What is Folic Acid?

Folate (Vitamin B-9) is important in red blood cell formation and for healthy cell growth and function. The nutrient is crucial during early pregnancy to reduce the risk of birth defects of the brain and spine.

Folate is found mainly in dark green leafy vegetables, beans, peas and nuts. Fruits rich in folate include oranges, lemons, bananas, melons and strawberries. The synthetic form of folate is folic acid. It's in an essential component of prenatal vitamins and is in many fortified foods such as cereals and pastas.

A diet lacking foods rich in folate or folic acid can lead to a folate deficiency. Folate deficiency can also occur in people who have conditions, such as celiac disease, that prevent the small intestine from absorbing nutrients from foods (malabsorption syndromes).

What is the best source of it?

Folate is naturally present in a wide variety of foods, including vegetables (especially dark green leafy vegetables), fruits and fruit juices, nuts, beans, peas, seafood, eggs, dairy products, meat, poultry, and grains. Spinach, liver, asparagus, and brussels sprouts are among the foods with the highest folate levels.

Dietary supplements

Folic acid is available in multivitamins and prenatal vitamins, supplements containing other B-complex vitamins, and supplements containing only folic acid.

About 85% of supplemental folic acid, when taken with food, is bioavailable. When consumed without food, nearly 100% of supplemental folic acid is bioavailable.

Dietary supplements containing 5-methyl-THF (also called methylfolate), a reduced form of folate, are also available. For some people, supplementation with 5-methyl-THF might be more beneficial than with folic acid as the bioavailability of 5-methyl-THF in supplements is the same as or greater than that of folic acid.

 

What are the deficiency symptoms of it?

Isolated folate deficiency is uncommon; folate deficiency usually coexists with other nutrient deficiencies because of its strong association with poor diet, alcoholism, and malabsorptive disorders. Megaloblastic anemia, which is characterized by large, abnormally nucleated erythrocytes, is the primary clinical sign of folate or vitamin B12 deficiency. Its symptoms include weakness, fatigue, difficulty concentrating, irritability, headache, heart palpitations and shortness of breath.

Folate deficiency can also produce soreness in and shallow ulcerations on the tongue and oral mucosa; changes in skin, hair, or fingernail pigmentation; gastrointestinal symptoms; and elevated blood concentrations of homocysteine.

Women with insufficient folate intakes are at increased risk of giving birth to infants with Neural tube defects (NTDs). Inadequate maternal folate status has also been associated with low infant birth weight, preterm delivery, and fetal growth retardation

Groups at Risk of Folate Inadequacy

The following groups are among those most likely to be at risk of folate inadequacy.

• People with alcohol use disorder
• Women of childbearing age
• Pregnant women
• People with malabsorptive disorders
• People with the MTHFR enzyme polymorphism

 

What are the benefits of having it?

Folate and health

This section focuses on seven diseases and disorders in which folate might play a role: 

• Cancer

Folate that is naturally present in food may decrease the risk of several forms of cancer. But folate supplements might have different effects on cancer risk depending on how much the person consumes. People who take recommended amounts of folic acid before cancer develops might decrease cancer risk.

• Cardiovascular disease and stroke

Folic acid supplements lower levels of homocysteine, an amino acid in the blood thats linked to a higher risk of cardiovascular disease. But the supplements don’t directly decrease the risk of heart disease. Some studies have shown that a combination of folic acid with other B-vitamins, however, helps prevent stroke.

• Dementia, cognitive function, and Alzheimer’s disease

Folic acid supplementation reduces the serum homocysteine levels and is therefore a possible method to help prevent dementia or age-related cognitive decline.

• Depression

People with low blood levels of folate might be more likely to have depression. In addition, they might not respond as well to antidepressant treatment as people with normal folate levels.

 

• Neural Tube Defects

Taking folic acid before becoming pregnant and during early pregnancy helps prevent neural tube defects in babies. NTDs are major birth defects in a baby’s brain (anencephaly) or spine (spina bifida). But about half of all pregnancies are unplanned. Therefore, all women and teen girls are recommended to consume folic acid daily from supplements, fortified foods, or both, in addition to the folate they get from following a healthy eating pattern.

• Preterm birth, congenital heart defects and other birth defects

Taking folic acid might reduce the risk of having a premature baby or a baby with birth defects, such as certain types of heart problems.

• Autism Spectrum Disorder (ASD)

ASD affects communication and behaviour, usually beginning by age 2. People with ASD have limited interests, repetitive behaviours, and difficulty communicating and interacting with others.