation in the limbs;
• inflammation of the mucous membrane of the tongue, accompanied by pain and the formation of ulcers in the oral cavity;
• diarrhea;
• breathing difficulties;
• delayed puberty in girls;
• early manifestation of gray hair and menopause;
• megaloblastic anemia.

Megaloblastic anemia due to folic acid deficiency

Folate deficiency megaloblastic anemia most often develops in women during menopause. However, this problem is not excluded at any other age. The development of the disease, first of all, is indicated by a large number of megaloblasts in the bone marrow and the presence of the following symptoms:

• fast fatiguability;
• headache;
• distraction of attention;
• dyspnea;
• increased heartbeat;
• bright red tongue.

Even in the absence of these signs, women after 50 years of age will also benefit from additional intake of vitamin B9.

Indications for taking folic acid

Indications for taking vitamin B9 when planning pregnancy and conception

Folic acid is required by the body at all periods of life, but during the planning and conception of a child, it is most important for the formation and development of a healthy fetus. Supplementation with folic acid in various preparations allows you to maintain normal level homocysteine ​​- amino acid, especially important during pregnancy.

This increases the likelihood of pregnancy and successful childbearing.

If one of the spouses is deficient in vitamin B9, pregnancy is unlikely.

It is important to remember that folic acid is needed in the earliest stages of embryonic development. In the first weeks after conception, the embryo actively grows and all important systems and organs are laid down. Folic acid is necessary for the embryo to form new tissues. Already in the second week, the nervous system begins to form in the fetus. Lack of vitamin B9 at this point can lead to malformations and abnormalities in the development of the fetus and significantly increase the risk of a delay in the development of the child in the future.

That is why gynecologists recommend drinking folic acid even at the stage of pregnancy planning, without waiting for a delay in menstruation. So by the time of ovulation, the body of the expectant mother will not lack vitamin B9 and will be able to ensure the normal development of the embryo at the earliest stages of gestation.

With a deficiency of folic acid for the fetus, the following negative consequences are possible:

• slowing down the process of fetal development;
• spontaneous abortion;
• placental abruption;
• premature birth;
• preeclampsia;
• heart defects;
• palate defects and splitting of the upper lip;
• anomaly of the urinary tract;
• underweight newborn.

Folic acid also plays an important role in the body. future mother, which during the period of bearing a child works in an enhanced mode. The functioning of the hematopoietic system, the growth and development of the placenta, the strengthening of the vascular network in the uterus - all this will not be provided properly without the necessary amount of folic acid.

Due to problems with the development of the placenta or inferiority of the vessels of the uterus, spontaneous abortion is possible. Therefore, doctors recommend starting folic acid intake during pregnancy planning, even before conception, for both future parents. If pregnancy was detected in fact, the drug should be started immediately and not stopped during the entire period of bearing the child. Since vitamin B9 is water-soluble, it is impossible to overdo it in the body.

The intake of vitamin B9 is necessary not only for the fetus and ensuring the processes of its development and formation.

Can You Do Without Folic Acid During Pregnancy?

According to statistics, most pregnancies are unplanned. A very small percentage of couples undergo a full examination before planning a child. Often a woman learns about pregnancy at the 2nd month of fetal development. And folic acid should be enough in the body already in the first days of conception.

If the couple of future parents are generally healthy, then the level of vitamin B9 may be sufficient and such an omission will not create problems for either the fetus or the expectant mother.

However, one should not hope for luck in such an important case, so taking folic acid is recommended by doctors at least three months before pregnancy. In some countries, folate preparations are used by all women of childbearing function.

Indications for taking folic acid for men

Folic acid is useful not only for the developing fetus and the female body, but also for men. Sperm quality depends to a large extent on adequate levels of vitamin B9. Therefore, when planning a pregnancy until the moment of conception, it is necessary to take folic acid preparations not only for women, but also for men.

In the male body, vitamin B9 performs the following functions:

• reduces the number of chromosomal defects in spermatozoa and reduces the risk of congenital pathology in a child;
• increases the activity and viability of spermatozoa, which increases the chances of successful conception;
• activates the immune system and improves the overall tone of the body.

Taking folic acid by both partners increases the chances of successful pregnancy and the birth of a healthy child and significantly reduces the risk of complications of gestation.

