How can I be sure I get enough folic acid? If swallowing pills is hard for you, try a chewable or liquid product with folic acid. What should I look for when buying vitamins with folic acid? Vitamin label Check the "Supplement Facts" label to be sure you are getting to micrograms mcg of folic acid. Can I get enough folic acid from food alone? What is folate-deficiency anemia? The symptoms of folate-deficiency anemia include: Fatigue Headache Pale skin Sore mouth and tongue If you have folate-deficiency anemia, your doctor may recommend taking folic acid vitamins and eating more foods with folate.
Can I get too much folic acid? Do I need folic acid after menopause? Are folic acid pills covered under insurance? Did we answer your question about folic acid? Sources Finer, L. Declines in unintended pregnancy in the United States, The New England Journal of Medicine; 9 — Preventive Services Task Force. Folic Acid Recommendations. Bailey, R. Total folate and folic acid intake from foods and dietary supplements in the United States: — American Journal of Clinical Nutrition; 91 1 : — Hamner, H.
Acculturation factors are associated with folate intakes among Mexican American women. The Journal of Nutrition; 10 : — Spina Bifida. Facts about Anencephaly. Mosher, W. National Health Statistics Reports; no. Government Printing Office. Federal Register; 61 44 : Morris, M. Folate and vitamin B12 status in relation to anemia, macrocytosis and cognitive impairment in older Americans in the age of folic acid fortification.
Am J Clin Nutr; 85 1 — Linde, M. Mabry-Hernandez, M. Citation of the source is appreciated. Language Assistance Available. Have a family member with spina bifida and could get pregnant. Take medicines to treat epilepsy , type 2 diabetes , rheumatoid arthritis , or lupus. A systematic review demonstrated that, when used alongside antidepressant medication, treatment with folate-based supplements, including folic acid and methylfolate, were associated with significantly greater reductions in depressive symptoms, compared with antidepressant medication treatment alone Supplementing with folate-based supplements, including folic acid, may help improve heart health and reduce your risk of heart disease risk factors.
Having elevated levels of the amino acid homocysteine is associated with an increased risk of developing heart disease. Blood levels of homocysteine are determined by both nutritional and genetic factors. Folate plays a major role in the metabolism of homocysteine, and low folate levels can contribute to high homocysteine levels, known as hyperhomocysteinemia Research has shown that supplementing with folic acid may reduce homocysteine levels and heart disease risk.
Additionally, folic acid supplements have been shown to improve blood flow, which may help improve cardiovascular function This list is not exhaustive, and there are many other reasons why people use folate-based supplements.
Some people have genetic variations that affect how they metabolize folate. Genetic polymorphisms in folate metabolizing enzymes, such as methylenetetrahydrofolate reductase MTHFR , can affect health by interfering with folate levels in the body. One of the most common variants is CT.
People with the CT variant have lower enzyme activity. As such, they may have elevated levels of homocysteine, which may increase heart disease risk. These variants may also increase the risk of birth defects, migraine , depression, pregnancy loss, anxiety, and certain cancers 30 , The incidence of genetic variants that influence folate metabolism varies depending on ethnicity and geographical location.
Recommended treatment typically involves supplementing with biologically active 5-methyltetrahydrofolate and other B vitamins. However, individualized treatment is often necessary Folate plays essential roles in fetal growth and development. This is why having optimal folate levels is important both before and during pregnancy. Since the s, flour and other food staples have been fortified with folic acid based on study results linking low folate status in women with a significantly increased risk of neural tube defects in their children.
It has been proven that both food fortification programs and folic acid supplementation before and during pregnancy significantly reduces the risk of neural tube defects, including spina bifida and anencephaly Beyond its protective effect against birth defects, supplementing with folic acid during pregnancy may improve neurodevelopment and brain function in children, as well as protect against autism spectrum disorders 34 , However, other studies have concluded that high folic acid intake and high levels of unmetabolized folic acid in the bloodstream may have a negative effect on neurocognitive development and increase autism risk, which will be discussed in the next section Folate is also important for maternal health, and supplementing with folic acid has been shown to reduce the risk of pregnancy-related complications, including preeclampsia.
Additionally, high maternal folate levels have been associated with a significantly reduced risk of preterm birth 37 , Although folic acid supplements are most important during the first few months of pregnancy, some research shows that continuing to take folic acid throughout pregnancy may help boost folate levels in both maternal and umbilical cord blood It may also prevent the rise in homocysteine levels that usually occurs in late pregnancy.
