Folic acid is a synthetic form of vitamin B9 that is widely used in food fortification and supplements. It is commonly prescribed to women who are trying to conceive to reduce the risk of neural tube defects in their offspring. However, recent studies suggest that unmetabolised folic acid may have adverse effects on our health, including cancer, autism, and reduced DNA methylation. In this article, we will explore the risks of unmetabolised folic acid and its implications for fertility patients.
Folate Metabolism
Folate is essential for DNA synthesis and cell growth, and it plays a critical role in many biochemical reactions in the body. Folic acid, which is not found naturally in food, is converted into methyl folate or folinic acid, the active forms of folate in the body. However, this conversion process can be disrupted, leading to unmetabolised folic acid in the bloodstream.
Why Folic Acid Cannot Be Metabolised the Same Way as Methyl Folate or Folinic?
The reason why folic acid cannot be metabolised in the same way as methyl folate or folinic acid is due to the enzyme that converts it, called dihydrofolate reductase (DHFR). This enzyme has a low binding affinity to folic acid, meaning that it cannot convert it efficiently, resulting in unmetabolised folic acid in the bloodstream.
What Are the Adverse Effects of a High Level of Unmetabolised Folic Acid?
Studies suggest that a high level of unmetabolised folic acid in the bloodstream may have adverse effects on our health, including:
- Cancer: Unmetabolised folic acid has been linked to an increased risk of certain cancers, such as prostate, breast, and colorectal cancer.
- Autism: Some studies suggest that unmetabolised folic acid may increase the risk of autism in offspring.
- Reduced natural killer cell activity: High levels of unmetabolised folic acid may reduce natural killer cell activity, which plays a vital role in the immune system.
- Reduced DNA methylation: Unmetabolised folic acid may reduce DNA methylation, which can have implications for gene expression and cell function.
- Increased uracil misincorporation: Uracil is a nucleotide base that should not be present in DNA. High levels of unmetabolised folic acid may increase uracil misincorporation, which can lead to DNA damage and mutations.
How Long Does It Take to Remove Folic Acid from the Body After You Stop Eliminating It from Food and Supplements?
The clearance rate of unmetabolised folic acid from the bloodstream is not well understood. However, some studies suggest that it may take several months for the body to remove it completely.
Methyl Folate Cannot Build Up Like Unmetabolised Folic Acid, Why Is This?
Methyl folate, the active form of folate, cannot build up in the body like unmetabolised folic acid because it is converted into other forms of folate and excreted from the body.
Why Is It Important to Evaluate and Consider the Form of Folate That We Use?
It is crucial to evaluate and consider the form of folate that we use, especially for fertility patients. Methyl folate or folinic acid may be a better option than folic acid because they are the active forms of folate and do not have the adverse effects of unmetabolised folic acid. By using the appropriate form of folate, we can reduce the risk of potential adverse effects and improve the chances of a healthy pregnancy.
Food Sources:
Foods that are naturally high in folate include leafy green vegetables, such as spinach and kale, as well as beans, peas, lentils, and avocado.
Conclusion
Unmetabolised folic acid is a growing concern in the medical community, and its implications for our health cannot be ignored. While folic acid is widely used in food fortification and supplements to prevent birth defects, its conversion into active forms of folate can be disrupted, leading to the accumulation of unmetabolised folic acid in the bloodstream. This can have adverse effects on our health, including cancer, autism, and reduced DNA methylation. As healthcare practitioners, we need to be mindful of these risks, especially when it comes to fertility patients, and evaluate and consider the appropriate form of folate to use. By using the active forms of folate, such as methyl folate or folinic acid, we can reduce the risk of potential adverse effects and improve the chances of a healthy pregnancy. It is essential to continue to monitor the research on unmetabolised folic acid to ensure that we provide the best care possible for our patients.
If you have concerns about your folate levels or need guidance on incorporating folate-rich foods into your diet, consider consulting with a qualified healthcare practitioner or registered dietitian.
