Folic Acid, Friend or Foe?

This article on Folic Acid was guest written for Guide to Organics and first published on the 26th January 2016.

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It’s a term you’ve probably seen on the back of a food packet or supplement jar, but what is Folic Acid?

Quite simply it’s a synthetic B vitamin created to mimic the naturally occurring folate, which occurs naturally in green leafy vegetables and legumes. It’s hugely important for a number of processes in the human body, but it’s most famous for its role in the development of healthy babies. Inadequate levels of folate can lead to big problems for unborn children such as malformation of the neural tube which is implicated in spina bifida and incomplete formation of the brain (anencephaly).

The neural tube is the embryonic tissue that becomes the brain and spinal cord of the baby while the foetus grows in the womb.

The potentially devastating effects of folate deficiency, lead the Australian government to follow the recommendations adopted by America, Ireland and the UK and passed mandatory folic acid fortification laws in September 2009 (3). The Australian law requires all conventionally farmed wheat flour sold in Australia to be fortified by synthetic folic acid before sale.

This requirement was based on data showing a reduction in neural tube defects. In Canada, the incidence is recorded as occurring 1.58 times per 1000 births prior to fortification and reducing to 0.86 times per 1000 births after folic acid fortification was introduced, giving a 46% reduction in incidence of neural tube defects (2).

We can see that neural tube defects in unborn babies are considerably reduced by folic acid fortification, but what the figures don’t consider is what effect does folic acid have on the general population?

Before we consider that question in relation to folic acid, it is important to understand the role of folate in the human body. Folate is needed for a range of essential functions including:

  • methylation;
  • detoxification;
  • blood production;
  • sperm production;
  • DNA and RNA formation;
  • Control of homocysteine levels;
  • activation of  B12;
  • synthesis of mood hormones and neurotransmitters such as Serotonin, Dopamine and Norepinephrine.

When we consume naturally occurring folate in food, our bodies convert it to active forms for use. The most useful are folinic acid which is essential for DNA and RNA repair and the active form methylfolate which is folate with the addition of a methyl group.

THIS ALL IMPORTANT METHYL GROUP IS NECESSARY TO TRIGGER THE METHYLATION CYCLE IN YOUR BODY. IN SIMPLISTIC TERMS, THE METHYLATION CYCLE IS RESPONSIBLE FOR USING METHYL GROUPS AS SWITCHES TO TURN ON AND OFF A RANGE OF ESSENTIAL FUNCTIONS IN THE BODY, THEN RECYCLING THOSE SWITCHES FOR reuse.

Without methylation and it’s switches; virus’s can’t be switched off, DNA can’t be repaired, toxins can’t be excreted, vitamins can’t be used, stress and inflammation can’t be reduced and baby’s aren’t formed correctly in early pregnancy. Suffice to say, you wouldn’t be here without it functioning to some extent in your parents and in yourself.

Unfortunately not every person has the right genes to activate folate and these people have even more difficulty using the synthetic folic acid. It is estimated that 35% of Australians have at least one copy of a faulty gene and another 15% have two copies of that gene that makes it difficult make the active form, methylfolate (1). This gene is responsible for the enzyme called methylene-tetrahydrofolate reductase and is known as MTHFR for short. The MTHFR mutation that reduces folate metabolism is named C677T. If you suspect that you have this gene mutation, a simple blood test ordered via your GP will diagnose it.

For people with the MTHFR C677T gene, synthetic folic acid binds to the folate receptors without activating them, which results in even less useable folate being activated. Folic acid also creates a burden of unmetabolised folic acid (UMFA) to excrete and for people with an already compromised ability to excrete toxins, this can be an extra challenge.

For the 50% of the population who have healthy genes, folic acid requires healthy DHFR genes as takes a lot of other B vitamins and nutrients to make it useable. For the other 50% who have a MTHFR C677T defect, folic acid consumption leads to significant health problems including (but not limited to) a higher incidence of stroke, prostate cancer, embolism, parkinsons and alzheimers.

In pregnant women with MTHFR C677T, the population that is supposed to benefit from folic acid fortification, a higher rate of miscarriage, pre-eclampsia, children born with autism, down syndrome, congenital heart defects as well as midline defects including tongue tie, lip tie and umbilical hernia are found(4). Emerging research from all over the world is suggesting that population wide supplementation is not the one size fits all solution that it was intended to be.

THE GOOD NEWS?

Even if you don’t know your genetics, it’s easy to avoid exposure to synthetic folic acid by avoiding supplements that contain folic acid or the term folate and only selecting supplements containing calcium folinate (folinic acid) or 5-Lmethyltetrahydrofolate (methylfolate). As with any supplementation, it is always best to check with your practitioner trained in nutritional medicine before self prescribing.

The best news I’ve saved for last. In Australia, organic wheat flour isn’t subject to the same fortification laws. So, if you would like to include wheat in your diet and it agrees with your body, there is a safe option for people with MTHFR C677T. It’s just another reason why you can’t beat eating certified organic foods.

References:

1. Lorenzo D. Botto and Quanhe Yang. (2000)“5,10-Methylenetetrahydrofolate Reductase Gene Variants and Congenital Anomalies: A HuGE Review”. American Journal of Epidemiology. Accessed 24/1/2016

http://aje.oxfordjournals.org/content/151/9/862.full.pdf

2. Philippe De Wals, Ph.D., Fassiatou Tairou, M.Sc., Margot I. Van Allen et al. (2007)“Reduction in Neural-Tube Defects after Folic Acid Fortification in Canada”. New England Journal of Medicine. Accessed 24/1/2016

http://web1.sph.emory.edu/users/hpacho2/ReferencesPublicHealthImpactFortification/deWals_2007.pdf

3. Food Standards Australia New Zealand. (2009) “Mandatory Folic Acid Fortification guide 2009” Accessed 24/1/2016

http://www.foodstandards.gov.au/code/userguide/pages/mandatoryfolicacidfo4208.aspx

4. Ben Lynch, Dr. (2011) “MTHFR Mutations and the Conditions They Cause” Accessed 24/1/2016

http://mthfr.net/mthfr-mutations-and-the-conditions-they-cause/2011/09/07/

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