How folic acid works
Folic acid, formerly also called vitamin B9, is a vital vitamin. Strictly speaking, a distinction must be made between folate in general and folic acid as an individual substance. All substances that can be used by the body as a vitamin, i.e. that can be converted to vitamin B9, are referred to as folate.
As a water-soluble vitamin, folate plays an important role in all growth processes that take place in the human body, especially in cell division and duplication of genetic material – it is involved in the formation of new building blocks for the genetic substance deoxyribonucleic acid (DNA). In addition, the vitamin is needed for amino acid metabolism (amino acids = building blocks of proteins).
When is folic acid used?
Folic acid is used for:
- Treatment of a folic acid deficiency (e.g. in the context of anemia = anemia)
- Prevention of neural tube defects in the unborn child (such as “open spine”)
- Reduction of side effects of methotrexate therapy (MTX therapy, e.g. in cancer)
- prevention of folic acid deficiency
According to current studies, folic acid deficiency also has an influence on the development of cardiovascular diseases. The so-called homocysteine level in the blood can be lowered with the help of a vitamin B12-folic acid combination, which has a positive effect on the prevention of arteriosclerosis.
This is very important because the lack of folic acid during pregnancy can lead to a so-called neural tube defect in the unborn child. This term covers embryonic malformations of the central nervous system such as “open back” (spina bifida) and anencephaly (underdevelopment/non-development of the brain).
How folic acid is used
The German Nutrition Society recommends a daily intake of 300 micrograms of folic acid equivalent (= 1 µg of dietary folic acid or 0.5 µg of synthetic folate on an empty stomach) for adolescents and adults. Quantities of up to about 1,000 micrograms of synthetic folate are harmless, since excess amounts of the water-soluble vitamin can be excreted by the kidneys.
People who consume large amounts of alcohol have an increased need for folic acid.
Folic acid & pregnancy
For women of childbearing potential, pregnant women and nursing mothers, the recommended intake is higher. Pregnant women ideally consume 550 micrograms of folic acid equivalents daily, and nursing mothers 450 µg.
The intake of appropriate vitamin preparations should be started as early as four weeks before pregnancy and continued throughout the first trimester. Since the onset of pregnancy can hardly be predicted, the recommendation applies in principle to all women who wish to have children.
What are the side effects of folic acid?
If folic acid is overdosed for a prolonged period of time, depression, nightmares, and epileptic seizures may result.
What you should be aware of when taking folic acid
Drug interactions
Certain medications should not be used together with folic acid tablets. These include certain drugs for infections or malaria (such as trimethoprim, proguanil, and pyrimethamine) and some cancer drugs such as methotrexate and fluorouracil.
Your doctor or pharmacist can give you more specific information about possible interactions between a vitamin supplement and other medications.
What you should also know about folic acid
Adequate dietary intake of the vitamin is important at any age. Experts recommend foods such as cabbage (e.g. broccoli, Brussels sprouts, cauliflower), spinach, asparagus and summer salads as excellent natural sources of folic acid.
Folic acid is sensitive to heat. Foods containing folic acid should therefore only be cooked or blanched briefly.
Despite information, a large percentage of Germans do not consume enough of the vitamin in their daily diet, resulting in a deficiency. However, experts in Germany are at odds over the mandatory addition of folic acid to foods (like iodide in table salt).
Nevertheless, Germany compares poorly with other countries when it comes to the frequency of the dreaded neural tube defects. For this reason, pediatricians and health politicians continue to call for the mandatory addition of folic acid to food.