Indications for taking vitamin B9 in adulthood

Given the peculiarity of a mature organism, after 50 years, a sufficient level of folic acid should be maintained in the body. The fact is that folic acid has an estrogen-like effect, which improves well-being during menopause. Reduces the severity of negative symptoms:

• sweating and sensation of heat decrease;
• increased heart rate is eliminated;
• the frequency of hot flashes and their severity decreases;
• sleep is normalized;
• the state of the psyche improves;
• normalizes blood pressure.

Vitamin B9 not only generally has a positive effect on the body in menopause, but also protects against diseases associated with the destruction of the retina and deterioration of visual acuity.

Eat more foods containing folic acid.

The use of folic acid

Since folic acid is an important element for the normal course of pregnancy, it is advisable to conduct an examination for vitamin B9 deficiency in the body before planning conception. If a significant deficiency of folic acid is found as a result, drugs containing folacin are prescribed.

If there are no acute problems with a lack of this element, the doctor may recommend taking vitamin complexes and enhanced nutrition with foods rich in vitamin B9.

Most folic acid is found in the following foods:

• liver and other offal;
• yeast;
• sunflower seeds;
• vegetables and leafy greens - lettuce, turnips, spinach, asparagus;
• legumes - lentils, peas;
• egg yolk;
• semi-finished products made with the addition of folic acid.

The liver is one of the most valuable sources of vitamin B9, this product also contains many useful components and nutrients for the body.

Dosage of folic acid preparations

The daily dose of folic acid in the usual case is 400 mg per day for an adult. But during the planning period of pregnancy, doctors recommend higher dosages.

Men are prescribed a drug containing 700-1100 mg of vitamin B9. It should be taken once a day for 3 months before conception. Women are shown taking 600-800 mg of folic acid per day.

What are vitamins with folic acid

Special multivitamins for pregnant women contain a loading dose of folina, so you can’t take such drugs on your own without a doctor’s recommendation.

For prevention possible problems Doctors prescribe special preparations containing vitamin B9 to the expectant mother:

1. "Folic acid" - one tablet contains 1000 micrograms of vitamin B9.
2. "Foliber" with vitamin B12. Each tablet contains 400 micrograms of folic acid.
3. "Folic acid" with B6 and B12. Folic acid in one tablet - 600 mcg, vitamin B12 - 5 mcg, vitamin B6 - 6 mg. This drug is a dietary supplement.
4. Complex vitamin preparations with folic acid in the composition: "Multi-tabs perinatal" (400 mcg), "Pregnavit" (750 mcg), "Elevit" (1000 mcg), "Vitrum Prenatal" (800 mcg), "Materna" (1000 mcg).

"Folio" with iodine contains B9 in the amount of 400 mcg and iodine - 200 mcg.

Features of the reception and assimilation of folic acid

Vitamin B9 deficiency is often accompanied by a number of diseases of the gastrointestinal tract - celiac disease, gastritis, malabsorption, since this element is poorly absorbed in that case. A lack of folic acid for the same reason can also be observed when using certain drugs:

• glucocorticosteroids,
• aspirin,
• antacids,
• nitrofurans,
• contraceptive drugs.

The following diseases require special attention doctor when prescribing folic acid preparations:

• disorders in the work of the kidneys;
• anemia;
• overweight with a BMI of 30 or more;
• history of spontaneous miscarriages of previous pregnancies;
• diabetes mellitus, both type 1 and type 2;
• taking drugs, one of the components of which is valproic acid;
• alcohol abuse.

Be sure to tell your doctor if you have any of these aggravating circumstances. He will adjust the regimen of administration and dosage in accordance with the existing diseases.

Folic acid (vitamin B9) - description, instructions for use, how and how much to take when planning pregnancy and after conception, symptoms of deficiency and excess of folic acid, content in food, reviews

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Folic acid also called vitamin B 9 and is a water-soluble vitamin necessary for the normal course of hematopoiesis in the bone marrow and protein synthesis. With a deficiency of folic acid, a person develops macrocytic anemia, which, in its signs and mechanism of development, is similar to megaloblastic or pernicious anemia due to a lack of vitamin B12.

Folic acid enters the human body with food or is produced by microflora in the intestine. The vitamin is absorbed into the blood after being first converted into a free form and delivered to the liver, bone marrow and other organs and tissues.

