Folic acid, also called folate or vitamin B-9, is necessary for metabolizing fats and protein, as well as for maintaining the health of your skin, hair, eyes, liver and nervous system. Folic acid is especially important for women as a lack of folic acid during pregnancy can cause birth defects. As a woman, getting healthy amounts of folic acid is imperative even if you use a method of birth control, including oral contraceptives.
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Folic acid is a critical nutrient for women of child-bearing age, and it is especially important if you are pregnant or plan to become pregnant. Infants born to mothers with folic acid deficiency preceding pregnancy and in early pregnancy may have significant birth defects of the brain and spine, including spina bifida and anencephaly. Even if you're taking oral contraceptives or using other birth control methods to prevent pregnancy, it's important to remember that no birth control method is 100 percent effective and that half of all pregnancies are unplanned, according to the Centers for Disease Control and Prevention. Folic acid is also crucial for women who become pregnant shortly after they stop using oral contraceptives; for this reason, the FDA has approved an oral contraceptive containing folic acid.
According to the University of Maryland Medical Center, long-term oral contraceptive use may possibly reduce folic acid levels as well as the body's ability to use folic acid. However, there is not conclusive evidence to indicate this, notes a 2010 report on birth control and nutrition from the University of Colorado. According to the report, while there are some reported cases of women who developed folic acid deficiency while taking birth control pills, it appears that many of these women had an insufficient folate status or problems absorbing this vitamin prior to taking oral contraceptives. Still, a pre-existing folic acid deficiency can be exaggerated by taking oral contraceptives, which may prove especially dangerous if you get pregnant shortly after stopping birth control, cautions U of C. It is thus essential to get plenty of folic acid in your diet when taking birth control pills.
Sources and Supplements
Folic acid is present in many foods. Enriched breads and cereals, dark green leafy vegetables, lean meats, eggs and orange juice are all rich in dietary folate. Whole grains, lima beans, soybeans, salmon, avocados, beef liver, beets and milk also provide folic acid. If you are unable to get the 400 mcg recommended dietary allowance of folic acid in your diet, or if you have problems absorbing folic acid, your doctor may recommend a dietary supplement that provides folic acid. A folic acid supplement is also a good idea for women who plan to become pregnant after stopping birth control as dietary folic acid needs rise to 600 mcg during pregnancy. At the amounts provided by the RDA, folic acid is associated with very few side effects, but it is still important to talk to your health care provider before taking dietary supplements.
Besides birth control pills, taking other medications may also interfere with your body's absorption of folate and thereby increase your folic acid needs. Drugs that lower folic acid levels include antacids, H2 blockers, proton pump inhibitors, nonsteroidal anti-inflammatory drugs, bile acid sequestrants, carbamazepine, sulfasalazine and triamterene. Folic acid should not be taken at the same time as the antibiotic tetracycline as folic acid may reduce the effectiveness of tetracycline, according to UMM. According to U of C, there is some evidence that oral contraceptives may also reduce levels of other nutrients, including vitamin C and zinc. Birth control pills can also worsen a pre-existing riboflavin deficiency. Still, the RDAs for these nutrients -- as well as that for folic acid -- are the same for women using oral contraceptives as they are for nonusers, notes the University of Colorado report.
REFERENCES & RESOURCES
- South Dakota Department of Health: Nutrition and Birth Control
- Colorado State University Extension; Nutrition and Oral Contraceptives; J.E. Anderson; December 2010
- University of Maryland Medical Center; Vitamin B9 (Folic Acid); May 2009
- Centers for Disease Control and Prevention: Unintended Pregnancy