Folic acid and epilepsy when you’re pregnant

  • July 29, 2021
  • 3
In this article

There are many things to think about when you become pregnant - from your baby’s name, to where you’ll give birth, and how it’ll affect your lifestyle. There are also changes in your diet to think about - and that is especially true if you experience seizures. Your doctor might recommend you take certain vitamins to give your baby the best start in life.

In this article we will look at the link between folic acid and epilepsy when you are pregnant.

What is folic acid?

Folic acid is a vitamin that is found in a wide variety of foods, particularly salads and green vegetables (like spinach, cabbage, kale or asparagus). Your body uses folic acid to make healthy red blood cells which help carry oxygen around the body.

Why is folic acid important during pregnancy?

If a pregnant woman does not get enough folic acid during pregnancy, this could affect how her baby develops. It could lead to minor problems like small abnormalities to the fingers or toes, or major issues such as brain problems, a cleft palate, or a hole in the heart.

To avoid these kinds of issues, the CDC recommends that all women take folic acid supplements as part of their diet before and during pregnancy.

Pregnancy, folic acid and seizures

If you are planning to get pregnant and have epilepsy, it is especially important to think about folic acid. This is because certain anti-epilepsy drugs might make it harder for your body to absorb folic acid. These include:

  • Phenytoin
  • Carbamazepine
  • Barbiturates
  • Possibly valproate

Because these medicines can reduce the amount of folic acid that your body absorbs, it may increase the risk that your child could have some developmental issues.

If you are taking any of the anti-epilepsy medication listed above, it is vitally important to speak to your epileptologist. Your epilepsy treatment team may recommend increasing the amount of folic acid in your diet by taking a supplement every day.

If you become pregnant unexpectedly, it is recommended that you should keep taking your anti-epilepsy medication but begin buying folic acid supplements from your local pharmacy until you can see your gynecologist.

Can folic acid deficiency cause seizures?

Maybe. Research suggests that having too much folic acid in your blood could make certain anti-epilepsy medications less effective. For example, the anti-epilepsy medication phenytoin may become less effective if you are taking more folic acid than usual. 

Other folic acid and epilepsy medication interactions may include phenobarbital and primidone. It is always a good idea to speak to your doctor and your gynecologist if you are planning to get pregnant to learn how folic acid and seizure medicine affect one another.

What foods have folic acid?

Since the 1990s, the government has required that all bread, flour and cereals be fortified with folic acid. That means most people get enough of this vitamin from their regular diets. But if you’re pregnant and have epilepsy, your doctor might recommend taking additional folic acid supplements.

Foods containing folic acid include:

  • Most green leafy plants, including salads, spinach, kale, cabbage, broccoli, asparagus and Brussels sprouts
  • Legumes - chickpeas and kidney beans are especially rich in folic acid
  • Many breakfast cereals (check the packaging to see if they are fortified)
  • Eggs
  • Peanuts
  • Liver and seafood (but these should not be eaten when you are pregnant)

Folic acid and epilepsy - planning your pregnancy

Thinking about what you eat during pregnancy is especially important if you have epilepsy. Knowing about the link between folic acid and seizures is therefore important. By talking to your epilepsy treatment team and telling your gynecologist about your seizure medication, you can work together to decide on the best plan for your pregnancy.  

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