Folic acid - A vital B vitamin

What is folic acid?

Folic acid is a vital vitamin that the body can't produce itself. Every person is therefore dependent on regular intake.

Folic acid plays an important role in all growth and development processes in the body - and is therefore particularly important in pregnancy.

In the metabolism, folic acid helps to 'dispose' of the vascular-damaging substance homocysteine from the blood. This means that the blood vessels and the heart can also benefit from the vitamin.

Experts speak of 'critical care' for folic acid: Many people still don't get enough of this vitamin - even in an 'abundance country' like Germany.

Folic acid is one of the water-soluble B vitamins and is very sensitive to light, air and heat.

The body can almost completely utilize added folic acid, for example in food supplements as folic acid tablets or fortified foods.

Food folate is not quite as useful for the body and is more easily destroyed when cooking than folic acid.

Folic acid is a B vitamin that supports the body in building and maintaining cells. B vitamins are water-soluble substances that can't be synthesized by the body. Therefore, the need for folic acid and its second form, folate, must be met through the diet.

Folic acid refers to the synthetic form of the vitamin. Folate is found in various fruits and vegetables, such as spinach, broccoli, bananas, mushrooms, okra and asparagus. The chemical structure of folate is practically identical to the structure of synthetic folic acid. The only difference is that the folate structure is deprotonated, meaning that one hydrogen atom has been removed.

This difference between folate and folic acid does not affect the effectiveness of the folate. These two terms are used interchangeably to reflect the fact that the body converts both folic acid and folate in the same way.

Health benefits of folic acid

Folic acid is recommended

• against anemia due to folic acid deficiency
• against folic acid absorption disorders in the intestine (malabsorption syndrome, alcohol abuse, inflammatory bowel diseases)
• before and during pregnancy to prevent the neural tube defect
• against brain dysfunctions (forgetfulness, dementia, Alzheimer's, depression)
• against cardiovascular diseases
• if you are prone to thrombosis, stroke and heart attack
• to prevent cell degeneration
• against wound healing disorders
• for increased susceptibility to infections
• against folic acid deficiency due to medication

Folic acid and cardiovascular health

Folic acid has been shown to lower homocysteine levels in the blood. Homocysteine is a molecule with a similar structure to cysteine, an amino acid that is found in enzymes and proteins.

However, homocysteine is not used in the body's proteins and high levels of homocysteine in the blood are associated with an increased risk of heart disease. Folic acid may improve cardiovascular disease development by controlling homocysteine levels.

Research has shown that people with normal to slightly elevated homocysteine levels in their blood can decrease their homocysteine levels by 20 - 30% by taking a folic acid supplement.

Folic acid and stroke

The benefits of folic acid may include protection against possible heart attacks or strokes.

In a new study published by the Journal of the American Medical Association, the researchers observed over 20,000 adults with high blood pressure in China.

• In China, unlike the United States, food is not fortified with folic acid.
• The participants were divided into two groups: one group took folic acid tablets and an anti-hypertensive agent, while the other group only took tablets containing the anti-hypertensive agent.
• The average treatment length of the participants was 4.5 years.
• The study found that 2.7% of the participants had their first stroke when taking folic acid tablets plus the anti-hypertensive drug, while 3.4% of those who took the anti-hypertensive drug had a first stroke.

The study therefore says that folic acid supplements when taken with hypertension drugs can reduce the risk of a stroke.

Folic acid and fertility

Folic acid can increase fertility in women. In 2006, the American Society for Reproductive Medicine reported the results of a study that included 18,500 women who hoped to conceive within eight years.

The study found that women who took a multivitamin with folic acid 6 or more days a week were 40 percent more likely to get pregnant than women who did not take folic acid supplements.

On the other hand, a 2014 study published in Reproductive Biomedicine Online found that taking folic acid in women with unexplained fertility problems was unrelated to the results of successful in vitro fertilization (IVF).

Further research is therefore needed as these studies claim that folic acid supplements may increase fertility in women who attempt to conceive through non-in vitro fertilization.

Folic acid and pregnancy

Folic acid is an important supplement for pregnant women. Symptoms of a folate deficiency include diarrhea, anemia, shortness of breath, mental confusion, headache and numbness.

However, in pregnant women, a folate deficiency can result in a miscarriage, pregnancy complications and birth defects. For example, an improper intake of folic acid can cause neural tube defects in the growing embryo.

During the third week of pregnancy, the embryo cells form the neural tube, which later develops into the spinal cord and brain of the baby. Damage to the neural tube prevents normal development during this process and can lead to serious birth defects.

These include: an open or a curved spine; anencephalia, the inability to develop a full brain, and inienencephaly, a condition that causes severe neck problems.

In the United States, folic acid fortification has helped reduce the incidence of neural tube defects in the population. However, an expectant mother is still strongly recommended to add folic acid to her diet to ensure healthy growth and proper development of their growing child.

Who Can Benefit From Folic Acid Supplements?

• People with a proven folate deficiency
• Women before and during pregnancy
• People with kidney problems or high blood pressure
• People with cardiovascular diseases
• Alzheimer's patients
• People with elevated homocysteine levels

Does folic acid have side effects?

The side effects of folic acid are minimal to none, provided the person in question is on the prescribed dose.

Folic acid interactions and combinations

Folic acid supplements should not be used with certain medications to treat epileptic seizures. This includes phenobarbital, fosphenytoin and phenytoin. People taking methotrexate should also avoid folic acid capsules, as the two substances mutually neutralize their effects.

Folic acid dosage

The recommended dosage for folic acid preparations varies depending on the circumstances. A daily dose of 400 mcg (micrograms) in the form of folic acid tablets or folic acid capsules is recommended, for example, to prevent neural tube defects in pregnant women, while a dose of 800 mcg to 1000 mcg/day (micrograms) is recommended for people who want to lower their homocysteine levels in the blood.

What experts say about folic acid

Folic acid deficiency widespread - little awareness

The German Nutrition Society, DGE, announced in the latest annual report on the nutritional situation that about 90% of the German population suffers from a folic acid deficiency. For women, this percentage is 99%. It is an astonishing admission by an antiquated and restrictive association, which always emphasized that vitamin deficiency is unimaginable in Germany.

The fact that women in particular suffer so drastically from a folic acid deficiency is all the more tragic, since this deficiency has a direct impact on the malformation rate of newborns. 'If the folic acid deficiency could be treated, even before pregnancy, 70% of the malformations could be prevented' (Dr. Robert Marger, former head of pediatric surgery, St. Gallen)

Folic acid rejuvenates the brain for years

Seniors who take twice the recommended dose of folic acid remain mentally fit longer, according to a study by the Dutch Wageningen University. Folic acid works like mental anti-aging. Aging is associated with a reduced mental performance.

Researchers have now found that doubling the recommended folic acid dosage has a positive effect on memory. The scientists presented their results at the Alzheimer Association's annual convention currently held in Washington. Over 800 people between the ages of 50 and 75 had received either 800 mcg of folic acid or a placebo for three years. An intelligence test showed that the memory functions with folic acid intake were as good as in people who are 5.5 years younger.

Increased intake of folic acid is good for the heart and brain

According to Professor Klaus Pietrzik, sensible nutritional medicine measures for health prevention are not used to the desired extent in Germany. The Bonn nutritionist is counting on supplementation with folic acid. Neural tube defects can be prevented during pregnancy as well as cardiovascular risks when using a folic acid supplementation, said Pietrzik at the annual conference of the German Society for Prevention and Rehabilitation of Cardiovascular Diseases in Berlin.