Things that doctors don’t tell you: Truth About Iron and Folic Acid Supplementation in Women
I didn’t know that women need to take iron and folic acid supplement until I engage to the medical and health industry.
My Ob-gyn didn’t tell me this when I was trying to get pregnant.
I remember asking my doctor If I can take supplements and recommend me good one. Turns out that doctors in Japan do not usually recommend supplements, they encourage their patients to take nutrients in whole foods. On the other hand, there are some countries that highly recommend supplements.
Due to the different health situation in every countries, Guidelines and recommendations may differ.
However, In pregnancy, supplementation of Iron and Folate in pregnant women are recommended to all pregnant women in all settings because of the increased risk to maternal and neonatal outcomes.
We all know that iron is an essential mineral for blood production and need to take them to prevent anemia and that folic acid is good for the baby and need to take both iron and folic acid during pregnancy.
But do you know that women need these supplementation PREGNANT OR NOT?
First let me walk you through the mechanism and importance of iron and folic acid.
IRON
Iron is an essential mineral that is responsible of producing hemoglobin, a protein in red blood cells that carries oxygen from the respiratory organs to all parts of the body. Lack of iron leads to iron deficiency anemia.
Iron deficiency anemia weaken resistance to infection and reduces physical capacity. In addition, pregnant women are in high risk of negative maternal and neonatal outcomes.
30 to 60 mg of elemental iron is the daily oral iron recommended dose.[1,2]
FOLIC ACID
Like iron, folic acid also helps with the production of blood and helps produce DNA and involved in amino acid synthesis and vitamin metabolism.
Folic acid requirements during pregnancy increase because of the rapidly dividing cells in the fetus and elevated urinary loses that excrete folate from our body.
Evidence suggests that supplementation of 400 μg (0.4mg) folic acid reduced risk of neutral tube defects.[1,2]
Folate deficiency also leads to anemia (Folate deficiency anemia).
ANAEMIA
Anaemia, is a low blood haemoglobin concentration, has been shown to be a public health problem that affects low-, middle- and high-income countries and has significant adverse health consequences, as well as adverse impacts on social and economic development .[4]
Anaemia is a condition in which your blood has a lower number of red blood cells and if your red blood cells don't contain enough hemoglobin. Hemoglobin helps red blood cells carry oxygen from the lungs to the rest of the body.
As a result, you may feel tired or weak. You also may have other symptoms, such as shortness of breath, dizziness, or headaches.
Severe or long-lasting anemia can damage your heart, brain, and other organs in your body. Very severe anemia may even cause death.[5]
Why women need Iron and Folic acid even if they are not pregnant?
Women's reproductive biology(menstrual cycle, pregnancy and birth) is one of the factors making all women vulnerable in iron and folate deficiency. [3]
And because Iron and folate cannot be synthesized in our body, maintaining iron and folic acid levels in our diet is very much necessary.
According to WHO, in malaria endemic areas, provision of iron and folic acid supplements should be implemented in conjuction with measures to prevent, diagnose and treat "Malaria".[1]
In India, because of its high prevelance of anemia in all groups children, adolescent girls, pregnant women and adult men and women compared to other developing countries, Government of India has started WIFS programme. In this programme students from Government schools and school dropout adolescent girls in Anganwadis will be given Weekly Iron Folic Acid tablets and Albendazole (deworming) tablets twice a year.[6]
Image by: National Health Mission - Goa
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