Folic acid is a form of the water-soluble vitamin, B-9. It is a key factor in the synthesis of nucleic acid - one of a large family of molecules that include DNA and RNA.
The human body does not store folic acid; because of this, we need to consume it every day to ensure that we have enough in our system.
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Here are some key points about folic acid. More detail and supporting information is in the main article.
Why is folic acid important?
All women of childbearing age should consume adequate folic acid.
According to the British Dietetic Association, vitamin B9 (folic acid and folate inclusive) is vital for several bodily functions:
- The synthesis and repair of DNA and RNA
- Aiding rapid cell division and growth
- To produce healthy red blood cells
- Enhances brain health - Dutch researchers reported that folic acid supplementation might improve memory
- Age-related hearing loss - one study found that folic acid supplements might slow the onset of age-related hearing loss
- Heart health - some evidence suggests that folic acid can protect heart health
It is particularly important for pregnant women to have enough folic acid to prevent major birth defects of her baby's brain or spine (neural tube defects, including spina bifida and anencephaly). To reduce the incidence, women planning to get pregnant should take a folic acid supplement for a full year before conception.
Folic acid and autism
"Periconceptional folic acid [before conception and during early pregnancy] may reduce [autism spectrum disorder] risk in those with inefficient folate metabolism. The replication of these findings and investigations of mechanisms involved are warranted."
Folic acid and cleft lip and palate
A literature review carried out in 2014 concluded that "There is increasing evidence that folic acid supplementation may [...] reduce the incidence of oral facial clefting."
In 1992, the American FDA (Food and Drug Administration) advised fortifying the country's food supply with folic acid. In 1998, folic acid started being added to breads and other grains.
Who should take folic acid?
All women of childbearing age should take folic acid, not only those who are planning to get pregnant, according to March of Dimes- an organization that funds research and works to end premature birth, birth defects, and infant mortality.
March of Dimes director, Dr. Richard Johnston, Jr., said that in order to be effective in preventing birth defects, women should take folic acid before getting pregnant as well as during the first 4 weeks after conception.
As almost half of all pregnancies in the United States are unplanned, every woman who is capable of getting pregnant should be taking daily folic acid supplements.
The Teratology Society is a group dedicated to studying the "causes and biological processes leading to abnormal development and birth defects, and appropriate measures for prevention."
They say that all women who are capable of having babies should take 0.4 milligrams of folic acid, or make sure they consume enough fortified cereal grain products to reach 0.4 milligrams of folic acid per day.
The online journal PLOS Medicine wrote in 2009 that females who take folic acid supplements for at least 12 months before becoming pregnant could cut their risk of having a premature baby by about half. The researchers concluded:
"Preconceptional folate supplementation is associated with a 50-70 percent reduction in the incidence of early spontaneous preterm birth."
Folic acid is essential for the growth of the embryo's spinal cord. Because the spinal cord is one of the first parts of the body to be formed, it is important that folic acid levels are right during the earliest stages of development.
Natural sources of folic acid
Spinach is rich in folic acid
Dark green vegetables are good sources of folic acid. Be careful not to overcook, as the folic acid content can drop considerably.
The following foods are known to be rich in folic acid:
- Baker's yeast
- Brussel sprouts
- Egg yolk
- Jacket potato (large)
- Liver (pregnant women should not consume liver)
- Many fruits have moderate amounts, papaya and kiwi have more
- Sunflower seeds
- Whole wheat bread (usually fortified)
Folic acid deficiency anemia
Individuals who do not eat sufficient folic acid can develop folic acid deficiency anemia. Because folate is important in the production and maintenance of red blood cells, if levels are not adequate, the overall number of red blood cells is lower than the body needs to carry around enough oxygen to supply the body.
This condition can also appear in people who require higher quantities of folate and are not taking supplements, such as pregnant and lactating women.
Folic acid deficiency anemia can also occur in individuals with medical problems like sickle cell disease, or people who have conditions where the body does not absorb enough folate, for instance in alcohol abuse or kidney disease.
The signs and symptoms of folic acid deficiency disease include:
- Fatigue, tiredness
- Feeling generally weak
- Sores around the mouth
- Being irritable
- Loss of appetite
- Weight loss
Patients with folic acid deficiency anemia are given folic acid pills to be taken daily. Once folate levels are returned to normal, the body is able to produce enough blood cells to allow the body to function normally again.
Folic acid deficiency
Apart from anemia and birth defects, folate acid deficiency can result in:
- A higher risk of second heart attacks.
- A higher risk of strokes. A study in the medical journal Circulation reported that adding folic acid to foods contributes significantly to reducing stroke death by lowering homocysteine levels, a risk factor for cardiovascular disease.
- A higher risk of some cancers, such as stomach cancer.
- A considerable drop in male sperm count and, consequently, male fertility. One study found that folic acid may improve a man's chances of fathering a child.
- A higher risk of developing clinical depression - lower levels of folate and other B vitamins have been found in depressed patients.
- Possible memory and mental agility problems.
- Perhaps a higher risk of developing allergic diseases.
- A higher long-term risk of lower bone density (hypothesis).
Folic acid side effects
There are no serious side effects to taking folic acid. Sometimes, certain individuals report an upset stomach, but this is a rare occurrence.
Even if more folate is taken than needed, there is no cause for concern. Because folic acid is water-soluble, any excess will be naturally excreted (passed in urine).
Folic acid and pregnancy
This video below, by March of Dimes, talks about the importance of folic acid during pregnancy: