Download FOLIC ACID What is the nutrient?

FOLIC ACID
1. What is the nutrient?
Vitamin B9-Folic acid (man-made)/ folate (plant source)
Like all B-vitamins, folate assists in converting food into a usable source of energy. B
complex vitamins promote nervous system function, healthy hair, skin, eye and liver
function. Folate contributes to brain function, mental and emotional health, and is
especially important during periods of rapid growth such as infancy, adolescence, and
pregnancy. It plays a role in the production of DNA and RNA, and works with
vitamin B12 to produce healthy red blood cells. In conjunction with vitamins B6 and
B12, folate regulates blood levels of the amino acid, homocysteine, which has been
linked to heart disease at high levels.
2. What is the RDA/DRI for the nutrient?
All adults need 0.4 mcg (400mg) per day. Women who are pregnant or breastfeeding
should aim for up to 0.8 mcg per day. Because pregnancies may be unplanned, it is
recommended that all women who could become pregnant take in 0.4-0.8 mcg of
folic acid each day. Adequate levels of folic acid are needed before, as well as during
pregnancy.
3. How is the nutrient metabolized?
Folate is a water-soluble vitamin, which means that if more than what the body needs
is consumed or supplemented, the excess will be excreted in the urine. It cannot be
stored in the body so it must be consumed or supplemented on a regular basis.
Absorption occurs in the small intestine.
4. What are food sources of the nutrient?
All grains and cereals in the United States are fortified with folic acid. Whole foods
that provide folate include dark leafy greens like spinach and mustard greens, beets,
turnips, asparagus, soybeans, lima beans, Brussels sprouts, root vegetables, bulgur,
wheat germ, white beans, mung beands, kidney beans, salmon, avocado, milk, and
orange juice.
5. What disease states alter the nutrients metabolism?
Some individuals may have increased need for folic acid due to various disease states
such as celiac disease, sickle cell disease, liver disease, kidney disease, or high
alcohol intake. Dialysis or medications used to treat epilepsy, Type 2 diabetes,
rheumatoid arthritis, lupus, asthma, psoriasis, and inflammatory bowel disease may
also alter folic acid metabolism.
6. What are the tests or procedures to assess the nutrient
level in the body?
Basic information about nutrient status is evaluated using patient history and a
physical exam. A blood test is used to assess the amount of folic acid in the body.
Sometimes it is difficult to differentiate between folate deficiency and vitamin B12
deficiency. Measuring RBC folate levels in the blood can be used to confirm folate
deficiency. It is important to confirm that the issue is folate before beginning
supplementation due to the fact that high levels of folic acid can mask Vitamin B12
deficiency.
7. What is the drug –nutrient interactions?
Very high doses of NSAIDs (such as used in the clinical setting), anti-convulsants
such as phenytoin, phenobarbital, and primidone, some cholesterol-lowering drugs,
methotrexate (used to treat psoriasis and rheumatoid arthritis), some antibiotics,
triamterene (blood pressure medication), Sulfasalazine (ulcerative colitis), and oral
contraceptives that deliver high doses of estrogen, have all been shown to
compromise folate status to varying degrees. Folic acid may increase the effects of
chemotherapy drugs to dangerous levels.
8. How is the nutrient measured?
Folic acid is measured in micrograms for dosing purposes. Blood tests are used to
determine levels within the body.
9. What is the Upper Tolerable Limits?
It is not necessary or recommended to exceed 800-1000mg per day.
10.What are the physical signs of deficiency?
Low levels of folate are associated with anemia, irritability, forgetfulness, mental
sluggishness, poor growth, gingivitis, shortness of breath, pallor, poor appetite, and
tongue inflammation. Inadequate intake of folate before and during pregnancy is
linked to serious birth defects including Spina bifida, cleft palate, and brain damage.
11.What are physical signs of toxicity?
It is difficult to take in too much folate from plant sources. Also, because folic acid is
a B-vitamin it is water soluble, meaning that it is excreted daily rather than stored in
the body. In rare cases, excessive supplementation of folic acid could lead to toxicity.
Signs of toxicity include rash, abdominal cramps, nausea/stomach upset, diarrhea,
sleep disorders, confusion, behavior changes, or seizures. Too much folic acid may
also mask vitamin B12 deficiency, which could result in nerve damage.