Folic acid is a water-soluable vitamin belonging to the B-complex group of vitamins
. These vitamins help the body break down complex carbohydrates into simple sugars to be used for energy. Excess B vitamins are excreted from the body rather than stored for later use. This is why sufficient daily intake of folic acid is necessary.
Folic acid is also known as folate, or folacin. It is one of the nutrients most often found to be deficient in the Western diet, and there is evidence that deficiency is a problem on a worldwide scale. Folic acid is found in leafy green vegetables, beans, peas and lentils, liver, beets, brussel sprouts, poultry, nutritional yeast, tuna, wheat germ, mushrooms, oranges, asparagus, broccoli, spinach, bananas, strawberries, and cantaloupes. In 1998, the U.S. Food and Drug Administration (FDA) required food manufacturers to add folic acid to enriched bread and grain products to boost intake and to help prevent neural tube defects (NTD).
Folic acid works together with vitamin B12
and vitamin C to metabolize protein in the body. It is important for the formation of red and white blood cells. It is necessary for the proper differentiation and growth of cells and for the development of the fetus. It is also used to form the nucleic acid of DNA and RNA. It increases the appetite and stimulates the production of stomach acid for digestion and it aids in maintaining a healthy liver. A deficiency of folic acid may lead to anemia, in which there is decreased production of red blood cells. This reduces the amounts of oxygen and nutrients that are able to get to the tissues. Symptoms may include fatigue
, reduced secretion of digestive acids, confusion, and forgetfulness. During pregnancy
, a folic acid deficiency may lead to preeclampsia, premature birth, and increased bleeding after birth.
People who are at high risk of strokes and heart disease may greatly benefit by taking folic acid supplements. An elevated blood level of the amino acid homocysteine
has been identified as a risk factor for some of these diseases. High levels of homocysteine have also been found to contribute to problems with osteoporosis
. Folic acid, together with vitamins B6
, helps break down homocysteine, and may help reverse the problems associated with elevated levels.
Pregnant women have an increased need for folic acid, both for themselves and their child. Folic acid is necessary for the proper growth and development of the fetus. Adequate intake of folic acid is vital for the prevention of several types of birth defects
, particularly NTDs. The neural tube of the embryo develops into the brain, spinal cord, spinal column, and the skull. If this tube forms incompletely during the first few months of pregnancy a serious, and often fatal, defect results in spina bifida
or anencephaly. Folic acid, taken from one year to one month before conception through the first four months of pregnancy, can reduce the risk of NTDs by 50-70%. It also helps prevent a cleft lip and palate
Research shows that folic acid can be used to successfully treat cervical dysplasia, a condition diagnosed by a Pap smear, of having abnormal cells in the cervix. This condition is considered to be a possible precursor to cervical cancer
, and is diagnosed as an abnormal Pap smear. Daily consumption of 1,000 mcg of folic acid for three or more months has resulted in improved cervical cells upon repeat Pap smears.
Studies suggest that long-term use of folic acid supplements may also help prevent lung and colon cancer
. Researchers have also found that alcoholics who have low folic acid levels face a greatly increased possibility of developing colon cancer
To correct a folic acid deficiency, supplements are taken in addition to food. Since the functioning of the B vitamins is interrelated, it is generally recommended that the appropriate dose of B-complex vitamins be taken in place of single B vitamin supplements. The Recommended Dietary Allowances (RDA) for folate is 400 mcg per day for adults, 600 mcg per day for pregnant women, and 500 mcg for nursing women. Medicinal dosages of up to 1,000-2,000 mcg per day may be prescribed.
Folic acid is not stable. It is easily destroyed by exposure to light, air, water, and cooking. Therefore, the supplement should be stored in a dark container in a cold, dry place, such as a refrigerator. Many medications interfere with the body's absorption and use of folic acid. This includes sulfa drugs, sleeping pills, estrogen, anti-convulsants, birth control pills, antacids
, quinine, and some antibiotics
. Using large amounts of folic acid (e.g., over 5,000 mcg per day) can mask a vitamin B12
deficiency and thereby risk of irreversible nerve damage.
At levels of 5,000 mcg or less, folic acid is generally safe for use. Side effects are uncommon. However, large doses may cause nausea, decreased appetite, bloating, gas, decreased ability to concentrate, and insomnia
. Large doses may also decrease the effects of phenytoin (Dilantin), a seizure medication.
As with all B-complex vitamins, it is best to take folic acid with the other B vitamins. Vitamin C is important to the absorption and functioning of folic acid in the body.
Centers for Disease Control and Prevention. 1600 Clifton Rd., NE, Atlanta, GA 30333. (800) 311-3435, (404) 639-3311. http://www.cdc.gov.
Adams, Suzanne L. The Art of Cytology: Folic Acid/ B-12 Deficiency. email@example.com. 〈http://www.concentric.net/∼Suza2/page22.htm〉.
