Vitamin B9 ( Folic acid / Folate )
The B complex vitamin, simply called folate – and also known as folacin or folic acid at times – has a very important role to play in many of the vital systems that are vital to the maintenance of the body’s metabolic rate and internal biochemical balance in the health continuum of the human body.
Scientist have found that folate is vital for the biochemical synthesis of the essential nucleic acids, DNA and RNA; at the same time, research has still not let us to an understanding of the exact role performed by folate in human cellular metabolism. Folate is also involved in the synthesis of some essential biochemical proteins that are essential for cellular reproduction and division; therefore it is not hard to realize just how devastating a deficiency of this vitamin could be to a person. Organs that are most affected or hardest hit by a deficiency of folate include organs which are dependent on the rapid proliferation of new cells, such as bone marrow tissues, hair and fingernails, the immune system, as well as certain mucous membranes and red blood cells.
Physical symptoms that are considered to be classic or almost the norm during a case of folate deficiency include anemia and generalized weakness, an inflamed and sore tongue, a general numbness or tingling sensation in the hands and the feet, problems like indigestion and diarrhea, persistent depression, constant irritability, pallor and drowsiness all underlined by a slow and weakened pulse rate. Most of these symptoms are also seen in people affected by pernicious anemia, resulting from a deficiency of cobalamin (B12) vitamin.
These so called classic symptoms are similar with the symptoms induced by a deficiency of most of the other essential vitamins and minerals, and have been experimentally revealed by means of severe deprivation of the vitamin in the body of test subjects. The health continuum of the human body joins together a wide range of illnesses and different health disorders. At the same time, this health continuum does not have a definite cut off point in which the difference between supply and demand can suddenly turn severe enough to be termed a deficiency and lead to the causation of deficiency symptoms in the person. An adverse biochemical effect results as soon as the supply of the nutrient does not meet the demand from the diet and the result is a deficiency in the levels of the nutrient within the body. The real effects on the state of health of the person may not be significant; however, such a situation will occur as long as a deficiency exists. In a state of deficiency, the healing rate of wounds slow down. The volume of hair that falls out may be greater than what normally occurs. The affected person may also be frequently affected by different infections than what normally affects them. The person experiencing a deficiency can also start being affected by some of the classic symptoms.
At the same time, blood sugar levels are apparently maintained at a normal rate by the folate present in the human body. In animal experiments, where a comparison of the difference in blood sugar levels was studied, it was found that folate supplemented rats had a much higher blood sugar level following a fast of forty eight hours than did rats that were not given any folate supplements. Some people suffering from a chronic low blood sugar level can benefit from this therapeutic action of the folate supplement.
The body’s requirement for folate and other nutrients rise during a term of pregnancy. Physical symptoms induced by a deficiency of folate include persistent depression and insomnia, as well as constant irritability. In addition, women who are inclined to having a spontaneous abortion and problems like miscarriage can also benefit from the preventive actions of folate. Supplements of folate may help such women in carrying a fetus to full term and deliver a healthy baby.
Folate is an essential nutrient in the proper and timely development of a fetus and is also needed for the synthesis of new tissues – other people also need sufficient levels of this vitamin in the body to avoid deficiency symptoms. Extreme and severe side effects can affect the baby if a mother suffers from a deficiency of folate deficiency during her term of pregnancy.
A symptom known simply as restless legs syndrome is one of the simpler side effects induced by a deficiency of folate. Physical symptoms of folate deficiency that usually affect the person at night, include symptoms such as insomnia and leg numbness as well as muscular cramps that can only be relieved by movement and massage of the calves. Low dietary and blood levels of folate was found to be directly connected to the restless legs syndrome experienced by the tested persons during one clinical investigation. Nine volunteers out of a group of twenty one pregnant women were affected by restless leg syndrome during a study. A folate supplement had been given to only one of these women during the test. Ten women out of the other twelve that were not affected by restless leg syndrome had been given supplements of folate.
Folate deficiencies can be induced by the use of oral contraceptive pills, such deficiencies can remain in the body for many months even following the discontinuance of contraceptive use.
The metabolism of folate in the human body can be disrupted by many commonly used medications – such disruptions can cause a deficiency to appear in the person. The rate of folate elimination from the blood plasma is increased by the use of oral contraceptives. Folate is also antagonized by the medication called methotrexate, a drug extensively used in bringing about immune-suppression in diseases like cancer and psoriasis. Folate metabolism in the human body is also affected by other medications such as aminopterin, as well as anti-malarial drugs including the compounds pyrimethamine, the compound phenytoin, the compound pentamidine, the compounds trimethoprim, primidone, phenobarbitone, isoniazid and cycloserine combination therapy. Folate metabolism is also affected by alcohol in the body; the vitamin is affected adversely by the use of diphenylhydantoin, by drugs like barbiturates, hormones like estrogens, as well as anti-convulsant medications and phenothiazines.
