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Vitamin B9, Folic Acid: Benefits, Deficiencies, Sources, Dosage & Risks

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What is Folic Acid?

Folic Acid, also known as Vitamin B9 and Folate, is part of the B-complex Vitamins. These vitamins are essential for the body and maintain the liver, skin, hair, eyes, and nervous system. They help the body convert food into energy as well as help the body use fat and protein. This water-soluble vitamin cannot be made by the body so it needs to be obtained from food or supplements. The name comes from the Latin word for leaf due to the fact that the highest concentrations are found in green leafy vegetables. It is needed for development of the body, specifically the nervous system for the fetus. Vitamin B9 is essential for creating DNA, RNA, and amino acids for cell processes in the body like cell replication.

Folate

  • Natural form of Vitamin B9
  • Found in food naturally

Folic Acid

  • Synthetic form of Vitamin B9
  • Found in supplements and in fortified foods such as cereals and other grains

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Vitamin b9 aka Folate

Why is Folic Acid Essential?

  • Brain Function: Folic Acid is important for mental and emotional health as well as maintenance of the central nervous system. Low levels of Vitamin B9 can lead to depression.
  • Folic Acid is needed to make new cells, leading to the renewal of skin, hair, and nails.
  • Cellular Mechanisms: Working with vitamins B6 and B12, Vitamin B9 controls the blood levels of homocysteine, an amino acid associated with heart disease. It is also needed for the creation and maintenance of cells in the body. For example, Vitamin B9 and Vitamin B12 work together to make red blood cells and facilitate iron transport. Folic Acid is needed for creating DNA and RNA as well as preventing changes to the DNA, linking Folic Acid to cancer prevention. This is very important when the cells in the body are rapidly growing like during the development of the fetus.
  • Fertility & Fetal Development: Folic Acid is needed in both men and women to assist in fertility, such as the process of creating sperm cells or spermatogenesis. Infertility in women can be linked to genetic defects for metabolism of Folate.
  • Cancer Prevention: People that eat a diet high in Folic Acid have a lowered risk of developing some cancers like:
    • Colon cancer
    • Breast cancer
    • Cervical cancer
    • Pancreatic cancer
    • Stomach cancer

Folic Acid prevents mutations in DNA, by proxy preventing cancerous mutations. Folic Acid supplements have not proven beneficial to cancer prevention, however a diet with natural Folate has been shown to provide protection against disease.

  1. Fetal Development

Pregnant women and women who are trying are advised to increase Vitamin B9 levels in the body through diet and supplements to reduce the risk of neural tube birth defects and miscarriage. Neural tube defects affect the developing brain, spine, or spinal cord during the first month of pregnancy. Two of the most common defects are spina bifida and anencephaly. Spina bifida is caused when the spinal column isn’t closed completely, leading to nerve damage or lower extremity paralysis. Anencephaly is caused when the majority of the brain and skull are not formed, leading to death in the womb or at birth. Folic Acid deficiency is commonly associated with genetic abnormalities, leading to miscarriage. Taking Folic Acid supplements can reduce the risk of neural tube defects between 72 and 100%.

  1. Organ Health

High levels of homocysteine in the blood have been linked to stroke and heart disease and increasing intake of Folic Acid lowers levels up to 30%. Research is not clear if supplements assist with reducing risk. Those with kidney disease also have high levels of homocysteine, which gets lowered with taking Folic Acid. Folic Acid also treats liver disease and ulcerative colitis.

  1. Depression

Research suggests that Vitamin B9 deficiency is linked to depression. Taking folic acid in addition to antidepressant medications improve symptoms of depression due to affecting noradrenaline and serotonin receptors in the brain acting as an additional antidepressant.

  1. Vision Health

Increasing intake of Vitamin B9, B6, and B12 decreases the risk of developing Age-Related Macular Degeneration leading to vision loss.

  1. Vitiligo

This skin disorder causes discoloration of the skin, and taking Folic Acid supplements seem to improve the symptoms.

  1. Aging

Folic Acid renews and protects the skin, and brings nutrients to the hair.

  1. Memory/Alzheimer’s

Taking Folic Acid supplements decrease the risk of Alzheimer’s and postpone age-related memory loss.

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Symptoms of Folic Acid Deficiency

A Folic Acid deficiency starts at the molecular level, inhibiting DNA synthesis and cellular division in the body. Folic acid is typically added to a lot of grains and cereals in many countries, although deficiency is still common. Poor diet, alcoholism, medications, inflammatory bowel disease, and celiac disease can all cause a Vitamin B6 deficiency.

Anemia

The division of blood cells is most dramatically affected. As the body realizes that there is a problem with DNA replication, repair and cell division, it ships out abnormal blood cells, which leads to anemia. In turn, the body releases more immature cells to compensate for anemia, making matters worse. Anemia is the inability for the blood cells to carry enough oxygen to the body.

