Doctors of USC

Functions

Folate's functions include:

• Helping amino acid metabolism and conversion
• Aiding in the conversion of homocysteine to methionine
• Producing and maintaining new cells
• Making DNA and RNA, the building blocks of cells
• Preventing changes to DNA that may lead to cancer
• Making red blood cells and preventing anemia
• Assisting in the manufacture of neurotransmitters, chemicals that regulate sleep, pain, and mood

Recommended Intake:

  Folate Deficiency

Folate deficiency is one of the most common vitamin deficiencies. It can occur for a variety of reasons, including:

• Need is increased, as with pregnancy
• Dietary intake is lacking
• Body is excreting more than usual
• Medications interfering with the body's ability to use folate include:
  • Anti-convulsant medications—(eg, hydantoins)
  • Metformin
  • Sulfasalazine
  • Triamterene
  • Methotrexate

Folate Toxicity

The tolerable upper intake level (UL) for folate from dietary sources and supplements combined is 1,000 mcg. Folate itself is essentially nontoxic. Large doses of folate can mask symptoms of a vitamin B12 deficiency. Although folate supplementation will alleviate the megaloblastic anemia caused by the B12 deficiency, the neurologic damage caused by the B12 deficiency will continue undetected.

Major Food Sources

Health Implications

The following populations may be at risk of folate deficiency and may require a supplement:

• Pregnant women: Folate is critical for the production and maintenance of new cells. This is especially important during pregnancy—a period of rapid cell division.
• People who consume excessive amounts of alcohol: Folate deficiency has been observed in alcoholics. Alcohol interferes with the absorption of folate and increases excretion by the kidneys. In addition, many alcoholics tend to have diets low in essential nutrients, like folate.
• People on certain medications (see Folate Deficiency above): Certain medications can interfere with the body's ability to use folate. Check with your doctor about supplementation if you are on a medication that may affect your folate status.
• People with inflammatory bowel diseases: Malabsorption of folate can occur with inflammatory bowel diseases.
• The elderly: Many elderly have low blood levels of folate, which can occur from low intake of the vitamin or problems with absorption.

In 1991, a landmark study found a relationship between folate and birth defects. Subsequent research has supported the finding that adequate folate intake during the period before and just after conception protects against a number of neural tube defects, including spina bifida and anencephaly.

The crucial period is before and very early after conception—a time when most women do not know they are pregnant. Therefore, the recommendation is that all women of childbearing age make sure they have a folate intake of at least 400 mcg.

Tips for Increasing Your Folate Intake:

To help increase your intake of folate:

• Spread a little avocado on your sandwich in place of mayonnaise
• Drink a glass of orange juice or tomato juice in the morning
• Add spinach to your scrambled eggs
• Slice a banana on top of your breakfast cereal
• Sprinkle some toasted wheat germ on top of pasta or a stir-fry
• Throw some chickpeas or kidney beans into a salad
• If you take a vitamin supplement, make sure it contains folate