folic acid

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Folic Acid



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 and B12, 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.

Side effects

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.


Adams, Suzanne L. The Art of Cytology: Folic Acid/ B-12 Deficiency. 〈∼Suza2/page22.htm〉.
"Folic Acid: Coming to A Grocery Store Near You." 〈〉.
"Folic Acid."
"Folic acid (oral/injectible)." Dr. 700 N. Mopac, Suite 400, Austin, TX 48731. 〈〉.
Pregnancy and Nutrition Update. 〈〉.

Key terms

Homocysteine — An amino aid involved in the breakdown and absorption of protein in the body.
Preeclampsia — 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.
Raynaud's disease — 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.
Water-soluble vitamins — 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.

folic acid

a vitamin of the B complex; it is involved in the synthesis of amino acids and DNA. Green vegetables, liver, and yeast are major food sources; folic acid can also be produced synthetically. Folic acid deficiency (leading to megaloblastic anemia) may result from the inability of the body to use the vitamin. Because of the important role of folate in prevention of neural tube defects, it is now recommended that 400 μg of folate be taken daily before conception occurs. See also vitamin.
folic acid antagonist an antimetabolite of folic acid; some are used as antineoplastic agents because they interfere with DNA replication and cell division by inhibiting the enzyme dihydrofolate reductase. Examples include trimethoprim, an antibacterial; pyrimethamine, an antimalarial agent; and methotrexate, an antineoplastic agent.

fo·lic ac·id

(fō'lik as'id),
1. A collective term for pteroylglutamic acids and their oligoglutamic acid conjugates. N-[p-[[(2-Amino-4-hydroxypteridin-6- yl)methyl]amino]benzoyl]-L(+)-glutamic acid; specifically, pteroylmonoglutamic acid.
See also: homocysteine.
2. 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.

folic acid

/fo·lic ac·id/ (fo´lik) a water-soluble vitamin of the B complex, pteroylglutamic acid or related derivatives, which is involved in hematopoiesis and the synthesis of amino acids and DNA; its deficiency causes megaloblastic anemia. See tetrahydrofolic acid and folic acid antagonist.

folic acid

(fō′lĭk, fŏl′ĭk)
A yellowish-orange compound, C19H19N7O6, of the vitamin B complex group, occurring in green plants, fresh fruit, liver, and yeast. Also called folacin, folate, vitamin Bc.

folic acid (FA)

[fō′lik, fol′ik]
a yellow crystalline water-soluble vitamin essential for cell growth and reproduction. It functions as a coenzyme with vitamins B12 and C in the metabolism and use of proteins and in the formation of nucleic acids and heme for hemoglobin. Deficiency results in poor growth, graying of hair, glossitis, stomatitis, GI lesions, and diarrhea, and it may lead to megaloblastic anemia. Deficiency is caused by inadequate dietary intake of the vitamin, malabsorption, metabolic abnormalities, or drug-nutrient interactions. Need for folic acid increases in pregnancy, infancy, and periods of stress. A daily intake of 400 mg before conception and during early pregnancy has been found to lower the risk of fetal neural tube defects. Rich dietary sources include spinach and other green leafy vegetables, liver, kidney, asparagus, lima beans, nuts, orange juice, and whole-grain cereals. It is both heat- and light-labile, and considerable loss of the vitamin occurs during cooking and when it has been stored for a long period. Also called folacin, pteroylglutamic acid, vitamin B9.

folic acid

A general term for pteroylglutamic acids and their related conjugates. This family of B vitamins are required for normal haematopoiesis (production of red blood cells), and are present in leafy green vegetables, liver and yeast; it is used to treat megaloblastic anaemia and folate deficiency, prevent against cervical cancer and neural tube defects, and may ward against coronary artery disease as it counteracts the effects of homocysteine, an amino acid which, if elevated, increases smooth muscle proliferation, narrowing affected arteries.

folic acid

Folate A family of water-soluble B vitamins not synthesized by mammals, which are required for normal hematopoiesis; it is used to treat megaloblastic anemia, and folate deficiency, prevent cervical and other CAs, neural tube defects; ↓ in alcoholism, malabsorption, anticonvulsants. See Megaloblastic anemia.

