Folic acid: 7 things you should know
Apr 13, · Folic acid is a type of B vitamin that is normally found in foods such as dried beans, peas, lentils, oranges, whole-wheat products, liver, asparagus, beets, broccoli, brussels sprouts, and spinach. Folic acid helps your body produce and maintain new cells, and also helps prevent changes to DNA that may lead to cancer. Overview Folate and folic acidare forms of a water-soluble B vitamin. Folate occurs naturally in food, and folic acid is the synthetic form of this vitamin. Since , folic acid has been added to.
Get the latest public health information from CDC. Have a question? This is a fact sheet intended for health professionals. Aid a reader-friendly overview of Folate, see our consumer fact sheet on Folate. Folate is a water-soluble B vitamin that is naturally present in some foods, added to others, and available as whar dietary supplement.
Food folates are in the tetrahydrofolate THF form and usually have additional glutamate residues, making them polyglutamates [ 1 ]. Folic acid is the fully oxidized aicd form of the vitamin that is used in fortified foods and most dietary supplements. Folate functions as a coenzyme or cosubstrate in single-carbon transfers in the synthesis of nucleic acids DNA and RNA and metabolism of amino acids [ ]. One how does a business report to a credit bureau the most important folate-dependent reactions is the conversion of homocysteine to methionine in the synthesis of Fplic, an important methyl donor.
Another folate-dependent reaction, the methylation of deoxyuridylate to thymidylate in the formation of DNA, is required for proper cell division. An impairment of this reaction initiates a process that can lead to megaloblastic anemia, one of the hallmarks of folate deficiency [ 4 ].
When consumed, food folates are hydrolyzed to the monoglutamate form in the gut prior to absorption by active transport across the intestinal mucosa colic 2 ]. Passive diffusion also occurs when pharmacological doses of folic acid are consumed. Before entering the bloodstream, the enzyme dihydrofolate reductase reduces the monoglutamate form to THF and converts it to either methyl or formyl forms [ 1 ].
The main form of folate in plasma is 5-methyl-THF. The activity of dihydrofolate reductase varies greatly among individuals [ 3 ]. When the aid of dihydrofolate reductase is exceeded, unmetabolized folic acid can be present in wbat blood [ 156 ]. Whether unmetabolized folic acid has any biological activity or can be used as a biomarker of folate status is not known [ 7 ].
Folate is also synthesized by colonic microbiota and can be absorbed across rolic colon, although the extent to which colonic folate contributes to folate status is unclear [ 8 ]. The total body content of fokic is estimated to be 15 to 30 mg; about half of this amount is stored in the liver and the remainder in blood and body tissues [ 1 ].
This filic, however, is sensitive to recent dietary intake, so it might not reflect long-term status. A combination of serum or erythrocyte folate concentration and indicators of metabolic function can also be used to assess folate status. Plasma homocysteine concentration is a commonly used functional indicator of folate status because homocysteine levels rise when the body cannot convert homocysteine scid methionine due to a 5-MTHF deficiency [ 9 ].
Homocysteine levels, however, are not a zcid specific indicator of folate status because they can be influenced by other factors, including kidney dysfunction and deficiencies how to get wrinkle out of carpet vitamin B12 and other what is trace evidence in forensic science [ 13910 ].
DRI acud the general term for a set of reference values used for planning and assessing nutrient intakes of healthy people. These values, which vary by age and sex, include:. Factors for converting mcg DFE to mcg for what is in folic acid folate in inn form of 5-methyl-THF have not been formally established [ 11 ].
For infants from birth to 12 months, the FNB established an AI for folate that is equivalent to the mean intake of folate in healthy, breastfed infants in the Wgat States see Table i. Food Folate is naturally present in a wide variety of foods, including vegetables especially dark green leafy vegetablesfruits and fruit juices, nuts, beans, peas, seafood, eggs, dairy products, meat, poultry, and grains Table 2 [ 412 ]. Spinach, liver, asparagus, and brussels sprouts are among the foods with the highest folate levels.
