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Vitamin B-9
Description:
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.
Method of Action:
Tetrahydrofolic acid is a folic acid enzyme that acts as a carrier for single carbon groups (i.e., methyl groups) from one substance to another. It is of primary importance in the synthesis of purine and pyrimidine bases which are constituents of DNA and RNA.
Tetrahydrofolic acid also plays a role in the formation of methionine from its precursor homocystine; in the formation of choline from its precursor ethanolamine; the synthesis of histidine, and its conversion to glutamic acid.
Folacin is important for the conversion of phenylalanine to tyrosine; the formation of part of the hemoglobin structure; the metabolism of long chain fatty acids in the brain; and the formation of both red blood cells and white blood cells in the bone marrow.
Folacin is absorbed through the upper part of the intestinal tract; this absorption occurs via active transport and diffusion. Vitamin C and various antibiotics facilitate its absorption.
Properties & Uses:
Folic acid is used in treating nutritional megaloblastic anemia (formerly known as pernicious anemia) caused by folate deficiency. Folacin is also effective in treating the megaloblastic anemia of pregnancy and infancy. Other anemias, which fail to respond to vitamin B-12, can be treated with folacin. Additionally, it is useful for relieving symptoms of tropical sprue, such as anemia and gastrointestinal disturbance.
The folic acid antagonist aminopterin has been useful in inhibiting the excessive white blood cell production characteristic of the potentially lethal disorder leukemia. Aminopterin tends to interfere with the formation of the active coenzyme necessary for the production of white blood cells.
Folic acid supplementation is advised in the treatment of alcoholic patients, because of the increased folacin requirements and depletion typical in these individuals.
Toxicity Levels:
There are no known symptoms of folic acid toxicity.
Recommended Dietary Allowances:
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, many people who eat grains have followed the new recommendation of supplementing only 100 mcg of folic acid 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.13 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.
Food Sources:
Beans, leafy green vegetables, citrus fruits, beets, wheat germ, and meat are good sources of folic acid.
Deficiency Symptoms:
Many people consume less than the recommended amount of folic acid. 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. In fact, it has been suggested that increasing folic acid intake could prevent an estimated 13,500 deaths from cardiovascular diseases each year.1
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.2 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.
Side Effects & Interactions:
Folic acid is not generally associated with side effects.14 However, 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.15 Although vitamin B12 deficiency is uncommon, no one should supplement with 1,000 mcg or more of folic acid without consulting a doctor.
Vitamin B12 deficiencies often occur without anemia (even in people who do not take folic acid supplements). Some doctors do not know that the absence of anemia does not rule out a B12 deficiency. If this confusion delays diagnosis of a vitamin B12 deficiency, the patient could be injured, sometimes permanently. This problem is rare and should not happen with doctors knowledgeable in this area using correct testing procedures.
Folic acid is needed by the body to utilize vitamin B12. Proteolytic enzymes inhibit folic acid absorption.16 People taking proteolytic enzymes are advised to supplement with folic acid.
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