Join Dr. James Odell for Season 2 of the Science of Self-Healing Podcast! He's the Medical and Executive Director for BRMI, as well as a practicing naturopathic doctor for over 35 years, and he's here to share with you his extensive knowledge of medicine from a different perspective.
Join Dr. Odell, as he unveils the surprising truth about the two forms of vitamin B9 - folate and folic acid. In this eye-opening episode, you'll discover why making the right choice could be the missing link to your health and wellness.
Dive deep into the:
Crucial differences between natural folate and synthetic folic acid.
Remarkable health benefits of folate and risks of folic acid consumption.
Insider tips to ensure you're getting adequate natural folate from your diet.
Whether you're interested in nutrition, pregnancy, or general wellness, this episode is packed with valuable insights to help you make informed dietary choices. Tune in to understand why choosing folate over folic acid is critical for a happy and healthy life!
Transcript: The Hidden Dangers of Folic Acid: Health Concerns You Need to Know
Hello, everyone, and welcome to the Science of Self-Healing podcast. For health and wellness knowledge from a different perspective. Produced by the Bioregulatory Medicine Institute, also known as BRMI. We are your source for unparalleled information about how you can naturally support your body's ability to regulate, adapt, regenerate, and self-heal. I'm your host, Dr. James Odell, the medical and executive director for BRMI, as well as a practicing naturopathic doctor for over 35 years. And remember, this podcast is for informational purposes only and is not intended to be a substitute for the direct care of a qualified health professional who oversees and provides unique and individual care. The information here is to broaden our different perspectives and should not be construed as medical advice or treatment. Let's get started.
Hello everyone and welcome to another episode of the science of self-healing. In this podcast, we'll explore three key topics related to folate and the toxic synthetic folic acid. First, we'll discuss the crucial distinctions between natural folate and synthetic folic acid. Next, we'll examine the health benefits of folate and the potential risks associated with the intake of folic acid. Finally, we'll provide practical advice to ensure you're getting an adequate intake natural folate an essential vitamin. I may repeat myself in this podcast as some of this information is a bit complicated.
Our discussion will highlight why understanding these differences matters for your health and offer actionable information to help you make informed dietary choices. Whether you're concerned about nutrition, pregnancy, or general wellness, this episode will provide valuable insights into the role of folate in your body and how to optimize your intake.
So, what is the difference between folate and folic acid?
You might hear people talk about "folate" or "folic acid" - they're related but vastly different in the way they are metabolized in the body. Folate is part of the B-vitamin family and is also called vitamin B9. Folate is required for DNA synthesis and epigenetic regulation and is crucial during early pregnancy to reduce the risk of birth defects of the brain and spine. Folate deficiency has been linked with an increased risk of neural tube defects, cardiovascular disease, cancer, and cognitive dysfunction.
Folate is naturally occurring in many foods such as dark green leafy vegetables, beans, peas and certain nuts. Fruits rich in folate include oranges, lemons, bananas, melons, and strawberries. It dissolves in water, which means our body can't store large amounts of it. We need to get folate regularly from the foods we eat.
Food folates are hydrolyzed to the monoglutamate form in the gut before absorption by active transport across the intestinal mucosa. Therefore, before entering the bloodstream, the monoglutamate form is reduced to tetrahydrofolate (THF) and converted into methyl forms (5-MTHF).
Thus, when we eat foods with folate, our intestine turns it into a form it can use, called tetrahydrofolate (THF for short). THF is the active form that our body can utilize to do important metabolic functions.
So, let’s talk about the man-made, synthetic and toxic version of folate, folic acid.
Folic acid is a synthetic form of folate, and it was first created in a laboratory in 1943. Thus, folic acid doesn’t occur naturally and has no biological functions. To be utilized, the human body must metabolize and reduce it to 5-MTHF using a multistep enzymatic conversion in the liver. The process robs methyl molecules necessary for the conversion of methionine into homocysteine and homocysteine into cysteine.
Specifically, folic acid 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. Even minimal quantities of folic acid can lead to a rapid saturation or inhibition of the DHFR enzyme, resulting in an accumulation of unmetabolized folic acid causing unmetabolized folic acid syndrome. Also, unmetabolized folic acid may compete with natural folate (5-MTHF) for the folate transporter and the folate receptor, thus depleting active folate for participation in the metabolic cycles.
