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Special Cases That Require More Folic Acid

For a woman trying to conceive with no known issues or a woman who has an uncomplicated pregnancy, she will usually take an over the counter prenatal vitamin with folate or one with folic acid or a prescription from her doctor with folic acid. She will usually follow the guidelines of not exceeding 2,000 mcg of folic acid, unless the doctor or other health care provider she is seeing recommends she takes MORE folic acid for X reason.

So what are these X reasons that a woman may require MORE Folic Acid?
  • Baby with Neural Birth Defects (4-5 mg)

If you have / had a baby that has a neural birth defect (examples: Anencephaly or Spina Bifida), it is recommended in a subsequent pregnancy to take 4 mg of Folic Acid one- two months before conception and during the first trimester of pregnancy under the supervision of a doctor.  The idea behind why this occurs in some women is that they do not absorb folate / folic acid as well and require higher doses. The one story I know who had a baby born with Anencephaly, she was taking 1 mg of folic acid before trying to conceive and throughout her pregnancy. Links: Cleveland Clinic.org: Anencephaly and Drugs.com: Folic Acid

  • Multiples Pregnancy (1 mg)
Women who are expecting Multiples (twins, triplets...) may require more folic acid. Experts in the field recommend 1 mg of folic acid a day. Links: Drugs.com: Folic Acid


  • Type 1 Diabetes & Pregnant (4-5 mg)
It has been recommend that pregnant women who are diabetic should take higher doses of folic acid, 4-5 mg. Links: What Dose of Folic Acid Should Be Used For Pregnant Diabetic Women?, Identifying Women Who Might Need More Folic Acid


  • Obesity & Pregnancy (5 mg)
It is recommended that women who are obese may benefit from taking higher levels of folic acid, 5 mg.  Link: Identifying Women Who Might Need More Folic Acid

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