Patients with type 1 diabetes who are pregnant are advised to take 5 milligrams of folic acid. I’ve advised to take folate, not folic acid. My questions is whether they need to only take it until 12 weeks, and does it matter if they get extra folate in multivitamin and mineral supplements?

Chris Kresser:  I think a moderate dose of folate throughout the pregnancy in a patient with autoimmune disease—or any patient, for that matter, depending on their diet—is a good insurance policy. I don’t think 5 milligrams is necessary, and that might even be too much and could lead to overmethylation, getting back to the under- and over-methylation idea. Folic acid is poorly converted into folate, so 5 milligrams might be the right dose there because not all of it’s being converted into folate. But if you’re taking active folate, I think something like 800 micrograms is enough.