A 2014 published study clearly showed that 86% of FA in the hepatic portal vein is unmetabolized, while almost all the natural folate was converted correctly.
Before folic acid’s creation, humans had never been exposed to this compound – and that is most likely a big problem.
In 1998, the U.S. government mandated the addition of folic acid to certain staple grain products, including enriched breads, flour, cornmeal, pasta, and rice. This decision was based on evidence that folate intake before and during early pregnancy significantly reduces the risk of neural tube defects in newborns, such as spina bifida. But again, folic acid is not natural occurring folate.
The fortification level of folic acid was set at 140 micrograms per 100 grams of grain product, targeting these foods due to their widespread consumption in the American diet. Beyond mandatory fortification, many food manufacturers voluntarily add folic acid to other products like breakfast cereals and corn tortillas.
This fortification program has unfortunately led to unprecedented levels of folic acid exposure in the general population, raising serious concerns about the potential long-term effects of its high intake. I’ll get into that in a moment after I discuss the benefits of natural folate.
So, let’s get into the benefits of natural folate.
It is well established that adequate folate intake from the consumption of folate-rich foods is essential for health. But remember that the differences between folate and folic acid are like night and day.
Folate is important because it aids the complete development of red blood cells, it helps make DNA and RNA, it’s crucial for cell division and importantly reduces levels of homocysteine in the blood. Prolonged exposure to high homocysteine can damage the blood vessels, contributing to blood clots, and can lead to the onset of cardiovascular disease, including atherosclerosis, stroke, and inflammatory syndromes as well as neuronal pathologies. Because healthy blood vessels and folate levels are essential for fertility and pregnancy, high homocysteine can make it difficult to conceive and maintain a pregnancy. Thus, folate is well known for its role in preventing neural tube defects in newborns, so women of childbearing age who wish to have children must be sure to have an adequate intake before and during pregnancy.
Many sources suggest increasing folate intake 2 to 3 months prior to conception because neural tube defects occur very early in pregnancy - around the 28th day of development. This is best before pregnancy.
Another interesting function of folate is its crucial role in DNA methylation, which is a process that regulates gene expression. This means folate can influence which genes are turned on or off in your body, potentially affecting various aspects of health and development.
Also, folate may help fight depression. Studies show individuals with depression have lower serum levels of folate and dietary folate intake than individuals without depression
Now let’s talk about how you can add folate to your diet.
Excellent sources of dietary folate include vegetables such as romaine lettuce, spinach, asparagus, turnip greens, mustard greens, parsley, collard greens, broccoli, cauliflower, beets, and lentils. Not surprisingly, some of the best food sources of folate are calf liver and chicken liver. I personally do not eat liver, but some do enjoy its taste and benefits. But a word of caution – you must be careful where the liver is from as many animals are very toxic with chemicals and these concentrate in their liver. Adults typically need about 400 micrograms of folate per day, but pregnant women need more.
Interestingly, 1 cup of cooked lentils will give you almost a full serving of folate since it contains 358 mcg, although cooking can reduce this amount a bit. Avocados are also a good choice at 90 mcg per cup, beef liver is about 215 mcg per 3 oz., and chickpeas are about 142 mcg per cup. Lastly, yellow passionfruit is exceptionally high in folate coming in at 272 mcg per 100 grams.
You can supplement with folate if your dietary intake is inadequate. Look for products that contain or list “5-methyltetrahydrofolate” or “5-MTHF” on the label.
If you take a multivitamin, make sure to check the ingredients carefully, because most multivitamins contain folic acid, not folate.
Supplementation may be especially important for people with MTHFR genotypes. People with MTHFR genotypes tend to have blood folate levels about 16% lower than people without the mutation when consuming the same amount of folate.
Naturally occurring 5-MTHF has important advantages over synthetic folic acid – it is well absorbed even when gastrointestinal pH is altered and its bioavailability is not affected by metabolic defects. Using 5-MTHF instead of folic acid reduces the potential for masking hematological symptoms of vitamin B12 deficiency, reduces interactions with drugs that inhibit dihydrofolate reductase and overcomes metabolic defects caused by methylenetetrahydrofolate reductase polymorphism. Use of 5-MTHF also prevents the potential negative effects of unconverted folic acid in the peripheral circulation.
