Folic Acid Frequently Asked Questions

Folic acid is the synthetic (man-made) version of the water-soluble vitamin folate. This vitamin is sometimes referred to as folate or Vitamin B9. It is folic acid (the synthetic form) that is available in supplements.

Dietary folate and folic acid supplements play an important role in forming healthy red blood cells and maintaining brain health. However, folic acid, the synthetic form of folate, is one of the most important vitamins in pregnancy. In ground-breaking research in 1991, it was discovered that folic acid plays a crucial role in helping the unborn baby’s spine and brain develop and protect against the risk of Neural Tube Defects (NTDs), such as spina bifida.

While natural folate is found in a wide variety of foods such as broccoli, Brussel sprouts, spinach etc., it is easily lost from these foods during storage, preparation and cooking. This is because folate is a water-soluble vitamin (dissolves easily in water). While a good diet of foods naturally rich in folate will provide enough folate for adult human needs, this will not provide the extra amount required to protect pregnancies.

Women need extra folic acid before and during pregnancy – especially in very early pregnancy when the baby’s spine and brain are developing. Therefore, it is essential for women who may become pregnant to take a 400 micrograms (µg) folic acid supplement daily to help prevent NTDs. Taking a folic acid supplement daily could potentially prevent up to two thirds of neural tube defects each year.

It is important to have adequate folate levels before pregnancy and in the first 3 months. During this time, the baby’s brain and spine are developing even before a woman may realise that she is pregnant. Choosing foods fortified with folic acid and a diet rich in folate containing foods in addition to folic acid supplements will help.

What exactly is a neural tube defect (NTD)?

Neural tube defects (NTDs) happen when part of the unborn baby’s brain or spine doesn’t develop properly. Spina bifida and anencephaly are the most common NTDs and literally means "split spine” which can lead to lifelong disabilities.

Does taking folic acid prevent all neural tube defects?

Up to two thirds of neural tube defects can be prevented with proper timing and dosage of daily folic acid supplements, alongside folic acid fortified foods, and a folate-rich diet. In some cases, there are other reasons why NTDs occur, but taking folic acid can help to reduce the risk of NTDs.

I’m using contraceptives so why would I need to take a folic acid supplement?

No contraceptive method is 100% effective so you may still become pregnant. An unborn baby’s brain and spine develop fully in the first 3-4 weeks after conception, often before a person may realise they have become pregnant. This is why it’s so important you take a folic acid supplement, in the correct dosage, every day.

What if I am not planning on having a baby now?

A minimum of 30% of pregnancies are unplanned in Ireland. Therefore, daily supplementation is required, regardless of pregnancy intention. Dietary folate, including folic acid supplements, plays an important role in forming healthy red blood cells and maintaining brain health. Taking 400 micrograms (µg) of folic acid every day as a supplement is safe for you to take.

Why is it recommended to take folic acid every day?

Your body does not store folic acid, so you need to take it every day to maintain enough quantities in your body. This is because folate is water-soluble (dissolves in water) and leftover amounts leave the body through the urine.

Where can I get folic acid? Could I get enough folic acid through a multivitamin?

Folic acid supplements/tablets are on sale in most pharmacies, supermarkets and health stores. You can buy a folic acid supplement for the cost of just a few cents per day. Any brand of folic acid supplement can be used but ensure you read the label to check the supplement contains the recommended 400 micrograms (µg) of folic acid. If you have a medical card, your doctor can write a prescription for a folic acid supplement for you.

Many multivitamin formulas for women, even store brands, also contain 400 micrograms (µg) of folic acid but to be sure always check the labels - some multivitamin supplements also provide Vitamin A, which is not recommended during pregnancy. Follow your GP's and/or Healthcare Professional’s instructions about how and when to take supplements during pregnancy.

Can I avoid taking supplements and get folic acid from my food instead?

It is very difficult for women to get enough folic acid from their diet alone, even with the use of other fortified foods with folic acid added (e.g. some breakfast cereals and some yogurts). Because women need extra folic acid in early pregnancy, a daily supplement of 400 micrograms (µg) is recommended, as well as the folic acid you get from food.

Which foods contain folic acid?

Some types of foods which may be fortified with folic acid include (you need to check the labels):

• Breakfast cereals and breakfast bars
• Milks
• Yogurt

Please note that folic acid food fortification is intended to support, not replace, current advice on folic acid supplementation.

Dietary folate is found naturally in a wide variety of foods such as broccoli, Brussel sprouts and spinach. As it is a water-soluble vitamin (dissolves easily in water), it can be lost from food during cooking. This can be reduced by steaming or microwaving vegetables instead of boiling and avoiding over-cooking. While a good diet of foods naturally rich in folate will provide enough folate for adult human needs, this will not achieve the requirement level to protect from NTDs. Taking folic acid daily as a supplement, alongside consuming foods fortified with folic acid and a diet rich folate containing foods can help prevent NTDs.

What does the UK folic acid fortification of flour mean for Ireland?

Women generally begin taking folic acid supplements when they realise that they are pregnant, but this is often too late (after the first 6 weeks of pregnancy) to protect against NTDs. Many women of childbearing age do not take folic acid supplements daily. At a minimum, 30% of pregnancies are unplanned in Ireland. Routine fortification of flour with folic acid is a simple way to increase folic acid intake for everyone. However, it is impossible for women to get enough folic acid from their diet alone, even with the addition of fortified foods.

