Important knowledge about folic acid (folate, vitamin B9)

- for pregnant women and others

Important knowledge about folic acid (folate, vitamin B9) Folic acid supplements are typically recommended to people with anemia and to expecting mothers. However, folic acid supplements can also be important for the cardiovascular system, the brain and memory, and for preventing stroke. The widespread lack of this nutrient is a result of poor diets, pregnancy, ageing, alcohol abuse, and the consumption of birth control pills and various types of medicine.

Folic acid is important for pregnancy and growth, blood formation, energy levels, the nervous system, the brain, mood, and vitamin B12 uptake. Folic acid also regulates blood levels of homocysteine, a compound that can contribute to blood clots if levels are too high. Lack of folic acid can also cause a variety of symptoms and complications in connection with pregnancy, as described in the following.

Symptoms of low folic acid levels in the blood

Folic acid is important for the formation of red blood cells that carry oxygen to all parts of the body. The cells need the oxygen to convert calories into energy. Lack of folic acid can result in anemia, and if the cells are not able to produce sufficient amounts of energy, several other symptoms may follow in the wake such as:

  • Tiredness
  • Poor concentration
  • Headaches
  • Irritability
  • Depression
  • Paleness
  • Wounds/infections on the tongue or in the oral cavity
  • Fetal damage

A lack of folic acid during pregnancy may result in serious fetal damage

Pregnant women have an increased need for folic acid because the nutrient is needed to form DNA to help the fetus grow and develop. A lack of folic acid may disrupt normal cell division in the fetus and result in imperfect brain development and spina bifida, which can cause severe handicaps, heart defects, and stillbirth. A folic acid deficiency during pregnancy may also result in low birth weight or overweight at a later stage in the child’s life.

  • Good sources of folic acid include spinach, avocado, beans and other vegetables, liver, nuts, and fruit.
  • The daily reference intake (RI) level for folic acid in adulthood is 200 micrograms, but pregnant women need more.

How much folic acid does a pregnant woman need?

Pregnant women are recommended to get at least 400 micrograms of folic acid per day, starting one month before conception and continuing at least 12 weeks into pregnancy to lower the risk of giving birth to a child with neural tube defects or spina bifida.
According to a study that was presented at an annual conference for British psychologists in Brighton, England, taking folic acid supplements throughout the entire pregnancy can improve the psychological development of the child. This, among other things, is important for the child’s ability to handle its own emotions and performing socially. Folic acid is also important for the health, energy levels, and mental balance of the expecting mother, which should also be taken into account. Unfortunately, many pregnancies are not planned in advance and are discovered too late. Also, many pregnant women forget to take their folic acid supplements.

  • Every year, 5,000 children in Europe are born with neural tube defect and other serious congenital defects of the central nervous system.
  • Lack of folic acid during pregnancy can also affect the child’s psychological development.

Folic acid supplementation lowers the risk of hypertension causing stroke

On a global scale, hypertension causes more premature deaths than any other risk factor. Many people have elevated blood pressure without knowing it, and it is important to address the problem. Chinese scientists have found that folic acid supplements combined with anti-hypertensive drugs can lower the risk of stroke by nearly 75 percent, and there is a natural explanation to that. It is already known that having too much of the amino acid homocysteine in your blood can contribute to blood clot formation, and folic acid is known to control levels of homocysteine. Having too little folic acid in your system therefore increases homocysteine levels.

Folic acid deficiencies and poor utilization of the nutrient are caused by

  • Poor diets and inferior diet schemes
  • Abuse of alcohol and other substances
  • Pregnancy
  • Smoking
  • Poor absorption of folic acid from the intestine
  • Ageing
  • Birth control pills
  • Methotrexate against rheumatism and cancer
  • Anti-seizure medication (phenytoin)

Dementia and Alzheimer’s disease

The number of seniors is increasing worldwide, making it challenging to curb the increasing rate of dementia and Alzheimer’s disease. Studies show that people with sufficient amounts of folic acid in their blood have a lower risk of developing dementia. Although it is not yet proven that folic acid supplementation can prevent dementia, healthy eating habits that include good folic acid sources such as leafy greens are associated with a reduced risk.
Alzheimer’s disease is one of the most frequent causes of dementia. The disease is caused by plaque deposits and inflammation in the brain. A small Chinese pilot study of patients that had recently been diagnosed with Alzheimer’s revealed that supplementation with high quantities of folic acid combined with Donepezil (a drug against Alzheimer’s disease) can improve the treatment result. The scientist observed improvements in cognitive functions such as learning and memory skills. They also found that folic acid controlled homocysteine levels and various inflammation markers.

Scientists: We need folic acid enrichment of foods

It has serious human and economic costs that so many children are born with neural tube defects and defects of the central nervous system. Later in life, the widespread lack of folic acid may lead to tiredness, poor memory, blood clots, insomnia, dementia and a number of other problems that are often treated with medical drugs without physicians addressing the underlying cause.
Danish scientists say that we Europeans should enrich flour and other foods with folic acid as soon as possible, just like they have done in the United States and Canada. However, even if this measure it taken, it is still necessary for pregnant women to take a supplement.

Diagnosis and supplements

A blood sample can reveal if there is a folic acid deficiency. Deficiencies are commonly seen in connection with lack of vitamin B12. Some researchers suggest that high quantities of folic acid may mask a vitamin B12 deficiency. It is therefore advisable not to take folic acid in doses higher than 1,000 micrograms daily without the physician’s recommendation. In any case, one should make sure to get plenty of folic acid by eating a coarse and green diet with fresh raw materials.

References

Debra Sullivan. What to know about folate deficiency. Medical News Today 2019

Wang G, el al. Associations of maternal pregnancy BMI and plasma folate concentrations with child metabolic health. JAMA Pediatrics. 2016

Nutrition insight. Taking Folic Acid Throughout Pregnancy May Increase Children´s Emotional Intelligence. 12 May 2017

Wang G, el al. Associations of maternal pregnancy BMI and plasma folate concentrations with child metabolic health. JAMA Pediatrics. 2016

Kong X et al. Platelet Count Affects Efficacy of Folic Acid in Preventing First stroke. Journal of the American College of Cardiology. Published online May 7, 2018

Shaheen lakhan. Vitamin B9 and How Folic Acid Affects Dementia. Verywellhealth. 2019

Hui Chen et al. Folic Acid Supplementation Mitigates Alzheimer´s Disease by Reducing Inflammation: A Randomized Controlled Trial. Mediators of Inflammation. 2016

Queen Mary University of London. Upper intake of folate is invalid: Government urged to fortify flour with folic acid.

Kristian Sjøgren. Forskere: Put folinsyre i danske dagligvarer. Videnskab.dk 2015

Ernæringsrådet. Folsyre til kvinder, der planlægger graviditet – kun få følger anbefalingerne