Folic Acid: Uses, Benefits, Deficiency, Side Effects and Precautions

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Folic Acid

Overview:

Super hero

You have heard and also seen superheroes. Today we are going to introduce you with a new superhero, the pregnancy superhero; the “Folic acid“.

          Folic acid is a man-made form of B-complex vitamin called folate, but there is a difference:

                    Folate is the natural form of this vitamin. It’s found in food.

                    Folic acids the man-made form. It’s put into vitamin pills and fortified foods, such as fortified breakfast, cereals.

     This is a water-soluble vitamin also known as vitamin B9.

          It is used to make the extra blood your body needs during the period of pregnancy. All ladies of childbearing age should consume 400-800 micrograms of folic acid a day.

        Folate plays an important role in the production of Red blood cells and helps in the development of neural tube into your baby’s brain during pregnancy. Hence high dose of folic acid are recommended in the pregnancy to prevent birth defects.

Folic acid and pregnancy

               Everyone needs folic acid but for women who may get pregnant, it is really important. Getting enough folic acid during pre-pregnancy and Pregnancy can prevent major birth defects of her baby’s brain and spine.

          A woman should start taking folate prior to getting pregnant. Neural tube defects usually develop in the first 4 weeks of pregnancy, often before a woman even knows that she is pregnant.

                          If you find you are pregnant and have not been taking folic acid, you should start now to help prevent any neural defects in the first three months of pregnancy.

Uses of Folic Acid:

DNA damage

Why should you take folic acid?

Our bodies required folate to make DNA and other genetic material.  Folate is also required for the body’s cell division. It is mostly important for unborn infants because it helps the nervous system development.  In the first 4 weeks of pregnancy, the neural tube closes and fuses. This neural tube later becomes the baby’s brain and spinal cord.

Spina bifida- folic acid deficiency

In the absence of folic acid the possibility of a neural tube defect that is a defect in the development of the spinal cord increases.

A condition known as spina bifida in which the spinal cord is exposed. If the vertebrae (bones of the spinal cord) surrounding the spinal cord do not close properly during the first 4 weeks after fertilization, the cord or spinal fluid bulge through, usually in the lower back.

A severe underdevelopment of the brain called anencephaly also occurs due to the absence of folic acid.

Folic acid may also protect your baby against:-

  1. Palate & cleft lip.
  2. Low birth weight.
  3. Poor growth in the womb.
  4. Premature birth.
  5. Miscarriage.
  6. Preeclampsia.
  7. Heart disease.
  8. Stroke.
  9. Some types of cancers
  10. Alzheimer’s disease.

How to prevent Neural Tube Defects?

A decrease in the folate levels during the initial 4 weeks of pregnancy has been linked to neural tube defects in babies that is malformations of the brain and spinal cord.

However, these defects are significantly lower in children of women who supplement with folate during pre-pregnancy and throughout the pregnancy.

Since most of the women do not have sufficient folate levels for the highest protection against neural tube defects. It is recommended that all women of reproductive age take folate as supplement at least 400 mcg per day.

There are many prenatal supplements that contain folic acid, it may be beneficial to look for the varieties that contains methylated folate. This is because methylfolate is also known vitamin B9 or 5-MTHF  is the active form of the vitamin which can use your body without converting it from one form to another.

How can I Know If the baby in my womb is at risk  of Neural Defects and what are the ways of prevention?

Women who have had a previous pregnancy that involved a neural defect are the highest chance of this defect and also for those women who are not eating a balanced diet that contains folic acid are at high risk.

The best way to prevent neural defects is to consume the recommended 400 mgm of folic acid daily for one month before conception and during the first three months of pregnancy.

                    The multivitamin supplements that include folic acid should only be used under the advice of your doctor.

How Are Neural Tube Defects Diagnosed?

Neural tube defects are detected through an AFP test (alpha-fetoprotein test ). AFP is a blood test administered at 16-18 weeks gestation.  The test measures AFP, a substance produced by the growing baby and secreted into the amniotic fluid.

              AFP is also found in the mother’s blood. The level of AFP in the mother’s blood peaks at about 30-32 weeks.  Abnormally high amounts of AFP may indicate that a baby has a neural tube defect.

