Folic Acid

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The Eclectic PhysicianVitamin and Mineral Information

Folic acid/ Folate

The information on this page compiled by Beth Burch N.D. Index (click on the keywords)

FunctionFolic acid, along with vitamin B-12 is required for the manufacture of DNA and brain transmitters, and to reduce levels of homocysteine in the body. Elevated homocysteine levels have been linked to atherosclerosis, heart disease and osteoporosis. Folic acid deficiency is the most common vitamin deficiency. Since folic acid is vital for cell reproduction, deficiency affects rapidly dividing cells like red blood cells, and the cells that line the gastrointestinal and genitourinary tracts resulting in symptoms like anemia, poor growth, diarrhea, gingivitis and cervical dysplasia. Other symptoms of folic acid deficiency include depression, fatigue, irritability, memory problems, insomnia and loss of appetite. Folic acid deficiency in early pregnancy causes birth defects, especially neural tube defects like spina bifida. Deficiency is very common in malnutrition, malabsorption and alcoholism. Many medications interfere with absorption or utilization of folic acid including anticonvulsants, oral contracepti ves and some chemotherapy drugs.

Forms

Folic acid (Folate)

Folinic acid (activated folic acid)

Food Sources

Excellent sources of folic acid include nutritional yeast, rice or wheat germ, legumes and liver. Good sources include dark green leafy vegetables and nuts.

Dosage

Recommended Daily Allowance (RDA)

Infants- 25-35 mcg

Children (ages 1-10)- 50-100 mcg

Adults- 150-200 mcg

Pregnancy- 400 mcg

Lactation- 280 mcg

Optimal Supplementation

400 mcg daily

Treatment of Health Conditions

400 mcg- 10 mg daily. Amounts over 800 mcg daily must be accompanied by vitamin B-12 supplementation to prevent masking of vitamin B-12 deficiency.

Conditions used for

Prevention of neural tube defects

Memory loss (1, 15)

Cervical dysplasia (2, 3, 4, 15)

Elevated homocysteine (4, 13, 14)

Prevention of occlusive vascular disease & thrombosis (4)

Malabsorption (4)

Dementia (5,6, 15)

Stroke (5)

Depression (7, 8, 9, 12, 15)

Schizophrenia (11, 12)

Fatigue (11)

Prevention of hearing loss (10)

Restless legs syndrome(11, 15)

Peripheral neuropathy (11, 15)

Cardiovascular disease (13, 14)

Folic acid deficiency

Side effects

Nausea, gas and loss of appetite in high doses.

Contraindications

Allergy to folic acid preparations

Epilepsy

Undiagnosed anemia

Interactions with other nutrients

Works with vitamin B-12 and B-6

Interactions with medications and herbs

Decreased absorption or utilization of folic acid with oral contraceptives, anticonvulsant medications including phenytoin (16) and barbiturates (18), folic acid antagonists including methotrexate, sulfasalazine, trimethoprim and pyrimethamine and pancreatic enzymes.

Diuretics decrease serum folate levels resulting in increased homocysteine (17)

References

1. Hassing L et al, Further evidence on the effects of vitamin B12 and folate levels on episodic memory functioning: a population-based study of healthy very old adults, Biol Psychiatry 1999;45(11):1472-80 2. Kwasniewska A et al, Folate deficiency and cervical intraepithelial neoplasia, Eur J Gynaecol Oncol 1997;18(6):526-30 3. Liu T, A case control study of nutritional factors and cervical dysplasia, Cancer Epidemiol Biomarkers Prev 1993;2(6):525-30 4. Green R et al, Folate deficiency beyond megaloblastic anemia: hyperhomocysteinemia and other manifestations of dysfunctional folate status, Semin Hematol 1999;36(1):47-64 5. Ebly EM et al, Folate status, vascular disease and cognition in elderly Canadians, Age Ageing 1998;27(4):485-91 6. Ortega RM et al, Functional and psychic deterioration in elderly people may be aggravated by folate deficiency, J Nutr 1996 Aug;126(8):1992-9 7. Alpert JE et al, Nutrition and depression: the role of folate, Nutr Rev 1997 ;55(5):145-9 8. Ortega TM et al, The role of folates in the diverse biochemical processes that control mental function, Nutr Hosp 1994;9(4):251-6 9. Fava M et al, Folate, vitamin B12, and homocysteine in major depressive disorder, Am J Psychiatry 1997;154(3):426-8 10. Houston DK et al, Age-related hearing loss, vitamin B-12, and folate in elderly women, Am J Clin Nutr 1999;69(3):564-71 11. Audebert M et al, Folate and the nervous system, Sem Hop 1979;55(31-32):1383-7 12. Procter A, Enhancement of recovery from psychiatric illness by methylfolate, Br J Psychiatry 1991;159:271-2 13. Bellamy MF et al, Oral folate enhances endothelial function in hyperhomocysteinaemic subjects, Eur J Clin Invest 1999;29(8):659-62 14. Weiss N et al, Influence of Folic Acid, Pyridoxal Phosphate and Cobalamin on Plasma Homocyst(e)ine Levels and the Susceptibility of Low-Density Lipoprotein to ex-vivo Oxidation, Eur J Med Res 1999;4(10):425-432 15. GS, Folates: supplemental forms and therapeutic applications, Altern Med Rev 1998;3(3):208-20 16. Seligmann H et al, Phenytoin-folic acid interaction: a lesson to be learned, Clin Neuropharmacol 1999;22(5):268-72 17. Morrow LE et al, Long-term diuretic therapy in hypertensive patients: effects on serum homocysteine, vitamin B6, vitamin B12, and red blood cell folate concentrations, South Med J 1999;92(9):866-70 18. Ravakhah K et al, Case report: subacute combined degeneration of the spinal cord from folate deficiency, Am J Med Sci 1995 Nov;310(5):214-6

* The information presented in this web site is intended to inform and educate. It is not intended replace a qualified medical practitioner to diagnose or treat medical conditions.