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Folic Acid
Overview

Folic acid is a water-soluble B vitamin. Since 1988, it has been added to cold cereals, flour, breads, pasta, bakery items, cookies, and crackers, as required by federal law. Foods that are naturally high in folic acid include leafy vegetables (such as spinach, broccoli, and lettuce), okra, asparagus, fruits (such as bananas, melons, and lemons) beans, yeast, mushrooms, meat (such as beef liver and kidney), orange juice, and tomato juice.

Folic acid is used for preventing and treating low blood levels of folic acid (folic acid deficiency), as well as its complications, including "tired blood" (anemia) and the inability of the bowel to absorb nutrients properly. Folic acid is also used for other conditions commonly associated with folic acid deficiency, including ulcerative colitis, liver disease, alcoholism, and kidney dialysis. Women who are pregnant or might become pregnant take folic acid to prevent miscarriage and "neural tube defects," birth defects such as spina bifida that occur when the fetus's spine and back don't close during development.

Some people use folic acid to prevent colon cancer or cervical cancer. It is also used to prevent heart disease and stroke, as well as to reduce blood levels of a chemical called homocysteine. High homocysteine levels might be a risk for heart disease.


Folic acid is used for memory loss, Alzheimer's disease, age-related hearing loss, preventing the eye disease age-related macular degeneration (AMD), reducing signs of aging, weak bones (osteoporosis), jumpy legs (restless leg syndrome), sleep problems, depression, nerve pain, muscle pain, AIDS, a skin disease called vitiligo, and an inherited disease called Fragile-X syndrome. It is also used for reducing harmful side effects of treatment with the medications lometrexol and methotrexate. Some people apply folic acid directly to the gum for treating gum infections.

What is Folic Acid ?
Folic acid, sometimes called folate, is a B vitamin (B9) found mostly in leafy green vegetables like kale and spinach, orange juice, and enriched grains. Repeated studies have shown that women who get 400 micrograms (0.4 milligrams) daily prior to conception and during early pregnancy reduce the risk that their baby will be born with a serious neural tube defect (a birth defect involving incomplete development of the brain and spinal cord) by up to 70%.

The most common neural tube defects are spina bifida (an incomplete closure of the spinal cord and spinal column), anencephaly (severe underdevelopment of the brain), and encephalocele (when brain tissue protrudes out to the skin from an abnormal opening in the skull). All of these defects occur during the first 28 days of pregnancy - usually before a woman even knows she's pregnant. That's why it's so important for all women of childbearing age to get enough folic acid not just those who are planning to become pregnant. Only 50% of pregnancies are planned, so any woman who could become pregnant should make sure she's getting enough folic acid.

Doctors and scientists still aren't completely sure why folic acid has such a profound effect on the prevention of neural tube defects, but they do know that this vitamin is crucial in the development of DNA. As a result, folic acid plays a large role in cell growth and development, as well as tissue formation.

In 1998, the U.S. Food and Drug Administration mandated that folic acid be added to enriched grain products - so you can boost your intake by looking for breakfast cereals, breads, pastas, and rice containing 100% of the recommended daily folic acid allowance. But for most women, eating fortified foods isn't enough. To reach the recommended daily level, you'll probably need a vitamin supplement.

During pregnancy, you require more of all of the essential nutrients than you did before you became pregnant. Although prenatal vitamins shouldn't replace a well-balanced diet, taking them can give your body and therefore your baby an added boost of vitamins and minerals.

Where it is found
Excellent sources of folate include romaine lettuce, spinach, asparagus, turnip greens, mustard greens, calf's liver, parsley, collard greens, broccoli, cauliflower, beets, and lentils. Very good sources include squash, black beans, pinto beans, garbanzo beans, papaya and string beans.

See Folic Acid related videos:
video icon Healthy Pregnancy, Healthy Baby: Folic Acid for Women (video module - 3.28 minutes)
video icon Understanding the role of Folic acid(video module - 1.44 minutes)
Product related PDF file
All About Folic Acid
Difference Between Folate and Folic-Acid
Folic Acid for Every Women Everyday
Folic Acid Study June 2001
 
Benefits / uses
arw Treating and preventing folic acid deficiency.


arw Lowering homocysteine levels in people with kidney disease. About 85% of people with serious kidney disease have high levels of homocysteine. High levels of homocysteine have been linked to heart disease and stroke. Taking folic acid lowers homocysteine levels in people with serious kidney disease.


arw Lowering homocysteine levels ("hyperhomocysteinemia") in people with high amounts of homocysteine in their blood. High levels of homocysteine have been linked to heart disease and stroke.


arw Reducing harmful effects of a medicine called methotrexate, which is sometimes used to treat rheumatoid arthritis and psoriasis. Taking folic acid seems to reduce nausea and vomiting, which are possible side effects of methotrexate treatment.


arw Decreasing the risk of certain birth defects (neural tube defects) when taken by pregnant women.


arw Reducing the risk of getting colorectal cancer. Getting more folic acid from the diet and supplements seems to lower the chances of developing colon cancer, but does not seem to help people who already have colon cancer.


arw Reducing the risk of breast cancer. The benefit is greater when women get extra vitamin B12 and vitamin B6 in their diet in addition to folic acid.


arw Depression, when used with conventional antidepressant medicines.


arw Treating a skin disease called vitiligo.


arw Gum problems due to a drug called phenytoin when applied to the gums.


arw Treating gum disease during pregnancy, when used in mouthwash.


arw Reducing the risk of pancreatic cancer.


arw Macular degeneration. Some research shows that taking folic acid with other vitamins including vitamin B6 and vitamin B12 might help prevent getting the eye disease called age-related macular degeneration.