"Folic Acid: Coming to A Grocery Store Near You." 〈http://www.mayohealth.org/mayo/9710/htm/folic.htm〉.
"Folic Acid." http://www.cybervitamins.com/folicacid.htm.
"Folic acid (oral/injectible)." Dr. Koop.com.Inc. 700 N. Mopac, Suite 400, Austin, TX 48731. 〈http://www.drkoop.com/hcr/drugstore/pharmacy/leaflets/english/d00241a1.asp〉.
Pregnancy and Nutrition Update. 〈http://www.mayohealth.org/mayo/9601/htm/pregvit.htm〉.
— An amino aid involved in the breakdown and absorption of protein in the body.
— A serious disorder of late pregnancy in which the blood pressure rises, there is a large amount of retained fluids, and the kidneys become less effective and excrete proteins directly into the urine.
— A symptom of various underlying conditions affecting blood circulation in the fingers and toes and causing them to be sensitive to cold.
Recommended Dietary Allowance (RDA)
— Guidelines for the amounts of vitamins and minerals necessary for proper health and nutrition established by the National Academy of Sciences in 1989.
— Vitamins that are not stored in the body and are easily excreted. They must, therefore, be consumed regularly as foods or supplements to maintain health.
fo·lic ac·id (fō'lik as'id),
A collective term for pteroylglutamic acids and their oligoglutamic acid conjugates. N
(+)-glutamic acid; specifically, pteroylmonoglutamic acid.
See also: homocysteine
The growth factor for Lactobacillus casei
, and a member of the vitamin B complex necessary for the normal production of red blood cells. It is a hemopoietic vitamin present, with or without l
-(+)-glutamic acid moieties, in peptide linkages in liver, green vegetables, and yeast; used to treat folate deficiency and megaloblastic anemia, and to assist in lowering homocysteine levels. Synonym(s): Lactobacillus casei factor
, liver Lactobacillus casei factor
, pteroylmonoglutamic acid
[L. folium, leaf, + -ic]
Natural sources of folic acid include whole-grain breads and cereals, orange juice, lentils, beans, yeast, liver, and green leafy vegetables such as broccoli, kale, and spinach. Folic acid and cobalamin (vitamin B12) serve as components of coenzymes in 1-carbon reactions such as the methylation of homocysteine to methionine. Folic acid deficiency results in macrocytic anemia due to impairment of erythrocyte synthesis and is associated with elevation of the plasma homocysteine level, a risk factor for cardiovascular disease including coronary atherosclerosis, stroke, and thromboembolism. Deficiency of folic acid in pregnancy is associated with an increased risk of neural tube defects such as spina bifida and anencephaly as well as an increased risk of preterm delivery and low birth weight. People with inherited deficiency of the enzyme 5,10 methylenetetrahydrofolic acid reductase have increased needs for dietary folic acid. The prevalence of the homozygous form of this deficiency may exceed 10% of the general population. Intake of therapeutic dosages of folic acid, pyridoxine (vitamin B6), and cobalamin has been associated with a substantially lower risk of coronary artery disease and of neural tube defects. Mandatory fortification of enriched grain products after October 1998 was followed by a 31% reduction in spina bifida and a 16% reduction in meroanencephaly during the succeeding year. Nutritionists recommend at least 400 mg/day of folic acid for all people, and 1 mg/day or more for pregnant women and those with elevated plasma homocysteine levels. see also homocysteine.
Patient discussion about folic acid
Q. Why should I take folic acid? I heard that it is recommended for women to take folic acid every day. Should I take it even if I am not pregnant?
A. Folic acid is a B vitamin promoted mainly as part of a healthy diet to reduce the risk of neural tube birth defects (such as spina bifida and anencephaly), some types of cancer, and heart disease. It has also been studied for use in Alzheimer's disease and in chronic fatigue syndrome. While evidence of its ability to reduce neural tube defects in infants (when taken by the mother before and during pregnancy) is fairly strong, its effects against other conditions are still under study.
Q. Why to take Folic Acid during pregnancy? I am in the beginning of my pregnancy and the Doctor told me to take Folic Acid every day, why?
A. Folic acid can reduce your risk of having a baby with a serious birth defect of the brain and spinal cord, called the “neural tube.” A baby with spina bifida, the most common neural tube defect, is born with a spine that is not closed. The exposed nerves are damaged, leaving the child with varying degrees of paralysis, incontinence, and sometimes mental retardation. Recommended daily dose of Folic acid is 600 mcg.
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Q. Which foods contain folic acid? I was told by my Doctor to take folic acid. Which foods are rich with folic acid so I can add them to my diet?
A. Folic acid is a B vitamin found in many vegetables, beans, fruits, whole grains, and in fortified breakfast cereals. More discussions about folic acid