Folic Acid

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

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The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

Folic acid is a B vitamin. Like most vitamins and mineral, it is best to get it from the food we eat. Folic acid is in whole grain products, legumes and dark green vegetables. Folic acid is important for your blood, some people on an arthritis medication called methotrexate need extra, but maybe the most important group of people that should watch their folic acid intake are women of child bearing age. While planning a pregnancy, before becoming pregnant, it is important for women to start taking folic acid because it can prevent certain birth defects from occurring.

Birth defects, or congenital defects, can be defined as physical abnormalities that are present at birth. About 3 to 4 percent of babies are born with a major birth defect, and some may not be discovered until a child grows. By age five, 7.5 percent of all children are diagnosed with a birth defect, although many of these are minor. The type of birth defect that is associated with not enough folic acid is called a neural tube defect. Neural tube defects (NTD) include such conditions ancephaly and spina bifida. Ancephaly is when the child is born with most of its brain missing, or the brain does not develop at all. The infant cannot survive and is either stillborn or dies within a few days of birth. Spina bifida is where one or more of the vertebrae fail to develop completely leaving a portion of the spinal cord unprotected. Spina bifida is strongly linked with folic acid deficiency in the diet, especially early in pregnancy. Symptoms can vary, where some children have few or no symptoms, whereas others are weak and paralysed in all areas reached by nerves below the level of the defect.

To prevent neural tube defects, folic acid supplements should be taken before becoming pregnant, and continue throughout the first trimester. The neural tube forms and closes in the first four weeks of pregnancy. This is often before pregnancy tests can tell if you are pregnant, so that is why we want you to start before you are pregnant. A minimum of 0.4 mg of folic acid daily is recommended for women who are planning to become pregnant, and higher doses are recommended for women who already have a child with a neural tube defect. Prenatal vitamins, such as Materna, contain as much as 0.8 to 1 mg of folic acid, and these vitamins should be used in pregnancy rather than regular vitamin formulations.

A couple of years ago there was a lot of excitement about older people taking folic acid, vitamin b6 and vitamin b12 to reduce their homocysteine levels and reduce heart attacks. You see it was found that people with heart disease had high levels of homocysteine. So it was thought if you reduced their homocysteine, their heart disease would go away. So the researchers gave a bunch of people the folic acid, b6 and b12 and another bunch placebo. The folic acid, b6 and b12 group did have their homocysteine levels drop, but their heart disease levels stayed the same. So, unfortunately I can’t tell you that inexpensive B vitamins are an effective heart disease treatment. However, from the ashes of the heart disease trials, some researchers think that folic acid, b6 and b12 may reduce incidence of stroke. Stay tuned!

As always if you have any questions or concerns about these or other products, ask your pharmacist.