Folic acid is the synthetic form of folate, a water-soluble vitamin B9, crucial to integrate and repair DNA (Deoxyribonucleic acid) and RNA (Ribonucleic acid).
Folate is the naturally available form of vitamin B9, while folic acid is the man-made form. Folate is naturally seen in green leafy vegetables, fruits (banana, watermelon, oranges), okra, asparagus, mushrooms, meat (liver and kidney), dried beans, peas, and nuts. Because of its health benefits, folic acid is added to bread, cereals, cookies, and other grain products.
Folic acid must be converted into active vitamin B9, known as 5-MTHF (L-Methylfolate) before the body can use it. This is a four-step process that requires several enzymes, including an enzyme called MTHFR (methylenetetrahydrofolate reductase). Some people have a genetic mutation that makes the enzyme MTHFR less effective, leading to a folic acid build-up in the blood. This has been linked to negative health impacts on some people. It might cause poor immunity, reduce brain function, and increases the growth of pre-existing cancer.
Folate might be useful in treating or preventing the following health conditions:
Folate Deficiency: Taking folic acid supplements improves the symptoms caused by folate deficiency.
Heart Disease and Stroke: Kidney diseases cause high levels of homocysteine in the blood (hyperhomocysteinemia). This high level of homocysteine is linked to heart diseases and stroke. Folate helps in lowering the homocysteine, thus preventing stroke and heart disease.
Birth Defects: It helps in reducing the risk of neural tube birth defects. A neural birth defect is when your baby’s neural tube does not close properly. Spina bifida, encephalocele, and anencephaly are examples of such defects. Research shows that taking folic acid reduces the incidence of such defects by 50 %. It is also shown to protect your baby against the cleft lip, premature delivery, low birth weight, miscarriage, etc.
Methotrexate-Induced Anemia: Methotrexate is a chemotherapeutic drug and an immunosuppressant. It is used in the treatment of cancer and rheumatoid arthritis. Methotrexate removes folate from the body and causes gastrointestinal symptoms like nausea and vomiting. Folate supplements are given to reduce the gastrointestinal side effects of Methotrexate.
Depression: It is seen that people with low folate levels in their blood are more prone to have depression. Folate supplements, especially the ones with 5-MTHF might make the antidepressants more effective.
Gum Diseases: It seems to improve gum diseases during pregnancy when applied directly to the gums. It is also useful in gingivitis caused by taking Phenytoin.
Vision: Taking vitamin supplements has been shown to reduce the risk of developing age-related vision loss.
Vitiligo: It helps to improve the symptoms caused by vitiligo. Vitiligo is a type of skin discoloration.
Apart from these, it is also vital in forming red blood cells, synthesis and repair of DNA and RNA, aiding rapid cell division and growth, and improving age-related hearing loss.
By consuming folate-rich food regularly in the right amount and with the help of fortified food products, the daily requirement of folate is usually met.
The recommended daily amount of folate intake for adults is 400 mcg.
Generally, the recommended dose for women is as follows:
While planning a pregnancy - 400 to 800 mcg.
First trimester – 400 mcg.
Second and third trimester – 600 mcg.
While breastfeeding – 500 mcg.
Women having spina bifida or had a baby with a neural tube defect or have a family member with spina bifida – 4000 mcg.
This dosage can vary depending on your condition, so always take medicines under medical supervision.
Folate supplements can interact with various medications. A few of the examples are as follows:
Methotrexate: Folic acid might decrease the effectiveness of Methotrexate.
Anti-Seizure Medications: Medicines like Phenytoin, Carbamazepine, and Valproate, which are used to treat seizures, may reduce the blood levels of folate. So, taking folate supplements minimizes the effectiveness of these medicines.
Sulfasalazine: Sulfasalazine is used for ulcerative colitis. It can reduce the folate-absorbing ability of the body and cause folate deficiency.
It is best to get the daily vitamin B9 requirement from food. So, add dark leafy vegetables, meat, and other folate-rich food in your diet. A balanced diet contains vitamins, minerals, fiber, and other substances required for a healthy life. Take folate supplements only if prescribed by your physician. Tell your doctor about all the other medicines that you are taking, as it can interfere with folate and might cause side effects.
Folate deficiency can result in anemia, which is a blood disorder that causes weakness, trouble concentrating, headache, palpitations, and shortness of breath. It can also cause ulcers in the mouth and might change the color of the skin, hair, and nails. Women with folate deficiency are at risk of having babies with neural tube defects like spina bifida and anencephaly. It also increases the chances of having a premature baby or a low-weight baby.
Spina Bifida: The condition where a baby’s spinal column does not close fully during development in the womb, is called spina bifida. It leaves the baby’s spinal cord exposed; as a result, the nerves controlling the legs and other organs do not work. Such children have lifelong disabilities and need many corrective surgeries.
Anencephaly: In this condition, a part or the entire brain and skull do not develop in the womb. Such babies die before or soon after birth.
You should not consume more than 1000 mcg of folic acid a day unless prescribed by your doctor. Some precautions and side effects have to be considered before taking folate:
Mask Vitamin B12 Deficiency: Megaloblastic anemia can be caused by both folate and vitamin B12 deficiency. Just taking folate for anemia might hide vitamin B12 deficiency. Vitamin B12 deficiency can lead to permanent damage to the brain, nerves, and spinal cord.
Risk of Cancer: High doses of folate might increase the risk of colorectal cancer and a few other types of cancer. It can also increase the growth of any pre-existing cancer.
Reduce Immunity and Brain Function: As folic acid takes time to be converted into its active form, it gets accumulated in the bloodstream. This is linked to poor immunity and reduced brain function.
