Folic acid has a number of names, some familiar, others not. For example, folic acid is also known as vitamin B9, and folate. One other name, pteroylglutamic acid, is so difficult to pronounce it’s no surprise one rarely sees or hears it. Folic acid is the most common used term.
Folic acid is another of those water-soluble B vitamins. As such it needs to be replaced daily, either by diet or by taking a supplement. The one difficulty with supplements like folic acid is that they can lead to an imbalance in other B vitamins, which operate interdependently. In spite of that, medical professionals observe that raising the upper limit of folic acid – to 400 micrograms daily – could potentially eliminate more than half the estimated 300,000 babies born with neural tube defects. In this instance, folic acid works best if dosing begins at least 30 days before becoming pregnant.
In the United States, the mandatory addition (by the U.S. Food and Drug Administration, or FDA) of folic acid to refined grain products, effective 1998, has reduced the prevalence of these neural tube defects. Researchers are now investigating the role of folic acid in the formation of congenital anomalies like cleft lip and cleft palate.
There is less doubt about the role of folic acid in heart disease, and the American Heart Association now recommends screening of at-risk groups with an eye toward folic acid supplementation. These groups include those with a family history of premature cardiovascular disease, malnutrition or malabsorption syndromes, hypothyroidism, kidney failure, or lupus; and individuals taking certain medications like theophylline, methotrexate, and L-dopa. Folic acid (and vitamin B12) is often prescribed to patients on Alimta, a powerful cancer drug used to treat mesothelioma.
Getting enough folic acid in one’s diet means eating organ meats (especially liver), egg yolks, dried peas and beans, nuts, wholegrain breads, potatoes, cruciferous vegetables like broccoli and Brussels sprouts, and fruits – especially citrus fruits. Foods highest in folic acid are those with the least processing. Heating destroys folic acid therefore fruits should be eaten raw to get the full folic acid benefit.