Birth Defects

Pregnant women with a Folic Acid deficiency leads to an increase in the likelihood of a neural tube defect early in the pregnancy. Examples of a neural tube defect include:

  • Cleft Palate

The roof of the mouth doesn’t completely form and usually has an opening in it. This defect can affect the soft or hard palate of the mouth. Taking Folic Acid supplements when pregnant can reduce the likelihood of your baby developing a cleft palate by 25%

  • Spina Bifida

This defect occurs when the spinal column does not close completely around the spinal cord. It usually occurs in the lower back and can lead to fluid on the brain, paralysis, incontinence, disability, depression, and sexual dysfunction. Taking Folic Acid supplements can prevent spina bifida by up to 70%.

  • Anencephaly

This defect happens when the neural tube does not close during the first month on the head region. Sometimes there is a lack of parts of the brain or the entire brain with the top of the head exposed. If the fetus is born alive it is blind, deaf and unable to feel pain, with usually the only part of the brain functioning covers basic unconscious actions like breathing. Taking a Folic Acid supplement before becoming pregnant can reduce the risk of this defect to 0.03%.

Less severe symptoms and effects of a Folic Acid deficiency include

  • Irritability
  • Sores on tongue
  • Changes in skin and hair color
  • Exhaustion
  • Heart palpitations
  • Shortness of breath
  • Diarrhea
  • Loss of appetite &malabsorption of nutrients
  • Decrease in Male Fertility (sperm count)
  • Gingivitis
  • Forgetfulness and Mental fog
  • Increased risk of:
    • Stroke
    • Cancer
    • Heart Attack
    • Depression

Top 10 Health Benefits of Folic Acid

  1. Normal Fetal Development

normal-fetal-development

Folic acid is essential in facilitating proper neural tube development in the fetus. Supplements are recommended for women who may become pregnant and those who are pregnant. Taking a Folic Acid supplement decreases the risk of the fetus having a neural tube defect significantly. Cleft palate is decreased by 25%, spina bifida is decreased by 70%, and anencephaly is decreased by 99.08%.

  1. Eye Health

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Folate is one vitamin used to reduce the risk of Age-Related Macular Degeneration. Deficiency in Folic Acid can lead to degeneration of the optic nerve in the eye, disrupting the signal from the eye to the brain and causing vision loss.

  1. Maintain Male Fertility

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Folic acid reduces the amount of genetic abnormalities in sperm up to 30% as well as increasing overall sperm count and increasing the sperm’s mobility.

  1. Cancer prevention

cancer-prevention

A diet high in natural Folate has been shown to decrease the risk of developing cancer. Folic Acid repairs and protects DNA from mutations. Studies have shown that it decreases the risk of developing cancers of colon, breast, cervical, pancreatic and stomach.

  1. Antidepressant

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Folic Acid interacts with neurotransmitters in the brain, specifically serotonin and dopamine and can act as a type of antidepressant. Studies have shown that Folic Acid in conjunction with traditional antidepressant medication greatly improves the effectiveness.

  1. Hair Growth

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Folic Acid renews cells that facilitate hair growth and can prevent baldness and thinning in both men and women. Hair follicles receive nutrients from the body, in part because Folate breaks down foods to absorb nutrients.

  1. Maintains Skin Health

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Vitamin B9 repairs DNA that is damaged by the UV rays of the sun and facilitates cell turnover rate and collagen production. This leads to youthful, healthy skin. In those with the disorder vitiligo, Folic Acid supplements can prevent the damage done to melanin-producing skin cells.

  1. Memory & Brain Health

memory-brain-health

Those that take the recommended amount of Folic Acid have a 50% decreased risk of developing Alzheimer’s. Folic Acid also is important for preventing age-related memory loss. Homocysteine levels also interact with the brain and folate levels, especially in the case of dementia among the elderly. Folic Acid can reduce the likelihood of dementia and other age-related memory issues.

  1. Cardiovascular Health

cardiovascular-health

Large amounts of homocysteine lead to heart disease, and Folate lowers these levels. This in turn leads to a lower risk of heart disease and stroke.

  1. Red Blood Cell Production

red-blood-cell-production

Folate is a fundamental nutrient needed for creating red blood cells in the body. Red blood cells carry oxygen to the body. A deficiency in Folic Acid leads to deformed and immature red blood cells that cannot efficiently carry oxygen, leading to anemia.

Top 10 Food sources of Folic Acid

Many cereals, flour, breads, pasta, cookies, and crackers are now fortified with Folic Acid in most countries to prevent deficiency.

