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Folic Acid

Folic acid is a B vitamin needed for cell replication and growth. Folic acid helps form building blocks of DNA, the body’s genetic information, and building blocks of RNA, needed for protein synthesis in all cells. Therefore, rapidly growing tissues, such as those of a fetus, and rapidly regenerating cells, like red blood cells and immune cells, have a high need for folic acid. Folic acid deficiency results in a form of anemia that responds quickly to folic acid supplementation.

This supplement has been used in connection with the following health conditions:

Used for Amount Why
Birth Defects At least 400 mcg daily Supplementing with folic acid before and during the early weeks of pregnancy dramatically reduces the risk of neural tube defects.
Depression and Folic Acid Deficiency See a doctor for evaluation Taking folic acid can help correct deficiencies associated with depression.
High Homocysteine (Vitamin B12, Vitamin B6) 400 to 1,000 mcg of folic acid daily, 10 to 50 mg of vitamin B6 daily, and 50 to 300 mcg of vitamin B12 daily Vitamin B6, folic acid, and vitamin B12 all play a role in converting homocysteine to other substances within the body and have consistently lowered homocysteine levels in trials.
Age-Related Cognitive Decline 800 mcg per day Folic acid has been shown to slow the rate of cognitive decline in people with high homocysteine levels.
Atherosclerosis Consult a qualified healthcare practitioner Blood levels of an amino acid called homocysteine have been linked to atherosclerosis and heart disease in most research. Taking folic acid may help lower homocysteine levels.
Breast Cancer 400 mcg daily For women who drink alcohol, folic acid may reduce breast cancer risk by reversing the damaging effect alcohol has on DNA.
Celiac Disease and Folic Acid Deficiency Consult a qualified healthcare practitioner The malabsorption that occurs in celiac disease can lead to multiple nutritional deficiencies. Supplementing with folic acid may correct a deficiency.
Colon Cancer 400 mcg daily Folic acid may help prevent colon cancer, especially in people with ulcerative colitis and people who drink alcohol.
Halitosis and Gum Disease Use 5 ml twice per day of a 0.1% solution Folic acid is often recommended by doctors to help prevent and treat periodontitis and has been shown to reduce the severity of gingivitis when taken as a mouthwash.
Heart Attack 500 to 800 mcg daily Taking folic acid may reduce blood levels of homocysteine. High homocysteine levels have been linked to an increased heart attack risk.
Macular Degeneration (Vitamin B6, Vitamin B12) 2.5 mg folic acid, 50 mg vitamin B6, and 1 mg vitamin B12 daily In a double-blind study of female health professionals who had cardiovascular disease or risk factors, daily supplementation with folic acid, vitamin B6, and vitamin B12 significantly decreased the incidence of age-related macular degeneration.
Preeclampsia 5 mg daily Supplementing with folic acid and vitamin B6 may lower homocysteine levels. Elevated homocysteine damages the lining of blood vessels and can lead to the preeclamptic symptoms.
Skin Ulcers Consult a qualified healthcare practitioner Large amounts of folic acid given both orally and by injection could promote healing of chronic skin ulcers due to poor circulation.
Vitiligo Refer to label instructions Studies have shown folic acid to be effective at skin repigmentation in people with vitiligo.

How It Works

Many doctors recommend that all women who are or who could become pregnant take 400 mcg per day in order to reduce the risk of birth defects. Some doctors also extend this recommendation to other people in an attempt to reduce the risk of heart disease by lowering homocysteine levels. Since the FDA-mandated addition of folic acid to grain products, the average intake of folic acid from food has increased in the United States by about 100 mcg per day. However, studies have found that this amount of folic acid is inadequate to maintain normal folate levels in a significant percentage of the groups assessed. It now appears that, for pregnant women, supplementing with at least 300 mcg (and optimally 400 mcg) of folic acid per day is sufficient to prevent a folate deficiency, even if dietary intake is low.

Where to Find It

Beans, leafy green vegetables, citrus fruits, beets, wheat germ, and meat are good sources of folic acid. Folic acid naturally found in food is much less available to the body compared with synthetic folic acid found both in supplements and added to grain products in the United States. Women with a recent history of giving birth to babies with neural tube defects participated in a study to determine which form of folic acid is best absorbed—dietary folic acid or folic acid from supplements. They received either orange juice containing 400 mcg of folic acid per day or a supplement containing the same amount. Overall, the supplement folic acid was better absorbed than the folic acid from orange juice.

Possible Deficiencies

Many people consume less than the recommended amount of folic acid. Other possible deficiencies:

  • Scientists have found that people with heart disease commonly have elevated blood levels of homocysteine, a laboratory test abnormality often controllable with folic acid supplements. This suggests that many people in Western societies have a mild folic acid deficiency.
  • Folic acid deficiency has also been common in alcoholics, people living at poverty level, those with malabsorption disorders or liver disease (e.g., cirrhosis), and women taking the birth control pill.
  • Recently, elderly people with hearing loss have been reported to be much more likely to be folic acid–deficient than healthy elderly people. Folate deficiency is also more prevalent among elderly African American women than among elderly white women.
  • A variety of prescription drugs including cimetidine, antacids, some anticancer drugs, triamterene, sulfasalazine, and anticonvulsants interfere with folic acid.
  • Deficiency of folic acid can be precipitated by situations wherein the body requires greater than normal amounts of the vitamin, such as pregnancy, infancy, leukemia, exfoliative dermatitis, and diseases that cause the destruction of blood cells.
  • People with kidney failure have an increased risk of folic acid deficiency. Recipients of kidney transplants often have elevated homocysteine levels, which may respond to supplementation with folic acid. The usual recommended amount of 400 mcg per day may not be enough for these people, however. Larger amounts (up to 2.4 mg per day) may produce a better outcome, according to one double-blind trial.

Side Effects

With the exception of rare cases of allergic reactions, folic acid is not generally associated with side effects, although there have been rare case reports of allergic reactions to the vitamin. Folic acid supplementation can interfere with the laboratory diagnosis of vitamin B12 deficiency, possibly allowing the deficiency to progress undetected to the point of irreversible nerve damage. Although vitamin B12 deficiency is uncommon, no one should supplement with 1,000 mcg or more of folic acid without consulting a doctor.

Interactions with Supplements, Foods, & Other Compounds

Folic acid is needed by the body to utilize vitamin B12. Proteolytic enzymes inhibit folic acid absorption. People taking proteolytic enzymes are advised to supplement with folic acid.

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