Folic Acid Deficiency, Should You Supplement

A folic acid deficiency seems like something you would want to pay attention to. After all, folic acid is a B vitamin, and B vitamins are among the most popular supplements. The nutrient folic acid has gotten attention in years past. Most of this attention has been generated as a result of the need to prevent a folic acid deficiency and the complications that can occur with it.

What is a Folic Acid Deficiency?

In short, a folic acid deficiency is a bit of a misnomer. A folic acid deficiency is really a folate deficiency. Folic acid deficiency and folate deficiency sound similar, and they are, but the difference is huge.

There is some history to understand here, mostly as it relates to pregnancy. Neural tube defects, or incomplete closure of the tube that contains the spinal cord, were becoming more prolific. As a result, the government felt the need to intervene and attempt to prevent this from happening. Since the cause of this was linked to folate, the government solution was to use synthetic folic acid as a replacement for the folate. This seemed like an ideal solution. In fact, it was good enough that it decreased the number of infants born with neural tube defects dramatically. And of course you know how we as humans think. If a little is good, a whole lot more must be better.

Well it turns out that more folic acid is not a good thing, especially when you are not really treating a folic acid deficiency, but a folate deficiency. You see, folic acid is not a naturally occurring substance. You do not find it in nature anywhere. There is not a true place for it in the human body. In fact, the only source of folic acid is synthetic. In contrast, folate is a bioidentical nutrient. There are several systems in the body that are dependent on folate, just not folic acid.

Correcting a Folic Acid Deficiency Should be Easy

If you actually had a folic acid deficiency, correcting it would be very easy. All you would have to do is eat the standard American diet that is loaded with refined grains, and for the points I am making here about folic acid, probably better stated fortified grains. The whole idea that the food you are deriving from nature is so incomplete that you have to add things to it to make it “better” or “sufficient for human health” should on its own raise red flags. Since 1998, the United States has been fortifying food with folic acid, to correct the supposed folic acid deficiency, which you now know is actually a folate deficiency. Not only is this taking place in the United States, it is also taking place in around 50 other countries across the world. While neural tube defects have decreased, there is a less talked about dark side to folic acid fortification, especially if you are exceeding around 400mcg per day. Ironically the amount of folic acid recommended for child-bearing women is 400-800mcg.

The Result of Correcting a Folic Acid Deficiency

Correcting the supposed folic acid deficiency by supplementing the entire population seems risky. Rarely does a “one size fits all” approach make for good health care. In fact, in the case of supplementing folic acid through mandatory fortification of foods, it is a bad idea. The reason is that universal fortification increases the risk of some cancers. According to medical literature the progression of pre-existing cancers through the stages of severity is increased by the availability of folic acid. The form of cancer that appears to be the most impacted is colon cancer. In fact, in the United States and Canada, a rise in colorectal cancer was seen the following three years after the initiation of the fortification of foods. Clearly there is an upper limit to the amount of folic acid that you should be used.

Apart from affecting cancer outcomes, folic acid has the additional concerns of masking a B12 deficiency with the possible implication of affecting the red blood cells and anemias as well as degeneration of the nervous system. There is some concern also about interactions with certain classes of medications.

How to Address Your Folic Acid Deficiency

First, understand that you don’t have a folic acid deficiency. If you have a deficiency of B9, what you have is a folate deficiency. A folate deficiency is not uncommon and is something that I observe on testing routinely. As all of the aforementioned information lays out, if you are going to supplement for a “folic acid deficiency”, then you need to avoid folic acid and use folate for repletion. Folate has not been shown to have an upper limit to use. That seems fairly logical since it is a bioidentical nutrient that we easily find in nature. If you really want to easily avoid of folic acid and only ingest folate, this can be accomplished by limiting your diet to Paleo principles and staying clear of all processed foods.

Resource: The Mandatory Fortification of Staple Foods with Folic Acid