Folic Acid -- Vitamin B9

Folic acid (folate)

Alternative names:

Vitamin B9; Vitamin B9 (folic acid) deficiency; Deficiency - vitamin B9 (folic acid); Folic acid (vitamin B9) deficiency; Folate; Diet - folic acid; Pteroylglutamic acid

Definition:

A water-soluble vitamin of the B-complex group.

Function:

Folic acid acts as a coenzyme (with vitamin B-12 and vitamin C) in the breakdown (metabolism) of proteins and in the synthesis of new proteins. It is necessary for the production of red blood cells and the synthesis of DNA (which controls heredity), as well as tissue growth and cell function. It also increases the appetite and stimulates the formation of digestive acids.

Synthetic folic acid supplements may be used in the treatment of disorders associated with folic acid deficiency, and may also be part of the recommended treatment for certain menstrual problems and leg ulcers.

Source

Vitamin B9 (Folic acid)

In 1941, a substance extracted from spinach leaves and named folic acid from the Latin word "folium" for leaf was found to be effective in the treatment of anemia.

Folic acid is the parent compound of a large group of naturally occurring, structurally related compounds collectively known as the folates.

Folic acid is a water-soluble vitamin.
This vitamin is absorbed from the small intestine, carried by the bloodstream and stored in the body, but not in significant amounts. 7 mg are stored in the liver and other tissues but they can supply the deficiency only for a few months. The body uses what it needs and excretes what is in extra through urine.

Roles
Folic acid participates in several important metabolic processes in the body.
It is essential for the normal growth and maintenance of all cells because it acts as a coenzyme for normal DNA and RNA synthesis.

Folate is vital for the reproduction of the cells within the fetus. A deficiency affects normal cell division and protein synthesis, especially impairing growth.

Vitamin B9, with the collaboration of vitamin B12 converts homocysteine in methionine therefore reducing blood levels of homocysteine and lowering risks of heart disease.

It also maintains nervous system's integrity and intestinal tract functions. It is involved in the production of neurotransmitters such as serotonin, which regulate mood, sleep and appetite.

Intake

*Ref: Recommended dietary allowances for the french population: CNRS-CNERMA*
Ages	micrograms of folic acid per day
Infants	70
Children 1-3 years	100
Children 4-6 years	150
Children 7-9 years	200
Children 10-12 years	250
Children 13-15 years	300
Males 16-19	330
Males 20-50+	330
Women 16-19	300
Women 20-50+	300
Pregnant women	400
Nursing women	400

Deficiency symptoms
A deficiency of folic acid limits cell function (cell division and protein synthesis) and affects the normal growth and repair of all cells and tissues in the body.
The tissues that have the fastest rate of cell replacement are affected first.

Symptoms are:

Anemia
Gastrointestinal upset
Memory problems
Impaired brain and nerve functions
Birth defects

Who is at risk?

People who have an unbalanced diet
Alcoholics
Smokers
Elderly: This category of people usually have a poor diet, malabsorption problems and most of them take drugs that interact with the absorption of this vitamin.
People who are deficient in vitamin B12
People who have a usually high production of red cells (hemolytic anemia).
People who suffer illnesses or injuries that require the body to manufacture new cells fast.
Pregnant women

Good vegetarian sources

Brewer's yeast
Green leafy vegetables
Orange
Banana
Red fruits
Nuts
Avocado
Whole grains

It is partially destroyed by cooking and light.

Cautions
Cooking destroys most of the folates contained in vegetables. Even storing at room temperature accelerates the loss of this vitamin.
Keep you vegetables in a dark, cool place and eat them quickly.
High dose of folic acid may mask a vitamin B12 deficiency.

Natural Medicine

Vitamin B9 (Folic Acid)

Folic acid, also called folate or vitamin B₉, is critical to many body processes, including the health of your nervous system, blood, and cells. It protects against heart disease, birth defects, osteoporosis, and certain cancers.

Uses

Folic acid protects the body against, and helps treat, many disorders, including the following.

Birth defects. Low levels of folic acid have been linked with birth defects. Half of neural tube defects (such as spina bifida) are believed to be preventable if women of childbearing age supplement their diets with folic acid. Studies suggest that the amount of folic acid needed to prevent neural tube defects is more easily reached with supplements than from dietary sources alone.
Heart attacks and stroke. Folic acid is essential to a process that clears a substance called homocysteine from the blood. High homocysteine levels have been linked with increased risk of heart disease and stroke.
Cancers. Low levels of folic acid may play a role in cancer development, particularly cancers of the cervix, lung, and colon.
Osteoporosis. Lack of folic acid, and the resulting increase in homocysteine levels, weakens bones, making them more likely to fracture.
Depression and other mental problems. Folic acid is important for brain function. It helps regulate mood, sleep, and appetite. Increasing levels of folic acid has reversed negative mental or psychological symptoms in some people, particularly older people. Folic acid has a mild antidepressant effect, and taking folic acid supplements has been shown to improve the effect of the drug Prozac.

Folic acid is also beneficial in the following ways: prevents anemia, which can decrease the function and number of red blood cells, helps treat headaches, may relieve rheumatoid arthritis, can help with infertility treatment, may help acne, and may be useful for people with AIDS.

Dietary Sources

Foods that contain a significant amount of folic acid include liver, lentils, rice germ, brewer's yeast, soy flour, black-eyed peas, navy beans, kidney beans, peanuts, spinach, turnip greens, lima beans, whole wheat, and asparagus.