fo·lic ac·id

(fō'lik as'id)
1. Collective term for pteroylglutamic acids and their oligoglutamic acid conjugates.
2. Pteroylmonoglutamic acid, a member of the vitamin B complex necessary for the production of red blood cells; present in liver, green vegetables, and yeast; used to treat folate deficiency and megaloblastic anemia.
[L. folium, leaf, + -ic]

folic acid

A vitamin of the B group originally derived from spinach leaves, hence the name (Latin folium , a leaf). The vitamin is necessary for the synthesis of DNA and red blood cells. Deficiency causes MEGALOBLASTIC ANAEMIA. Folic acid is plentiful in leafy vegetables and in liver but is also produced by bacteria in the bowel and then absorbed into the circulation. Deficiency may occur after antibiotic treatment. Folic acid taken immediately before pregnancy and during the first few weeks can virtually eliminate the risk of embryonic neural tube defects and resulting SPINA BIFIDA or ANENCEPHALY in the baby. It will also reduce the risk of CLEFT PALATE. Normal dietary intake may not provide enough for this purpose. It has been reported, however, (January 2004) that women whose babies have neural tube defects have serum autoantibodies to folate receptors. The drug is on the WHO official list. The drug is available under the brand name Lexpec and, in conjunction with iron salts under the brand names Lexpec with iron, Folex-350, Meterfolic and Pregaday, Ferfolic SV, Ferrograd Folic, Galfer F.A., Meterfolic and Slow-Fe Folic.

folic acid


vitamin M


vitamin Bc

a member of the B-COMPLEX group of vitamins that is synthesized by microorganisms in the mammalian gut, but is also required in the normal diet. Folic acid is involved in the synthesis of NUCLEIC ACIDS as well as red blood cells, and a deficiency causes reduced growth and anaemia.

folic acid

B-complex vitamin, essential for normal erythrocyte development, used as dietary supplement to prevent anaemia in patients using antimetabolite drugs (e.g. methotrexate); dietary supplementation before and in very earliest stages of pregnancy reduces risk of fetal spina bifida

fo·lic ac·id

(fō'lik as'id)
The growth factor for Lactobacillus casei, and a member of the vitamin B complex necessary for the normal production of red blood cells. 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.
[L. folium, leaf, + -ic]

folic acid,

n vitamin B9, a water-soluble B vitamin needed for erythropoiesis, increases red blood cell, white blood cell, and platelet formation in megaloblastic anemias. It functions as a coenzyme with vitamin B12 and C in the breakdown and utilization of proteins and in the formation of nucleic acids. It is prescribed for use during pregnancy (helps prevent neural tube defects) and for megaloblastic or macrocytic anemia caused by folic acid deficiency, liver disease, alcoholism, hemolysis, and intestinal obstruction.
folic acid analog,
n an antimetabolite drug used as an antineoplastic agent in the treatment of malignant cell growths.

folic acid

one of the vitamins of the B complex. Folic acid is involved in the synthesis of amino acids and DNA; its deficiency causes megaloblastic anemia. Folic acid is supplied in adequate amounts by natural pasture plants and most diets for dogs and cats. Possibly required in greater amounts in racing horses confined to stables. Called also vitamin Bc, pteroylmonoglutamic acid.

folic acid antagonist
a compound such as trimethoprim or methotrexate which acts as an antimetabolite of folic acid, interfering with DNA replication and cell division by inhibiting the enzyme dihydrofolate reductase.

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
References in periodicals archive ?
Dr Jaber added that folic acid consumption reduces the risk of birth defects of the baby's brain and spinal cord, therefore it is advisable that all married women of child-bearing age should take 400mcg of folic acid daily.
2) Folic acid is chemically known as pteroylglutamic acid (PGA) and is a crystalline substance (no food vitamins are naturally crystalline in structure).
With regard to folic acid, the FDA evaluated the projected human dietary exposure, toxicological data, and other relevant information, including whether folic acid remained stable in corn masa flour.
Our own group examined the evidence in a meta-analysis published in 2006 and found significant support for an expanded role for folic acid (J Obstet Gynaecol Can.
Folic acid helps prevent serious birth defects of the brain and spine, including spina bifida and hydrocephalus, among newborns.
When comparing pre- and post-conceptual folic acid supplementation, the prevalence of birth weight lower than the 10th percentile was 9.
The current study aimed to assess the level of knowledge about folic acid supplements and its associated factors as well as to estimate the prevalence folic acid intake during first trimester of pregnancy among pregnant women attending antenatal care clinic at Al-Hejrah primary health care center, Makkah Al-Mokarramah, 2012.
Health care professionals may want to explain, in layman's terms, the difference between folate and folic acid to their patients.
Chi-square test of significance with 95% confidence level was used to find association between education level and practice of folic acid intake among WOCBA.
Young-In Kim said that this is a critically important issue because breast cancer patients and survivors in North America are exposed to high levels of folic acid through folic acid fortification in food and widespread use of vitamin supplements after a cancer diagnosis.
There's no doubt about it; research supports humans' need for an adequate amount of the nutrient folic acid to achieve optimal health.