Folic acid, History, Best uses, use in Pregnancy, Side effects, Benefits, Dosage and Price

Folic Acid: An Essential Nutrient for Health and Development

Folic acid, also known as vitamin B9, is a vital nutrient essential for overall health and development. It is crucial in various bodily functions, including cell growth and reproduction. It also essential during pregnancy, as it helps in the formation of the neural tube, which eventually develops into the baby’s brain and spine, preventing serious birth defects known as neural tube defects (NTDs).

History of Folic acid

The history of folic acid, also known as vitamin B9, is marked by several significant scientific discoveries and developments throughout the 20th century. These milestones collectively advanced our understanding of this vital nutrient and its importance in human health.

Early Discoveries

In the 1930s, British scientist Lucy Wills made a groundbreaking discovery while researching tropical macrocytic anemia, a severe type of anemia prevalent among pregnant women in India. She identified a “new hemopoietic factor” present in yeast and liver extracts that could cure this condition in humans and experimental anemia in monkeys. This unidentified substance, which would later be recognized as a form of folate, was initially termed the “Wills factor” by researchers Janet Watson and William B. Castle.

Identification and Early Research

Subsequent studies demonstrated that this unknown substance was also effective against nutritional pancytopenia in monkeys and experimental anemia in chicks. Due to its activity in different species, it received various interim designations, such as vitamin M (for monkey) and vitamin B(c) (for chick). Additionally, researchers noted its growth-promoting effects on microorganisms like Lactobacillus casei, leading to the use of names like folic acid, reflecting its abundance in leafy green vegetables.

Isolation and Synthesis

The race to isolate and identify the Wills factor led to significant competition among pharmaceutical research teams. In the early 1940s, Robert Stokstad at Lederle Laboratories and Joseph John Pfiffner at Parke-Davis Research Laboratory independently succeeded in isolating factors that exhibited the biological properties of the Wills factor. Lederle Laboratories extracted the factor from a bacterial culture, while Parke-Davis obtained it as a conjugate of folate from yeast and liver.

Between 1943 and 1945, the isolated substance was crystallized, chemically identified, and synthesized as Pteroylglutamic acid, which was then named folic acid. This breakthrough enabled the production of folic acid in large quantities, facilitating its use in dietary supplements and fortified foods.

Further Studies and Applications

Throughout the 1950s and beyond, extensive research continued on the different forms of folate, including the monoglutamic form (folic acid) and the polyglutamyl form found in yeast isolates. These studies expanded the understanding of folic acid’s role in health, particularly its importance in DNA synthesis, repair, and cell division.

Public Health Impact

One of the most significant public health impacts of folic acid was its role in preventing neural tube defects (NTDs) in newborns. Research in the late 20th century revealed that adequate intake of folic acid before conception and during early pregnancy dramatically reduces the risk of NTDs such as spina bifida and anencephaly. This led to widespread recommendations for women of childbearing age to take folic acid supplements and the implementation of folic acid fortification programs in many countries.

Mechanism of Action: How Folic Acid Works in the Body

Folic acid, also known as vitamin B9, exerts its beneficial effects in the body through various mechanisms. It is a water-soluble vitamin that plays a crucial role in several essential metabolic processes. Understanding the mechanism of action of folic acid helps shed light on its importance and the ways it supports overall health.

Conversion to Active Forms

When we consume folic acid, it undergoes a process known as reduction and methylation within the body to become biologically active. This conversion primarily occurs in the liver and other tissues. Folic acid is transformed into its active forms, primarily 5-methyltetrahydrofolate (5-MTHF), which is the metabolically active form of folate that the body can readily use.

DNA and RNA Synthesis

One of the primary functions of folic acid is its involvement in DNA and RNA synthesis. Folate, in the form of 5-MTHF, is essential for the production and repair of DNA. It provides the necessary methyl groups for the synthesis and maintenance of DNA strands, which are crucial for cell division, growth, and development.

Amino Acid Metabolism

Folic acid also plays a critical role in amino acid metabolism. It is involved in the conversion of the amino acid homocysteine to methionine. This process requires the enzyme methionine synthase, which relies on folate as a coenzyme. By participating in this conversion, folic acid helps regulate homocysteine levels in the blood. Elevated levels of homocysteine are associated with an increased risk of cardiovascular disease.

