Things to be aware of when taking folic acid
Concerns have been raised that excess folic acid intake may have unknown consequences. [8]
While folic acid fortification is deemed safe and used in anything labeled as ‘enriched’ (including flour, grain, and cereal products), it’s important to understand whether it is right for you.
As mentioned previously, folic acid is a synthetic and chemically stable form of folate and not the natural form of the vitamin found in whole foods.
One of the side effects of folic acid is that high dosages can build up in an unmetabolized form in the blood. This is because the conversion process is slow and depends on the availability of several enzymes. [9]
One study found a 19% increase in the risk of breast cancer in postmenopausal women taking ≥ 400 μg/day folic acid. [10] The Swedish Mammography Cohort also found a statistically significant 19% increased risk of breast cancer in those taking multivitamins made with folic acid. [11]
High concentrations of UMFA (unmetabolized folic acid) in plasma have been found to decrease natural killer (NK) cell cytotoxicity, an immune response potentially promoting carcinogenesis. [12]
Studies in mice have also found that high folic acid consumption in those with an MTHFR mutation may cause degeneration of hepatocytes (liver cells) resulting in liver injury. [13]
In the elderly, a combination of high folate levels and low vitamin B-12 status may be associated with an increased risk of cognitive impairment and anemia and, in pregnant women, with an increased risk of insulin resistance and obesity in their children. [14]
Most importantly, some people have MTHFR genetic variations that decrease the body’s ability to convert folic acid. A mutated MTHFR enzyme may only have 55-70% of the efficiency of a normal MTHFR enzyme. The incidence of people presenting a form of polymorphism of MTHFR is about 40-50% worldwide. [15]
Levels of circulating UMFA in the population are persistent in countries where the folic acid fortification of grains and cereals has been implemented.
Who needs folate?
Folate plays an essential role in numerous bodily processes. It is vital for everyone, but certain individuals or life stages require it even more than others.
Folate is required for:
• Pregnant women
Demands for folate increase during pregnancy because it plays a crucial role in DNA replication, amino acid synthesis and vitamin metabolism; all of which are required for growth and development of a healthy baby. Folic acid deficiency (which is actually folate deficiency) can lead to health issues in both the mother (anemia, peripheral neuropathy) and congenital abnormalities in the fetus. [17]
Studies show that unmetabolized folic acid (UMFA) has been found in the umbilical cord of the fetus, and even in infants' blood. [18]
• Those with cardiovascular concerns
Folate is required for converting homocysteine to methionine, which is critical for reducing homocysteine levels in the blood. Homocysteine is an amino acid linked to atherosclerosis, stroke, and blood vessel damage.
• Those with mood disorders and/or treatment-resistant depression
Folate is required for producing serotonin and dopamine, which are vital neurotransmitters involved in healthy mood and nervous system maintenance. Those with depression and other mood-related disorders are often found to be low in folate. [19]
Overall health and vitality
Folate is vital for detoxification, energy production, immune function, maintenance and regulation of genes, mood balancing, and control of inflammation. [20]
Why take folic acid?
For most people, the main reason for taking folic acid is that their doctor has recommended it, and it is relatively cheap. Vitamin B9 benefits everyone, but methylfolate may be more beneficial for those who cannot absorb folic acid.
Sources of folic acid
As folic acid is man-made, it is not present in any natural sources. Folic acid is added to certain products during the manufacturing process. Foods high in folic acid include breads, flours, pastas, rice, and cornmeal, corn masa flour (used to make corn tortillas and tamales); and some breakfast cereals. Folic acid is also found in certain dietary supplements. [21]
Benefits of methylfolate supplements
Those with a MTHFR mutation(s) are unable to properly break down folic acid, which will not only mean they are not getting the benefits, but may also be at increased risk of developing unmetabolized folic acid syndrome. [22]
For these people, it is much safer and more effective to take methylfolate, the active form of folate. Methyl-Life® has a carefully curated range of methylfolate supplements to suit every medical condition and stage of life. Methylfolate 2.5 mg is ideal for those who are pregnant and/or new to methylated supplements, while Methylfolate 5 mg is great for supporting cardiovascular health, healthy immune function, cognitive function, and many other methylation processes.
Methylfolate 15 mg is ideal for those seeking optimal mood support. Clinical studies show that 15 mg methylfolate is effective for those with treatment-resistant depression when taken in combination with antidepressants. [23]
The takeaway
Folate is one of the most important nutrients for human growth, development, maintenance, and overall function. But it’s not to be confused with folic acid. Folic acid is the synthetic form of folate that has been used in fortified foods and supplements for the last 60 years. Folate itself is the form naturally present in foods, while L-methylfolate is the bioactive form available as a supplement that your body can immediately absorb and use.
Folic acid is safe but may not be suitable for everyone, particularly those who cannot metabolize it properly due to MTHFR genetic mutations. Talk to your health professional about what form of folate is right for you, and learn more about methylfolate at Methyl-Life®.
References
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8418216/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257747/
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8235569/
4. https://www.ncbi.nlm.nih.gov/books/NBK554487/
5. https://www.sciencedirect.com/topics/earth-and-planetary-sciences/folic-acid
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5849489/
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5849489/
8. https://pubmed.ncbi.nlm.nih.gov/18326588/
9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5849489/
10. https://pubmed.ncbi.nlm.nih.gov/16600944/
11. https://pubmed.ncbi.nlm.nih.gov/20335555/
12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7508257/
13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340065/
14. https://pubmed.ncbi.nlm.nih.gov/18326588/
15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9380836/
16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3218540
17. https://pubmed.ncbi.nlm.nih.gov/35204698/
18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3026708/
19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1810582
20. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9380836/
21. https://www.fda.gov/food/new-nutrition-facts-label/folate-and-folic-acid-nutrition-and-supplement-facts-labels
22. https://www.mdpi.com/2218-273X/12/2/197
23. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3402301/