Folic acid, a water-soluble B vitamin, occurs naturally in food and can also be taken as food supplements. Naturally occurring sources of folic acid include green leafy vegetables (spinach, turnip), poultry, pork, shellfish, peas beans, liver, cereal and citrus fruits. Folic acid is one of the necessary elements required for production and maintenance of human cells.

Folic acid deficiency and diseases:

  • Folic acid deficiency may cause various disorders. Some of these are highlighted below.
  • Folic acid deficiency may cause weakness, poor growth, graying hair, inflammation of the tongue, palpitations and behavioral disorder.
  • Folic acid deficiency is also associated with common stomach disorders including diarrhea, mouth ulcer and peptic ulcer, loss of appetite and weight loss.
  • Folic acid deficiency in pregnant women may cause premature delivery, low birth weight of infants and infants with neural tube defects (NTD).
  • Anemia is sometimes associated with an advanced stage of folic acid deficiency.
  • You may need increased folic acid intake if you are anemic, have kidney or liver disease, pregnant or breast-feeding. In all such cases you should consult your doctor before taking folic acid supplements.
  • The maximum folic acid intake should be limited to 1000 micro grams per day or as directed by the health care provider.
  • Some other medications may interact with folic acid including medicines for epilepsy, medicines for controlling blood sugar, methotrexate (medicines for treating cancer) and diuretics. If you are taking any of these medicines, you should contact your doctor.
  • If you are 50 years of age, you should carry out your vitamin B-12 level before taking supplemental diet of folic acid, as these are chances of interaction between B-12 vitamins and folic acid.

Role of folic acid during pregnancy:

Neural tube defects (NTD) is a major defect of the brain and spine in babies causing damage in those areas. The major NTD include spina bifida (spinal problems) and Anencephaly (brain problems) and up to 70% of these NTD’s can be prevented by taking enough folic acid every day before conception and during pregnancy.

A woman is likely to be at higher risk to deliver a NTD affected baby if she has had a previous NTD affected pregnancy, is diabetic, takes medicine to treat epilepsy and/or is of Hispanic ethnicity. It is recommended if you are likely to become pregnant, you should take 400 micro grams of folic acid every day. Consuming supplemental folic acid in addition to a healthy folic acid rich diet before and during pregnancy significantly reduces the risk of having neural tube defects in babies.

Spina Bifida and Anencephaly disorders

Spina bifida is a spinal disorder where part of spine at the lower end is damaged and a sack of fluid is entrapped in the baby’s back. Most children born with this spinal disorder live a full life but often have lifelong symptoms including being unable to move the lower part of the body, loss of bowel and bladder and fluid pressure to the brain.

Anencephaly is a brain disorder where part of the cranial bones may not form correctly in babies. Most of the babies having this defect die before or just after birth.

Role of folic acid and heart disease:

Low concentration of folic acid may increase the amino acid homocysteine in the blood levels and consequently increases the risk of heart disease. High level of homocysteine may damage the coronary arteries or can cause the blood clots, however there is no evidence that supplemented folic acid will reduce the risk of heart disease.

Role of folic acid and cancer:Folic acid is one of the essential elements involved in the synthesis of DNA and its deficiency may cause defects in DNA and consequently may lead to cancer. There is enough evidence to conclude that the deficiency of folic acid is associated with the increased risk of breast, colon and pancreatic cancer, however it is not advisable to supplement folic acid solely based on reducing the risks of such cancer. As always, consult a physician before considering taking any new medication or supplement.

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