How do folate levels affect seizure control in pregnancy?

Question

Hello Doctor,

I am a 30-year-old female on Lamotrigine for epilepsy. I am planning to conceive and just found out my serum folate is 4.1 ng/mL. My neurologist says Lamotrigine is safer than Valproate, but I am still worried. What is the folate target for seizure control in pregnancy? Should I switch medications or increase Folic acid?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

According to your medical history and considering your pregnancy plans, you have mentioned that you are taking Lamotrigine for epilepsy. Lamotrigine is generally considered safe during pregnancy. It does not harm the fetus, so there is no need to worry. You have also inquired about folate. Your serum folate level is within the normal range. A serum folate level above 4 ng/mL (nanograms per milliliter) is considered normal and beneficial for health. Folate, also known as vitamin B9, plays a crucial role in red blood cell production, DNA (deoxyribonucleic acid) synthesis, and overall cell growth, which are all important during pregnancy.

A low folate level (below 4 ng/mL) is not healthy and may lead to complications such as megaloblastic anemia and neural tube defects in the developing baby. Therefore, I recommend taking Folic acid supplements during the first trimester of pregnancy, even if you are already on Lamotrigine. This helps in preventing potential health risks like megaloblastic anemia and neural tube defects in the fetus. Please do not worry; go ahead with your pregnancy plans.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.