Folic Acid (Vitamin B-9)

BASIC INFORMATION

Folic acid is also called folate, pteroyglutamic acid,
folacin.
Brand names:
Folic-Acid Tablets
Apo-Folic(R)
Folvite(R)
Novofolacid(R)
Vitamin B-9(R)
Available from natural sources? Yes
Available from synthetic sources? Yes
Prescription required? Yes, for injectable forms
Fat-soluble or water-soluble? Water-soluble

NATURAL SOURCES

Barley
Beans
Brewer's yeast
Calves' liver
Endive
Fruits
Garbanzo beans (chickpeas)
Green, leafy vegetables
Lentils
Orange juice
Oranges
Peas
Rice
Soybeans
Split peas
Sprouts
Wheat
Wheat germ

REASONS TO USE

Promotes normal red-blood-cell formation.

Maintains nervous system, intestinal tract, sex organs, white blood cells, normal patterns of growth.

Regulates embryonic and fetal development of nerve cells.

Promotes normal growth and development.

Treats anemias due to folic-acid deficiency occurring from alcoholism, liver disease, hemolytic anemia, sprue, pregnancy, breast-feeding, oral-contraceptive use.

UNPROVED SPECULATED BENEFITS

Prevents mental problems.

Acts as a natural analgesic or pain killer.

WHO NEEDS ADDITIONAL AMOUNTS?

Anyone with inadequate caloric or nutritional dietary intake or increased nutritional requirements.

Older people (over 55 years).

Pregnant or breast-feeding women.

Women who use oral contraceptives.

Those who abuse alcohol or other drugs.

People with a chronic wasting illness, excess stress for long periods or those who have recently undergone surgery.

Those with a portion of the gastrointestinal tract surgically removed.

People with recent severe burns or injuries.

Young infants not receiving breast milk or fortified commercial formula.

Extremely ill people who must be fed intravenously or by nasa-gastric tube.

DEFICIENCY SYMPTOMS

Hemolytic and megaloblastic anemia in which red blood cells are large and uneven in size, have a shorter life span or are likely to have cell membranes rupture

Irritability

Weakness

Lack of energy

Sleeping difficulties

Paleness

Sore red tongue

Mild mental symptoms, such as forgetfulness and confusion

Diarrhea

UNPROVED SPECULATED SYMPTOMS

Depression

Cervical dysplasia

Psychosis

LAB TESTS TO DETECT DEFICIENCY

Serum folic acid

Blood cells showing macrocytic anemia coupled with normal levels of B-12 in blood

DOSAGE AND USAGE INFORMATION

Age	RDA
0-6 months	30mcg
6-12 months	45mcg
1-3 years	100mcg
4-6 years	200mcg
7-10 years	300mcg
11+ years	400mcg
Pregnant	+400mcg
Lactating	+100mcg

What this vitamin does:

Acts as co-enzyme for normal DNA synthesis.

Functions as part of co-enzyme in amino acid and nucleoprotein synthesis.

Promotes normal red-blood-cell formation.

Miscellaneous information:

Cooking vegetables causes loss of some folic-acid content.

Available as:

Tablets: Swallow whole with full glass of liquid. Don't chew or crush. Take with meals or 1 to 1-1/2 hours after meals unless otherwise directed by your doctor. NOTE: Folic acid is sometimes omitted from multivitamin/mineral preparations. Check labels.

WARNINGS AND PRECAUTIONS

Don't take if you:

Have pernicious anemia. Folic acid will make the blood appear normal, but neurological problems may progress and be irreversible.

Take anti-convulsant medication.

Consult your doctor if you have:

Anemia

Over age 55:

No problems expected.

Pregnancy:

No problems expected.

Don't take megadoses.

Breast-feeding:

No problems expected.

Don't take megadoses.

Effect on lab tests:

May cause false-low results in tests for vitamin B-12.

Storage:

Store in cool, dry place away from direct light, but don't freeze.

Store safely out of reach of children.

Don't store in bathroom medicine cabinet. Heat and moisture may change action of vitamin.

Others:

Renal dialysis reduces blood folic acid. Patients on dialysis should increase RDA by 300%.

OVERDOSE/TOXICITY

Signs and symptoms:
Prolonged use of high doses can produce damaging folacin
crystals in the kidney. Doses over 1,500mcg/day can cause
appetite loss, nausea, flatulence, abdominal distension, may
obscure existence of pernicious anemia.

What to do:

For symptoms of overdosage: Discontinue vitamin, and consult doctor. Also see ADVERSE REACTIONS OR SIDE EFFECTS section below.

For accidental overdosage (such as child taking entire bottle): Dial 911 (emergency), 0 for operator or your nearest Poison Control Center.

ADVERSE REACTIONS OR SIDE EFFECTS

Reaction or effect	What to do
Bright-yellow urine (always)	Nothing.
Diarrhea	Discontinue. Call doctor
	immediately.
Fever	Discontinue. Call doctor
	immediately.
Skin rash	Discontinue. Call doctor when
	convenient.

INTERACTION WITH MEDICINE, VITAMINS OR MINERALS

Interacts with	Combined effect
Analgesics	Decreases effect of folic
	acid.
Antibiotics	May cause false-low results
	in tests for serum-folic acid.
Anti-convulsants	Decreases effect of folic
	acid and anti-convulsant.
Chloramphenicol	Produces folic-acid
	deficiency.
Cortisone drugs	Decreases effect of folic
	acid.
Methotrexate	Decreases effect of folic
	acid.
Oral contraceptives	Decreases effect of folic
	acid. Those who take oral
	contraceptives require
	additional folic acid.
Phenytoin	Decrease phenytoin effect.
	Patients taking phenytoin
	should avoid taking folic
	acid.
Pyrimethamine	Decreases effect of folic
	acid and interferes with
	effectiveness of
	pyrimethamine. Avoid this
	combination.
Quinine	Decreases effect of folic
	acid.
Sulfasalazine and other sulfa	Decreases effect of folic
drugs	acid.
Trimethoprim	Decreases effect of folic
	acid.
Trimterene	Decreases effect of folic
	acid.

INTERACTION WITH OTHER SUBSTANCES

Tobacco decreases absorption. Smokers may require supplemental folic acid.

Alcohol abuse makes deficiency more likely. Alcoholism is the principal cause of folic-acid deficiency.