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Vitamin B9: Folate

Vitamin B9: Folate

Authored By Murigi

The health benefits of vitamin B9

Vitamin B9 is popularly known as folic acid or folate. It is an important member of the vitamin B-complex that is made up of 8 other vitamins. Folic acid is a synthetic preparation of the vitamin while folate is the naturally occurring B9. Like the other vitamins in this group, it is water soluble and so the body cannot store it for long. For this reason it has to be continually provided through the diet or nutritional supplements.

What does vitamin B9 do in the body?

Together with other vitamins in this group, vitamin B9 helps in breaking down carbohydrates to simple sugars (glucose) that the body can burn for energy. It is also needed for the metabolism of fats and proteins. Other functions include:
  • It’s a coenzyme in the nucleic acid metabolism. This is important in the control of gene expression and cell differentiation. If anything goes wrong with DNA at this point then the risk of cancer development is increased
  • Helps in metabolism of amino acids. There are a number of amino acids that are metabolized with the help of folate coenzymes. Methionine is one of the amino acid. Folate helps to synthesize this amino acid from homocysteine. A deficiency of folate may thus lead to an accumulation of homocysteine which has been associated with an increased risk of degenerative health disorders that include heart disease and dementia.

Signs and symptoms of vitamin B9 deficiency

Folate deficiency can lead to serious health problems. If a mother is deficient in the vitamin, her baby can get severe congenital problems that may include poor development of the brain and spinal cord and their related boney structures. These are called neural tube defects (NTDs). Common NTDs disorders include spina bifida and anencephaly (no brain).  Other signs and symptoms of deficiency include:
  • Generalized weakness
  • Difficulty in breathing
  • This type is referred to as megaloblastic anemia.
  • Pale skin and mucus membranes
  • Chronic fatigue
  • Irritability
  • Oral sores
  • Tongue swelling
  • Graying hair
  • Stunted growth
  • Mental fogginess
  • Diarrhea
  • Poor memory

Factors that increase risk of vitamin B9 deficiency

A diet that is low on fruits and vegetables can lead to subtle vitamin B9 deficiency and associated symptoms. Overcooked foods can lead to folate degradation and deficiency despite eating folate-rich foods. Other risk factors include:
  • Gut diseases that affect absorption of nutrients. These include
  • Pregnancy
  • Patients on medications such as phenytoin, methotrexate, certain sulfa-based drugs
  • Alcoholism
  • The elderly
  • Sickle cell disease

Sources of vitamin B9

Vegan sources of vitamin B9 include:
  • Dark green and leafy vegetables such as spinach and broccoli
  • Lima beans
  • Asparagus
  • Soybeans
  • Whole grains
  • Bulgur wheat
  • Brewer’s yeast
  • Brussels sprouts
  • Turnips
  • Beets
  • Orange juice
  • mushrooms
  • Avocado
Vitamin B9 is also available as nutritional supplements and also in fortified foods. Supplemental B9 can be natural or synthetic. The natural form is folate while the synthetic one is folic acid. Although the two are thought to work in the same way, they are not metabolized in the same way. Folic acid has to be reduced in the liver before it is available to the body. This, a study suggests, can lead to excess freely circulating folic acid which can be harmful to health.

Science based benefits of vitamin B9

  1. Promotes a healthy and safe pregnancy
Adequate vitamin B9 prevents (megaloblastic) anemia. Anemia can lead to poor tissue oxygenation and subsequent respiratory and heart issues.
  1. Supports healthy fetal growth and development
Neuro tube defects (NTDs) occur quite early in pregnancy. It happens by the fourth week after conception. By this time many women are not even aware that they are pregnant. This shows that it is important for women to consider vitamin B9 supplements when they are planning to have a baby. The risks for other fetal disorders that can be reduced by using folate before conception and during pregnancy include:
  • Reduces risk of congenital heart problems. A study published in the European Heart Journal of February 2010 suggested that the risk of congenital heart disease can be reduced by up to 20% with folate supplementation
  • Reduces risk of cleft-lips and palates
  • Lowers the risk of low-birth weight babies
  • Lowers risk of preeclampsia
  • Lowers the risk of placenta abruptio - premature placenta detachment
  1. Promotes heart health
Although vitamins B6 and B12 have homocysteine lowering effects, vitamin B9 has the greatest ability to do this. Repeated studies involving many people have over and over again proven this homocysteine lowering ability. Normalized levels of homocysteine are associated with a lower risk of heart disease.
  1. Lowers risk of developing certain types of cancers
These include:
  • Colo-rectal cancer
  • Breast cancer
  • Wilm’s tumors (a type of childhood tumor)
  1. Supports cognition
Adequate consumption of folate-rich fruits and vegetables has been associated with a lower risk of dementia. Study subjects were also found to suffer from lower gray matter loss for those who were adequately given vitamin B9

Other possible benefits of folate

  • Lowers risk of age-related macular degeneration
  • Promotes gum health
  • Supports healthy spermatogenesis
  • Improves symptoms of vitiligo
  • Helps with depression

Vitamin B9 safety

This vitamin is safe when taken as recommended. It is safe in pregnancy. It can interact with certain medications. These include some of those used in the treatment of seizures, some antibiotics and many others. If you are on any medications, talk to your doctor before using folate or folic acid supplements.

References and further reading

Zhao, R., Min, S. H., Qiu, A., Sakaris, A., Goldberg, G. L., Sandoval, C., … Goldman, I. D. (2007). The spectrum of mutations in the PCFT gene, coding for an intestinal folate transporter, that are the basis for hereditary folate malabsorption. Blood, 110(4), 1147–1152. http://doi.org/10.1182/blood-2007-02-077099 Bailey LB, Gregory JF, 3rd. Folate metabolism and requirements. J Nutr. 1999;129(4):779-782 Molloy AM, Daly S, Mills JL, et al. Thermolabile variant of 5,10-methylenetetrahydrofolate reductase associated with low red-cell folates: implications for folate intake recommendations. Lancet. 1997;349(9065):1591-1593. Zhao R, Min SH, Qiu A, et al. The spectrum of mutations in the PCFT gene, coding for an intestinal folate transporter, that are the basis for hereditary folate malabsorption. Blood. 2007;110(4):1147-1152 Food and Nutrition Board, Institute of Medicine. Folate. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, D.C.: National Academy Press; 1998:196-305 Chowers Y, Sela B, Holland R, Fidder H, Simoni FB, Bar-Meir S. Increased levels of homocysteine in patients with Crohn's disease are related to folate levels. Am J Gastroenterol. 2000;95(12):3498-3502. Powers, H. (2007). Folic acid under scrutiny. British Journal of Nutrition, 98(4), 665-666. doi:10.1017/S0007114507795326 National Guideline Clearinghouse (NGC). Guideline summary: Neural tube defects. In: National Guideline Clearinghouse (NGC) [Web site]. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); 2003 Jul 01. [cited 2017 Apr 01]. Available: https://www.guideline.gov van Beynum IM, Kapusta L, Bakker MK, den Heijer M, Blom HJ, de Walle HE. Protective effect of periconceptional folic acid supplements on the risk of congenital heart defects: a registry-based case-control study in the northern Netherlands. Eur Heart J. 2010;31(4):464-471 Su LJ, Arab L. Nutritional status of folate and colon cancer risk: evidence from NHANES I epidemiologic follow-up study. Ann Epidemiol. 2001;11(1):65-72. Smith AD, Smith SM, de Jager CA, et al. Homocysteine-lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment: a randomized controlled trial. PLoS One. 2010;5(9):e12244.


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