Folic acid - general characteristics and biological role

Folic acid gets its name from the Latin word "folium" which means "leaf" because largest quantities of this vitamin are found in green leaves of various vegetables, such as spinach, lettuce, etc. In addition to folic acid, vitamin B 9 includes a number of compounds that are its derivatives and are combined common name folacin or folates. But since all compounds united by the common name "folacin" have vitamin activity and are absorbed by the body, in the future text of the article we will use the concepts of "vitamin B 9" and "folic acid" as synonyms, meaning by them all folacins.

Folic acid can enter the human body not only with food and dietary supplements, but also produced in the upper third of the small intestine by microorganisms of normal microflora. In many cases, folic acid is produced by microorganisms in the intestinal microflora in quantities that fully satisfy the daily needs of a person. Therefore, even if folic acid is supplied with food in insufficient quantities, symptoms of its deficiency may not develop, since the missing amount of this vitamin is synthesized by the microflora in the intestine.

Vitamin B 9 is necessary for the formation of red blood cells in the bone marrow. The fact is that folic acid activates enzymes that ensure the flow of biochemical reactions, during which mature red blood cells are formed. Therefore, with a deficiency of folic acid, anemia develops.

In addition, vitamin B 9 is necessary for the synthesis of proteins and DNA, and, accordingly, for cell division of all organs and tissues. During division, new cells are formed to replace dead or damaged ones. That is, folic acid provides the process of repair and replacement of dead cellular elements with new ones and, thus, maintains the normal structure of all organs and tissues. In addition, folic acid ensures the normal development of the fetus, especially in the first 12 weeks of pregnancy, since it is during this period that very intensive cell division takes place, during which organs and tissues are formed.

Since the formation of new cells occurs at an unequal rate in different tissues, the need for folic acid in different organs is different. So, the greatest need for folic acid is experienced by tissues in which there is a frequent renewal of the cellular composition, namely the skin, mucous membranes, hair, blood, testicles in men and ovaries in women, the fetus is on early stages pregnancy, etc. That is why, with a deficiency of folic acid, the organs in which intensive cell division occurs are the first to suffer.

So, with a deficiency of folic acid, defective spermatozoa and eggs are formed, malformations are formed in the fetus, the skin becomes dry, flaky and flabby, and various diseases develop in the organs of the gastrointestinal tract. This is because the cells of these organs are intensively dividing and they need folic acid for the normal course of this process.

In addition, vitamin B 9 is involved in the production of serotonin, the hormone of joy, which ensures a normal mood and well-being. Therefore, with a lack of folic acid, a person can develop dementia (dementia), depression, neurosis, and some other disorders of brain function.

Folic acid is also involved in the transmission of nerve impulses. Therefore, with a deficiency of folic acid, neuritis and polyneuritis can develop.

Folic acid - application

Folic acid when planning pregnancy

Folic acid is the only vitamin that all pregnant women must take without fail until at least 12 weeks, since it is during this period that the development of the nervous system and the laying of other organs and tissues of the fetus, which requires folacin. However, it is recommended to take folic acid already at the planning stage, without waiting for the onset of pregnancy, in order to create a normal concentration of this vitamin in the tissues. In this case, by the time of pregnancy, the woman is guaranteed to be free of folic acid deficiency, which can be critical for the growth and development of the fetus, as well as the course of pregnancy.

When planning a pregnancy it is recommended to start taking folic acid 3 to 4 months before the intended conception so that by the time the fetal egg attaches to the wall of the uterus in the woman's body there is no deficiency of this vitamin. When the results of the tests reveal conception, folic acid should be continued until at least the 12th week of pregnancy . After this gestation period, folic acid intake can be discontinued or continued at the request of the woman if she does not have a deficiency of this vitamin. If there are signs of folic acid deficiency, then it must be taken before childbirth in an individual dosage prescribed by a doctor. In addition, if a woman who is not folate deficient is willing and financially able to take folic acid after 12 weeks of pregnancy, she can also do so until delivery. Moreover, doctors and scientists consider it desirable to take folic acid at the planning stage and after the 12th week of gestation before delivery. And taking folic acid from the beginning to the 12th week of pregnancy is considered mandatory by doctors.

