| Folic acid (or folate) | ||||||||
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- Why folic acid is good for you
- Important folic acid facts
- Groups at risk of folic acid deficiency
- Symptoms of folic acid deficiency
- Folic Acid and health
- Folic Acid in foods
- Folic Acid recommended daily intake (RDI)
- Folic Acid works best with
- Overdosage, toxicity and cautions for folic acid
Why folic acid is good for you
Folic acid is one of the B vitamin co-factors. It helps the B vitamins to function more effectively.
Folic acid is required for DNA synthesis and cell growth and is important for red blood cell formation (it helps to make new red blood cells work efficiently and properly), energy production as well as to help form amino acids. It is important for healthy cell division and replication, since it is involved as a coenzyme for DNA synthesis - it is especially useful for cells that wear out and divide rapidly, such as red blood cells, skin cells and the cells that line the small intestine.
Folic acid also helps with proper digestion, a healthy nervous system and improves mental as well as emotional health. Folic acid is needed to build muscles and to keep the body strong and in good condition. It is also required for protein metabolism and in treating folic acid anaemia.
Folic acid is also very important in the development of the nervous system of a developing foetus.
Basically folic acid is needed for the normal growth and maintenance of every cell in the body.
- In the past few years research has identified that folic acid prevents birth defects. The research findings are so compelling, that extra folic acid has now been added to a variety of foods, such as bread, breakfast cereal, past and rice and women of child-bearing age, who are considering getting pregnant, are recommended to take a daily folic acid supplement to assist in preventing these birth defects
- Only about 50% of the folic acid from food is absorbed
- Much of the folic acid in beans and vegetables is lost in cooking and processing. Cook fresh vegetables in as little water as possible, to preserve the folic acid
- Beans are an excellent natural source of folic acid. To reduce the gas production, soak dried beans in nine cups of water for each cup of beans. Drain the beans and change the water at least twice during the 24-hour soaking period. Then drain and rinse well before using. If canned beans are being used, drain and rinse well at least once using them
- Folic acid may be effective in treating depression and anxiety
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Groups at risk of folic acid deficiency
- Pregnant women – doctors will usually prescribe a folic acid supplement. Even women who are not currently pregnant, but are of childbearing age, need extra folic acid.
- Breastfeeding women – a lot of nutrients ingested are being passed onto the baby, some more folic acid may be required - doctors will normally prescribe folic acid if it is required
- Alcoholics – absorb less of some of the B vitamins and may not eat properly, plus alcohol seems to block absorption of folic acid
- Smokers – are usually low on all of the B vitamins and B Vitamin co-factors, including folic acid
- Women taking oral contraceptives – these drugs can interfere with Folic acid absorption, so supplementation may be required
- People taking certain drugs – some drugs actually block absorption of folic acid. These include - anti-convulsant medications, Chloramphenicol, Cortisone, Methotrexate, Pyrimethamine, Quinine, Sulfasalazine, Sulfa drugs, and Trimethoprim. People on these drugs should talk to a medical professional about the interaction of the drugs they are taking and folic acid supplementation
- People over 65 years – older people absorb less of some of the B vitamins, and many older people may not be eating properly
Talk to a medical professional about folic acid supplements BEFORE taking them.
Symptoms of folic acid deficiency
Folic acid deficiency affects the growth and repair of the body’s tissues. The tissues that have the fastest rate of cell replacement are the first ones to be affected, so the blood and digestive tract are where the signs of deficiency will most likely appear. A deficiency of folic acid on an unborn baby may increase the risk of the baby being born with spina bifida and other serious defects of the nervous system. |
Deficiency in folic acid presents with the following symptoms:
- anaemia
- nausea and loss of appetite
- diarrhoea
- malnutrition from poor nutrient absorption (anorexia)
- weight loss
- weakness
- sore tongue
- headaches
- irritability
- mood swings
- heart palpitations
- Healthy babies - recent studies have conclusively shown that taking 400mg of folic acid each day before getting pregnant can prevent 50%-75% of all neural tube defects. Neural tube defects (NTD) occur when the growing brain, spinal cord and vertebrae (bones of the spine) of an unborn baby do not develop properly during the first month of pregnancy. All women between the ages of 15 and 47 are encouraged to take folic supplements (unless there is a medical reason not to, advised by a medical professional)
- Healthy hearts - not enough folic acid causes homocysteine levels to build up to dangerous levels. About 100-200mg of extra folic acid is all it takes to keep the homocysteine levels lowered. A blood test can check homocysteine levels, after which folic acid supplementation should be discussed if the homocysteine levels are high (>14micromoles/L for men and > 8.5micromoles/L)
Talk to a medical professional about folic acid supplements BEFORE taking them.
FUTURE DIRECTIONS
- Preventing cancer - recently folic acid is getting a lot of attention for its role in preventing cancer of the colon and cervix and maybe for preventing other cancers as well. Research is being conducted in this area
- Preventing colon cancer - recent studies show that people with low folic acid levels are more likely to get colon cancer. Women who get a lot of folic acid in their diet reduce their risk of colon cancer by 60%! This is not true for men. People with ulcerative colitis (UC), a serious, chronic disease of the large intestine, have an increased risk of colon cancer, and they often have low folic acid levels. For many patients, this is because the drug they take to help with UC, blocks absorption of folic acid. Recent studies showed that UC patients who took extra folic acid supplementation reduced their chances of colon cancer by nearly half! People with ulcerative colitis, should discuss folic acid supplementation with their doctor
- Preventing cervical cancer - recent studies have shown that women with HPV (human papillomavirus) and low folic acid levels were five times more likely to have abnormal cervix cells (cervical dysplasia). Other studies suggest that minor cervical dysplasia can be effectively treated with large doses of folic acid. This is not something to try except under medical supervision. Women with cervical dysplasia, should discuss treatment options with a medical professional
- Depression - a recent study of depressed patients in a US hospital showed that low folic acid levels were linked to depression. The most depressed patients had the lowest levels of folic acid and they were the least likely to benefit from antidepressant drugs
Talk to a medical professional about folic acid supplements BEFORE taking them.
