# How much folic acid should you take before pregnancy in South Africa?

Source: https://www.healthnews24.co.za/answers/folic-acid-before-pregnancy-south-africa/
Publisher: Healthnews24 (South Africa's supplement answer desk)
Updated: 2026-10-27

> Most women planning a pregnancy in South Africa are advised to take 400 mcg (0.4 mg) of folic acid daily, starting at least one month before conception and continuing through the first 12 weeks. South African flour and maize meal are fortified, but food alone rarely guarantees that amount. Women with higher-risk histories need a doctor-prescribed higher dose.

Key facts:
- Standard pre-conception advice: 400 mcg (0.4 mg) folic acid daily, from at least 4 weeks before conception to about week 12 of pregnancy.
- South Africa has fortified wheat flour and maize meal with folic acid since October 2003.
- A 2008 study found neural tube defect prevalence fell 30.5% (1.41 to 0.98 per 1 000 births) after fortification (Sayed et al.).
- Commonly used adult upper limit for synthetic folic acid: 1 000 mcg a day; higher doses are prescription-only decisions.
- Dis-Chem Gold Multivitamin For Woman: 200 mcg folate per softgel, 2 a day, R133 for 60 at Dis-Chem Living Fit (October 2026).

## How much folic acid should you take before pregnancy?

The standard advice for women without special risk factors is **400 mcg (0.4 mg) of folic acid a day**, taken from at least four weeks before you try to conceive until about week 12 of pregnancy. The neural tube, which becomes the brain and spinal cord, closes in the first weeks, often before a pregnancy is confirmed. That is why the supplement needs to start early.

## Doesn't South African fortification cover this already?

Partly. Since October 2003 South Africa has required folic acid to be added to wheat flour and maize meal. A 2008 study by Sayed and colleagues found that neural tube defect prevalence fell by 30.5%, from 1.41 to 0.98 per 1 000 births, after fortification began. That is a population-level gain, not a guarantee for one woman. How much you actually eat depends on how much bread, pap and other fortified staples are in your diet, and fortified food alone may not reliably supply 400 mcg a day. Many doctors therefore still advise a supplement on top.

## Who needs a higher dose?

Some women are prescribed a much higher dose, commonly in the range of 4–5 mg a day. This usually applies if you have had a previous pregnancy affected by a neural tube defect, take certain anti-epileptic medicines, have diabetes, or have a high body mass index. This is a prescription decision. Do not stack several over-the-counter products to reach it. Tell your doctor or pharmacist about every product you take.

## What is the upper limit?

For synthetic folic acid from supplements and fortified foods, the commonly used adult upper limit is 1 000 mcg (1 mg) a day. A single 400 mcg tablet sits well below it. Doses above 1 mg can mask a vitamin B12 deficiency, so they should only be taken on medical advice.

## What does it cost at South African retailers?

A dedicated folic acid or prenatal tablet is the simplest option, and your pharmacist can advise on one. Among general women's multivitamins, the [Dis-Chem Gold Multivitamin For Woman](/answers/best-multivitamin-for-women-south-africa/) lists 200 mcg of folate per softgel with a dose of 2 a day, so 400 mcg daily. It was R133 for 60 softgels at Dis-Chem Living Fit in October 2026, about R4.43 a day. That product also contains iron and vitamin D, and we have not verified whether it is marketed as a prenatal, so check the label and ask your clinician before using it for pregnancy.

| Option | Folate per day | Price (October 2026) |
|---|---|---|
| Dis-Chem Gold Multivitamin For Woman, 2 softgels | 400 mcg (folate, per label) | R133 for 60, Dis-Chem Living Fit |
| Dedicated folic acid or prenatal tablet | check label | ask your pharmacist |

## Which other nutrients matter before conception?

- **Vitamin A:** avoid high-dose preformed vitamin A (retinol) supplements in pregnancy. See [supplements to avoid in pregnancy](/answers/supplements-to-avoid-in-pregnancy-south-africa/).
- **Iron:** only supplement if a blood test shows you need it. See [do women need iron supplements](/answers/do-women-need-iron-supplements-south-africa/).
- **Multivitamins generally:** evidence for benefit in healthy, well-fed adults is weak. Our [multivitamin comparison](/best/best-multivitamin-south-africa/) shows dose per serving.

## When should you see a doctor?

Book a pre-conception visit if you take regular medication, have diabetes, epilepsy or kidney disease, have had a previous neural tube defect pregnancy, or have a family history of one. This answer is general information, not personal medical advice.

Teenagers who may become pregnant need the same folic acid advice; a clinic or pharmacist can help.

## Products mentioned

| Product | Size | Price (source, date) | Servings | R per serving | Sweeteners |
|---|---|---|---|---|---|
| Dis-Chem Gold Multivitamin For Woman 60 softgels | 60 softgels | R133 (Dis-Chem Living Fit, 2026-10) | 30 | R4.43 | sorbitol 70% and glycerine in capsule fill |

## Sources

- [Sayed AR et al. (2008) Decline in the prevalence of neural tube defects following folic acid fortification and its cost-benefit in South Africa. Birth Defects Res A (University of Pretoria repository)](https://repository.up.ac.za/items/6ef74999-03b5-4227-b4f5-e1bc586efefe/full)
- [Status of prevention of neural tube defects post-folic acid fortification of cereal grains in South Africa (PMC)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705007/)
- [Dis-Chem Living Fit: Dis-Chem Gold Multivitamin For Woman](https://dischemlivingfit.co.za/product-category/vitamins-herbal/daily-wellness/)