Question about higher dose folic acid

[WonderfulCheese]

Holy smokes, I got two lines!

Facts:

I have had a number of miscarriages, up to 20 weeks.

I do have two little ones who made it.

I'm 40

I'm bmi 31.7.

I must be 4 weeks pregnant.

Question:

I Know I need a higher dose of folic acid - 5mg was prescribed last time. However I only have the over the counter ones, which are 400micro grammes I think. I don't really understand why the extra weight requires a dose over ten times the usual, but can I just take ten of the smaller tablets? Feels a bit weird, and when I was previously told to take aspirin, I was told I couldn't chop a generic aspirin in half.

I tried calling the antenatal department today to book in but was told they couldn't help me before 8 weeks - but I just wanted the answer to my above questions and I have tried googling.

If anyone has been in this situation, I'd be grateful to hear from you :-)

Congratulations! Get onto your GP and tell them you need the higher dose folic acid and baby aspirin, they'll do you a prescription and I'm pretty sure you can claim the money back once you get your maternity exemption certificate. All very straightforward 😊

Ask your GP. I put in an e-consult and got a call back from the surgery pharmacist (who knew there was one!?) the following day and had it sorted. Did have to pay as I didn't have exemption certificate. Incidentally once I had my booking appointment the midwife mentioned that in my area the recommendation for 5mg kicks in at BMI of 35....

Yes that's what the midwife said, but it's difficult to get in with our gp, so I thought I might try to do it with over the counter stuff - it's only a few pence?

I can of course try again if there's no other way.

Interesting about the bmi 35!

I already have a pack of 75mg aspirin but can't remember how many to take - do you know?

You don't need to see the gp, just to tell them the situation and request the prescription. There will probably be a way to do that without an appointment- check with receptionist?

when I was previously told to take aspirin, I was told I couldn't chop a generic aspirin in half.
Why not?

I was put on 150mg because I'm over 40. I take half a 300mg tablet.

No reason not to take OTC folic acid, but you need 12 of the ones you have. A 5mg prescription is usually easier.

Aspirin 150mg (2 x 75mg OR 1/2 300mg), cutting the tablet is fine. Just don't tell the pharmacist you are pregnant.

The 5mg folic acid is recommended with a BMI of more than 30.

I asked about a higher dose of folic acid with my youngest as my previous baby was born with a cleft lip. I was told not to take the higher dose which I thought was weird. I had a high bmi too. My youngest is 9 now though so maybe guidelines have changed in the last 10 years.

Good question. I don't know. They said you can't just chop a 150 in half.

Is it really OK to chug 12 folic acid pills? I feel a bit like one of those people in an american film manically shaking the vallium bottle into their hand and swallowing them down without water 😂

Why do you say not to tell the pharmasist?

I am hoping to just quietly take the medication and sit tight until I hit 20 weeks. I hope when they do want to book me in they can just transfer my notes because I can't face two hours of form filling-in again.

Me and 12 folic acid pills: 😬

Aspirin is not licensed in pregnancy (the drug companies don’t want the hassle for a low cost medicine). If the pharmacist knows you are pregnant, they are not allowed to sell it to you.

I had the same issue as you! My doctor friend said not to take more of the lower dose because although you need the folic acid in them, you don’t want to be taking 12x whatever they use to bind the pills together.
just explain to GP tomorrow and get a prescription, I just called my GP reception and they had them waiting for me at the end of the day :)

I would take the OTC folic acid today at the OTC dose and contact your GP for the prescribed folic acid.

I take 5mg of folic acid because I take sulfasalazine. GP prescribes it after Rheumatology told them to.

When you get it prescribed, check how long you need to take it for. I have to take mine for the full pregnancy.

I’d definitely try contacting GP today, do you have econsult? I wouldn’t risk it

Oops I took the twelve today. I filled in an e consult and it says they will take ten days to get back to me.

It may well be faster but it's frustrating because I am high risk and don't know who to turn to for help here.

I think you can ride it out with your workaround as you are doing

They will probably come back faster than that on the eConsult but I would call your GP surgery in the morning and ask the receptionist to request a prescription. My surgery takes general enquiries after 10am which is basically anything other than same day appointments.

If it's hard to get through on phone you could also turn up in person and ask.

5mg? Are you sure? It seems way too much. The NHS says "400 micrograms of folic acid every day – from before you're pregnant until you're 12 weeks pregnant" https://www.nhs.uk/pregnancy/keeping-well/vitamins-supplements-and-nutrition/
It even seems that the upper safe limit is 1 mg per day.

And anyway, you need it in the first 30 days or so of pregnancy, once the neural tube has closed, there is no benefit, and definitely doesn't affect your risk of miscarriage

Oh wow! Doesn't exactly make e-consult an attractive alternative when you have to wait 10days (at mine you get a text same day or next day with either an appointment or a response). Definitely chase up with a request put in at reception OP.

Nope, bad info helenatthegym 5mg daily is the dose for obese women, those with MTHFR mutations and other indications like sickle cell etc

Bnf

Yeah I wouldn't take 12 tablets as like someone else said its the other ingredients in the tablets that you don't want x12 of. I would take the OTC dose, hope the GP gets back to you quickly and increase your folic acid consumption from food stuffs while you wait.

I think I'll compromise with maybe 4 of them for tomorrow...

@HelenAtTheGym I am technically obese, or as the midwife put it when she couldn't hear a heartbeat with the doppler, I have a "raised bmi" (mumtum)

I'm 13st 2.

Hello.

My BMI is 32 and also told to take Folic. They gave me a box of the regular artificial stuff. I purchased my own online which is Bioavilable 1000ug = 1mg so I take 5 a day to make up the 5mg needed. It is Bioavilable so absorbed easily. 75% of the population can not motabilise artificial folic acid and so there are lots of women not getting the benefits at all.
So if I have to take it let me take the good atuff.
I got mine from a Pharmacy in London but they post all over. My brother is a senior pharmacist and says it is 100% safe for me to take. And my BIL is a consultant OBGYN 25years + (big age gap between OH and his brothers) and checked the pack and said it was fine for me to take.

They messed up my prescription so it took ages and instead I just took ten of the normal tablets. I spaced them out thru the day, taking 2 or 3 at a time. It was fine