Vitamin B9
Folate and folic acid are vitamin B9 forms that are used to treat deficiency and to prevent pregnancy complications. Many foods contain or have folic acid added to them.
Vitamin B9
Folate and folic acid are vitamin B9 forms that are used to treat deficiency and to prevent pregnancy complications. Many foods contain or have folic acid added to them.
Overview
Folic acid has been required by federal law to be added to cold cereals, flour, bread, pasta, bakery items, cookies, and crackers since 1998. Leafy vegetables, okra, asparagus, certain fruits, beans, yeast, mushrooms, animal liver and kidney, orange juice, and tomato juice are all naturally high in folate. Folic acid can also be taken as a supplement and is frequently combined with other B vitamins.
Folic acid is used to prevent and treat low folate levels in the blood (folate deficiency) and high homocysteine levels in the blood (hyperhomocysteinemia). Pregnant women and those who may become pregnant should take folic acid to avoid serious birth defects such as spina bifida. Folic acid is also used to treat a variety of other conditions, including depression, stroke, memory and thinking skills decline, and many others.
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Source
Folate & Folic Acid
Folate is a B vitamin that can be found in a variety of foods. Folic acid is a synthetic form of folate.
Folate is also referred to as folacin and vitamin B9.
Good natural folate sources
Many foods contain trace amounts of folate.
Sources to consider include:
- Broccoli
- Brussels sprouts
- Leafy green vegetables, such as cabbage, kale, spring greens and spinach
- Peas
- Chickpeas and kidney beans
- Liver (but avoid this during pregnancy)
- Breakfast cereals fortified with folic acid
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Uses & effectiveness
Vitamin B9 serves a variety of purposes.
Folate helps:
- Folate deficiency. Taking folic acid improves folate deficiency.
- Cell reproduction. The body form healthy red blood cells
- Brain and spine birth defects (neural tube birth defects). Taking 600-800 mcg of folic acid orally daily during pregnancy lowers the risk of birth defects such as neural tube defects, such as spina bifida, in unborn babies. Folic acid can be obtained through diet or supplementation. Some people at high risk should take 4000-5000 mcg per day.
- Homocysteine levels in the blood are elevated (hyperhomocysteinemia). Heart disease and stroke have been linked to this condition. Folic acid taken orally lowers homocysteine levels in people with normal or high homocysteine levels, as well as those with kidney failure.
- Methotrexate toxicity is a side effect of the drug. Taking folic acid orally appears to reduce nausea and vomiting associated with methotrexate treatment.
- Memory and cognitive function decline in the elderly. Taking folic acid orally, with or without other supplements, may improve memory and thinking skills in older people who have a greater decline in thinking skills than is normal for their age. However, it does not appear to work in older people who are experiencing the normal decline in thinking skills associated with their age.
- Depression. Taking folic acid orally along with antidepressants appears to improve symptoms in some people suffering from depression.
- Blood pressure is too high. In some people with high blood pressure who are not taking other blood pressure medications, taking folic acid by mouth daily for at least 6 weeks lowers blood pressure.
- The drug phenytoin causes gum enlargement. Folic acid applied to the gums appears to prevent this problem. However, taking folic acid orally does not appear to help.
- Stroke. In areas where folic acid is not added to grain products, taking folic acid supplements can reduce the risk of stroke. Supplements, on the other hand, do not appear to be beneficial for people who live in countries where folic acid is added to grain products.
- A skin condition that causes white patches to appear on the skin (vitiligo). Taking folic acid orally appears to alleviate symptoms of this condition.
Some believe that it is effective for the following conditions but further studies are required:
- Anaemia (low levels of healthy red blood cells) that is caused by iron deficiency. Adding folic acid to an iron supplement does not improve anaemia treatment any more than taking an iron supplement alone does.
- Memory and thinking skills deteriorate as we get older. Taking folic acid orally does not appear to prevent the normal decline in mental function that occurs in healthy ageing adults.
- Cataracts. Taking folic acid orally along with vitamins B6 and B12 does not prevent cataracts. Indeed, it may increase the number of cataracts that must be removed.
- Diarrhoea. Taking folic acid orally does not appear to prevent diarrhoea in malnourished children. In fact, it may increase the likelihood of having diarrhoea that lasts more than a few days.
- Preventing falls. Taking folic acid with vitamin B12 orally does not appear to prevent falls in older people who also take vitamin D.
- Infertility in men. Taking folic acid orally, alone or in combination with other ingredients, does not appear to improve male fertility.
- Unborn or premature baby deaths. Taking folic acid orally during pregnancy does not appear to lower the risk of a baby dying shortly before or after birth. However, it does aid in the prevention of other health issues in the baby.
- White blood cell cancer. A type of cancer that affects the white blood cells (leukemia). Taking folate orally during pregnancy has no effect on the risk of developing this type of cancer in children.
- Bones that are weak and brittle (osteoporosis). Taking folic acid orally along with vitamin B12 and/or vitamin B6 does not appear to prevent broken bones in elderly people with osteoporosis.
- Physical performance in the elderly. Taking folic acid with vitamin B12 orally does not appear to help older people walk better or have stronger hands.