Others: Oral folate supplements may cause a bad taste in the mouth, confusion, loss of appetite, irritability, nausea, skin rash, etc.
Folic acid is not stored significantly in the body. A healthy diet with green leafy vegetables, meat, eggs, and milk balance the level of folic acid in the body. Pregnant ladies must be aware of the folic acid consequences and start taking supplements to avoid risks.
Folic acid is the form of folate that is available as vitamin B9. It is essential for the synthesis and repair of the DNA and RNA molecules. It is known to help treat a lot of health conditions such as stroke, heart problems, depression, gum diseases, and vitiligo. It is better to get recommendations from your doctor before consuming folic acid.
Folic acid can help in making ovulation regular in women. This is also known to increase the level of progesterone during the later half of the menstrual cycle. It will also enhance the fertility of women. Folic acid is beneficial for pregnant women because it can help prevent neural tube defects and other birth defects.
Folic acid is not good if it is taken at abnormally high levels. The potential risk factors for taking folic acid are:
- Increased risk of cancer.
- Vitamin B12 deficiency.
- Poor functioning of the brain.
It is also known to lower the levels of immunity in a few patients.
Folic acid can become harmful only if it is consumed in abundant levels. The known side effects of excessive folic acid consumptions are:
- Increased risk of cancer.
- Lower levels of immunity.
- Decreased function in the brain.
- Vitamin B12 deficiency.
One of the beneficial effects of folic acid is its role in the promotion of hair growth. It is having a positive influence on hair growth treatment. Folic acid helps in keeping all the cells healthy. It will also help in preventing the thinning of the hair and promotes hair growth.
Many medical researchers suggest that folic acid consumption might cause weight gain in a person due to fat accumulation. The high-fat diet is rich in folic acid, and it will cause inflammation in individuals. It also depends on the individual's health condition because weight loss is noted in for a few patients.
If you are planning for pregnancy, then it is recommended to take 400 mcg of folic acid before you are pregnant. The supplementation of folic acid should be continued until 12 weeks of pregnancy. After 12 weeks, the baby's neural tube will be closed, and there would not be any necessity to take folic acid. However, continuing the folic acid medications after 12 weeks is not harmful.
The supplementation of folic acid will help in the proper metabolism of proteins. It will also help in maintaining an ideal insulin level. This will contribute to the burning of excessive fat in the body. This will increase the process of weight loss. The aspect of weight gain or loss will change according to the health of an individual.
Folic acid can be taken every day. Only if it exceeds the daily requirement of 400 mcg, it becomes harmful. Otherwise, doctors recommend the consumption of folic acid, especially for children and pregnant mothers.
The doctor would prescribe folic acid for several health benefits. It is recommended for pregnant women for the following reasons:
- Prevention of neural tube defects.
- Prevention of diabetes mellitus and autism.
- Prevention of rheumatoid arthritis.
- Treatment of arthritis and depression.
- Treatment of vitiligo and stroke.
The symptoms of folic acid deficiency are:
- The problem in growth.
- Sores in the mouth.
- Gray hair.
- Swelling in the tongue.
The symptoms of anemia are known to occur due to folate deficiency. It includes:
- Persistent fatigue.
- Pale skin.
- Shortness of breath.
Folic acid is known to be a water-soluble component. A considerable amount of folic acid will be eliminated from the body through urine. Acid leaves the body through urine; the folic acid does not get stored in the body. This results in a situation where the patient might require a regular supply of folic acid either from the food we eat or any other supplement.
There is no specific time to take folic acid. You can take either in the morning time or at night. It is essential to take a folic acid tablet along with the water. It can be consumed before and after food. If you miss your dose, then you might take it as soon as you remember it.
Yes, folic acid will make you sleepy. Folic acid supplementation helps an individual to get vitamin B9 in the body. Vitamin B is associated with insomnia. Supplementation of vitamin B will help patients to attain a good quality of sleep.
- Enriched bread and pasta.
- Leafy green vegetables.
- Cooked lentils.
- Great northern beans.
- Fortified cereals.
Folic acid is noted to increase fertility on both males and females. It increases sperm count in men. It is also known to reduce the risk of several birth defects in the baby. You can consult your doctor before consuming folic acid.
Folic acid is a powerful stimulant of appetite. If it is consumed in higher doses, it will make a person more hungry. This is due to the stimulation of acids in the stomach.
Once pregnant women reach 12 weeks, then the spine will be developed in the baby. Hence, pregnant women can stop consuming folic acid if they wish. But, they may consume folic acid even after 12 weeks as it would not harm the baby.
Folic acid is a safe and effective drug. It is essential during pregnancy. The side effects of folic acid are nausea, vomiting, and insomnia. You should ask for recommendations from your doctor before consuming it.
Yes, folic acid can help in the regulation of periods. It helps in making the process of ovulation more regular. This will help in the regular menstrual cycle. Folic acid is also known to increase the level of fertility in women.
There are no standard levels of folic acid. The dosage is changed depending on the requirements and health condition of the patient. Generally, in adults, the recommended amount of folate in dietary format is 400 mcg. If you are consuming more than 1000 mcg of folic acid, it might have some harmful effects.
The dosage of folic acid that is to be consumed during pregnancy varies depending on the stage of pregnancy. If a woman plans to become pregnant, they are recommended to take 400 to 800 mcg of folic acid. During the first trimester, the recommended dosage is 400 mcg. In the second and third trimester, 600 mcg folic acid is recommended. When women are breastfeeding, the recommended levels of folic acid is 500mcg.
Last reviewed at:
10 Aug 2022 - 5 min read
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