Epilepsy, pregnancy and Folic Acid.

[Writerwannabe83]

Can I ask people about their folic acid intake? When did you start taking it? I didn't start until I found out I was pregnant but I've recently read that actually neural tube defects can happen in the very early weeks, even before the woman has a missed period, so folic acid should actually be taken before pregnancy if a couple are TTC.

I'm on Lamotrigine 400mg a day (thankfully one of the safest drugs I believe) and I take the 5mg tablets of Folic acid but I didn't start taking them until I got my BFP.

When I had my son I was told I must be on them for three months even before TTC, which I followed, but this time round I wasn't taking the tablets because I'd stopped believing I was ever going to get pregnant because we'd been trying for so long with constant BFNs. I feel really stupid and worried now.

I've read though that a lot of food types have folic acid added to them: bread, rice, pasta, all of which I ate very frequently so I'm hoping that might act as a buffer of sorts. Can you tell that's desperation talking?

I can't stop thinking there will now be something wrong with my baby and it will all be my fault. I'm currently 9+2.

From doing a bit of googling, the neural tube doesn't close until 12 weeks, so folic acid acid will still have some protective effect if you take it now. The risk of neural tube defects is still low even without taking folic acid so try not to worry x

I started as soon as we started TTC. Try not to worry, simply because it won't help. The chances of there being a problem are still very very small.

I'm on lamotrigine too. With DS1 the doctor said no need to increase dose during pregnancy. This isn't the case, and consultant for DS2 said I was lucky not to have had a fit while pregnant with DS1. With DS2 we increased it during pregnancy and then decreased afterwards, so make sure they do that for you.

Pregnancy/epilepsy care was definitely hit and miss for me. By the time I had DS2 I was seeing a specialist pregnancy/epilepsy nurse, but before then not much in terms of actual knowledge/help at all. Do push for specialist care if you can.

Thankfully Flowery my team are excellent. I have an epilepsy nurse and my Obstetrician specialises in Epilepsy during pregnancy.

When I had my son I was on 300mg a day but then I hit 20 weeks the drug concentration in my blood started to drop below therapeutic levels so my dose had to be increased to 400mg. After I had DS my Epilepsy nurse kept me on the 400mg to act as a buffer for all the sleep deprivation that a new born brings and even though my son is now almost three I'm still on the 400mg as neither my Epilepsy nurse or GP wanted to rock the boat by decreasing my dose and possibly triggering seizures.

When I had my pre-conception appointment with my Epilepsy nurse last year she checked my blood levels and they were 5.6 which is a little high as therapeutic range is between 1.8 and 4 but she was still happy for me to remain on that dose as she felt me staying seizure free was the most important factor. I asked if the slightly higher blood level meant there was a higher risk of a neural tube defect occuring she assured me there wasn't.

When I phoned her to tell her that I was pregnant one of the first questions she asked was "Are you taking your folic acid?" and I told her yes but didn't tell her I had only just started taking it

I'm so glad you're getting good care, that's excellent. All the best for your pregnancy, I'm sure everything will be fine with baby.

As long as you are taking it now I wouldn't worry. Ideally it should be taken for 3 months before TTC but as you say you're taking it now so there's no point in worrying. The risk is quite small anyways.

Have you looked at a full range pregnancy vitamin that includes everything else you might need. It might be worth speaking with your GP to see if they recommend those too with your other medications.

Congratulations!!