Adequate intake of folic acid/folate may be best known for preventing neural tube defects in the newborn and other pregnancy related issues. It is essential for detoxification, synthesis of DNA, growth, production of healthy red blood cells and prevention of cancer, heart disease, dementia, macular degeneration, depression, and a host of other ailments. It is such an important nutrient for healthy metabolism, that any ailment that doesn't readily respond to appropriate treatments may be indicative of a folic acid/folate deficiency.
Folic acid is the synthetic form of folate. The name folate comes from the Latin word folium, which means leaf: leafy vegetables are the principle source for dietary folate. Folate is found in spinach, kale, broccoli and many other vegetables. It is also found in whole grains, legumes, citrus fruits, melons, bananas and eggs. It doesn’t tolerate heat well, so the more a food is cooked; the less folate will be present. Folate or B9 is what is found in our food, not folic acid. There is a difference.
Because of the instability of folate, folic acid with a longer shelf life and less expensive manufacturing cost has been promoted as a food additive and vitamin supplement to prevent deficiency. To make use of folic acid the liver must first convert it into folate, but as we age, the liver does not do this very effectively. This leads to folate deficiency states and unhealthy folic acid metabolites. An additional concern is that 25 percent of the population has a genetic deficiency that hinders the body’s ability to convert folic acid into healthy folate derivatives.
One doctor mused: with the promotion of folic acid we may have created a monster. Here is what he was referring to. If a pregnant woman does not supplement with folic acid, and her fetus has the genetic folate deficiency gene(s), a miscarriage will result. Thus any subsequent neurologic issues such as autism and other pervasive developmental disorders that would likely arise in that child will never manifest. If the pregnant mother does supplement with folic acid and there is no miscarriage, once the child is born and stops receiving folic acid from the mom, neurologic issues are likely to manifest. Also, this child will increase the population gene pool of folate genetic deficiencies.
What to do? Stop supplementing with folic acid, begin supplementing with folate, and identify those at risk. There are tests available to identify folate genetic defects and hopefully one day soon they will be part of the standard pregnancy blood panels to ensure the health of both mother and baby. The basic test is called: MTHFR Test and it provides critical information relating to the most common MTHFR mutations: C677T and A1298C.
If a child or adult has the folate genetic defect they can address this by supplementing with folate or even better: L-5 methyltetrahydrofolate (L-5MTHF). Folate needs to be converted to its active form L-5MTHF (not R-5MTHF) before the body can use it. In the last few years L-5MTHF has become available as an oral and injectable supplement. The typical adult daily supplement dose for folate or L-5MTHF is 400 mcg and if pregnant 500mcg to 800mcg daily. I generally don’t recommend more than 1,000 mcg of folate or L-5MTHF for general health, but will prescribe a higher dose for those with the folate genetic defect.
It is very important to compliment folate or L-5MTHF supplements with B12, B6 and B2 as found in good multiple vitamin mineral formulas (see website newsletter Supplement – Complete Life). Hydroxycobalamin or methylcobalamin (see website newsletter on B12) are the best forms of B12 to use for this condition.
There are a few individuals who are sensitive to folate and 5MTHF, and they must start at a low dose along with the vitamins mentioned above to avoid the following possible side effects: irritability, anxiety, nausea, headaches and insomnia.
In summary: eat your green leafy vegetables. Don’t consume folic acid, and study labels to ensure you are getting folate or L-5MTHF in your supplements. Remember: folate is such an important nutrient for healthy metabolism, that any ailment that doesn’t readily respond to appropriate treatments may be indicative of a folate deficiency issue.
Jon Dunn, ND