Folic acid is a water-soluble vitamin and is important for cell division, blood formation and DNA synthesis.
Many women are familiar with it from pregnancy, as it is particularly important during this time to prevent so-called spina bifida (“open back”) in the unborn child. It is recommended to take it before pregnancy occurs, as the so-called neural tube closes before the woman finds out about her pregnancy.
Folic acid: Sensitive to heat and light
Folic acid cannot be stored. Sufficient daily dietary intake is usually achieved through green vegetables (especially broccoli, spinach, cabbage, fennel), legumes, nuts, cirus fruits, whole grain products and liver. Important to know: At least 50% of folic acid is lost during cooking, as folic acid is sensitive to heat and light.
A sufficient daily requirement for an adult is 300 ug, pregnant women need approx. 550 ug and women who wish to have children should take 400 ug of folate daily.
How do you notice a folic acid deficiency?
The blood count shows a lack of folic acid in the form of so-called megaloblastic anemia, i.e. a reduced number of red blood cells, which are also enlarged. As the red blood cells bind oxygen via the iron, the first sign of this resulting anemia is often fatigue. It can also cause inflammation in the mouth(aphthae) and digestive problems.
Caution: As a vitamin B-12 deficiency causes the same type of anemia with enlargement of the individual red blood cells, the vitamin B12 level or the active form holotranscobalamin should also be determined before supplementing folate.
What causes a folic acid deficiency?
A common cause is simply too few vegetables and salad in the diet. This happens, for example, when people mainly eat industrially processed food, i.e. fast food and ready meals. A high and regular consumption of alcohol can also cause a folic acid deficiency. In addition, people who have digestive problems, such as coeliac disease, are often affected by folic acid deficiency.
Various medications interfere with the metabolism of folic acid or its absorption via the intestine. For example, methotrexate (rheumatism and cancer medication), metformin as one of the most commonly used diabetes medications and also individual antibiotics.
Genetic cause of folic acid deficiency despite sufficient intake
However, there is also a genetic cause that is not so rare: an MTHFR mutation can lead to a folic acid deficiency in the cell, even though sufficient folic acid is present. Due to an enzyme error, folic acid cannot be converted into the active form methylfolate in these cases. An indication of this is a folic acid deficiency in the red blood cells (can be determined separately), which cannot be remedied by taking folate, or an elevated homocysteine level, which cannot be reduced by taking folate and vitamin B12.
Simple solution in these cases
Take the bioactive form methyl folate immediately and for life. People who have this gene mutation often not only have frequently recurring inflammatory mouth ulcers and anemia, but also anxiety disorders, depression and early vascular abnormalities due to an increase in homocysteine. A combination of these symptoms should always suggest an MTHFR mutation.
