Guest guest Posted July 31, 2002 Report Share Posted July 31, 2002 Thank you a! Debbie Mc [ ] Folic Acid, FAQs, Can women get too much folic acid? Folic acid has no known toxic level. If you were to eat a bowl of fully fortified cereal (400 micrograms), take a folic acid supplement (400 mcq), and eat fortified foods and foods rich in folate, women of reproductive age would not have a problem with too much folic acid. Even in very high amounts folic acid is non-toxic. Nevertheless, it is recommended that women consume no more than 1,000 micrograms of synthetic folic acid a day. Large amounts of folic acid may hide the ability to quickly diagnose a rare vitamin B-12 deficiency, pernicious anemia. This condition primarily affects the elderly population and, in some cases, can lead to neurological damage. Today, doctors can use a simple test to check for a B-12 deficiency. http://www.cdc.gov/ncbddd/folicacid/folicfaqs.htm#women Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 31, 2002 Report Share Posted July 31, 2002 > Can women get too much folic acid? > > Folic acid has no known toxic level. If you were to eat a bowl of fully > fortified cereal (400 micrograms), take a folic acid supplement (400 mcq), > and eat fortified foods and foods rich in folate, women of reproductive age > would not have a problem with too much folic acid. Even in very high amounts > folic acid is non-toxic. Nevertheless, it is recommended that women consume > no more than 1,000 micrograms of synthetic folic acid a day. Large amounts > of folic acid may hide the ability to quickly diagnose a rare vitamin B-12 > deficiency, pernicious anemia. This condition primarily affects the elderly > population and, in some cases, can lead to neurological damage. Today, > doctors can use a simple test to check for a B-12 deficiency. > > a, when taking methotrexate shouldn't you be careful of the amount of folic acid, since it may affect the affectiveness of the methotrexate. in WA > > http://www.cdc.gov/ncbddd/folicacid/folicfaqs.htm#women Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 31, 2002 Report Share Posted July 31, 2002 > > , > Actually supplementing with folic acid allows us to tolerate a higher dose of > mtx. > The folic acid reduces the liver toxicity. Studies support that the higher > the dose of > mtx, the higher the dose of folic acid should be. Mouth sores and GI side > effects > weren¹t helped by the increase, but the liver was definitely helped. They > don¹t know > how mtx works for rheumatic diseases, but they know it has something to do > with interfering with folic acid, > however according to the research taking folic acid doesn't reduce it¹s > effectiveness. > > My understanding is that it helps the toxic side effects but they don¹t want > us to take it > on the day of mtx because folic acid is an antagonist of mtx and it may reduce > it¹s effectiveness. > I wish I could explain it better, but today is a day of ³high pain-no brain². > > I¹ll see if I can find anything written on taking folic acid on the same day > of mtx. > Here¹s an abstract that says it does NOT affect it¹s effectiveness: > > > > Folic acid and folinic acid for reducing side effects in patients receiving > methotrexate for rheumatoid arthritis (Cochrane Review) > > Ortiz Z, Shea B, Suarez Almazor M, Moher D, Wells G, Tugwell P > ABSTRACT > > > A substantive amendment to this systematic review was last made on 14 July > 1999. Cochrane reviews are regularly checked and updated if necessary. > Background: Methotrexate (MTX) is classified pharmacologically as an > antimetabolite due to its antagonistic effect on folic acid metabolism. > Although its mechanism of action is uncertain, it has become the second line > drug of choice for many rheumatologists > > Objectives: To assess the effects of folic acid and folinic acid in reducing > the mucosal and gastrointestinal (GI) and haematologic side effects of > low-dose of Methotrexate (MTX) in patients with Rheumatoid Arthritis (RA) and > to determine whether or not folate supplementation alters MTX efficacy. > > Search strategy: We searched the Cochrane Controlled Clinical Trial's Register > (CCTR), the Cochrane Musculoskeletal Group Specialized Register and Medline up > to and including June 1999, using the search strategy developed by the > Cochrane Collaboration (Dickersin 1994). > > We also handsearched the following: (i) bibliographic references; (ii) current > contents of the last 6 months; (iii) abstracts of the rheumatology meetings; > and (iv) all issues of four journals; Journal of Rheumatology, Arthritis & > Rheumatism, Clinical and Experimental Rheumatology, and British Journal of > Rheumatology. > > All languages were included. Principal investigators were also contacted in > order to look for unpublished literature. > > Selection criteria: We selected all double-blind, randomized, > placebo-controlled, clinical trials (RCTs), in which adult RA patients were > treated with a low dose of MTX ( <20 mg / week) concurrently with folate > supplementation. > > Data collection and analysis: Two observers extracted the data and assessed > the quality of the trials. (BS, Z0) The overall treatment effect across trials > was calculated using a fixed effect model. Disease activity was evaluated > using standardized mean differences to ensure comparability across outcome > measures. Results are presented with 95% Confidence Inervals (95% CI). > Subgroup analyses were conducted evaluating different doses and sensitivity > analysis looking at the quality of the trials. Publication bias was assessed > with an inverted funnel plot technique. Heterogeneity of the trials was > measured using a standard chi square test. Costs per month in different > countries were compared. > > Main results: Of the 12 trials retrieved, 7 met the inclusion criteria. The > total sample included 307 patients, of which 147 were treated with folate > supplementation, 80 patients with folinic acid and 67 patients with folic > acid. A 79% reduction in mucosal and GI side effects was observed for folic > acid [OR = 0.21 (95% CI 0.10 to 0.44)]. For folinic acid, a clinically but > non-statistically significant reduction of 43% was found [OR = 0.57 (95% CI > 0.28 to 1.15)]. No major differences were observed between low and high doses > of folic or folinic acid. Haematologic side effects could not be analyzed, > since details of each haematologic side effect by patients were not provided. > No consistent differences in disease activity parameters were observed when > comparing placebo and folic or folinic acid at low or high doses, although > patients on high dose folinic acid had an increase in the number of tender > joints, but not swollen joints. Large differences in costs across countries > were found, but folinic acid was more expensive in all. > > Reviewers' conclusions: The results support the protective effect of folate > supplementation in reducing MTX side effects related to the oral and GI > systems. We could not determine if folic was different from folinic acid. > Therefore, for folinic acid to be considered cost-effective it must be found > more effective than folic acid at reducing MTX side effects. > > Citation: Ortiz Z, Shea B, Suarez Almazor M, Moher D, Wells G, Tugwell P. > Folic acid and folinic acid for reducing side effects in patients receiving > methotrexate for rheumatoid arthritis (Cochrane Review). In: The Cochrane > Library, Issue 3 2002. Oxford: Update Software. > > More reading: > > http://www.hopkins-arthritis.som.jhmi.edu/news-archive/2001/folicacid.html > http://www.cancer.org/eprise/main/docroot/ETO/content/ETO_5_3X_Folic_Acid?site > area=ETO > > > a > >> > >> > a, when taking methotrexate shouldn't you be careful of the > amount of folic acid, since it may affect the affectiveness of the > methotrexate. in WA >> > Quote Link to comment Share on other sites More sharing options...
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