Many countries, such as the USA and Canada, have introduced mandatory fortification of flour with folic acid, and have seen a significant reduction in the number of births affected by NTDs.

From December 2026, in the UK, non-wholemeal wheat flour will be fortified with folic acid, with some products expected to contain flour fortified with folic acid from Autumn 2025. Non-wholemeal wheat flour will be fortified with 0.25 milligrams of folic acid per 100 grams of flour.

Ireland relies on the UK for a significant portion of its flour supply. This mandatory folic acid fortification of flour in the UK is expected to have effects on Ireland with the potential for increased folic acid intake in the Irish population through consumption of UK-produced fortified flour.

What is fortification and will it harm me?

Fortification of folic acid has existed in many countries for over 40 years, with over 70 countries adding folic acid to food products such as grains or flour. Studies carried out in Ireland, and across many other countries like the United States and Australia, have shown folic acid is safe to supplement and it is very difficult to consume too much.

Introducing the fortification of flour with folic acid will have the wider benefit of increasing the intake of folic acid and improving folate status across the whole population. Folate, including folic acid, plays an important role in forming healthy red blood cells and maintaining brain health.

What if I need a higher amount of folic acid?

Some women may be at a higher risk of having a baby with an NTD and should consult with their GP and/or Healthcare Professional first about whether they need a prescribed medicine providing a much higher dose of folic acid.

For example:

• If you or your child has a neural tube defect (NTD) for example spina bifida or anencephaly
• If you or your partner’s family have a history of NTDs
• If you are living with obesity
• If you have type-1 or type-2 diabetes.
• If you have Epilepsy

In Ireland, folic acid is available under the GMS and DPS schemes when prescribed by your medical doctor. The medicine providing a high dose of folic acid is prescribed by a doctor who will monitor you throughout.

Folic acid can also affect certain medications you may be taking, for example for epilepsy. Irish research indicates that many women taking antiseizure medicines do not start folic acid early enough. This is a key at-risk group that needs early specialist review. If you are unsure for any reason, we recommend you consult your family doctor and specialist for medical advice and to discuss the options, given your own personal circumstances.

I just found out I am pregnant - is it too late to start taking folic acid?

If you’ve just found out you are pregnant and have not been taking folic acid supplements before now, start taking them straight away. Continue to take them until at least the 12th week of your pregnancy.

My first baby was not affected by any NTDs. Do I still need to take folic acid in the future?

Yes, you still need to take folic acid if you could potentially get pregnant.

Whether you are a first-time mother or already have children (with an NTD or not), you are still at risk and you need to follow the guidelines. This still applies if you do not have a family history of NTDs or major health issues. Research shows that fewer women take folic acid during their second and subsequent pregnancies than their first, which increases their risk.

When should I start taking folic acid?

All women who may become pregnant should be taking a daily 400 micrograms (µg) folic acid supplement. Folic acid is absorbed very quickly in the gut once taken. If you're taking it for folate deficiency anaemia, it may be a few weeks before you start to feel better. If you're taking it because you're pregnant, you probably will not feel any different, but that does not mean it's not working.

Can I take folic acid?

Most adults and children can take folic acid. To make sure it is safe for you, tell a doctor or pharmacist before you start taking folic acid if you have any of the following:

• had an allergic reaction to folic acid or any other medicine
• low vitamin B12 levels (vitamin B12 deficiency anaemia) or pernicious anaemia
• cancer
• chronic kidney disease which requires dialysis
• a stent in your heart

Can I take folic acid while breastfeeding?

Folic acid is safe to take while you're breastfeeding. It passes into your milk, but it's not harmful to your baby. If your baby is premature or has health problems, check with your GP first.

How do I take folic acid?

If folic acid is prescribed for you or your child for folate deficiency, follow your GP's instructions about how and when to take the folic acid. If you have bought folic acid without a prescription from a pharmacy or shop, follow the instructions that come with the packet or provided by your pharmacist. .

Should I take folic acid before and during pregnancy?

All women who could become pregnant should take a 400 micrograms (µg) folic acid supplement every day. They should do this even if they are not planning to get pregnant. Your GP may recommend a higher dose of folic acid if you have certain medical conditions. If you're pregnant or trying for a baby, take folic acid until you're 12 weeks pregnant. It helps your baby grow normally.

Folic acid when planning a pregnancy

When should I take folic acid?

You usually take the folic acid 400 micrograms (µg) supplement once a day and can take folic acid with or without food. Swallow the tablet whole with a drink.

Do not drink alcohol with folic acid as it may stop folic acid being absorbed. It is also safer not to drink any alcohol if you're pregnant or trying to get pregnant because it can damage your baby's growth.

What if I forget to take my daily folic acid?

Missing 1 or 2 doses will not matter. Never take 2 doses to make up for a forgotten one. Take your missed dose as soon as you remember. If it's nearly time for your next dose, skip the missed dose and just take your next dose as normal.

What if I take too much?

Folic acid is generally very safe. Taking too much is unlikely to harm you or your child. Speak to a pharmacist or your GP if you are worried.

Glossary