- Pregnancy-related hypertension. High-dose folic acid supplements do not appear to reduce blood pressure or the risk of developing pre-eclampsia during pregnancy.
- Infection of the lungs. Taking folic acid orally does not appear to prevent infections in the lungs in malnourished children.
- Noncancerous tumours of the large intestine and rectum (colorectal adenoma). Supplementing with folic acid does not prevent growth in the large intestine or rectum.
- A genetic condition characterised by learning disabilities (fragile-X syndrome). Taking folic acid orally has no effect on the symptoms of fragile X syndrome.
- Premature birth. Taking folic acid orally during pregnancy has no effect on the risk of having a premature baby. However, it does aid in the prevention of other health issues in the baby.
There is some interest in using folic acid for a variety of other purposes, but there isn’t enough reliable information to say whether it will be beneficial in these cases.
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Side Effects
When taken orally, most people are likely to be safe taking folic acid in doses of no more than 1 mg daily. Doses greater than 1 mg per day may be hazardous. These doses may cause nausea, diarrhoea, irritability, confusion, behavioural changes, skin reactions, seizures, and other side effects.
L-5-methyltetrahydrofolate (L-5-MTHF) is another form of folic acid that can be found in supplements. In doses of up to 400 mcg daily, this type of folic acid may be safe for most people.
There is some concern that taking too much folic acid for an extended period of time may result in serious side effects. According to some research, taking folic acid in doses of 0.8-1.2 mg daily may increase the risk of cancer or heart attack in people who already have heart problems.
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If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed on this page. In the UK you can also report side effects directly to the Yellow Card Scheme By reporting side effects you can help provide vital information on the safety of this medical supplement.
Is this medicine suitable for you?
Take precautions:
- Pregnant and breastfeeding. During pregnancy, 300-400 mcg of folic acid per day is recommended to prevent certain birth defects. During pregnancy or breastfeeding, the maximum recommended amount of folic acid is 800 mcg daily for those under the age of 18 and 1000 mcg daily for those over the age of 18. Use no more than directed by a healthcare professional.
L-5-methyltetrahydrofolate (L-5-MTHF) is another form of folic acid that can be found in supplements. When pregnant or breastfeeding, this type of folic acid may be safe to take at a dose of up to 400 mcg daily.
- Children. It is likely that taking folic acid by mouth in the recommended amounts for their age is safe for children. Children, on the other hand, should avoid taking folic acid in doses that exceed the daily upper limits. These limits are 300 mcg for children aged 1-3 years, 400 mcg for children aged 4-8 years, 600 mg for children aged 9-13 years, and 800 mcg for children aged 14-18 years.
L-5-methyltetrahydrofolate (L-5-MTHF) is another form of folic acid that can be found in supplements. This type of folic acid may be safe for children.
- Procedures to widen narrowed arteries (angioplasty). The use of folic acid, vitamin B6, and vitamin B12 may aggravate narrowed arteries. People recovering from this procedure should not take folic acid.
- Cancer. According to preliminary research, taking 0.8-1 mg of folic acid daily may increase the risk of cancer. People with a history of cancer should avoid high doses of folic acid until more is known.
- Seizure disorder. Taking folic acid supplements, particularly in high doses, may exacerbate seizures in people with seizure disorders.
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Consult your doctor
If you are taking any of the following medicines please consult your doctor:
- Fosphenytoin (Cerebyx). Fosphenytoin is used for seizures. The body breaks down fosphenytoin to get rid of it. Folic acid can increase how quickly the body breaks down fosphenytoin. Taking folic acid along with fosphenytoin might decrease the effects of fosphenytoin for preventing seizures.
- Phenobarbital (Luminal). Phenobarbital is used for seizures. Taking folic acid can decrease how well phenobarbital works for preventing seizures.
- Phenytoin (Dilantin). The body breaks down phenytoin to get rid of it. Folic acid might increase how quickly the body breaks down phenytoin. Taking folic acid and taking phenytoin might decrease the effectiveness of phenytoin and increase the possibility of seizures.
- Primidone (Mysoline). Primidone is used for seizures. Folic acid might cause seizures in some people. Taking folic acid along with primidone might decrease how well primidone works for preventing seizures.
- Pyrimethamine (Daraprim). Pyrimethamine is used to treat parasite infections. Folic acid might decrease the effects of pyrimethamine for treating parasite infections.
- 5-Fluorouracil. There is some concern that taking large amounts of folic acid with 5-fluorouracil might increase some side effects of 5-fluorouracil, especially stomach problems. Talk with your healthcare provider before taking folic acid.
- Capecitabine (Xeloda). There is some concern that taking large amounts of folic acid might increase the side effects of capecitabine, especially stomach problems like diarrhoea and vomiting. Talk with your healthcare provider before taking folic acid.
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Dosage
Every day, adults require 200 micrograms of folate. A microgram is 1,000 times the size of a milligramme (mg). The Greek symbol followed by the letter g (g) is sometimes used to represent the word microgram.
Because there are no long-term stores in the body, you must consume folate-containing foods on a regular basis.
Most people should be able to meet their folate requirements by eating a varied and balanced diet.
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Other names
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