Folic Acid, also known as Folate, is Vitamin B9. Iron is a mineral (or trace element) essential for the production of red blood cells in the body.
Vitamins and minerals are two types of nutrients that our bodies need daily (primarily from food) in very small amounts, but they must be sufficient for the body to function normally.
Folic Acid: It is one of the 13 vitamins that need to be provided daily (including 4 fat-soluble vitamins A, D, E, K, vitamin C, and 8 water-soluble B vitamins, with folic acid belonging to the water-soluble B group).
Folic acid is essential for the normal production of red blood cells and affects the synthesis of DNA and RNA, closely related to the process of cell division and replication. A deficiency in folic acid can lead to megaloblastic anemia. If pregnant women do not receive adequate folic acid, it can result in defects in the formation of the spinal cord in the fetus, increasing the risk of spina bifida.
Recent studies have shown that elevated levels of homocysteine in the blood can lead to various cardiovascular diseases such as atherosclerosis, arterial thrombosis, and myocardial ischemia. Supplementing folic acid along with certain other B vitamins can help lower homocysteine levels in the blood, assisting in the prevention of these cardiovascular diseases.
Iron: Among the minerals provided daily, iron plays a crucial role as it is essential for the formation of hemoglobin, which gives red blood cells their color and is responsible for transporting oxygen and carbon dioxide during respiration. A deficiency in iron can lead to iron-deficiency anemia. It is important to note that there are various forms of anemia, and iron-deficiency anemia is the most common type (alongside folic acid deficiency anemia and vitamin B12 deficiency anemia).
To prevent vitamin and mineral deficiencies, it is generally advisable to maintain a balanced diet. To ensure adequate intake of folic acid and iron, one should consume red meats (pork, beef), liver, green leafy vegetables, legumes, and whole grains. However, it is important to note that women are particularly prone to deficiencies in iron and folic acid, and in some cases, dietary intake of these essential nutrients may not be sufficient.
Women are more likely to experience iron-deficiency anemia than men because their iron reserves are lower due to blood loss during menstruation. Non-pregnant women should be aware of risk factors that promote iron-deficiency anemia and folic acid deficiency, such as prolonged bleeding, heavy menstrual flow, and excessively restrictive diets (sometimes due to an obsession with avoiding obesity). If affected by this type of anemia, women may frequently feel fatigued, experience decreased physical activity, and suffer from memory decline.
For pregnant women, the risk of iron-deficiency anemia and folic acid deficiency is significantly higher. During pregnancy, the iron reserves available in a woman’s body may not meet the increased demand for red blood cell production due to the growing blood volume needed to support the fetus. Additionally, the requirement for folic acid increases fourfold compared to pre-pregnancy levels. In pregnant women, iron-deficiency anemia raises the risk of infections and increases the likelihood of significant blood loss during and after childbirth, as well as risks of miscarriage, fetal growth retardation, and premature birth. A deficiency in folic acid can result in the fetus being at high risk for neural tube defects (a condition where the neural tube fails to close properly; the most common neural tube defect is spina bifida).
Due to the loss of folic acid during food processing and preservation, many countries, including the United States and several European nations, have legislation mandating the fortification of wheat flour with folic acid to prevent folic acid deficiency in the community. If a pregnant woman is being treated for malaria, epilepsy, or is taking methotrexate, she must supplement with folic acid.
Preventing iron-deficiency anemia and folic acid deficiency is not difficult for women of reproductive age and pregnant women. Simply taking one tablet containing folic acid and iron daily is sufficient to meet the body’s needs for these nutrients.
Notes on Taking Folic Acid and Iron Supplements:
– Do not take with tea; instead, drink with plain boiled water (as tea hinders iron absorption).
– Do not take with antacids for gastric ulcer treatment (iron will not be absorbed) or with tetracycline (tetracycline absorption will be reduced).
– After taking the supplement, your stool may turn black (due to the iron content; this is not a cause for concern).
Given the adverse effects of iron-deficiency anemia and folic acid deficiency mentioned above, it is crucial to prioritize the prevention and early treatment of these disorders in women’s reproductive health care programs.