  1. Asparagus
  2. Broccoli
  3. Brussel Sprouts
  4. Lentils
  5. Spinach
  6. Cabbage
  7. Cauliflower
  8. Whole Grain Bread
  9. Oranges
  10. Peas

Dosage

The CDC recommends that women take 400 micrograms of Folic Acid daily if trying to become pregnant to prevent birth defects.

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Daily Recommendation for Folic Acid:

  • Infants
    • 0 to 6 months: 65 micrograms
    • 7 to 12 months: 80 micrograms
  • Children
    • 1 to 3 years: 150 micrograms
    • 4 to 8 years: 200 micrograms
    • 9 to 13 years: 300 micrograms
  • Teenagers
    • 14 to 18 years: 400 micrograms
  • Males & Females
    • 19 and older: 400 micrograms
  • Pregnant Females
    • 600 micrograms
  • Breastfeeding Females
    • 500 micrograms

Special Doses:

  • Deficiency: 250-1000 micrograms
  • Prevention of Birth Defects: 400 micrograms one month before pregnancy to one month after pregnancy. Those with a history of neural tube defect pregnancies should take 4 milligrams one month before until three months after conception.
  • Colon Cancer Prevention: 400 micrograms
  • Lowering Homocysteine: 0.5 to 1 milligram
  • Depression: 200 to 500 micrograms
  • Vitiligo: 5 milligrams twice daily
  • Age-Related Macular Degeneration prevention
    • Vitamin B9: 2.5 micrograms
    • Vitamin B12: 1000 micrograms
    • Vitamin B6: 50 milligrams

How to Increase Folic Acid Intake?

  1. Eat a balanced diet that includes naturally Folate-rich foods such as leafy green vegetables like spinach and cabbage.
  2. Eat grains that are fortified with Folic Acid. Many countries require that cereals, pasta, flour, and bread have Folic Acid added to it.
  3. Add a vitamin that contains Folic Acid, either a multivitamin or a Folic Acid specific supplement. It can be found in chewable, drops, tablets, soft gel, and lozenge form.

Side Effects and Dangers

The possibility of Folic Acid toxicity is low because any excess will be excreted through urine and not be stored in the body. High doses of Folic Acid may cause the following:

  • Abdominal cramps
  • Diarrhea
  • Rash
  • Sleep problems
  • Confusion
  • Nausea
  • Irritability
  • Loss of appetite
  • Bloating and gas
  • Depression

If any signs of an allergic reaction occur, seek medical attention immediately. An allergic reaction includes:

  • Hives
  • Difficulty breathing
  • Swelling of face, tongue, throat, or lips

Consult your doctor before starting any supplement or medication. Be especially careful with the following conditions:

  • Pregnancy/Breastfeeding: Confirm with your doctor for dosage requirements to prevent birth defects. Usually 300-400 microgram is given for pregnant women.
  • Angioplasty: This procedure widens narrowed arteries and can be made worse by taking Vitamin B9, Vitamin B12, and Vitamin B6 both intravenously and orally.
  • Cancer: Taking large doses of Folic Acid may increase the risk of cancers in those with a family history.
  • Heart Disease: Those with a history of heart disease in the family should avoid taking Vitamin B6 and Vitamin B9 because it can increase the risk of heart attack.
  • Anemia: Anemia that is caused by a Vitamin B12 deficiency can have its symptoms masked by Vitamin B6 supplementation and delay proper treatment. Consult with your doctor if you have symptoms of Anemia.
  • Seizures: High doses of Folic Acid supplements can make seizures worse in individuals with a history of seizure.

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Medicine Interactions: What Other Drugs Will Affect Folic Acid?

Medicines that interact with Folic Acid:

  • Tetracycline Antibiotics: All B-Complex supplements, including Vitamin B9, interact with the absorption and effectiveness of this antibiotic.
  • Anti-Seizure Medication: Phenytoin may lower the amount of folate in the body. Alternatively, Folic Acid supplements may disrupt how the medicine works, increasing seizure risk.
  • Pyrimethamine: This medicine is used for treatment of malaria and toxoplasmosis. Folic Acid can interfere with the effectiveness of this medication.
  • Chemotherapy medication: Folic Acid can increase chemotherapy medicines to dangerous levels in the body.

Medicines that lower levels of Folic Acid by affecting absorption in the body:

  • Antacids, Proton pump inhibitors, and H2 blockers
  • Cholesterol medication
  • Nonsteroidal Anti-Inflammatory Drugs: If taken for extended periods of time it can increase the body’s need for Vitamin B9.
  • Sulfasalazine: Used in the treatment of inflammatory bowel disease and rheumatoid arthritis
  • Triamterene/water pill
  • Cycloserine (antibiotic)
  • Trimethoprim (antibiotic)
  • Methotrexate

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Sources

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