Red Blood Cell Formation

Folic acid is vital for the production of red blood cells, a process called erythropoiesis. It supports the maturation and division of red blood cell precursors in the bone marrow. Adequate folic acid levels are necessary to prevent megaloblastic anemia, a condition characterized by the production of abnormally large and immature red blood cells.

Neural Tube Development

Folic acid plays a crucial role in the development of the neural tube in embryos. During early pregnancy, the neural tube develops into the baby’s brain and spinal cord. Adequate folic acid intake before and during pregnancy is essential for the proper closure of the neural tube, reducing the risk of neural tube defects (NTDs) such as spina bifida and anencephaly.

Methylation Reactions

Folic acid is involved in various methylation reactions throughout the body. Methylation is a process that adds a methyl group to molecules, which can affect gene expression, neurotransmitter synthesis, and other essential functions. Folic acid provides the necessary methyl groups for these reactions, contributing to proper cellular function and overall health.

Folic acid Uses

Folic acid, also known as vitamin B9, is utilized for various purposes due to its essential role in the body. Here are some common uses of folic acid:

1. Preventing Folate Deficiency: It is used to prevent and treat low blood levels of folate, known as folate deficiency. Folate deficiency can occur due to poor diet, certain medical conditions, alcoholism, or pregnancy. Adequate folate levels are crucial for the formation of healthy red blood cells and overall health.
2. Reducing the Risk of Birth Defects: Folic acid supplementation is recommended for women who are pregnant or planning to become pregnant. Taking this supplements before and during pregnancy helps prevent major birth defects of the baby’s brain and spine, such as spina bifida and anencephaly. It is an essential nutrient for proper fetal development.
3. Treating Folic Acid-Deficiency Anemia: It is used to treat certain types of anemia caused by folic acid deficiency. Anemia occurs when the body lacks enough healthy red blood cells to carry oxygen to tissues. Folic acid supplementation can help restore folate levels and improve anemia symptoms.
4. Supporting Brain Health: It plays a crucial role in maintaining brain health and cognitive function. It is involved in neurotransmitter synthesis and helps support memory and thinking skills. Adequate folic acid intake may contribute to overall brain health and mental well-being.
5. Supporting Methotrexate Therapy: Folic acid is often prescribed alongside methotrexate, a medication used to treat conditions such as severe arthritis, Crohn’s disease, or psoriasis. Methotrexate can deplete folate levels, and folic acid supplementation helps prevent methotrexate-induced folate deficiency and reduce potential side effects.
6. Management of Hyperhomocysteinemia: Elevated levels of homocysteine in the blood are associated with an increased risk of cardiovascular diseases. Folic acid, often in combination with vitamins B6 and B12, is used to lower homocysteine levels and potentially reduce the risk of heart disease and stroke.

Folic Acid for Pregnancy

Folic acid, a B vitamin also known as vitamin B9, is of utmost importance during pregnancy. It plays a vital role in supporting the healthy development of the fetus and preventing certain birth defects. Adequate folic acid intake before and during pregnancy is essential to ensure optimal outcomes for both the mother and the baby.

Prevention of Neural Tube Defects

One of the primary reasons folic acid is recommended for pregnant women is its ability to reduce the risk of neural tube defects (NTDs). Neural tube defects are serious birth defects that affect the baby’s brain and spinal cord. By taking folic acid before conception and throughout the early stages of pregnancy, women can significantly lower the risk of NTDs, such as spina bifida and anencephaly.

Fetal Brain and Spinal Cord Development

Folic acid is crucial for the development and growth of the fetal brain and spinal cord. During the early stages of pregnancy, the neural tube forms and closes, eventually developing into the baby’s brain and spinal cord. Sufficient folic acid intake supports this process, ensuring the proper formation and closure of the neural tube, reducing the risk of NTDs.

Red Blood Cell Production

Folic acid is essential for the production of red blood cells. During pregnancy, the body undergoes significant changes, requiring increased blood volume to support the growing fetus. Adequate folic acid intake helps prevent and treat anemia during pregnancy, ensuring that the mother’s body can produce enough healthy red blood cells to support both her and the baby’s oxygen needs.