Remember that folic acid is the fully oxidized and synthetic form of the vitamin folate found in supplements and fortified foods and does not occur naturally in foods.
Some researchers have raised alarms about the potential risks of long-term, high-level intake of folic acid, especially because our body handles folic acid differently than natural folates. Unlike natural folates, which are easily processed by the body, folic acid requires a two-step conversion in the liver to become usable. However, the human liver isn't highly efficient at this, leading to unmetabolized folic acid circulating in the bloodstream when intake is excessive.
Studies have found that excessive folic acid intake has been associated with increased cancer risk, particularly in older adults or those with pre-existing conditions.
For instance, in Norway, where food isn't fortified with folic acid, patients with ischemic heart disease who received folic acid plus vitamin B12 treatment saw higher cancer rates and overall mortality.
Similarly, studies in the United States, Canada, and Chile linked folic acid supplementation programs with a rise in colon cancer prevalence.
A randomized control trial also found an increased risk of prostate cancer with daily supplementation of just 1 mg of folic acid.
Why might folic acid increase the risk of cancer?
Well, some research suggests that high folic acid levels impair natural killer cells in the immune system, weakening the body's ability to combat cancer cells.
There are additional concerns about excess folic acid masking vitamin B12 deficiency, particularly in older adults. This masking effect could lead to cognitive decline and anemia in seniors with low B12 levels -- possibly due to central nervous system deterioration. For example, older adults consuming more than 400 micrograms of folic acid daily experienced a significantly faster rate of cognitive decline than non-supplement users. Another study found a higher prevalence of anemia and cognitive impairment in older adults with low B12 status who had high folic acid intake, suggesting serious cognitive risks associated with excessive folic acid in the elderly.
B-Vitamins Work Synergistically Together
So, folate is the way to go, and it's best to get it already methylated in the form of 5-methyltetrahydrafolate.
Now let’s talk about other B vitamins you can take along with folate to boost folate’s benefits. It’s important to understand that b vitamins work synergistically with each other, and folate is no exception.
First up, is Vitamin B12. Vitamin B12 (cobalamin) and folate collaborate closely in several important processes, including DNA synthesis, red blood cell formation, and homocysteine regulation. Both vitamins are crucial for DNA synthesis and cell division, and they work together to help produce healthy red blood cells. A deficiency in either can lead to anemia.
Vitamin B6 (pyridoxine) is another vitamin that complements folate's functions in amino acid metabolism, homocysteine regulation, and immune function.
Vitamin B2 (riboflavin) supports folate's functions indirectly by being necessary for the activation of folate in the body, ensuring it can perform its vital functions.
While not directly interacting with folate, vitamin B3 (niacin) complements its effects on DNA repair processes and overall cellular health and function.
The B vitamins work together to support various bodily functions, such as energy production and nervous system health. While folate is not directly involved in energy production, other B vitamins like B1, B2, B3, and B5 work together to help convert food into energy.
Folate, along with B6 and B12, also supports nervous system function.
This synergy underscores the importance of a balanced intake of all B vitamins for optimal health, as folate functions most effectively when working in concert with other B vitamins.
Conclusions
Recent data suggest the need to distinguish between naturally occurring folates and synthetic folic acid, as these terms are often mistaken and used interchangeably, both by practitioners and consumers, causing considerable confusion.
We talked a lot about avoiding processed foods and shifting over to more whole foods in the previous podcasts, and once again we see how important good nutrition is for our health. Please be sure to be on the lookout for nutrition labels and avoid foods containing synthetic folic acid. In particular, 5-methyltetrahydrofolate has been shown as a superior alternative to folic acid supplementation. Testing every pregnant woman for the existence of a mutated MTHFR gene isn’t a standard medical protocol, but probably should be. Women expressing MTHFR polymorphism are less able to transform folic acid and should be supplemented with folate as 5-methyltetrahydrofolate. Because the association between the MTHFR polymorphism and a low folate concentration has been assessed, the direct supplementation of an active form, 5-MTHF, through fertility supplements, prenatal vitamins, and dietary supplements, should be strongly considered as universally beneficial. Particularly when taken together with methylcobalamin (the methylated form of b-12) and a good b-complex. In short, always choose folate over folic acid.
Well, that’s all for this podcast, until next time - be well.
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