The level of folate in the body is rapidly depleted in the period following a severe injury or physical trauma. The systemic bacterial infection in the body also impairs the absorption rate of folate in the body. A folate deficiency is often seen in people affected by sickle cell anemia. A deficiency of the essential mineral zinc also leads to a lowering in the rate of folate absorption from the food present in the intestine. A deficiency of the vitamin C can also lead to a deficiency of folate, as this compound is essential for the biochemical conversion of folate to its biologically active form.
Folate is found abundantly in natural sources including various organ meats, in all kinds of dark green and leafy vegetables, in vegetables like asparagus, legumes like lima beans, in yeast, in whole grains and wheat germ, in lentils, and in orange juice. Cooking and heat degrades about fifty to ninety five percent of the folate, this vitamin is also destroyed in the canning, processing or storage process involving all kinds of packaged foods – this is because the vitamin can be degraded by exposure to heat and sunlight or to acids and related preservatives used in the food industry.
The recommended amount of folic acid is not consumed by the majority of people as part of the diet – due to the large scale degradation of the vitamin in the cooking of food. The beneficial effects of folic acid was recently under investigation by scientists who found through research that many people suffering from heart disease possess elevated blood levels of the compound homocysteine – the levels of this amino acid is often regulated by folic acid in the human body. Based on this evidence, it can be said that a mild deficiency of folic acid affects many people in modern Western societies. Some clinical researchers are so sure of folate’s beneficial effects that they estimate the 13,500 deaths occurring from cardiovascular diseases can be prevented by an increased intake of folic acid as part of the diet or as supplements. Impoverished people in developing countries, all alcoholics, people affected by malabsorption disorders as well as women who use contraceptive pills commonly develop a deficiency of folate. From the evidence based on a recent study, a folic acid deficiency was also much more likely to affect elderly people suffering from loss of hearing than other healthy elderly individuals with no hearing problems.
In women who are pregnant, the RDA for folate is about 0.8 mg and it can be as less as 0.05 mg for infants. The RDA of folate for otherwise healthy adults is about 0.4 mg. However, the real human requirement for folate has not been verified by any medical reference book – the essential nature of this vitamin is based on the symptoms seen when it is deficient in the body. This confusion about the real requirement of this nutrient need not worry the average person as the same thing could be said for just any of the other vitamins – the needs of the individual determines to a large extent the kind of nutrients required at a certain time. What is apparent is that to overcome any deficiency of folate – high doses may be required as part of a prolonged supplemental regimen. At the same time, it seems many people are indeed deficient with respect to folate and may need to overcome their deficiencies.
Side effects and cautions
The use of folic acid has usually not been connected to any adverse side effect in supplemental amounts. At the same time, supplements of folic acid may possibly interfere with the laboratory diagnosis of a deficiency of the vitamin B12; this interference can possibly allow the B12 deficiency to go on undetected to a level where the body has already sustained some irreversible nerve damage at the biochemical level. A nutritionally oriented doctor must always be consulted when supplementing with 1000 mcg or more of folic acid to avoid a vitamin B12 deficiency – though even a B12 deficiency is quite rare.
However, even individuals who are not using folic acid supplements, a vitamin B12 deficiency can still develop without anemia or related blood disorders. An absence of anemia may not necessarily rule out a B12 deficiency according to some doctors, while other medical people are not certain about this fact. A patient may suffer damage at the biochemical level if this confusion about vitamin requirement delays a diagnosis of a vitamin B12 deficiency in a patient – this biochemical damage may be irreversible in some cases. If the doctor is proficient about such disorders, then there should be no problem as such deficiencies are rare and professional clinicians using the correct testing procedures will be able to fully diagnose the deficiency and work out a satisfactory supplemental regimen for the patient if it is required.
The body requires folic acid to properly utilize the vitamin B12 in the body. The absorption of folic acid in the intestines is inhibited by proteolytic enzymes and antacids. Supplements of folic acid are suggested by doctors for all individuals already using either of these compounds.
Supplements that contain folic acid can interfere with methotrexate therapy used in treating cancer patients. The presence of any folic acid in dietary supplements and their use on individuals taking methotrexate for the treatment of cancer must be supervised or assessed by a doctor. Till recent times, folic acid metabolism was believed to be affected by the use of the compound methotrexate used in treating people affected by rheumatoid arthritis. This theory has been shown to be false by the evidence garnered in recent research conducted in controlled experiments. The fact is that, large doses of folic acid are beneficial to people suffering from rheumatoid arthritis especially if they are already on methotrexate therapy. People affected by severe psoriatic arthritis who are on methotrexate may also benefit from high dose supplements of folic acid according to further studies. At the same time, clinical supervision is a must whenever a person takes very high levels of folic acid for any purpose.