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| FOOD | AMOUNT | Folic Acid (mcg) |
|---|---|---|
Chicken, liver |
85g | 660 |
Lentils |
1 cup | 358 |
Chickpeas |
1 cup | 282 |
Lima beans, baby |
1 cup | 273 |
Black beans |
1 cup | 256 |
Navy beans |
1 cup | 255 |
Kidney beans |
1 cup | 229 |
Beef, liver |
85g | 200 |
Asparagus, cooked |
½ cup | 132 |
Black-eyed peas |
½ cup | 123 |
Wheatgerm |
¼ cup | 82 |
Collard greens, cooked |
½ cup | 65 |
Avocado |
½ medium | 56 |
Spinach, raw |
½ cup | 54 |
Brussels sprouts, cooked |
½ cup | 47 |
Orange |
1 medium | 47 |
Beets, cooked |
½ cup | 45 |
Peanuts, dry roasted |
28g | 41 |
Broccoli, cooked |
½ cup | 39 |
Corn kernels |
1 cup | 38 |
Romaine lettuce |
½ cup | 38 |
Endive, raw |
½ cup | 36 |
Rockmelon (cantaloupe) |
1 cup | 27 |
Banana |
1 medium | 22 |
Bread, wholewheat |
1 slice | 14 |
Folic Acid recommended daily intake (RDI)
| RDA | lifestage | age | amount |
|---|---|---|---|
| INFANTS | 0-6mths 7-12mths |
65mcg 80mcg |
|
| CHILDREN | 1-3yrs 4-8yrs |
150mcg 200mcg |
|
| CHILDREN | 9-13yrs 14-18yrs |
300mcg 400mcg |
|
| ADULTS | 19-50yrs | 400mcg | |
| SENIORS | 51+yrs |
400mcg | |
| PREGNANT | 600mcg | ||
| LACTATING | 500mcg | ||
| TOLERABLE UPPER LIMIT | lifestage | age | amounT |
| INFANTS | 0-12mths | n/a* | |
| CHILDREN | 1-3yrs 4-8yrs |
300mcg 400mcg |
|
| CHILDREN | 9-13yrs 14-18yrs |
600mcg 800mcg |
|
| ADULTS | 19-50yrs | 1000mcg | |
| SENIORS | 51+yrs |
1000mcg | |
| PREGNANT | <18yrs 19-50yrs |
800mcg 1000mcg |
|
| LACTATING | <18yrs 19-50yrs |
800mcg 1000mcg |
|
| TOXIC LEVELS | Essentially non-toxic | ||
The tolerable upper limits should only be taken for short periods and only under medical supervision.
* The tolerable upper limit for folic acid (folate) for infants aged 0-12 months has not yet been determined due to a lack of data about the adverse effects in this age group. The only source of folic acid (folate) intake should be from food (breast milk and/or baby formula).
Overdosage, toxicity and cautions for folic acid
Doses above 7150mcg/day can cause the following side-effects:
- abdominal bloating
- flatulence
- hyperactivity
- irritability
- nausea
- sleep disturbances
- vivid dreams
- weakness
CAUTION
Folic acid keeps the drug Phenytoin (Dilantin) and most other anti-convulsant medications (used for epilepsy) from working properly. People who take this drug should NOT take folic acid supplements.
Talk to a medical professional about folic acid supplements BEFORE taking them.
references
- Bazzano LA, He J, Ogden LG, et al. Dietary intake of folate and risk of stroke in US men and women: NHANES I Epidemiologic Follow-up Study. National Health and Nutrition Examination Survey. Stroke 2002;33(5):1183-1188
- Butterworth CE Jr, Hatch KD, Macaluso M, et al. Folate deficiency and cervical dysplasia. JAMA. 1992;267(4):528-533
- Cravo ML, Albuquerque CM, Salazar de Sousa L, et al. Microsatellite instability in non-neoplastic mucosa of patients with ulcerative colitis: effects of folate supplementation. Am J Gastroenterol. 1998;93:2060-2064
- Honein MA, Paulozzi LJ, Mathews TJ, Erickson JD, Wong LYC. Impact of folic acid fortification of the US food supply on the occurrence of neural tube defects. JAMA. 2001;285(23):2981-2236
- Lee BJ, et al. Folic acid and vitamin B12 are more effective than vitamin B6 in lowering fasting plasma homocysteine concentration in patients with coronary artery disease. EJCN 2004, Vol58 (3); 481-487
- McMahon JA, Green TJ, Skeaff CM, et al. A controlled trial of homocysteine lowering and cognitive performance. N Engl J Med. 2006 Jun 29;354(26):2764-72
- Office of Dietary Supplements USA - has the official USA RDI for all vitamins (these are also adopted by Australia), accessed 9 August 2005
- Osiecki, Henry, The Nutrient Bible 2002, BioConcepts Publishing
- Rohan TE, Jain MG, Howe GR, Miller AB. Dietary folate consumption and breast cancer risk [communication]. J Natl Cancer Inst. 2000;92(3):266-269
- Sellers TA, Kushi LH, Cerhan JR, et al. Dietary folate intake, alcohol, and risk of breast cancer in a prospective study of postmenopausal women. Epidemiology. 2001;12(4):420-428
- Taylor MJ, Carney SM, Goodwin GM, et al. Folate for depressive disorders: systematic review and meta-analysis of randomized controlled trials. J Psychopharmacol 2004;18(2):251-256
