Written by Dr. Sanjana V.B Bhms,dbrm,cdn

Founder & medical director of siahmsr wellness.in
All rights reserved with siahmsr digital healthcare[siahmsr wellness]
Reviewed by SIAHMSR medical team.

Folic acid 

Folic acid [Vitamin B9] is a water-soluble B vitamin essential for all age groups including mothers and children.

 Folic acid is very important to produce healthy red blood cells and is crucial during periods of rapid growth, such as during pregnancy and fetal development.

Folic acid is very important for early fetal development, particularly neural tube and spinal cord in foetus. It is vital for the formation of DNA and RNA .

Folate is also involved in protein metabolism.

 It plays a key role in breaking down homocysteine, an amino acid that is harmful to the body if accumulated in its original form.

 High homocysteine levels have detrimental effects on cardiovascular system and  brain. It can cause heart attack, stroke and dementia or cognitive decline in elderly.

Some research has shown that a combination of vitamin B12 and folate can significantly improve cognitive performance and is superior to either folate or B12 administration alone.

What are the foods rich in folic acid?

•     Dark green leafy vegetables

•     Turnip greens, spinach, romaine lettuce, asparagus, Brussels sprouts, broccoli ,black-eyed peas, mustard greens, green peas,

•     kidney beans

•     Canned tomato juice

•     Fresh fruits-Oranges, Grapefruit, Papaya, Banana, Avocado

•     cantaloupe

•     Beans

•     Peanuts 

•     Sunflower seeds

•     Whole grains

•     Liver

•     Seafood

•     Eggs

•     Fortified foods and supplements

•     Dungeness crab

•     hard-boiled egg

•     beef liver

           SIAHMSR                        

RDA [The Recommended Dietary Allowance for folate]

Men                                              400 mcg DFE

Women                                        400 mcg DFE

Alcoholics                                   600 mcg DFE 

Pregnant &lactating women    600mcgDFE &500mcg DFE respectively 

Who are at risk of folate deficiencies?

•     People who have undergone intestinal surgeries or people having digestive disorders, which cause malabsorption. Celiac disease and inflammatory bowel disease can decrease the absorption of folate.

•     Chronic alcoholics are at risk of deficiency of folate regular and excessive intake of alcohol prevents folate absorption.

•     Pregnant women are at risk due to excessive demand of folic acid related to pregnancy and fetal development. Deficiency may cause neural tube and spinal cord anomalies in the fetus.

•     People with MTHFR polymorphism, which is a genetic condition that impairs the ability to convert folate to its active form and leads to elevated levels of an amino acid called homocysteine in the blood.

 Folate deficiency Anaemia 

 Folate deficiency may cause anemia called folate deficiency anemia.

 Symptoms:

•     Weakness, irritability, headache, palpitations, and shortness of  breath, fatigue, trouble in concentrating

•     Sores on the tongue and inside the mouth

•     A change in color of the skin, hair, or fingernails

   Folic acid deficiency can result in macrocytic megaloblastic anemia. Oral  folic acid supplements recommendations are 1 to 5 mg once daily, but doses up to 15 mg once daily have been recommended as well.

Why is folic acid supplements recommended in pregnant women?

•     Folic acid can reduce the risks of preterm birth, heart irregularities, and cleft palate. Women planning on getting pregnant should take folic acid supplements to reduce the risk of neural tube defects (NTDs), such as spina bifida, arising in the developing fetus. Folic acid intake reduces spinal cord or neural tube defects in fetus.

•     Pregnant women with spina bifida or a family history of neural tube defects should take 4,000 mcg per day. Lactating or breast feeding mothers should aim to take around 500 mcg per day.

     If the expectant mother were to take 4mg of folic acid daily, it could take 20 weeks for her body to reach optimal folate levels for reducing the risk of a neural tube defect. Because of this, supplementation should be initiated 5 to 6 months before conception

•     Folic acid deficiency can result in macrocytic megaloblastic anemia. Oral  folic acid supplements recommendations are 1 to 5 mg once daily, but doses up to 15 mg once daily have been recommended as well.

Folic acid deficiency & depression

•     Some observational studies show that people with lower levels of folate may be more likely to experience depression. Research indicates that as many as 30% of severely depressed patients have a folate deficiency.

According to a  study, having less than 6.0 nanograms per milliliter (ng/mL) of serum folate was associated with increased suicidal behavior in patients with depressive disorders.

However, there is no clarity in the matter, if folic acid supplements could improve depression symptoms.  Further extensive studies are needed in this regard.

Until today, the folic acid fortification program guidelines across the world have yielded no established risks or adverse effects. However, intake of folic acid supplements in the physician or health care provider doses is safe.

The term folate is typically used as a generic name for the group of chemically related compounds based on the folic acid structure.

Folic acid is a synthetic dietary supplement that is present in artificially enriched foods and pharmaceutical vitamins. Neither folate nor folic acid is metabolically active. The reduced form is  l-5-Methyl-tetrahydrofolate (l-methylfolate) ,the predominant micronutrient form of folate that circulates in plasma and that is involved in biologic processes of the body.

Written by Dr. Sanjana V.B Bhms,dbrm,cdn[Copyight]

Founder & medical director of siahmsr wellness.in 

References

1.     https://www.cdc.gov/ncbddd/folicacid/about.html

2.     https://www.hsph.harvard.edu/nutritionsource/folic-acid/

3.     https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3218540/