Many of our patients at Mensah Medical have seemingly gotten the impression that we have a negative outlook in regard to folic acid. As we apply orthomolecular principles to our treatment of various cognitive challenges, we often caution some of our patients about taking folic acid supplements or eating too many foods that are high in folate. Folic acid is actually a very necessary and very powerful nutrient, and the cautions we share with patients are typically limited to very specific biotypes. Many of the cognitive challenges that bring patients to us have under-methylation as the underlying cause for those challenges. For the most part, folic acid is not very beneficial for under-methylators. On the other hand, folic acid can be a key element of a nutrient therapy program for someone who is over-methylated. It is certainly not our intent to vilify folic acid. It is important, however, to know when, and when not, to both uses or avoid folic acid. Today, even though we recommend avoiding folates for so many of our under-methylated patients, I want to share a balanced evaluation of some of the benefits of folic acid.
Physical Benefits
It is fairly common knowledge that folic acid is an important part of both prenatal planning and utilization in early pregnancy. Folic acid is a very powerful agent in helping prevent neural tube defects in a developing embryo. The brain and other structures related to the nervous system are developed from what is called the neural tube. If a pregnant mother does not have enough folic acid in her system for the developing embryo to draw from, there can be problems and some malformations with regard to the brain and brain development. So standardly, in all fields of medicine, we recommend the use of folic acid during the first trimester of pregnancy. Some of us practitioners, myself included, do have concerns about excessive use of folic acid beyond that first trimester, but I promised that today we’re going to be good and only talk about folic acid benefits, so perhaps we will save that discussion for a future blog/discussion. The bottom line is if you’re thinking about becoming pregnant, or you are pregnant and you haven’t gotten past your first trimester, please listen to your doctors and use folic acid.
Another condition for which you want to use folic acid is if you are having heart difficulties. High levels of homocysteine are a tell-tale sign of cardiovascular disease or cardiovascular impairment. We use folic acid to help bring down homocysteine levels and thereby improve cardiovascular health. Additionally, anemia (and particularly anemia related to B12 deficiency) is regularly treated with folic acid. So folic acid is vital to the proper development and/or function of our brains, our hearts, and our blood. We all need folic acid, in the proper concentrations, to survive and to thrive. Our challenges and concerns only come into play when we have excess amounts of folic acid used.
There is one other important reason for getting more folic acid into your system that I should mention, as it is one that people often don’t think about. There are a number of commonly used medications that reduce folic acid levels in the body. Patients taking Phenytoin (also known as Dilantin) or Methotrexate, for example, will need to take folic acid supplements to replace what these medicines are depleting from their systems.
Other Forms of Folate?
There is plenty of confusion around other forms of folate as it relates to folic acid. What about methylated folate? What about folinic acid? How do these compare to or differ from folic acid? We hear these types of questions regularly. The answer can actually be pretty simple. There is a slightly different process of change or modification that occurs for each version of folate once it enters the cell. However, no matter what form of folate you take, whether it’s methylated, or folic acid, or any other form, it ultimately gets converted into the same core agent. If you have a strong over-methylation condition, you don’t want to take methylated folate. Otherwise, you can take any version of the folate you want. The point is that they all turn into the same thing. Don’t be fooled by claims that one version or product gets into your system faster. Once the folate gets into the cell, it is modified and does the job that it is meant to do.
Dietary Sources
Many of you reading this, particularly you under-methylators who don’t miss a single detail, are probably remembering that I started this conversation by mentioning that we sometimes advise patients to avoid foods that are high in folates. Well, by the same token, if you have any of the physical concerns we have discussed here, then eating dark, green, leafy vegetables can be your natural source of life and vitality. Foods, like kale, broccoli, and spinach, as well as beans, peanuts, many fresh fruits, and several others, are rich in folic acid. Women who are planning to become pregnant, or who are in their first trimester of pregnancy, should certainly consume folate-rich foods. Patients with cardiovascular concerns might also want to consider a similar dietary shift, as well as patients taking medications known to deplete the body of folates. The list of foods with high folate content is too extensive to include here, so I encourage you to search for such lists online (I’m sure you under-methylators were already planning to do so). A certified nutritionist should also be very knowledgeable about foods that are rich in folates.
As with any nutrient, folic acid is not good or bad in and of itself. We are very cautious about using it and monitoring concentrations because it is a strong, powerful agent. The key is knowing your own biochemistry and using (or avoiding) folic acid based on that chemistry and the physical and cognitive conditions you are experiencing. In the end, folic acid is a very important nutrient. It is part of the system, and it is critical to how our bodies develop and function.