2023-05-31 20:08:34
Main points of the article:
- Folic acid is a water-soluble vitamin from group B, known as vitamin B9, which helps in the production of red blood cells.
- Folic acid helps prevent cardiovascular diseases, dementia diseases such as Alzheimer’s and improves the functioning of the nervous system.
- Folic acid plays a significant role in the development of the fetus in the first weeks, in particular the development of its brain and spine, so it is important to take it during pregnancy.
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What is folic acid and what is its importance?
Folic acid is a water-soluble vitamin from group B, known as vitamin B9, which helps in the production of red blood cells. Folic acid can be consumed by eating certain foods, especially green leaves, legumes and citrus fruits or as a food supplement. The name of the acid comes from the Latin word folium which means leaf, because the acid was first isolated from lettuce leaves. Folic acid is found in food in an inactive form and only after eating it undergoes decomposition with the help of enzymes in the digestive system and is absorbed in its active form into the bloodstream.
The importance of folic acid stems from the fact that it helps in the proper production of red blood cells, which carry oxygen from the lungs to all body cells. Folic acid deficiency can cause anemia. In addition, folic acid helps to reduce the level of homocysteine, a substance in the blood, an excess of which is linked to cardiovascular diseases, especially in men, as well as to Alzheimer’s, cognitive problems and dementia in old age. Therefore, folic acid intake may reduce the risk of cardiovascular disease and cognitive impairment.
Folic acid deficiency is also linked to dysfunction of the nervous system, including mental weakness, delirium, depression, restlessness, forgetfulness, confusion and insomnia. Folic acid maintains the balance between the amounts of molecules that transmit nerve messages in the brain.
Folic acid before pregnancy and during pregnancy
As will be noted later, folic acid is significant mainly during pregnancy and critical in the first weeks of pregnancy.
Folic acid helps build cells and has an important role in the development of the baby. In the first weeks of pregnancy, the body organs of the fetus develop, including the brain. A defect in the development of some cells at an early stage of pregnancy may cause malformations. The neural canal of the fetus, from which the brain and spine develop, closes as early as the third or fourth week after fertilization, and a defect in it or the brain of the fetus can lead to severe disability, illness and even death. Folic acid significantly reduces the risk of neural tube defects. Therefore, it is essential that a woman takes folic acid even before becoming pregnant and in the first three months of pregnancy.
Folic acid is important for fetal development. Image: Shutterstock
For those who are planning a pregnancy, it is very important to take folic acid daily, even before becoming pregnant and then during the first three months of pregnancy. Moreover, it is recommended to continue taking folic acid even later in pregnancy for the development of the fetus. Also, folic acid will help prevent anemia in a pregnant woman. In light of the fact that in many cases the pregnancy is not planned, there is a recommendation to take folic acid every day throughout the entire fertile age.
A test done in Israel in 1999 revealed that one out of every 750 pregnancies that lasted at least 16 weeks was of a fetus with an open malformation in the neural canal (at a rate of 1.46:1000 births). As a result, in 2000 the Ministry of Health recommended taking folic acid at a dose of 400 micrograms per day throughout a woman’s reproductive age, with an emphasis on the three months before becoming pregnant, and the first three months of pregnancy itself. In 2003, about three years later, the national malformation rate dropped to 1.15:1000 births (including live births, dead fetuses and induced abortions).
The Ministry of Health in Israel recommends that all women trying to conceive take 0.4 milligrams (400 micrograms) of folic acid per day as a nutritional supplement, and so also during the first 12 weeks of pregnancy, because during this period the spine of the fetus develops.
Women at high risk of giving birth to a baby with a neural tube birth defect should take 5 milligrams of folic acid once a day. Treatment must be started at least three months before pregnancy and continued during the first three months of pregnancy.
Who is at risk?
Women at high risk of giving birth to a baby with a neural tube birth defect:
- Those who previously gave birth to a baby who suffered from an open defect in the neural canal.
- are treated with antiepileptic drugs.
- treated with lithium or methotrexate.
- suffer from obesity (BMI of 30 or more).
- Women with a history of excessive alcohol use.
- Those who suffer from diseases that impair absorption in the intestines (which may impair the absorption of folic acid) such as Crohn’s and celiac disease.
Folic acid after birth
Even during breastfeeding, folic acid is important for the development of the baby’s brain. Doctors recommend 500 micrograms per day.
Folic acid in food
Folic acid is found in various types of food, especially green leaves (such as lettuce, spinach and broccoli), legumes, whole grains, citrus fruits, as well as foods enriched with folic acid. It is recommended to follow a diet rich in these foods: lentils, asparagus, spinach, broccoli, beets, lettuce, bak choy, cauliflower, parsley, calf’s liver. Other foods are zucchini, beans, cabbage, strawberries, pepper, Brussels sprouts, leeks, fennel, tomatoes, garden peas.
