Folic Acid in the First Days of Pregnancy
I have been honored to be working with Dr. Irva Hertz-Picciotto of the University of California at Davis, who is widely regarded as the world's leading expert on the epidemiology of autism. She has very recently informed me of some very exciting news, news that for the first time opens the door to possibly preventing autism.
Many of you may recall that I met Dr. Hertz-Picciotto roughly 2 years ago in preparation for leading a roundtable on finding the reversible causes of autism convened and hosted by Senator Sherrod Brown in the US Senate Meeting Rooms.
The exciting news is the result of years of work on the part of Dr. Hertz-Picciotto and her team in the MARBLES study (Markers of Autism Risk in Babies). Her colleague Dr. Rebecca Schmidt has just reported that mothers who take sufficient folic acid in the days prior to and just after conception have sharp reduction in their risk of their babies developing autism. This is how dramatic the news is: if your folic acid levels are high enough, your baby's risk of developing autism drops FIVE-FOLD. This is very dramatic news.
The impact is supported by other studies, so it is a replicated result, making it unlikely to be disproven with further studies.
How much is enough? When do you have to take it to get the protection? These are key questions.
How much is enough?
The actual answer is only determined by testing a blood level of folic acid, but Dr. Schmidt states that for nearly everyone, taking 800 micrograms a day will get you to the levels needed to see a five-fold reduction in the chance your child will develop autism.
When do you have to take it to get the protection?
The protection works best the earlier in pregnancy that it is taken. After one month of pregnancy, the protective effect already weakens. This means for best protection, your folic acid levels should be at the protective level before conception. We recommend that all girls and women take 800 mcg of folic acid a day from their first period to their last. That way, whenever pregnancy occurs, the protective effect of folic acid will be in place for the first days of embryonic development, the key time the protection is necessary. If this routine cannot be sustained, then it is critical that the folic acid be taken the whole period of your life when you think you may be having a baby.
How certain is this finding to work?
At this point it is highly likely to work. The last step in proof is for the population to take 800 mcg before every pregnancy and then see if autism does drop five-fold as anticipated.
Good evidence is now in hand to strongly suggest that if you take 800 mcg of folic acid every day the month before and then throughout pregnancy, your child will drop their risk of developing autism quite substantially, perhaps as much as five-fold.