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Review of B12 & Folate Research: May 2016

Tuesday, 10 May 2016 by | Comments: 1
Reading Time: 6 minutes

1-s2.0-C20090377144-cov150hAntony Haynes, BA, RNT explores two key questions realted to supplementation with B12 and Folic acid. Want to listen to a pod cast? click me

  1. Should we fortify foods with folic acid to help reduce the risk of neural tube defects (NTDs)? &
  2. Are there really dangers of ingesting too much folic acid, particularly with regard to neurological conditions?

Some countries such as the United States, Canada, Chile, Costa Rica, South Africa and others have implemented fortification policies with a risk reduction of between 20 and 50%, on average about a third.

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Reading Time: 2 minutes

Surprising new research demonstrates that diabetic neuropathy, an extremely painful condition, may respond to supplementation with the active forms of three b vitamins: methyl B12, methylfolate, and the active form of vitamin B6 (pyridoxal-5′-phosphate). In a 2011 study in the Review of Neurological Diseases, researchers reported that eleven diabetic patients with diabetic neuropathy were placed on these three supplements, and tested by means of punch biopsy before treatment and after six months of treatment. An astounding 73% of patients showed actual improvement in tissue on biopsy, and 82% reported reduced frequency and intensity of pain and numbness.(1)

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The question over fortification and supplementation with the synthetic form – monoglutamate folic acid in isolation has been brought up in context international interest in food fortification and some confusion regarding supplement recommendations.

Folic acid supplementation, the synthetic form of folate has been thrown a curve ball in the last few years because of its apparent association with an increase in colorectal cancer. In particular three papers have been flagged up; the first is by Cole[1] and his colleagues and the second by Mason[2] and the third by Hirsch.[3]

The first paper describes the results of a randomised trial of folic acid in the prevention of colonic adenoma (a type of benign colon tumour that can become malignant), where the subjects had previously had adenomas removed. In this paper the results have been incorrectly interpreted. The study does not show that folic acid supplementation poses a cancer hazard, it relates to adenomas not carcinomas – the malignant form. The actual incidence of adenomas in those who were supplemented vs. those who were not are virtually identical in the following two 3-4 year follow ups. The relative risks were 1.04 (p=0.58) and 1.13 (p=0.23).

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Folate (the naturally occurring form) and folic acid are forms of a water-soluble B vitamin (B9) that were first synthesized in 1945. Folate functions as an important cofactor in the transfer and use of 1-carbon moieties, primarily methyl groups. An important advance in understanding subclinical folate deficiency came in 1991 with the demonstration that folic acid supplementation before and during pregnancy dramatically reduced the risk of neural-tube defects in newborns. Folate supplementation of women before and during the first trimester of pregnancy has a dose-response effect in preventing neural-tube defects, ranging from a 23% reduction with 200 μg to an 85% reduction with 5000 μg of folic acid per day. The strong evidence demonstrating reduced risks of neural-tube defects led to mandatory folic acid fortification of cereal grain products in the United States by January 1, 1998. Fortification of foods with folic acid in the United States costs about $1,000 per neural-tube defect prevented. Even with all the information on the benefits of folate, many studies show inadequate folate intake among young women. Adequate folate levels have also been associated with reduced risks of coronary artery disease, colorectal cancer, and dementia.

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Folic acid, or vitamin B9, essential for red blood cell health and long known to reduce the risk of spinal birth defects, may also suppress allergic reactions and lessen the severity of allergy and asthma symptoms, according to new research from the Johns Hopkins Children’s Centre. In what is believed to be the first study in humans examining the link between blood levels of folate – the naturally occurring form of folic acid – and allergies, the Hopkins scientists say results add to mounting evidence that folate can help regulate inflammation. Recent studies, including research from Hopkins, have found a link between folate levels and inflammation-mediated diseases, including heart disease. Cautioning that it’s far too soon to recommend folic acid supplements to prevent or treat people with asthma and allergies, the researchers emphasise that more research needs to be done to confirm their results, and to establish safe doses and risks.

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