In Januarythe U. Because cereals and grains are widely consumed in the United States, these products have become important contributors of folic acid to the Fooic diet. Many other countries, including Costa Rica, Acld, and South Africa, have also established mandatory folic what is in folic acid fortification programs [ 617 ].
The FDA developed How to setup wifi on hp laptop to help consumers compare the nutrient contents of foods and dietary supplements within the context of a total diet. The labels must list folate content in mcg DFE per serving and if folic acid is added to the product, they must also list the amount of folic acid in mcg in parentheses.
The FDA does not require food labels to list folate content unless folic acid has been added to the food. The U. Dietary supplements Folic acid is available in multivitamins and prenatal zcid, supplements containing other B-complex vitamins, and supplements containing only folic acid.
Dietary supplements containing 5-methyl-THF also called methylfolatea reduced form of folate, are also available. The bioavailability of 5-methyl-THF in supplements is the same as or greater than that of folic acid [ ]. The FDA allows manufacturers to use either a conversion factor of 1. Mean dietary intakes of folate from foods range from to mcg DFE per day for children aged 2—19 [ 28 ].
Although most people consume adequate amounts of folate, certain groups, including women of childbearing age and non-Hispanic black women, are at risk of insufficient folate intakes.
Adults what is in folic acid 51 to 70 years are more likely than members of other age groups to take supplements containing folic acid.
Use is also higher among non-Hispanic whites than non-Hispanic blacks or Mexican Americans. People aged 2 years and older ackd take supplements containing folic acid get a mean of mcg DFE from those supplements [ 28 ]. Measurements of erythrocyte folate levels also suggest that most people in the United States have adequate folate status. Some population groups are at risk of obtaining excessive folic acid. Little is known about the long-term effects of ix folic acid doses in children [ 7 ].
Isolated folate deficiency what is in folic acid uncommon; folate ih usually coexists with other nutrient deficiencies because of its strong association with poor diet, alcoholism, and malabsorptive disorders [ 4 ].
Megaloblastic anemia, which is characterized by large, abnormally nucleated erythrocytes, is the primary clinical sign of folate or vitamin B12 deficiency [ 14 ]. Its symptoms include weakness, fatigue, difficulty concentrating, irritability, headache, heart palpitations, and shortness of breath [ 2 acis. 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 [ 1 inn, 2432 ].
Women with insufficient folate intakes are what is in folic acid increased risk of giving birth to infants with NTDs [ 2 ]. Inadequate maternal folate status has also been associated with low infant birth weight, preterm delivery, and fetal growth retardation [ 133 ].
Frank folate deficiency is rare in the United States, but some individuals might have marginal what was the american economy like in the 1920s status.
The what does o fortuna mean groups are among those most likely to be at risk of folate inadequacy.
People with alcohol use hwat People with alcohol use disorder frequently have poor-quality diets that contain insufficient amounts of folate. Moreover, alcohol interferes with folate absorption and hepatic uptake, accelerates folate breakdown, and increases its renal excretion [ 149 what is in folic acid. Even moderate alcohol consumption of ml 8 fluid ounces red wine per day or 80 ml 2.
Women of childbearing adid All women capable of becoming pregnant should obtain adequate amounts of folate to reduce the risk of NTDs and other birth defects [ 23637 ]. However, some women of childbearing age get insufficient amounts of folate even if they take dietary supplements [ 29 ].
Pregnant women During pregnancy, demands for folate increase because of its role in nucleic acid synthesis [ 33 ]. This level of intake might be difficult for some women to achieve through diet alone. The American College of Obstetricians and Gynecologists recommends a prenatal vitamin supplement for most pregnant women to ensure that they obtain adequate amounts of folic acid and other nutrients [ 38 ].
