Folic Acid

What is it?

Folic acid is a water-soluble vitamin B. It is found in many foods like mushrooms, yeast, beans, beef, kidney, fruits (lemons, tomato, melons, bananas, and oranges) and also vegetables like spinach, lettuce, asparagus and   lettuce.

Folic acid is highly important for many body functions, proper development of body components and also in the production of genetic DNA component of cells.  

Benefits

Studies have found that folic acid is definitely needed for those who have folic acid deficiency anemia, lower homocysteine levels in those with severe kidney disease/hyperhomocysteinemia, to reduce side effects for rheumatoid arthritis patients taking methotrexate and also to reduce neural tube defects in woman planning to conceive.

Some other studies have also found that folic acid may also be beneficial to reduce risk of colon cancer, pancreatic cancer, breast cancer, gum diseases, treating vitiligo and also macular degeneration.

There are currently insufficient evidence based studies that prove its effectiveness in certain conditions like cardiac diseases, stroke, fragile-X syndrome, Alzheimer disease, male infertility, cervical cancer, lung cancer, cancer as a result of ulcerative colitis, restless leg syndrome, liver diseases and osteoporosis.

Possible side effects

Folic acid is generally safe for most people when taken up to recommended dose of 400 mcg daily. However at much higher doses some may experience side effects like abdominal cramps, diarrhea, nausea, stomach upset, sleep disorders, irritability, confusion behavior changes, rash, seizures and excitability.

There is some studies that find that taking too high doses of folic acid like 800-1200 mcg may increase risk of heart attack in cardiac patients and increase risk of lung and prostate cancers.

Drug-drug interactions

1.         Anti-Seizure medications: Folic acid increases the breakdown of anti-seizure medications like phenytoin, phenobarbitone, primidone and fosphenytoin hence reduces its effectiveness and increases risk of seizures.

2.         Pyrimethamine: Folic acid increases the breakdown of pyrimethamine which is an anti-parasite medications making it less effective.

Dosage

The adequate intakes (AI) for everyone daily by age is as follows :

Infants 0-6 months: 65 mcg

Infants 7-12 months: 80 mcg for of age.

Children 1-3 years: 150 mcg

Children 4-8 years: 200 mcg

Children 9-13 years: 300 mcg

Adults over 13 years: 400 mcg

Pregnant women: 600 mcg

Breast-feeding women: 500 mcg.

Medically indicated dosage of folic acid supplements as below:

For reducing colon cancer risk: 400 mcg per day.

For preventing neural tube defects: at least 400 mcg of folic acid per day before conceiving till 3 months pregnant. For women with a history of baby with neural tube defects usually take 4 mg per day beginning one month before and continuing for three months after conception.

For folic acid deficiency: 250-1000 mcg per day.

For end-stage renal disease to treat high homocysteine levels : 0.8-15 mg/day have been used. Other dosage plans are 2.5-5 mg 3 times weekly have also been used. Doses higher than 15 mg daily are not anymore effective.

For treating hyperhomocysteine: 0.5-5 mg (milligrams)/day although 0.8-1 mg/day appears to be more effective.

For reduction of toxicity associated with methotrexate therapy for rheumatoid arthritis (RA) or psoriasis patients: 1 mg/day is probably enough up to maximum of 5 mg/day

For vitiligo: 5 mg is typically taken twice daily.

For preventing macular degeneration: folic acid 2.5 mg, vitamin B12 (cyanocobalamin) 1000 mcg, and vitamin B6 (pyridoxine) 50 mg daily.

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