Overall Maternal Health

In addition to its specific benefits for fetal development, folic acid also supports overall maternal health during pregnancy. It aids in various metabolic processes, including the synthesis of DNA and RNA, which are crucial for cell growth and division. Folic acid also helps maintain proper immune function and plays a role in the production of neurotransmitters, supporting mental health and well-being.

Best folic acid tablets for Pregnancy

Mom folic tablets 400mcg: It helps in the formation of the neural tube, which later develops into the baby’s brain and spinal cord. It is available for Rs/160 in Pakistan.

Folic acid pregnancy dose

The recommended dose of folic acid for pregnant women may vary based on individual circumstances. However, the general guidelines suggest the following:

1. Before Pregnancy: It is recommended for women who are planning to become pregnant to start taking a daily dose of 400 micrograms (mcg) of folic acid at least one month before conception. This early supplementation helps ensure sufficient folate levels in the body to support the healthy development of the baby’s neural tube.
2. During Pregnancy: Throughout the first 12 weeks of pregnancy, it is generally advised to continue taking a daily dose of 400 mcg of folic acid. This period is crucial for the formation and closure of the neural tube. Adequate folic acid intake during this time helps reduce the risk of neural tube defects.
3. High-Risk Pregnancies: Some women may have specific risk factors that require higher doses of folic acid. These risk factors may include a history of previous pregnancies affected by neural tube defects, certain medical conditions, or the use of medications that interfere with folate metabolism. In such cases, healthcare professionals may recommend an increased dose of folic acid, typically 5 milligrams (mg) per day.

Side Effects of Folic Acid

Folic acid, the synthetic form of vitamin B9, is generally considered safe when taken at recommended levels. However, like any supplement, it can cause side effects in some individuals, particularly at higher doses. Here are the potential side effects and considerations associated with folic acid supplementation:

Common Side Effects

Most people do not experience significant side effects when taking folic acid within the recommended daily intake. However, some may experience mild side effects, including:

1. Nausea: Some individuals might feel queasy or experience stomach discomfort.
2. Bloating and Gas: Gastrointestinal disturbances such as bloating, gas, or a feeling of fullness can occur.
3. Loss of Appetite: A reduced desire to eat is another potential mild side effect.
4. Bitter Taste in Mouth: Some people report a metallic or bitter taste after taking folic acid supplements.
5. Sleep Disturbances: Insomnia or difficulty sleeping may be experienced by some individuals.

Rare Side Effects

In rare cases, folic acid can cause more serious side effects, particularly when taken in large doses over extended periods:

1. Allergic Reactions: Though uncommon, some individuals may experience allergic reactions such as skin rash, itching, redness, and difficulty breathing. Severe allergic reactions (anaphylaxis) require immediate medical attention.
2. Seizures: High doses of folic acid may potentially trigger seizures in individuals with seizure disorders.
3. Behavioral Changes: There have been isolated reports of mood swings, irritability, or other changes in behavior.

Folic Acid Benefits for Men

Folic acid, also known as vitamin B9, provides several benefits for men’s health. While it is commonly associated with pregnancy and women’s health, folic acid is important for men as well. Here are some of the potential benefits of folic acid for men:

1. Sperm Health: It plays a vital role in the production and maturation of sperm. It contributes to the overall quality, motility, and DNA integrity of sperm cells. Adequate folic acid levels may help support male fertility and reproductive health.
2. Cardiovascular Health: Folic acid has been associated with a reduced risk of cardiovascular diseases in both men and women. It helps lower levels of homocysteine, an amino acid that, when elevated, is linked to an increased risk of heart disease. By reducing homocysteine levels, folic acid may promote heart health.
3. Mental Health and Cognitive Function: It is involved in the synthesis of neurotransmitters, such as serotonin, dopamine, and norepinephrine, which play a crucial role in mood regulation and mental well-being. Adequate folic acid intake may support mental health and cognitive function in men.

Folic acid tablet price in Pakistan

Iberet Folic tablet 500mg: It is a medication that contains folic acid available for Rs/235.85

Tri-hemic tablets 600mg: Tri-hemic tablet is used to treat anemia. It also contain folic acid which is available for Rs/123.30 in all Pharmacies in Pakistan.

Fefol vit Capsule: It is a medication that contains folic acid available for Rs/281.53 in all Pharmacies in Pakistan.