Because a high intake of folic acid can result in high levels of unmetabolized folic acid in the blood and may be associated with negative health outcomes, many experts suggest that pregnant women take 5-methyltetrahydrofolate, the biologically active form of folate, rather than folic acid Unlike a high intake of folic acid, a high intake of 5-methyltetrahydrofolate does not lead to unmetabolized folic acid in the blood. Plus, studies have shown that 5-methyltetrahydrofolate is more effective at increasing red blood cell folate concentrations.
Unlike with naturally occurring folate in food and biologically active supplemental forms of folate like 5-methyltetrahydrofolate, taking high doses of folic acid may lead to negative side effects. As mentioned above, due to differences in metabolism, only a high intake of folic acid through fortified food or supplements may result in high blood levels of unmetabolized folic acid 36 , Eating folate-rich foods or taking natural forms of folate, such as 5-methyltetrahydrofolate, does not result in excess blood levels of folic acid.
Though some studies have associated high maternal levels of folic acid with a decreased risk of autism and improved mental outcomes in children, others have associated high levels of unmetabolized folic acid in the blood with an increased risk of autism and negative effects on neurocognitive development. A recent study in mothers found that mothers with higher blood concentrations of folate at the 14th week of gestation were more likely to have children with autism spectrum disorder ASD On average, an adult in the United States will get mcg of folic acid per day from fortified foods.
The recommended dietary allowance of folate is mcg per day for an adult and mcg for a pregnant woman. Folate occurs naturally in many foods. Some foods contain more folate than others. Dark green, leafy vegetables, fruits, nuts, seafood, eggs, dairy products, poultry, orange juice, and grains all contain folate. Eating a varied diet with different sources of folate will help a person maintain a good balance of nutrients. Meat and dairy products are good sources of folate, but they may also be high in unhealthful fats.
Choose lean meat and lower fat dairy, or get protein and folate from nuts and beans instead. Both folic acid and folate are important for women before becoming pregnant and during early pregnancy.
Having a high enough level of folate in the blood can help prevent birth irregularities. Specifically, low blood folate levels may increase the risk of neural tube irregularities.
These congenital changes affect the spinal cord and brain. Two common examples are:. The Centers for Disease Control and Prevention CDC recommend that women begin to take a folic acid supplement at least 1 month before conception. The recommendation is mcg of folic acid per day, plus a varied diet with foods rich in folate.
Having low levels of folate in the blood can cause folate deficiency anemia. When this develops, the body makes larger red blood cells that do not work properly. Common symptoms include:. Folic acid works with other B vitamins to control levels of an amino acid called homocysteine.
Having high levels of homocysteine in the body can increase the risk of heart disease and stroke. For these reasons, supplementing with vitamin B9 is common. Fortifying food with this nutrient is mandatory in many countries, including the United States and Canada. In fact, leafy vegetables are among the best dietary sources of folate. The active form of vitamin B9 is a folate known as levomefolic acid or 5-methyltetrahydrofolate 5-MTHF.
In your digestive system, most dietary folate is converted into 5-MTHF before entering your bloodstream 6. Folate is the naturally occurring form of vitamin B9. Folic acid is a synthetic form of vitamin B9, also known as pteroylmonoglutamic acid. Unlike folate, not all of the folic acid you consume is converted into the active form of vitamin B9 — 5-MTHF — in your digestive system.
Instead, it needs to be converted in your liver or other tissues 5 , 6. Yet, this process is slow and inefficient in some people. After taking a folic acid supplement, it takes time for your body to convert all of it to 5-MTHF 7. Even a small dose, such as — mcg per day, may not be completely metabolized until the next dose is taken. This problem may become worse when fortified foods are eaten along with folic acid supplements 8 , 9. This is a cause for concern, as high levels of unmetabolized folic acid have been associated with several health problems.
However, one study suggests that taking folic acid along with other B vitamins , particularly vitamin B6, makes the conversion more efficient Folic acid is a synthetic form of vitamin B9. Your body does not convert it into active vitamin B9 very well, so unmetabolized folic acid may build up in your bloodstream. Several studies indicate that chronically elevated levels of unmetabolized folic acid may have adverse health effects, including:.
0コメント