Folacin
Over the years, folic acid has been called by many names, but folacin is the name now officially used. The term "folate" remains popular and is used to encompass the entire group of folate vitamin forms: the natural "folypolyglutamates" found in food, and "folic acid" (pteroylglutamic acid), the synthetic form added to dietary supplements and fortified foods. Other names include: Vitamin Bc, folate, Wills' factor, pteroylmonoglutamic acid (PGA), antianemia factor PGA, Vitamin M, SLR factor, factor R, factor U, factor CF, CF, factor LC, leucovorin, Vitamin U, Liver lactobacillus casei factor, citrovoram factor, yeast norit eluate factor, folsaure, Cytofol, Foldine, Folacin, Folaemin, Foliamin, Folicet, Folipac, Folettes, Folsan, Folvite, Incafolic, Millafol, Vitamin B9, Vitamin B10, and Vitamin B11.
When it was first isolated in 1941 from spinach, it was called folic acid because it was derived from "an abundance of green leaves," otherwise known as "foliage." But long before this isolation took place, its deficiency symptoms had been recorded when incidents were found in humans, animals, and microorganisms. One such incident occured in 1931 when a doctor in India was confronted with a macrocytic anemia in pregnant women that improved when extracts of yeast were given.
"Folic acid" was a generic name originally applied to a number of compounds having the same biologic properties as PGA (pteroylglutamic acid), as well as other compounds having the same activity including folinic acid, citrovorum factor, and leucovorin. Citrovorum factor is a derivative of folacin metabolized in the liver that is required for the growth of Leuconostoc citrovorum. Leucovorin is the calcium salt derivative used as an antidote for folacin antagonists and to treat folacin deficiencies.
Over the years, folic acid has been called by many names, but folacin is the name now officially used. The term "folate" remains popular and is used to encompass the entire group of folate vitamin forms: the natural "folypolyglutamates" found in food, and "folic acid" (pteroylglutamic acid), the synthetic form added to dietary supplements and fortified foods. Other names include: Vitamin Bc, folate, Wills' factor, pteroylmonoglutamic acid (PGA), antianemia factor PGA, Vitamin M, SLR factor, factor R, factor U, factor CF, CF, factor LC, leucovorin, Vitamin U, Liver lactobacillus casei factor, citrovoram factor, yeast norit eluate factor, folsaure, Cytofol, Foldine, Folacin, Folaemin, Foliamin, Folicet, Folipac, Folettes, Folsan, Folvite, Incafolic, Millafol, Vitamin B9, Vitamin B10, and Vitamin B11.
When it was first isolated in 1941 from spinach, it was called folic acid because it was derived from "an abundance of green leaves," otherwise known as "foliage." But long before this isolation took place, its deficiency symptoms had been recorded when incidents were found in humans, animals, and microorganisms. One such incident occured in 1931 when a doctor in India was confronted with a macrocytic anemia in pregnant women that improved when extracts of yeast were given.
Tetrahydrofolate is the "enzyme helper" that is formed when folacin is absorbed in the small intestine and then converted in the liver to folinic acid, the active metabolite. This conversion is enhanced by ascorbic acid (Vitamin C). Tetrahydrofolate then transfers single-carbon fragments from amino acid breakdown to create building blocks of purines and thymine for DNA and RNA production. As in all construction, when the materials are unavailable, the building cannot go up, and DNA synthesis halts in all cell replication. Tetrahydrofolate plays an important role in recycling methionine required to synthesize choline, a chemical needed to carry signals between nerve cells. It is also necessary in the production of epinephrine, a hormone that helps the body adapt to stress. These have the ability to increase the appetite after a long illness, act as a natural analgesic, and are an essential part of cell division especially in the formation of red blood cells and in cells of the immune system. In mice, severely reduced intakes of folacin were found to impair their immune response to the retrovirus.
The body can store folacin for about three to six months. The average American diet contains about 0.2 mg. of folic acid. However, with the consumption of medications and foods that interfere with its absorption and utilization, these figures cannot be considered sufficient.
Folacin deficiency is one of the most common vitamin deficiencies in the world as a whole. Those most at risk include alcoholics, women taking oral contraceptives, pregnant women, the elderly, and those who rely primarily on convenience/processed foods. US Public Health Service, as well as Canadian health authorities, advise women of child-bearing age to consume at least 400 mcg. of folic acid daily to reduce the chances of delivering a fetus with neural tube defects, which include spina bifida and anencephaly (an absence of the cranial vault). It is estimated that in doing so, a 50% to 70% reduction of such cases could result (Dec. 6, 1995 issue of JAMA). An estimated 4000 children in the US are born each year with such defects.
In a recent newspaper article, David Stonehouse (Ottawa Citizen News) reported that doctors are just not telling women that something as simple as a vitamin could prevent severe birth defects. Dr. Gideon Koren of Toronto's Hospital for Sick Children, who advises around 200 women a day, agrees stating that "This is the first birth defect in the history of mankind that a simple nutritional change can prevent." In order to be effective, however, folacin must be taken before pregnancy takes place. Since many pregnancies are unplanned, it is advisable for all child-bearing age women to include a good multiple vitamin in their daily routine. It is interesting to note that the average medical school graduate has less training in nutrition than the average weight loss counselor. This could be the reason for doctors not telling patients anything about nutrition. Couple this with the fact that medical education is based upon lucrative pharmaceutical perspectives, few doctors have the incentive to further study aspects of nutrition.
Many foods contain folacin, but not in amounts necessary to prevent severe birth defects, especially if the woman happens to be a smoker who also consumes too many caffeinated drinks. These practises usually go hand-in-hand with a poor overall diet contributing to nutritional deficiencies including folacin. Folacin deficiencies have also been linked to gestational toxemia, some types of cancer (lung, esophagus, breast, colon), and cervical dysplasia which is a precancerous state.
