Benefits and Risks of Preconceptional Folic Acid Supplementation —Reply

In Reply We thank Voinescu and colleagues for their comments on our recent article in JAMA Neurology. We agree that there is no study to date to help in determining the optimal dose of folic acid supplementation for women with epilepsy. Our findings of an increased risk of cancer in children of mothers with epilepsy who are taking antiseizure medication and are exposed to high-dose folic acid indicate that there could be an upper dose limit above which the risks outweigh the benefits. This suggests an upper limit below the 4 to 5 mg per day recommended dosage to mothers with epilepsy by some major guidelines (eg, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network).
Source: JAMA Neurology - Category: Neurology Source Type: research