Not just for pregnant women, folic acid shows promise to help offset Alzheimer’s disease.
History of Folic Acid Supplementation
Since the late 1990’s, both the Canadian and American Governments have mandated the addition of folic acid to foods such as cereals and pastas, as a way to help increase dietary folic acid. One of the key reasons for this was because of the significance adequate folic acid levels have on pregnancy. Folic acid, otherwise known as B9, plays a critical role in the healthy production and division of our cells, DNA synthesis and repair, and impacts fertility, pregnancy, anemia, and cardiovascular health. A folic acid deficiency can cause neural tube defects including spina bifida. More recently, it is also being investigated for the benefits it may have on the aging brain, in particular with Alzheimer’s disease.
A recent study looked at the effect of folic acid on the beta amyloid clumping found in Alzheimer’s disease and found that folate deficiency increased beta amyloid protein levels. These increases were prevented by correcting folic acid levels (Journal of Nutritional Biochemisty, August 2015). A second study looked at the possible progression of Alzheimer’s disease due to folate deficiency and found that again, folate rich diets may prevent high levels of beta-amyloid clumping (European Journal of Nutrition, July 2015). A different study found that folic acid rich diets led to decreases in homocysteine levels, which decreased the risks for Alzheimer’s disease, since higher homocysteine levels are considered a risk factor for Alzheimer’s disease (Zhongguo Ying Yong Sheng Li Xue Za Zhi, March 2013). A last study looked at the role folic acid might have on tau phosphorylation (tau proteins comprise the tangles found in Alzheimer’s disease). This study concluded that folate deficiency could be an important step leading to tau phosphorylation in the brain (Journal of Nutrition, Health and Aging, February 2015).
Folic Acid or Folate…Are They the Same?
Having discussed the studies and the potential benefits of folic acid, it is important to clear up a common misconception. Folic acid is referred to as the synthetic or man-made version of folate and is often understand to be interchangeable. In truth, naturally occurring folate is metabolized in the small intestine whereas folic acid needs to be metabolized initially in the liver. Because the liver is somewhat limited with how much folic acid it can break down, adding high amounts of folic acid further compromises the break down process and can result in higher amounts of un-metabolized folic acid in the blood. When the blood contains elevated un-metabolized folic acid, this can pose some risks to our health. The best starting point is looking at natural folate sources.
Natural Sources of Folate
When thinking of ways to increase folate naturally in the diet, remember that the word folate comes from the Latin word ‘folium’ meaning leaf. Naturally occurring folate is found in leafy vegetables such as spinach, collard, mustard, turnip and romaine leaves. Broccoli, asparagus, some citrus fruit, beans and lentils also serve as higher sources of naturally occurring folate.
How Do I Know if I Need Folic Acid Supplementation?
Pregnant women and those seeking to become pregnant are recommended to add folic acid to help prevent neural tube defects. However, others may want to start by naturally increasing dietary folate and getting blood work done to determine folate levels. The blood tests your doctor may order could be called B12 and folate, RBC folate or folic acid. Lower levels identified by blood work could be due to dietary deficiency, absorption issues or an increased need for higher levels (pregnancy, anemia, etc.)
Folic Acid or 5-MTHF Supplements
If it is determined that folic acid supplementation is desired, look for one with ‘5-MTHF’ or ‘5- methyltetrahydrofolate’ which means the folic acid it contains is the most bioavailable form and has already bypassed some of the essential steps of metabolism in the liver. In addition to helping avoid the pitfalls of taking too much folic acid (high blood levels of un-metabolized folic acid), 5-MTHF also bypasses the common problem many people experience if they lack a particular enzyme to help break down folic acid. Additonally, 5-MTHF is an important co-factor that helps to break down excess homocysteine levels in the body. Supplementation goals are determined on an individual basis and ranges will vary but 400-500 mcg. is the most common recommendation. As always, check with your healthcare provider to check your folate levels and determine best next steps to address any imbalances.
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