What is Folic Acid: Live Class with Dr. Joshua Jamero

A vitamin is an organic compound. It is a nutrient that the body requires, in small quantities, to maintain regular body functions and metabolism.

The easiest approach to receiving all the vitamins and minerals you require each day is to eat a variety of meals. The greatest options for obtaining the nutrients your body needs include fruits and vegetables, whole grains, low-fat dairy products, lean meats, fish, and chicken.

However, there are many available supplements to achieve the required amount of nutrients in the body. 

There are 13 known vitamins that are essential to maintain regular body function. But in this article, we will focus more on folic acid which is a water-soluble B vitamin.

Learn more about folic acid, its benefits, how to take it, and other frequently asked questions that you might have been thinking of as well.

The Difference Between Vitamins vs Minerals

Vitamins compounds derived from organic substances. Meaning, they are produced by living things such as plants as main sources. 

Whereas minerals are derived from inorganic substances, which means they are obtained from the earth. Such examples are iron, copper, and calcium.

Since they are organic, vitamins are significantly more delicate than minerals, which are inorganic and have a more straightforward chemical structure. Vitamins may also degrade with heat or time.

Let us dive into the different kinds of vitamins so that we can distinguish one from another. More importantly, folic acid will be discussed further.

Fat-soluble Vitamins

Generally, there are two types of vitamins: fat-soluble vitamins and water-soluble vitamins. Firstly, fat-soluble vitamins include vitamins A, D, E, and K. These vitamins are stored in the liver with the help of fat molecules such as lipoproteins for them to be absorbed in the intestine and consequently in the body.

Problems in fat absorption lead to impaired absorption of these vitamins. Cases such as Celiac Disease can cause this problem, and could further lead to vitamin deficiency. 

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Gluten, a protein present in wheat, barley, and rye, causes celiac disease, also known as celiac sprue or gluten-sensitive enteropathy, which is an immunological response to ingesting it.

Eating gluten sets off an immunological reaction in your small intestine when you suffer from celiac disease. This response wears down the walls of your small intestine over time and prevents some nutrients from being absorbed (malabsorption).

To give a quick overview, vitamins A, D, E, and K provide the following benefits to maintain our normal body functions.

  • Vitamin A – maintains normal vision, proper immunological function, reproduction, and growth and development.
  • Vitamin D – assists the body in retaining and absorbing calcium and phosphorus (calcium and phosphate metabolism) which is both essential in building stronger bones.
  • Vitamin E – contains antioxidant properties and maintains healthy blood, brain, and skin.
  • Vitamin K – helps in the production of several proteins required for blood coagulation and bone growth. A protein called thrombin, which is directly linked to blood clotting, depends on vitamin K.

Water-soluble Vitamins

Water-soluble vitamins are carried to the tissues of the body but are not stored.  Instead, they enter your bloodstream, absorbed by the tissues and organs, and any excess substances are then expelled through urine. ‌

These vitamins must be replaced frequently because they are easily expelled from the body. The following vital water-soluble vitamins are:

Vitamin C 

Vitamin C helps in collagen formation in our skin and connective tissues. It also helps in bile acid formation essential to dissolve fats, absorption of iron, and is an antioxidant.

Vitamin B Complex

The B complex is made up of eight water-soluble vitamins that play crucial and interconnected roles in cellular activity in the body.

The B vitamins are necessary for a variety of cellular processes, including the breakdown of carbohydrates and the transportation of nutrients throughout the body. They assist enzymes in our bodies in performing their functions.

More specifically each B vitamin serves their specific functions:

