Folic acid is also known as vitamin B9, and folate. It 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 vitamin B9 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, vitamin B9 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 vitamin B9 in heart disease, and the American Heart Association now recommends screening of at-risk groups with an eye toward vitamin B9 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. Vitamin B9 (and vitamin B12) is often prescribed to patients on Alimta, a powerful cancer drug used to treat mesothelioma.
Getting enough folic acid in your 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 vitamin B9 are those that have been the least processed. Heating destroys vitamin B9 therefore fruits should be eaten raw to get the full folic acid benefit.