Pitkin RM. Folate and neural tube defects. The American journal of clinical nutrition. 2007 Jan 1;85(1):285S-8S. Our team works hard to be transparent about why we recommend certain supplements; you can read more about our dietary supplement methodology here. CDC. General information about ntds, folic acid, and folate. Centers for Disease Control and Prevention. You'll usually take folic acid for as long as you take methotrexate. You may have to take it for a long time, possibly for the rest of your life. Vitamin B12 and folate are both important for the formation of your red blood cells and DNA. A deficiency in either vitamin can lead to fatigue, weakness and anemia. Unlike folate, B12 isn’t found in plants. B12 is mainly found in meat, eggs and dairy products. Vegetarians and vegans are at a high risk of B12 deficiency. Severe vitamin B12 deficiency can lead to complications such as depression, paranoia, delusions, memory loss, incontinence and loss of taste and smell. What is MTHFR polymorphism?

If you have a higher chance of having a baby with a neural tube defect your doctor will recommended an increased dose of 5mg, taken once a day. Dose for treating folate deficiency anaemia Those who eat a well-balanced diet. Folate is found naturally in many foods including dark leafy greens, asparagus, Brussels sprouts, oranges, orange juice, nuts, beans, and peas. Most breads, cereals, and pastas are also fortified with folic acid. If you eat a variety of foods and don’t have health conditions that interfere with folate absorption, you may not benefit from a folate supplement. Huang T, Chen Y, Yang B, Yang J, Wahlqvist ML, Li D. Meta-analysis of B vitamin supplementation on plasma homocysteine, cardiovascular and all-cause mortality. Clinical nutrition. 2012 Aug 1;31(4):448-54. A polymorphic MTHFR enzyme may function with approximately 55% to 70% efficiency as compared to a normal MTHFR enzyme. The incidence of people presenting a form of polymorphism of MTHFR is about 40% worldwide. This polymorphism is associated with an increased thermolability and reduced specific activity of MTHFR in vivo, resulting in a residual enzyme activity of 65% for heterozygous carriers and only 30% for homozygous carriers. 23, 24Ishihara J, Iso H, Inoue M, Iwasaki M, Okada K, Kita Y, Kokubo Y, Okayama A, Tsugane S, JPHC Study Group. Intake of folate, vitamin B6 and vitamin B12 and the risk of CHD: the Japan Public Health Center-Based Prospective Study Cohort I. Journal of the American College of Nutrition. 2008 Feb 1;27(1):127-36. A meta-analysis of 26 randomized controlled trials found that folic acid supplementation was not associated with a decreased risk of cardiovascular disease, heart disease, or deaths from these conditions, but it was linked with a decreasing trend in risk of strokes. [21] If you're pregnant or trying to get pregnant, it's recommended you take folic acid until you're 12 weeks pregnant. It helps your baby grow normally.

Armitage JM, Bowman L, Clarke RJ, Wallendszus K, Bulbulia R, Rahimi K, Haynes R, Parish S, Sleight P, Peto R, Collins R. Effects of homocysteine-lowering with folic acid plus vitamin B12 vs placebo on mortality and major morbidity in myocardial infarction survivors: a randomized trial. JAMA. 2010 Jun;303(24):2486-94. But the relationship between folate and cancer is a complicated one, especially for people at high risk of colon cancer. [29] Colorectal adenomas, or polyps, are pre-cancerous growths in the large intestine. A multiyear trial looked at whether high-dose folic acid supplements could prevent new polyps in people who had a history of polyps. [30] The study found that taking a daily pill with 1,000 micrograms of folic acid offered no protection against new polyps, and, more worrisome, increased the risk of developing multiple or more serious polyps. Supplementation with active folate 5-MTHF bypasses the entire folate metabolization, which is potentially impaired by MTHFR polymorphism, and 5-MTHF is directly absorbed to exert the biological activity. Therefore, using 5-MTHF as a food supplement instead of FA is strongly recommended for external supplementation. 13 help your baby's brain, skull and spinal cord develop properly in pregnancy, to avoid development problems (called neural tube defects) such as spina bifida

Pharmacy product

Pure Encapsulation B12 and folate is vegan, making it a good option for those who consume a plant-based diet with a higher risk for vitamin B12 deficiency. This is because vitamin B12 is found naturally in animal products.

Some people can have symptoms and also seem to have normal levels of these vitamins. And some people may have low levels despite having no symptoms. Identifying the cause FA is first reduced to dihydrofolate by the enzyme dihydrofolate reductase (DHFR) and then to tetrahydrofolate (THF). This is a rate-limiting step, leading to DHFR’s weak activity in humans, with considerable interindividual variations. High doses of FA can lead to a rapid saturation or inhibition of the DHFR enzyme, resulting in an accumulation of unmetabolized FA (UMFA) and the UMFA syndrome. 13-17 People with MTHFR gene variants. Some people have a genetic variant of the methylenetetrahydrofolate reductase (MTHFR) gene and cannot fully convert folic acid into the active form of folate, 5-MTHF. Taking a folate supplement with methylfolate may be better than taking folic acid for this population. Note that research is ongoing for the best folate supplement form for this population. The CDC still recommends taking 400 mcg of folic acid, not 5-MTHF. However, some healthcare providers disagree, and emerging research shows that 5-MTHF may be superior. A wide variety of foods naturally contain folate, but the form that is added to foods and supplements, folic acid, is better absorbed. In January 1998, the U.S. Food and Drug Administration required food manufacturers to add folic acid to foods commonly eaten, including breads, cereals, pasta, rice, and other grain products, to reduce the risk of neural tube defects. This program has helped to increase the average folic acid intake by about 100 mcg/day. [38,39] Good sources of folate include: The indication is to take folate for 3 months before conception and to continue taking it for at least the first 3 months of pregnancy to prevent having a baby with neural tube defects (NTDs), a malformation that develops in the first 28 days of pregnancy, before many women even know that they’re pregnant. 22, 23

References

a specialist in treating blood conditions (a haematologist) – if you have vitamin B12 or folate deficiency anaemia and your GP is uncertain of the cause, you're pregnant or symptoms suggest your nervous system has been affected a specialist in conditions that affect the digestive system (a gastroenterologist) – if your GP suspects you do not have enough vitamin B12 or folate because your digestive system is not absorbing it properly