  • Vitamin B1 (Thiamine) – Helps in nerve conduction. Because it may boost the immune system and increase resistance to stress, thiamine is frequently referred to as a “anti-stress” vitamin. It was given the name B1. Because it was the first B vitamin to be discovered and studied.
  • Vitamin B2 (Riboflavin) – It is involved in oxidoreductase metabolism 
  • Niacin – It is a coenzyme to a lot of metabolic pathways happening in the body. It functions to lessen the oxidative stress and nerve inflammation that cause migraine headaches. Moreover, the vitamin is necessary for healthy mitochondrial function since, occasionally, malfunctioning mitochondria in the brain can result in migraines.
  • Vitamin B5 (Panthothenic acid) – It is essential to make Coenzyme A (CoA), a chemical component that aids enzymes in the synthesis and breakdown of fatty acids as well as other metabolic processes, and acyl carrier protein, which is also involved in the synthesis of fats.
  • Vitamin B6 (Pyridoxine) – cofactor and coenzymes to metabolic pathways, biotin which regulates the cell cycle. It is vital for maintaining healthy neurological and immunological systems as well as normal brain development.
  • Vitamin B12 (Cobalamin) – when deficient, it can cause megaloblastic or pernicious anemia. Without enough vitamin B12 or vitamin B9, your body generates abnormal cells called megaloblasts. When megaloblasts do not divide and multiply like healthy cells do, your bone marrow contains less red blood cells.

Folic Acid

Folic acid is a B vitamin that is water-soluble, meaning it is also excreted in the kidneys, unlike the fat-soluble vitamins which is stored in the liver.

The importance of this water-solubility is that even if you consume lots of water-soluble vitamins like folic acid, it will just be excreted from your kidneys, preventing overdose. The body just intakes the amout that it needs, and the excess will be excreted via urinating. 

In contrast to fat-soluble vitamins, especially vitamin A and vitamin D, are stored in the liver. Excessive amounts of these vitamins can cause overdose.

Folate which is also termed tetrahydrofolate is the active form of folic acid. Because folic acid is a synthetic or man-made product, produced to be converted into folate, the active form of vitamin B9.

We can get folate by eating green leafy vegetables, fruits, beans, yeast, mushrooms, animal liver, and orange juice. Since 1998, folic acid has been added to cereals, flour, bread, pasta, and more, as required by the law. 

That is how important folate is to our body. Actually, folic acid is much better absorbed in the body than folate. 

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There was a study showing 85% (folic acid) vs 50% (folate) absorption. This is because folic acid is more heat-stable meaning it can withstand heat and light, as compared to folate. As humans, we are thermogenic, which means we can produce heat. Thus, folic acid is more stable inside our body as compared to folate.

The Benefits of Folic Acid

Everyone can take folic acid and can maximize its health benefits. Folic acid can be taken by women who are pregnant or may become pregnant to stop significant birth abnormalities including spina bifida

Folic acid is also used for many other disorders like depression, stroke, deterioration in memory and cognitive skills, and many others. 

The following are the main benefits of folic acid that you should take note of:

1. Regulates a healthy red blood cell production

The deficiency of this folic acid (folate) can cause anemia. Anaemia is the general term for having either fewer red blood cells than normal or having an abnormally low amount of hemoglobin in each red blood cell.

There are lots of causes of anemia like iron deficiency anemia, then there is vitamin B12 or Folate-Deficiency Anemia. These are the signs and symptoms:

  • extreme tiredness
  • a lack of energy
  • pins and needles (paraesthesia)
  • a sore and red tongue
  • mouth ulcers
  • muscle weakness
  • disturbed vision
  • psychological problems, which may include depression and confusion
  • problems with memory, understanding and judgment

2. Promotes cellular growth and fetal development

Folic acid (folate) is critical for rapid growth of cells, especially during pregnancy. The Department of Health and CDC promotes that pregnant women should intake 400 micrograms of folic acid every day to prevent neural tube defects

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Neural tube defects are serious birth defects of the brain and spinal cord. The two most common neural tube defects are spina bifida (a spinal cord defect) and anencephaly (a brain defect).

Neural tube defects develop very early during pregnancy when the neural tube—which forms the early brain and the spinal cord—does not close properly.

Moreover, anencephaly caused the greatest number of fetal mortality in children under the age of seven, with a mortality rate of 2.12 per 10,000 lbs.

Why do neural tube defects develop?

They develop during early pregnancy when the neural tube doesn’t close or form well. The baby’s neural tube closes during the first weeks of pregnancy, often before a woman knows that she is pregnant. If a woman consumes folic acid before and during early pregnancy, it can help increase the chance of her baby’s neural tube closing properly.

The ideal condition is that the neural tube is closed. When it is not closed, it can predispose the baby to have anencephaly (brain defect) or spina bifida (spinal cord defect).