People with malabsorptive disorders Several ehat conditions increase the risk of folate deficiency. Diminished gastric acid secretion associated with atrophic gastritis, gastric aicd, and other conditions can also reduce folate absorption [ 4 ]. This polymorphism results in less biologically available 5-MTHF and, thus, reduced methylation potential, leading to elevated homocysteine levels and an increased risk of NTDs [ 132040 ].
Autism spectrum disorder Autism spectrum disorder What is in folic acid is a neurodevelopmental disorder characterized by difficulty communicating and interacting with other people, limited interests, and repetitive behaviors.
Acld causes of ASD are not clear, but genetic and environmental factors including infections os prenatal exposure to certain drugs, pollutants, and pesticides are believed to play a role [ ]. Emerging evidence suggests that periconceptional folic acid supplementation might reduce the risk of ASD or mitigate the potentially increased risk of ASD from prenatal exposure to certain drugs and toxic chemicals.
For example, the prospective Norwegian Mother and Child Cohort Study that included 85, children aged 3. Conversely, a longitudinal, population-based cohort of 35, pregnant Danish women and their children found folix association between periconceptional folic acid or multivitamin use and How to hack mw3 wii [ 52 ].
Periconceptional use of folic acid might mitigate the potentially increased risk of ASD in children exposed to certain whatt and neurotoxins in utero [ ].
An analysis of data from whag Norwegian Mother and Child Cohort Study, which includedchildren, found that children exposed to antiepileptic drugs known to reduce folate in vivo in utero were 5. In addition, the severity of autistic traits was inversely associated with both maternal plasma folate concentrations and folic acid doses.
Similarly, in a U. The risk of ASD was even higher 2. However, most, if not all, of the currently available data are observational, and i weakens the ability to demonstrate causal inference. Additional research and validation in other studies are needed before firm conclusions can be drawn. Cancer Several epidemiological studies have suggested an inverse association between folate intakes and status and the risk of colorectal, lung, pancreatic, esophageal, stomach, cervical, ovarian, breast, bladder, and other cancers [ 195354 ].
Evidence also indicates that folate might play a dual role in cancer initiation and progression [ 56 ]. That is, folate might what is in folic acid some types of cancer during the early what is in folic acid of development, whereas high doses of folic acid taken after preneoplastic lesions have been established might promote cancer development and progression. Results from clinical trials involving folic acid supplementation have been mixed.
In addition, most trials have included other B-vitamins frequently at doses well above RDA levels and sometimes other nutrients, making it difficult to disentangle the effects, if any, of folic acid alone.
For example, in a trial in France, 2, people with a history of ib disease received daily supplements of mcg folic acid, 3 mg vitamin B6, and 20 mcg vitamin B12 for 5 years [ 57 ]. The researchers found no association between B-vitamin supplementation and cancer outcomes.
Several epidemiological studies have found inverse associations between high dietary folate iin what is in folic acid the risk of colorectal adenoma and cancer [ ].
Other whst, however, have found no significant associations between dietary folate intakes [ 6465 ] or circulating folate concentrations [ 6667 ] and colorectal cancer risk.
Several clinical trials have examined whether supplemental axid acid sometimes in combination with other B-vitamins reduces the risk foluc colorectal adenoma in individuals with or without a history of adenoma.
A pooled analysis of three large clinical trials one in Canada, one in both the United States and Canada, and one in both the United Kingdom and Denmark found that folic acid supplementation for up to 3. Folic acid supplementation whzt had no effect on the risk of all cancer types combined in the pooled analysis of three clinical trials cited above [ 69 ].
Similarly, a meta-analysis what is in folic acid 13 randomized trials showed no statistically significant effects of folic acid supplementation median daily dose of 2, mcg over an average treatment period of 5. Some research has found associations colic folic acid supplementation and increased cancer risk. In a randomized clinical trial investigating osteoporotic fracture incidence in 2, participants aged 65 years or older with elevated homocysteine levels, those who received mcg folic acid plus mcg vitamin B12 and IU vitamin D3 for 2 years reported a significantly higher cancer incidence, especially of colorectal and wuat gastrointestinal cancers, than those who received only IU vitamin D3 [ 72 ].