University of Washington researchers (JAMA, Oct. 14, 1995) found that by taking folacin, as many as 50,000 deaths attributed to artery disease, could be prevented. Studies have shown that when folacin consumption is low, the risk of heart attack and heart disease rises. The link seems to be with homocysteine, a derivative of the amino acid, methionine. Homocysteines are sulfur-containing amino acids that have been linked to several medical problems, including atherosclerosis. When homocysteine blood levels are high, the greater is the risk of atherosclerosis leading to heart attacks and strokes. Homocysteine injures blood vessels and accumulates when the presence of folacin is low, but the condition improves substantially with supplemental folacin of at least 400 mcg. daily.
Folacin deficiency symptoms include fatigue, numbness/tingling in hands and feet, slow/weak pulse, decreased number of white blood cells, decreased immunity, thinning hair, weakness, skin pallor, depression, diarrhea, sore/inflamed tongue, megaloblastic anemia, digestive disturbances, and retarded growth. Deficiencies can also produce mental symptoms such as irritability, weakness, apathy, and hostility.
The megoblastic anemias of pregnancy and infancy responds readily to folic acid therapy and diet adjustment. Megoblastic anemia results from defective DNA synthesis (RNA synthesis continues) when the primitive RBC's (red blood cells) do not properly mature and become much larger than the mature normal erythrocytes. It differs from pernicious anemia that results from a B12 deficiency. Another distinguishing factor is the neurologic lesions seen in B12 deficiency but does not occur with a folacin deficiency. However, folacin deficiency is indistinguishable from a B12 deficiency when it comes to peripheral blood and bone marrow findings.
As with other B vitamins, cooking and processing destroys folacin. As yet, it is not required to be added back into foods although, in 1993, the FDA suggested that it be added to grain and bread products to the tune of 0.14 mg./100 g. or roughly 40-70 mcg. per slice. The RDA is 200 mcg. for men and 180 mcg. for non-pregnant/non-lactating women. The RDI recommendation is 400 mcg for adults. At least half of all women of child-bearing age consumes less than the RDA for this vitamin.
B12 and folic acid have proven to reduce precancerous growths in smokers. Deficiencies in these two nutrients predisposes smokers to lung changes. Studies dating back to the 1970's demonstrated that precancerous cervical cells could be eliminated with large doses of B12 and folacin, yet designer drugs are still pushed as being the only answer despite their dismal "cure" rates. Even the Cancer Institute in the 1980's found that patients with some precancerous conditions had low levels of folic acid in the blood, but these findings were essentially dismissed. Since pharmaceutical companies fund the Institute, they, no doubt, wanted a "cure" that was more lucrative.
Causes of folic acid deficiency:
1) Drugs (see below)
2) Enzyme deficiencies either congenital or acquired through liver diseases
3) B12 deficiency
4) Alcohol
5) A Vitamin C deficiency
6) Excesses of certain amino acids in the diet (glycine and methionine)
7) Increased requirements in pregnancy, malignancies, infancy, increased blood production that occurs in some disorders, and increased exertion
8) Estrogen
There are other inhibitors that cause a reduction in the levels of folacin found in foods. These include: water and heat (it is a water soluble vitamin, so cooking releases the vitamin from the food and into the water which is generally thrown away), sunlight (destroys many nutrients after harvesting when a product is left sitting for long periods in a market, for example), and food processing.
Helpers that provide assistance in the metabolic process of folacin include: Vitamin B Complex, Vitamins B5, B12, B13, Bw (biotin), and C. Without them, folacin absorption and utilization is substantially diminished or cannot occur at all.
Although there is more chance of acquiring a deficiency of folacin, toxicities do develop when too much is taken without the proper knowledge. These toxicities include: GI upsets, emotional agitation, nervousness, altered sleep patterns, and allergic skin reactions.
CAUTIONS:
1) Megadoses of 10-20 grams per day may induce convulsions in epileptics. In fact, supplements are not recommended for people with a history of convulsive disorders or hormone-related cancers.
2) Folacin does not totally block zinc absorption, but it does interfere with it.
3) Folacin supplementation can mask a B12 deficiency, which is common in the elderly, and can eventually lead to nerve damage. Consequently, folacin and B12 should be taken together. In fact, it is advisable to take all of the B vitamins together to avoid producing a deficiency in any one of the others.
4) Excessive intake is not recommended, unless well supervised, because it can mask a diagnosis for pernicious anemia as well as other deficiencies. In lab testing, large doses produced kidney damage.
5) Since it is known to interfere with numerous medications, watch especially for the masking of certain blood test levels. For example, hematocrit testing may appear normal when, in fact, it is not.
6) A number of medications interfere with the uptake of folacin, including: oral contraceptives, glucocorticoids, barbiturates, anacids, aspirin and other salicylates, anticonvulsants, antimalarials, antibacterials, cholestyramines (used to treat high cholesterol) methotrexate (anticancer drug) and other related chemotherapeutic drugs, triamterene (a component in potassium-sparing diuretics Dyazide and Maxide), antitubercular drugs, sulfa medications, alcohol excess, tetracycline, pyrimethamine (used in the treatment of malaria and toxoplasmosis), pentamidine (a drug used in the treatment of pneumocystis carinii pneumonia most frequently seen in AIDS patients), trimethoprim (an antibacterial used alone or with sulfa drugs); and anticonvulsants.
7) Such seizure disorder drugs as phenytoin (Dilantin), carbamazepine (Tegretol), phenobarbital, and primidone can interfere with absorption of vitamins particularly folic acid. On the other hand, large doses of folic acid can block the effectiveness of phenytoin.