The importance of the use of folic acid at the planning stage and during pregnancy is due to the fact that this vitamin is critical for the rapid reproduction of cells that occurs during the growth of the embryo. With a deficiency of this vitamin, malformations of the nervous system are formed, and there is also an increased risk of miscarriages, placental abruption, intrauterine fetal death, etc. Thus, it was found that taking folic acid in the first 12 weeks of pregnancy prevents malformations of the nervous system in the fetus by 70%.

In addition, folacin prevents miscarriages, miscarriages, miscarriage, placental abruption and other complications of pregnancy, which are especially dangerous in its early stages, since they almost inevitably lead to the death of the fetus.

At the stage of pregnancy planning in most countries, including the CIS, doctors recommend taking 400 micrograms of folic acid per day for women who have not previously had births or miscarriages of fetuses with neural tube defects. If a woman has had cases of miscarriage or the birth of fetuses with neural tube defects, or she is taking antiepileptic drugs or cytostatics, then in this case, the dosage of folic acid at the stage of pregnancy planning should be increased to 800 - 4000 mcg per day. The exact dosage is determined by the doctor individually. After the onset of pregnancy, women should take folic acid in the same dosage as at the planning stage, up to the 12th week of gestation.

folic acid during pregnancy

Iron and folic acid are the only substances proven to improve the outcome and course of pregnancy in all women. That's why World Organization Health (WHO) recommends that all pregnant women take folic acid and iron without fail.

Vitamins with folic acid must be taken from the beginning of pregnancy until the 12th week of gestation, inclusive. This means that as soon as a woman finds out that she is pregnant, she should start taking folic acid on the same day. If vitamin B 9 was taken before pregnancy at the planning stage, then after the onset of conception, it is necessary to continue taking it at the same dosage up to and including the 12th week of gestation.

Starting from the 13th week of gestation, folic acid must be taken by pregnant women who are deficient in this vitamin or who are taking drugs that reduce its absorption, such as antiepileptic and antimalarial drugs, as well as cytostatics. For all other women, starting from the 13th week of gestation, it is recommended to continue taking folic acid until childbirth, but this is not necessary, but desirable.

If from the second trimester a woman begins to take multivitamin complexes for pregnant women, then there is no need to additionally drink folic acid, since this vitamin is part of all modern multivitamins. If these vitamin complexes are not taken during the entire pregnancy, then at times when a woman does not use them, it is advisable to drink folic acid separately.

During pregnancy, folic acid is recommended to be taken at a dosage of 400 micrograms per day for women who have not previously had births or miscarriages of children with neural tube defects. If a woman in the past had cases of childbirth or spontaneous abortions with a fetus with neural tube defects, then she should take folic acid at a dosage of 1000-4000 mcg (1-4 mg) per day. In addition, increase the dosage of folic acid to 800 - 4000 mcg should be pregnant women who take antiepileptic, antimalarial drugs or cytostatics. In these cases, the dosage of the vitamin is determined by the doctor individually.

Folic acid intake by pregnant women is mandatory, since this vitamin is very important for the normal course of pregnancy, as well as the growth and development of the fetus. Thus, the lack of folic acid is one of the main triggers that provoke miscarriage, spontaneous miscarriage, placental abruption, intrauterine fetal death, as well as the formation of neural tube malformations in a child. If malformations of the neural tube were formed at an early stage of pregnancy (up to 8-9 weeks), then in almost all cases they are not compatible with life, that is, fetal death and miscarriage occur. If the malformations of the neural tube formed after 8-9 weeks of gestation, then this can lead to the birth of a child with hydrocephalus, cerebral hernia, etc. In addition, even if a child does not develop neural tube malformations against the background of folic acid deficiency in the body of a pregnant woman, then after birth he may suffer from mental retardation, psychoses, neuroses, etc.

In addition, a lack of folic acid negatively affects the course of pregnancy and the general well-being of the woman herself. So, with a deficiency of this vitamin in a pregnant woman, the risk of developing toxicosis, depression, pain in the legs and anemia increases significantly. A lack of folic acid in the body of a pregnant woman can manifest itself with the following symptoms:

• Chronic fatigue and irritability;
• neuroses;
• Anxiety, anxiety;
• Feeling of heaviness in the stomach;
• memory impairment;
• Apathy;
• Dry skin and hair loss.