What are the other causes for an elevated AFP?

An elevated AFP could mean the problem with the placenta or the mother is carrying twins. This is also happens in case of women with diabetes or liver disease.

         However, other reasons are also there like severe kidney disease, liver disease, esophageal or intestinal blockage, Down Syndrome, urinary obstruction, or osteogenesis imperfecta.

“I Have An Elevated AFP”, What Additional Tests Are Available?
  1. Amniocentesis.
  2. Ultrasound.
  3. A second AFP.

Role of folate in Cancer Prevention

High dose of folate may protect against certain cancers like breast cancer, gut cancer, lung cancer and pancreas cancer, etc. This is because of the role of folate in gene expression.

  • Low folate levels prevent this process increasing the risk of abnormal cell growth and therefore cancer!
  • Low folate levels also causes formation of unstable DNA which breaks easily and ultimately increase the risk of cancer.

              However high folate intakes may promote tumor growth in peoples with pre-existing cancers or tumors.

Role of folate in reduction of Homocysteine Levels

Homocysteine is an inflammatory molecule involved in the development of heart diseases. Adequate folate intake helps reduction of Homocysteine level.

                    Folate catalyses convertion of homocysteine into another molecule called methionine that is why folate helps in lowering of Homocysteine. Without enough folate, this conversion slows down and homocysteine levels rise.

                 The reduction in homocysteine has not corresponded with lower rates of heart disease.The reasons for this is not clear, but it suggests that other important factors besides homocysteine causes the development of heart disease.

Signs and symptoms of Folic Acid deficiency

women in stress
  1. Increased level of homocysteine in the blood causes megaloblastic anemia which is a type of anemia with enlarged red blood cells.
  2. Fatigue.
  3. Shortening of breath.
  4. Irritability.
  5. Weakness.

    Folate deficiency can be tested by measuring the amount of folate which is either stored within your red blood cells or in the circulating blood.

How to get enough Folic Acid?

In addition to eating foods with folate from various diet, following are the ways women can get folic acid:-

suppliments for pregnant woment
  1. Taking a vitamin supplement that has folic acid in it.
  2. Vitamins are found at most pharmacy and grocery stores. To become sure, read on the label on the bottle that it contains folic acid of the daily recommended value which is 400 mcg.
  3. Eating fortified foods like breads, breakfast cereals and corn flour.
  4. Taking a combination of the two that is taking a vitamin that has folic acid and eating fortified foods.

Now-a-days, the number of unplanned pregnancies much more, so women of childbearing age should receive a daily dose fortified food for folic acid.

foods rich in vitamin b9

Some of the foods are listed below which can fulfill your recommended amount of folic acid:

  1. Leafy green vegetables like spinach.
  2. Citrus fruits like orange.
  3. Beans
  4. Cereals.
  5. Pastas
  6. Rice
  7. Breads

Natural food sources of folate include:

Liver
  1. Liver.
  2. Edamame.
  3. Lentils.
  4. Spinach.
  5. Collard greens.
  6. Beans.
  7. Okra.
  8. Asparagus.
  9. Antichokes.
  10. Broccoli.
  11. Turnip greens.

How much folic acid is recommended each day during pregnancy?

  1. While you are trying to conceive it is 400 mcg per day.
  2. For the first three months of pregnancy, it is 400 mcg per day.
  3. For months four to nine of pregnancy it is 600 mcg per day.
  4. During breastfeeding, it is 500 mcg per day.

Side Effects and Precautions of folic acid

Also, there are some side effects and precautions to be aware of when taking folic acids.

Mask the deficiency of vitamin B12 

Megaloblastic anemia can be a sign of both folate and vitamin B12 deficiency. Supplementing with folate could correct the anemia without addressing B12 deficiency and thereby leading to nerve damage.

Risk of cancer development

It has found that folic acid consumption develops some cancers. Folic acid may also accelerate the growth of pre-existing tumors.

Circulating free folic acid

As the conversion of folic acid to its active form is a slow process and therefore free folic acid can build up within your bloodstream which causes poor immunity and reduced brain function.

So before taking any Folic Acid supplements, consult with your doctors at least once.

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