When to take/Types to take.
Folic acid supplement are best taken with meal. It is not generally commercially available in various forms.

Doses
The Recommended Dietary Allowances for folic acid, set in 1998 by the Institute of Medicine at the National Academy of Sciences, are as follows:

arw 0-6 months: 65 micrograms


arw 6-12 months: 80 micrograms


arw 1-3 years: 150 micrograms


arw 4-8 years: 200 micrograms


arw Males 9-13 years: 300 micrograms


arw Males 14 years and older: 400 micrograms


arw Females 9-13 years: 300 micrograms


arw Females 14 years and older: 400 micrograms


arw Pregnant females of any age: 600 micrograms


arw Lactating females of any age: 500 micrograms

Possible Side effects / Precautions / Possible Interactions:
Folic acid is safe for most people. Most adults do not experience any side effects when consuming the recommended amount each day, which is 400 mcg.
High doses of folic acid might cause abdominal cramps, diarrhea, rash, sleep disorders, irritability, confusion, nausea, stomach upset, behavior changes, skin reactions, seizures, gas, excitability, and other side effects.

Research studies / References

arw Bazzano LA, He J, Odgen LG et al. Dietary intake of folate and risk of stroke in US men and women:NHANES I Epidemiologic Follow-up Study. Stroke 2002 May;33(5):1183-9 2002.




arw Beers MH, Berkow R. The Merck manual of diagnosis and therapy. Merck Research Laboratories, Whitehouse Station, New Jersey, 1999;850-870 1999.


arw Bower C, Stanley FJ, Nicol DJ. Maternal folate status and the risk for neural tube defects. The role of dietary folate. Ann N Y Acad Sci 1993;678:146-55 1993.


arw Brody T, Shane B, Stokstad ELR. Folic acid. In: Machlin LJ. (Ed). Handbook of vitamins. Marcel Dekker, New York, 1984 1984.


arw Coombs GF. The vitamins. Academic Press, San Diego, 1992;357-376 1992.


arw Duan W, Ladenheim B, Cutler RG et al. Dietary folate deficiency and elevated homocysteine levels endanger dopiminergic neurons in models of Parkinson's disease. J Neurochem 2002 Jan;80(1):101-10 2002.


arw Fernstrom JD. Can nutrient supplements modify brain function. Am J Clin Nutr 2000;71:(6 Suppl):1669S-75S 2000.


arw Groff JL, Gropper SS, Hunt SM. Advanced Nutrition and Human Metabolism. West Publishing Company, New York, 1995 1995.


arw Mason JB, Levesque T. Folate: effects on carcinogenesis and the potential for cancer chemoprevention. Oncology (Huntingt) 1996;10(11): 1727-1743 1996.


arw Montes LF, Diaz ML, Lajous J, et al. Folic acid and vitamin B12 in vitiligo: a nutritional approach. Cutis 1992;50:39-42 1992.


arw Onicescu D, Marin A, Mischiu L. Folate metabolism in normal human gingiva and in chronic marginal periodontitis. Rev Chir Oncol Radiol 1978;25(4): 257-64 1978.


arw Pancharuniti N, Lewis CA, Sauberlich HE, et al. Plasma homocyst(e)ine, folate, and vitamin B12 concentrations and risk for early-onset coronary artery disease. Am J Clin Nutr 1994;59:940-948 1994.


arw 13.Quadri P, Fragiacomo C, Pezzati R, Zanda E, Forloni G, Tettamanti M, Lucca U. Homocysteine, folate, and vitamin B-12 in mild cognitive impairment, Alzheimer disease, and vascular dementia. Am J Clin Nutr. 2004 Jul;80(1):114-22. 2004. PMID:15213037.


arw Ristow KA, Gregory JF, Damron BL. Thermal processing effects on folacin bioavailability in liquid model food systems, liver and cabbage. J Agr Food Chem 1982;30(5):801-806 1982.


arw Scholl TO, Johnson WG. Folic acid: influence on the outcome of pregnancy. Am J Clin Nutr 2000 May;71(5 Suppl):1295S-303S 2000. PMID:10430.


arw 16.Steinberg SE. Mechanisms of folate homeostasis. Am J Physiol 1984;246:G319-G324 1984.


arw Terry P, Jain M, Miller AB et al. Dietary intake of folic acid and colorectal cancer risk in a cohort of women. Int J Cancer 2002 Feb 20;97(6):864-7 2002.


arw 18.Ubbink JB, Vermaak WJ, van der Merwe A, Becker PJ. Vitamin B-12, vitamin B-6, and folate nutritional status in men with hyperhomocysteinemia. Am J Clin Nutr 1993 Jan;57(1):47-53 1993. PMID:19560.


arw van Meurs JB, Dhonukshe-Rutten RA, Pluijm SM, van der Klift M, de Jonge R, Lindemans J, de Groot LC, Hofman A, Witteman JC, van Leeuwen JP, Breteler MM, Lips P, Pols HA, Uitterlinden AG. Homocysteine levels and the risk of osteoporotic fracture. N Engl J Med. 2004 May 13;350(20):2033-41. 2004. PMID:15141041.


arw Vujkovic M, Steegers EA, Looman CW et al. The maternal Mediterranean dietary pattern is associated with a reduced risk of spina bifida in the offspring. BJOG: An International Journal of Obstetrics and Gynaecology. Kidlington: Feb 2009. Vol. 116, Iss. 3; pg. 408-415. 2009.


arw Zimmerman MB, Shane B. Supplemental folic acid. Am J Clin Nutr 1993;58:127-128 1993.