If a pregnant woman has four or more of the above symptoms, then this indicates that she suffers from a folic acid deficiency. In such a situation, you should donate blood to determine the concentration of vitamin B 9 in it, according to the results of which the doctor will select the necessary therapeutic dose of folic acid, which must be taken daily until childbirth. Normally, the concentration of folic acid in the blood is 3 - 17 ng / ml. The lower the content of the vitamin in the blood of a pregnant woman, the higher the dosage of the vitamin she needs.

Dosage of folic acid in planning and pregnancy

At the stage of pregnancy planning, folic acid should be taken at a dosage of 400 micrograms for women who have not previously had a miscarriage or the birth of children with neural tube defects. After the onset of pregnancy, these women must continue to take folic acid in the same dosage (400 mcg per day) without fail until the 12th week of gestation, inclusive.

If in the past a woman has had cases of miscarriage or the birth of children with neural tube defects (for example, spina bifida, hydrocephalus, etc.), then at the planning stage she should take folic acid at 1000 - 4000 mcg (1 - 4 mg) per day. After the onset of pregnancy, this category of women should take folic acid in the same dosage, that is, 1000 - 4000 mcg per day. In such situations, the dosage is determined by the doctor individually.

If a woman takes any drugs that reduce the absorption of folic acid (for example, antiepileptic, antimalarial, sulfanilamide, antihyperlipidemic, anti-tuberculosis, cytostatics, nitrofurans, drugs with alcohol, glucocorticoids, Aspirin in high doses), then she should drink at the stage of pregnancy planning folic acid at 800 - 4000 mcg per day. When pregnancy occurs, this category of women should take folic acid in the same dosage as at the planning stage, that is, 800-4000 mcg per day.

In addition, these women need to take folic acid without fail not until the 12th week of gestation, but throughout pregnancy or during the period during which drugs are taken that impair the absorption of the vitamin. That is, if medications are taken throughout pregnancy, then folic acid is also taken in the indicated dosages before childbirth. If, at some stage of pregnancy, a woman stops taking drugs that impair the absorption of folic acid, then she should do the following:

• If this happened before the 12th week of gestation, then it is mandatory to continue taking folic acid at a dosage of 400 mcg per day until the beginning of the 13th week;
• If this happens after the 12th week, then you should either stop taking folic acid, or continue, but reduce its dosage to 400 mcg per day.

Folic acid for men

Men, like women, need folic acid for normal hematopoiesis and the functioning of the intestines and stomach, as well as for the transmission of impulses along nerve fibers. However, this is the general biological role of folic acid, carried out by it in the human body.

In addition, folic acid is very important for conceiving a child, both for men and women. So, it is vitamin B 9 that takes part in the process of maturation and formation of normal, not defective, full-fledged spermatozoa in men. And therefore, taking folic acid by men increases the likelihood of conceiving a healthy child.

Recent studies have shown that taking folic acid at a dosage of 600-1000 mcg reduces the number of defective spermatozoa with the wrong number of chromosomes by 20-30%, which, accordingly, prevents the birth of children with malformations and genetic diseases, such as Down syndrome , Shershevsky-Turner syndrome, Marfan syndrome, Creutzfeldt-Jakob syndrome, etc.

In addition, a decrease in the number of defective sperm cells while taking folic acid increases the likelihood of conception. Thus, a man taking folic acid will be able to impregnate a woman faster and, in addition, healthier offspring will be born from him.

That is why men are advised to include foods rich in folic acid in their diet, such as liver, beef, pork, tuna, salmon, cheeses, legumes, bran, nuts, leafy vegetables, etc. In addition, men can take vitamins or supplements to get enough folic acid.

Separately, it should be noted the recommendation of doctors to take folic acid preparations at a dosage of 800 mcg per day for a week after drinking a large amount of alcohol. This recommendation is aimed at replenishing the deficiency of folic acid in the body of a man, which inevitably occurs after heavy alcohol consumption, since ethyl alcohol disrupts absorption and leaches this vitamin from organs and tissues.

Folic acid for children

Since folic acid deficiency most often develops in full-term or premature newborns or young children, it is necessary to carefully ensure that these categories of babies receive enough vitamin from food or dietary supplements.

Folic acid deficiency in children leads to the following negative consequences:

• Development of macrocytic anemia;
• Lagging in weight;
• Inhibition of hematopoiesis;
• Violation of the normal process of maturation of the mucous membrane of the gastrointestinal tract and skin;
• Increased risk of developing enteritis, diaper rash, and delayed psychomotor development.