Waiting until the first prenatal visit (typically, the 6th to 12th week of pregnancy) to start folic acid consumption will not prevent neural tube defects. Therefore, to help prevent neural tube defects, it is important for women to start folic acid consumption before pregnancy begins.

3. Reduces the occurrence of stroke by 21% 

There is a study found on the center for disease control website that taking folic acid each day can significantly reduce the occurrence of stroke by 21%.

More recently, a study looking at the results of 30 randomized control trials, involving more than 80,000 people, suggested a 10% lower risk of stroke and a 4% lower risk of overall cardiovascular (heart and blood vessel) disease among those taking folic acid supplements.

This is because folic acid reduces homocysteine. High homocysteine levels can cause atherosclerosis, which is the hardening of blood vessels. This leads to an increased risk of cardiovascular diseases, especially in men and women who are in the postmenopausal stage. 

By taking folic acid, it reduces the risk of cardiovascular and cerebrovascular diseases.

4. Decreases arsenic levels in the blood by 13.6%.

Arsenic is a poison found in soil, sediments and groundwater, as well as in seafood. By taking folic acid, it reduces the risk of illnesses attributed to arsenic poisoning.

5. How about cancer?

A recent analysis using data from randomized control trials included information on 50,000 individuals. This analysis showed that for people taking folic acid, there was neither an increase nor a decrease over time in the number of new cases of cancer of the large intestine, prostate, lung, breast, or any other specific site.

So far, no studies have presented and proven that folic acid could reduce or prevent cancer.

How To Take Folic Acid

400 micrograms of folic acid are enough every day, but it is okay to take 1 milligram to 5 milligrams each day. As previously stated, folic acid is a water-soluble vitamin, so any excess amount will be excreted by the urine. 

Frequently Asked Questions About Folic Acid

Q: Is folic acid the same as ferrous sulfate?

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No. folic acid is a B vitamin and it prevents folate deficiency anemia. Meanwhile, ferrous sulfate is a type of iron, which is a mineral, that is important to prevent iron deficiency anemia. In similarity, both are prenatal supplements.

Q: Is 5 mg of folic acid too much?

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No. folic acid can just be metabolized and excreted in the kidneys via urine. However, if you have certain rare diseases that inhibit folic acid metabolism or excretion then it can cause an overdose, but this is really rare.

Q: Can I take folic acid during menstruation?

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Yes. folic acid does not interfere with your menstrual cycle. It helps in the production of red blood cells during your period because there is no known harm from doing so. The growth and maintenance of the cells that carry and control the iron in your body are aided by folic acid.

Q: Can I take folic acid simultaneously while taking contraceptive pills?

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Yes. There is no drug interaction between folic acid and contraceptive pills. It is crucial to remember that you may take prenatal vitamins while you aren’t planning for pregnancy, but they aren’t suggested for long-term usage.

Hence, taking birth control and prenatal vitamins together is not hazardous, but it is also not something you should do frequently.

Q: Can I take folic acid even if I’m not pregnant?

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Yes. And it’s even better to take folic acid before getting pregnant, or in family planning. It is advised to take folic acid at this early stage because fetal development happens during early pregnancy. 

Q: Can males take folic acid?

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As previously discussed, folic acid can reduce homocysteine levels and high homocysteine levels are associated with atherosclerosis and cardiovascular diseases.

Q: Can I buy folic acid without a prescription?

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Yes, folic acid is just a vitamin, not a medication unlike antibiotics for example. Although, at higher doses, a prescription from your physician is needed.

Q: Can you take folic acid when you had a previous ectopic pregnancy or abortion?

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Yes, of course. Taking this vitamin has nothing to do with ectopic pregnancy or abortion.

Q: Can I take folic acid even if I am acidic?

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Yes. just because it is termed as folic acid doesn’t mean it can cause acidosis, or peptic ulcer disease, or pyrosis (heartburn).

Conclusion 

Folic acid is a water-soluble B vitamin that helps maintain regular body functions. It promotes healthy red blood cell production, cell growth and development, and reduces the risk of various complications such as neural tube defects, anemia, and cardiovascular diseases. Taking 400 micrograms of folic acid every day is beneficial for both men and women, even without pregnancy or during family planning.