Food processing (for example, boiling, heating) can destroy folic acid. Storing food at room temperature for long periods of time can also destroy its folic acid content. As of January 1998, commercial grain products are fortified with folic acid.

Other Forms

B₉ supplements are available as both folic acid and folinic acid. While folate is more stable, folinic acid is the most efficient form for raising body stores of the nutrient.

How to Take It

Folic acid comes as tablets, or as an injection that you get from your health care provider. Tablets are available in doses from 40 mcg to 1,000 mcg. The recommended dietary allowance (RDA) for folic acid depends on your age and sex (see below). Unless you are pregnant, you will likely get enough folic acid from your diet. Check with your health care provider before you start taking supplements and before giving folic acid supplements to a child.

The RDA for folic acid is as follows.

Infants under 6 months: 25 mcg
6 to 12 months: 35 mcg
Children 1 to 3 years: 50 mcg
Children 4 to 6 years: 75 mcg
Children 7 to 10 years: 100 mcg
Male and female 11 to 14: 150 mcg
Males 15 years and older: 400 mcg
Females 15 years and older: 400 mcg
Pregnant females: 400 mcg
Lactating females: 280 mcg

Precautions

Folic acid toxicity is rare. High doses (above 15 mg) can cause stomach problems, sleep problems, skin reactions, and seizures. Folic acid supplementation can mask vitamin B₁₂ deficiency, which can cause permanent damage to your nervous system. Folic acid supplementation should always include vitamin B₁₂.

Possible Interactions

Birth control medications, anticonvulsants (such as phenytoin), and cholesterol-lowering medications, particularly cholestyramine, may effect the levels of folic acid in the blood as well as the body's ability to use this vitamin.

Sulfasalazine, a medication used for ulcerative colitis and Crohn's disease, may affect the absorption of folic acid.

Methotrexate, a medication used for the treatment of cancer and resistant rheumatoid arthritis, increases the need for folic acid.

When taken for long periods of time, aspirin, ibuprofen, acetaminophen, and other anti-inflammatory medications can also increase the need for folic acid.

Supporting Research

Bendich A, Deckelbaum R, eds. Prevention Nutrition: The Comprehensive Guide for Health Professionals. Totowa, NJ: Humana Press; 1997.

Bronstrup A, Hages M, Prniz-Langenohl R, Pietrzik K. Effects of folic acid and combinations of folic acid and vitamin B12 on plasma homocysteine concentrations in healthy, young women. Am J Clin Nutr. 1998;68:1104–1110.

Cancers, Nutrition and Food. Washington, DC: World Cancer Research Fund/American Institute for Cancer Research; 1997.

Ebly EM, Schaefer JP, Campbell NR, Hogan DB. Folate status, vascular disease and cognition in elderly Canadians. Age Ageing. 1998;27:485–491.

1999 Drug Facts and Comparisons. Facts and Comparisons; 1998.

Endresen GK, Husby G. Methotrexate and folates in rheumatoid arthritis [in Norwegian]. Tidsskr Nor Laegeforen. 1999;119(4):534-537.

Giles WH, Kittner SJ, Croft JB, Anda RF, Casper ML, Ford ES. Serum folate and risk for coronary heart disease: Results from a cohort of US adults. Ann Epidemiol. 1998;8:490–496.

Imagawa M. Extra-intestinal complications of ulcerative colitis: hematologic complication [in Japanese]. Nippon Rinsho. 1999;57(11):2556-2561.

Lewis DP, Van Dyke DC, Stumbo PJ, Berg MJ. Drug and environmental factors associated with adverse pregnancy outcomes. Part II: Improvement with folic acid. Ann Pharmacother. 1998;32:947–961.

Malinow MR, Duell PB, Hess DL, et al. Reduction of plasma homocyst(e)ine levels by breakfast cereal fortified with folic acid in patients with coronary heart disease. N Engl J Med. 1998;338:1009–1015.

Matsui MS, Rozovski SJ. Drug-nutrient interaction. Clin Ther. 1982;4(6):423-440.

Morgan SL, Baggott JE, Lee JY, Alarcon GS. Folic acid supplementation prevents deficient blood folate levels and hyperhomocysteinemia during long-term, low-dose methotrexate therapy for rheumatoid arthritis: implications for cardiovascular disease prevention. J Rheumatol. 1998;25:441–446.

Moscow JA. Methotrexate transport and resistance. Leuk Lymphoma. 1998;30(3-4):215-224.

Murray MT. Encyclopedia of Nutritional Supplements. Rocklin, Calif: Prima Health; 1996.

Ortiz Z, Shea B, Suarez-Almazor ME, et al. The efficacy of folic acid and folinic acid in reducing methotrexate gastrointestinal toxicity in rheumatoid arthritis. A metaanalysis of randomized controlled trials. J Rheumatol. 1998;25:36–43.

Reavley N. Vitamins, etc. Melbourne, Australia: Bookman Press; 1998.

Rimm EB, Willett WC, Hu FB, et al. Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. JAMA. 1998;279:359–364.

Ringer D, ed. Physician's Guide to Nutriceuticals. St. Joseph, Mich: Nutritional Data Resources; 1998.

Seligmann H, Potasman I, Weller B, Schwartz M, Prokocimer M. Phenytoin-folic acid interaction: a lesson to be learned. Clin Neuropharmacol. 1999;22(5):268-272.

Watkins ML. Efficacy of folic acid prophylaxis for the prevention of neural tube defects. Ment Retard Dev Disab Res Rev. 1998;4:282–290.

Wolf PA. Prevention of stroke. Lancet. 1998;352 (suppl III):15–18.

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