In the fetus, newborns and children of the first year of life, folic acid deficiency develops due to a lack of this vitamin in the mother's body during pregnancy or its low content in milk formulas for artificial feeding. Natural feeding (breastfeeding) contributes to the rapid elimination of folic acid deficiency in infants, since human milk contains enough of it for the needs of a growing baby, even if the woman herself suffers from a lack of vitamin B 9.

Formula feeding does not correct an infant's folic acid deficiency, as this vitamin is destroyed when formula is heated. In addition, bottle feeding can lead to folic acid deficiency in an infant who was born without it, for the same reason - the destruction of the vitamin during the heating of the mixture.

Therefore, full-term children under one year of age who are bottle-fed are recommended to give vitamin B 9 at a dosage of 100 mcg per day. Premature babies, regardless of the type of feeding, must be given folic acid 100 mcg per day, because 2 to 3 weeks after birth, they develop vitamin deficiency and increase the risk of infectious complications.

Folic acid (vitamin B9) when planning pregnancy: instructions for use and dosage, recommended foods, advice from a geneticist - video

Instructions for use of folic acid

General rules

Folic acid can be taken in the form of vitamins or dietary supplements (BAA) in order to prevent or eliminate the deficiency of this vitamin in the body. To prevent deficiency, folic acid should be taken in the following cases:

• Insufficient quantity or quality of food;
• Increased need for folic acid (pregnant women, nursing mothers, premature babies, newborns who are bottle-fed);
• Reduced absorption of folic acid (for example, with alcoholism, inflammatory bowel disease, chronic diarrhea, malabsorption syndrome, sprue, taking antiepileptic drugs, drugs with trimethoprim, methotrexate, etc.);
• The presence of malnutrition (insufficient body weight), ulcers on the oral mucosa, anemia and chronic inflammatory diseases intestines.

Prophylactically, folic acid is taken at a dosage of 200 - 400 mcg per day. It is allowed to increase the preventive dosage of folic acid to 800 mcg per day, especially for nursing mothers and young children.

To eliminate folic acid deficiency, vitamin preparations and dietary supplements are taken in higher dosages compared to prophylactic ones. In such cases, the dosage is determined by the doctor individually and can reach up to 75-80 mg per day. That is, the therapeutic dose of folic acid can be 200 times higher than the prophylactic one.

Taking folic acid preparations to eliminate its deficiency in the body is necessary if you have the following symptoms:

• Megaloblastic anemia associated with thrombocytopenia and leukopenia;
• Dry red "varnished" tongue;
• Atrophic or erosive gastritis;
• Enteritis with diarrhea;
• growth retardation in children;
• Prolonged healing of wounds;
• Immunodeficiency;
• Exacerbation of chronic infectious diseases;
• Subfebrile body temperature, recorded for at least three weeks;
• memory impairment;
• Irritability;
• Hostility towards others;

All of the above conditions and diseases are caused by a deficiency of folic acid, so taking this vitamin helps to eliminate them, that is, to recover, improve the general condition, normalize well-being and vital processes.

Besides, folic acid in therapeutic dosages is used in the complex treatment of the following diseases:

• Enteritis;
• Diseases of the hematopoietic organs (bone marrow, spleen, liver);
• chronic hepatitis;
• Cirrhosis of the liver;
• Atherosclerosis;
• Psoriasis;
• Depression;
• Increased anxiety;
• Dysplasia of the cervix.

Dosage of folic acid

The dosage of folic acid depends on whether it is taken prophylactically or therapeutic purpose. To prevent folic acid deficiency against the background of a qualitatively and quantitatively balanced diet, it should be taken at 200 mcg per day. If nutrition is inadequate, then folic acid is recommended to be taken at 400 mcg per day.

To eliminate the deficiency of folic acid identified by the results of the analyzes (blood concentration below 3 ng / ml), it should be taken at a dosage of 800 - 5000 mcg per day. In this case, the dosage is determined by the doctor individually and is adjusted based on the concentration of folic acid in the blood according to the analysis. To eliminate the deficiency, folic acid in the indicated dosages must be taken within 20 to 30 days. After that, it is recommended to switch to taking folic acid in a prophylactic dosage (200-400 mcg per day), which can be continued for several months until the state of health is completely normalized and all deficiency symptoms disappear.

