Iodine, folic acid and pregnancy - practical advice

For healthy people in Germany with a balanced and varied diet, food supplements are usually unnecessary. Pregnant and breastfeeding women represent an exception: In order to ensure adequate supply with iodine and folate/folic acid, medical associations and the German Society for Nutrition recommend an additional intake via supplements for them. This applies in particular to folic acid already when planning a pregnancy. However, many women start taking it too late or not at all. "When it comes to imparting knowledge about the importance of iodine and folate/folic acid and to avoiding both deficiency symptoms and overdoses, medical advice on all aspects of pregnancy is crucial", says BfR Vice President Professor Dr. Tanja Schwerdtle. In order to support medical staff in this important task, the German Federal Institute for Risk Assessment (BfR) has updated its fact sheet "Iodine, Folate/Folic Acid and Pregnancy - Information for Physicians".

Fact sheet “Iodine, Folate/Folic Acid and Pregnancy - Information for Physicians” (in German):

When offering medical advice and support to pregnant women, breastfeeding women and women who wish to become pregnant, it is essential to take into account the nutritional behaviour and special nutritional requirements. An adequate supply of iodine and folate/folic acid is particularly important in the vulnerable phase of pregnancy. Information about the importance of iodine and folate/folic acid for the health of the mother and the (unborn) child should therefore be an essential part of the medical advice provided to women who are planning to become or who are pregnant or breastfeeding. The aim of the newly published BfR fact sheet is to support physicians in their day-to-day practice. The updated version provides information about causes, consequences and risk groups of an insufficient supply of iodine or folate/folic acid and about measures to improve supply. In addition to background knowledge, it provides tools for counselling practice: e.g. a list of questions regarding individual iodine-related history as well as specific recommendations for achieving folate requirements before and during pregnancy.

According to data from the national health survey of the Robert Koch-Institute (RKI), around 30 percent of the adults and 44 percent of the children and adolescents examined are at risk of insufficient iodine intake. For women of childbearing age, the risk is particularly high. An adequate supply of iodine is particularly important for pregnant and breastfeeding women, because the trace element is essential for the physical and mental development of the child. Therefore, in Germany, pregnant and breastfeeding women, after prior medical consultation, are advised to take a supplement containing 100 (up to 150) micrograms of iodine per day.

In the case of folate, data from the RKI indicate that the general adult population is adequately supplied with that vitamin. However, the majority of women of childbearing age do not reach the blood folate levels recommended by the World Health Organization (WHO) to reduce the risk of birth defects (neural tube defects). A neural tube defect is associated with serious consequences for the child's health and can be associated with lifelong disabilities. In order to reduce the risk of neural tube defects, it is recommended that women, who wish to become pregnant, supplement - in addition to a folate-rich diet - 400 micrograms of folic acid in tablet form daily, at least four weeks before and during the first three months of pregnancy.

About the BfR

The German Federal Institute for Risk Assessment (BfR) is a scientifically independent institution within the portfolio of the Federal Ministry of Food and Agriculture (BMEL) in Germany. The BfR advises the Federal Government and the States ('Laender') on questions of food, chemical and product safety. The BfR conducts its own research on topics that are closely linked to its assessment tasks.

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