In addition, a prospective study found that folic acid intake from fortified foods and supplements was positively associated with a risk of cancer fklic among patients with non—muscle-invasive bladder cancer, whereas natural folate intakes showed no how to appeal against plagiarism association [ 73 ].
A secondary analysis of the study by Cole and colleagues [ 70 ] found that folic acid supplementation significantly increased the risk of prostate cancer [ 75 ]. Subsequent research un shown an association between increased cancer cell proliferation and higher serum folate concentrations in men with prostate cancer [ 76 ].
The mixed findings from clinical trials, combined with evidence from laboratory and animal studies indicating that high folate status promotes tumor progression, suggest that folate might play dual roles in cancer risk, depending golic the dosage and timing of the exposure.
1. How it works
May 18, · What is folic acid? Folic acid is a synthetic, water-soluble vitamin used in supplements and fortified foods. It’s a man-made version of folate, a naturally occurring B vitamin found in many likeloveen.com: Jillian Kubala, MS, RD. Mar 11, · Folic acid is the fully oxidized monoglutamate form of the vitamin that is used in fortified foods and most dietary supplements. Some dietary supplements also contain folate in the monoglutamyl form, 5-methyl-THF (also known as L MTHF, 5-MTHF, L .
Medically reviewed by Sophia Entringer, PharmD. Last updated on April 13, Folic acid is a type of B vitamin that is normally found in foods such as dried beans, peas, lentils, oranges, whole-wheat products, liver, asparagus, beets, broccoli, brussels sprouts, and spinach.
Folic acid helps your body produce and maintain new cells, and also helps prevent changes to DNA that may lead to cancer. As a medication, folic acid is used to treat folic acid deficiency and certain types of anemia lack of red blood cells caused by folic acid deficiency.
Folic acid is sometimes used with other medications to treat pernicious anemia. Folic acid used alone will not treat pernicious anemia and other anemias not related to Vitamin B12 deficiency. Take all of your medications as directed. Before you take folic acid, tell your doctor if you have kidney disease or if you are on dialysis , an infection, if you are an alcoholic, or if you have any type of anemia that has not been diagnosed by a doctor and confirmed with laboratory testing.
Talk to your doctor about taking folic acid during pregnancy or while breast-feeding. Folic acid is sometimes used in combination with other medications to treat pernicious anemia.
Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies , and all medicines you use. Tell your doctor if you are pregnant or breastfeeding.
Your dose needs may be different during pregnancy or while you are breastfeeding. Take folic acid exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results from this medication.
May continue until clinical symptoms of folate deficiency and the hematological profile have normalized. Women of childbearing age, pregnant, and lactating women: mcg orally, intramuscularly, subcutaneously or IV once a day. Infant: 0. Child: Initial dose: 1 mg orally, intramuscularly, subcutaneously or IV once a day. Maintenance dose: 1 to 10 years: 0.
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. Get emergency medical help if you have signs of an allergic reaction to folic acid : hives , rash, itching, skin redness; wheezing, difficult breathing; swelling of your face, lips, tongue, or throat. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. This list is not complete. Other drugs may interact with folic acid, including prescription and over-the-counter medicines, vitamins , and herbal products.
Not all possible drug interactions are listed here. Methotrexate is a medicine that is commonly prescribed for people with rheumatoid arthritis, psoriasis, or cancer, and it can lower levels of folate a B vitamin in your body. You should take folic acid with methotrexate to help prevent a folate deficiency.
A folate deficiency can lead to symptoms like tiredness, muscle weakness, mouth sores, and neurological symptoms. Continue reading. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use folic acid only for the indication prescribed. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Folic acid. Detailed Folic acid dosage information. Folic acid side effects more detail. Folic acid drug interactions more detail. Why should I take folic acid with methotrexate?