For the treatment of folate deficiency anemia, vitamin B 9 preparations should be taken at 1000 mcg per day until the blood picture and hemoglobin level are normalized.

However, for the treatment of folate deficiency anemia and to eliminate the lack of vitamin B 9 in the body in people suffering from alcohol addiction, malabsorption syndrome, liver failure, cirrhosis of the liver, as well as those who have undergone removal of the stomach or are under stress, the dosage of folic acid is increased to 5000 mcg per day.

In the complex therapy of various diseases (atherosclerosis, cervical dysplasia, psoriasis, etc.), folic acid should be taken in very high dosages - from 15 to 80 mg per day (15,000 - 80,000 mcg), which are determined by the doctor individually.

How much to take folic acid?

In prophylactic dosages not exceeding 400 mcg per day, folic acid can be taken for as long as you like.

In the treatment of folic acid deficiency vitamin in therapeutic dosages must be taken within 20 to 30 days. After that, you should switch to taking folic acid in prophylactic dosages (200-400 mcg per day).

In the treatment of folate deficiency anemia vitamin should be taken up to the normalization of the blood picture (the disappearance of giant erythrocytes from it) and the level of hemoglobin.

When using folic acid in the complex therapy of various diseases the duration of its administration is determined by the doctor individually in each case. However, usually in such cases, folic acid in high dosages is taken for a long time.

How to take vitamin B 9?

Folic acid supplements should be taken by mouth with or without food. Tablets or capsules must be swallowed whole, without chewing, biting or crushing in other ways, but with a small amount of water.

How much folic acid does a person need per day?

To fully cover the daily requirements for folic acid, children and adults should receive the following amounts of this vitamin daily:

• Newborns up to six months - 65 mcg per day;
• Children 7 - 12 months - 85 mcg per day;
• Children 1 - 3 years -150 - 300 mcg per day;
• Children 4 - 8 years old - 200 - 400 mcg per day;
• Children 9 - 13 years old - 300 - 600 mcg per day;
• Children 14 - 18 years old - 400 - 800 mcg per day;
• Men and women over 19 years old - 400 - 1000 mcg per day;
• Pregnant women and nursing mothers - 600 - 1000 mcg per day.

For adults, an adequate and sufficient intake of folic acid to cover the needs of the body is 500-600 mcg per day.

folic acid deficiency

Folic acid deficiency is now common in the CIS countries - according to international organizations 66 - 77% of the population suffer from a lack of this vitamin. Most often, folic acid deficiency occurs in pregnant and lactating women, in the elderly and young children.

Vitamin B 9 deficiency can develop for the following reasons:

1. Insufficient intake of vitamin with food (qualitatively or quantitatively inadequate diet).

2. Increased need for a vitamin (pregnancy, breastfeeding, period of intensive growth in children and adolescents, skin diseases, hemolytic anemia, etc.).

3. Poor digestibility of folic acid in the intestines with various chronic diseases(for example, enteritis, chronic diarrhea, sprue, malabsorption syndrome, etc.).

4. The binding of folic acid and the deterioration of its digestibility while taking certain medications, such as:

• Medicines containing alcohol;
• Pentamine;
• Triamterene;
• Pyrimethamine;
• Trimethoprim;
• Aminopterin;
• Amethopterin;
• Sulfonamides;
• Antiepileptic drugs;
• Antimalarials;
• anti-tuberculosis drugs;
• Antihyperlipidemic drugs;
• Cytostatics;
• Preparations containing nitrofurans;
• Glucocorticoids;
• Aspirin in high dosages.

Folic acid deficiency is manifested by the following symptoms:

• Megaloblastic anemia;
• Thrombocytopenia (low platelet count in the blood);
• Leukopenia (low white blood cell count);
• Elevated levels of bilirubin in the blood;
• Cheilosis (blanching, maceration, transverse cracks and a bright red border at the junction of the lower and upper lips);
• Gunther's glossitis (dry, red, "varnished" tongue);
• Esophagitis;
• Conjunctivitis;
• Atrophic or erosive gastritis;
• Enteritis with diarrhea;
• Steatorrhea.

In severe folic acid deficiency, there is growth retardation in children, prolonged healing