Foods rich in vitamin B9. Photo: Shutterstock
It is important to know that the amount of folic acid that the body absorbs from food is often not enough, especially for pregnant women, therefore, to prevent nutritional deficiencies and birth defects in the fetus, women who are planning a pregnancy or are at the beginning of pregnancy should take folic acid tablets.
Folic acid for menopausal women
It is also recommended for menopausal men and women to take folic acid, which is known to prevent heart disease, dementia and certain types of cancer, such as lung, uterine, colon and breast cancer. The recommended dose is 400 micrograms per day.
Folic acid – side effects
Folic acid also comes in tablets as a supplement. Before starting to use folic acid, you must report your medical history, including medical conditions and illnesses, to the attending physician. You must also report any additional medication you are taking, including dietary supplements and herbs. The side effects following the intake of folic acid are often uncommon and even rare, but may be dangerous: Side effects of hypersensitivity such as rash, swelling, redness, itching, blistering on the skin, peeling skin, shortness of breath, wheezing and difficulty breathing, pressure in the chest or throat, swelling of one or more of the following organs: mouth, face, lips, tongue , the eyelids. These symptoms may be accompanied by a high fever.
Rare side effects due to taking folic acid will be loss of appetite, swelling, nausea, unpleasant sensations in the stomach, gas, hypersensitivity, lack of vitamin B12.
Folic acid – normal value
- In serum – 3.0-17.0 ng per milliliter.
- In red blood cells – 150-800 ng per milliliter of compressed blood cells
Folic acid – low level
In a 12-year follow-up in the USA, it was found that people with a low level of folic acid in their blood are at double the risk of dying from heart disease, compared to those who were found to have a high level of folic acid. A normal folic acid level maintains a low level of homocysteine in the blood, high levels of which can cause cardiovascular disease. In addition, in a long-term follow-up conducted in Canada among adults over the age of 65, it was found that low levels of folic acid increase the risk of stroke, depression and dementia and the risk of the need for institutional hospitalization.
What causes folic acid deficiency in the blood?
- Poor nutrition and low in folic acid.
- Lack of vitamins, especially of the B group – B1, B2 ,B3.
- Protein deficiency – proteins are needed to build molecules that bind folic acid in the digestive system and thus allow its absorption.
- Heavy alcohol consumption, heavy smoking and heavy coffee consumption.
What are the signs of folic acid deficiency?
- Restlessness, nervousness
- Mental weakness, forgetfulness, confusion
- depression
- Insomnia
- muscle weakness
- Gingivitis
- diarrhea
Excess folic acid
The recommended dose is 400 micrograms of folic acid per day, with the upper limit of the recommended folic acid dose for the entire population being 1 mg per day. An excess of folic acid may cause problems such as impairing the effectiveness of vitamin B12. Other symptoms of excess folic acid are insomnia, restlessness and problems with the activity of the digestive system. In most cases, a significant excess will only result from the consumption of nutritional supplements in very high doses and not from foods rich in folic acid.
Folic acid – recommended dose
The American National Academy recommends that:
Every woman over the age of 14 – 0.4 milligrams (400 micrograms) per day as a nutritional supplement.
Pregnant woman – 0.6 milligrams (500 micrograms) per day.
Lactating woman – 0.5 milligrams (500 micrograms) per day.
The American Academy has also determined that taking up to 1 milligram of folic acid per day as a dietary supplement is safe.
The Ministry of Health in Israel recommends that all women trying to conceive take 0.4 milligrams (400 micrograms) of folic acid per day as a nutritional supplement, as well as during the first 12 weeks of pregnancy, because during this period the spine of the fetus develops.
Folic acid – constipation
Constipation is not included in the list of side effects of excess folic acid. In rare cases, nausea, bloating, gas and loss of appetite will be felt. Folic acid in the right dose helps the digestive system.
Is folic acid kosher for Passover?
In Pesach 2023 it was found kosher:
- Folic acid (concoction) tablets FOLIC ACID (concoction TABS
- Folic acid (Sam On) (all doses) tablets FOLIC ACID (Sam On) (all doses) TABS
Folic acid for men and adults
It is also recommended for men of all ages and menopausal women to take folic acid, which is known to prevent heart disease, dementia and cancers such as lung, uterine, colon and breast cancer.
Questions and Answers
What is folic acid? Folic acid is a water-soluble vitamin from group B, known as vitamin B9, which helps in the production of red blood cells. It helps prevent cardiovascular diseases, dementia diseases such as Alzheimer’s and improves the functioning of the nervous system. Folic acid plays a significant role in the development of the fetus in the first weeks of pregnancy – in particular the development of its brain and spine, therefore it is important to take it during the fertile period.
When to take folic acid, morning or evening? The medicine can be taken at any time of the day, but it is recommended to adhere to a fixed time. The medicine can be taken with food but also on an empty stomach.
Is folic acid fattening? Folic acid is not fattening.
(Photos: Shutterstock)
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