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Folic Acid- Not Just for Women

Folic Acid is an Important Vitamin which Helps Process Amino Acids. It is Found Naturally in Many Foods, but is Best Metabolized in Oral Supplement Form.

Folic Acid is an Important Vitamin which Helps Process Proteins to Make New Healthy Cells. It is Found Naturally in Many Foods, but is Best Metabolized in Oral Supplement Form.

January is National Birth Defects Awareness Month, and the first full week of January is National Folic Acid Week. Dr. Zack at Johns Creek Family Medicine, serving patients from communities in South Forsyth, Gwinnett and North Fulton counties, and surrounding North Atlanta area, would like to share the importance of folic acid for all of their patients.

What is Folic Acid?

Folic acid is the synthetic form of folate, which is a B vitamin that helps the body make new healthy cells. All people need folic acid, which helps the body break down, use and create new proteins. It also is necessary for the formation of red blood cells and creation of new DNA. It is also thought to contribute to heart health, reduce potential for anemia, prevent cell changes that may lead to development of cancer, and help prevent other detrimental health conditions.

B vitamins are found naturally in dark-green leafy vegetables, citrus fruits, beans, and whole grains. Most people, particularly women of child-bearing age, do not get all of the folic acid they need through diet alone. For one thing, the body does not seem to metabolize the natural form, folate, as easily as the synthetic form, so consuming it in foods may not deliver enough as compared to taking it as an oral supplement. Folic acid is sometimes added to foods that are labeled “enriched,” such as: breakfast cereals, breads, flours, pastas, cornmeal, and white rice. However, it would take eating a large quantity of folate enriched foods to get the same amount of folate as a vitamin supplement containing folic acid.

While folate intake from food is not associated with any health risk because it is a water-soluble vitamin, so any significant excess will naturally be eliminated, there may be detrimental health risks from ingesting too much synthetic folic acid. No more than 1,000 micrograms (1 milligram) are recommended for anyone with good health, as it can cause a vitamin B-12 deficiency, or mask a vitamin B2 deficiency, and subsequent potential for permanent nerve damage. As well, stomach problems, sleep problems, skin reactions and seizures may occur from exceeding recommended doses unless higher doses are specifically prescribed by a physician to treat a particular disease or condition.

Why Do Men Need Folic Acid?

The recommended upper daily limit of folate for adult men is 1 milligram (1,000 mcg), which ideally would be supplied by food, but realistically most folic acid is ingested as a supplement. The proper amount of folic acid offers the following beneficial properties to men:

Prevents Against Heart Disease. Folic acid joins vitamin B12 as a co-enzyme to metabolize an amino acid called homocysteine. Without enough folic acid, an increased risk of heart attacks and strokes from high concentration levels of homocysteine may result. Elevated levels may contribute to plaque formation by damaging arterial walls.

Prevents Alzheimer’s Disease. Consuming the 400 mcg. recommended daily allowance of folic acid has been found to reduce the risk of developing Alzheimer’s by more than 50%. It has also been suggested that folic acid contributes toward prevention of general memory loss associated with aging.

Helps Prevent Type II Diabetes. Folic acid may increase the breakdown of triglycerides, which is the chemical form that fat exists in the blood, which may aid in the prevention of obesity and type II diabetes. Studies have shown that people with a BMI above 30 have low levels of folic acid.

Aids in Treatment for Depression. Folic acid deficiency has been linked to depression and may impact the success of a patient’s response to antidepressant medication.

Why Do Women Need Folic Acid?

Women’s health at all ages benefits from folic acid in the prevention of heart disease, Alzheimer’s, depression and Type II diabetes, the same as for men. However, it is particularly crucial for women during their child-bearing years because of the important role it plays in the development of the fetus’ spinal cord and brain. Folic acid deficiency can cause neural tube defects, which are severe birth defects affecting the brain and spinal cord. The most common neural tube defects attributed to an insufficient amount of folic acid prior to, and during pregnancy are:

• Spina Bifida, which occurs when an unborn baby’s spinal column does not close to protect the spinal cord, resulting in nerves that control leg movements and other functions that are non-operational. Children with spina bifida usually have lifelong disabilities and may require multiple surgeries to survive.

• Anencephaly, which is when most or all of the brain does not develop. Survival for any period of time is rare with children suffering from this condition.

Ideally, women of child bearing age should consume at least 400 to 800 micrograms of folic acid a day foods and supplements, whether or not planning to become pregnant, as statistics indicate that 50% of pregnancies are unplanned. For planned conception, the recommended dosage should be initiated at least 3 months prior to conception and during the entire pregnancy. Some doctors prescribe prenatal vitamins that contain even higher amounts of folic acid. In the case that a woman who has previously borne a baby with a neurological birth defect, who plans to become pregnant again, a woman, a woman with spina bifada in her immediate family, or in rare cases a woman with spina bifida, up to 4,000 mcg of folic acid, which is 10 times the normal dose may be prescribed to lower the risk. Women who breastfeed should also continue folic acid consumption of about 500 mcg. During and post menopause, women should take at least 400 mcg daily, as well as a vitamin B12 supplement.

What Circumstances Might Merit Prescription of Higher Dosages?

People with the following conditions may require higher concentration of folic acid:

• Taking medicines used to treat: epilepsy, type 2 diabetes, rheumatoid arthritis, lupus, psoriasis, asthma, and inflammatory bowel disease
• Have kidney disease and are on dialysis.
• Have liver disease.
• Have sickle cell disease.
• Have celiac disease.
• Consume more than one drink per day – alcoholics tend to have deficiencies because alcohol interferes with the absorption of folate and increases the amount of folate the kidney expels.

Talk with Dr. Zack if you feel you have a deficiency of your diet of essential minerals and vitamins, or any of the conditions cited above. As well, women within childbearing age, especially those who are planning to become pregnant, should discuss taking supplements with Dr. Zack. Finding a vitamin with adequate folic acid is not difficult. It’s available at most grocery, big box and drug stores, as well as health food stores.

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