Folate is a water-soluble B vitamin that occurs naturally in food. Folic acid is the synthetic form of folate found in supplements and added to fortified food. Folic acid is responsible for many important functions throughout the body. Everyone needs folic acid, especially pregnant women. Therefore, it is important to get the right amount of folic acid in your diet and through supplements to avoid a deficiency. However, taking too much folic acid can result in negative signs and symptoms.
Folic acid is essential in the creation of DNA and RNA, the building blocks of all cells. Folic acid is required for normal red blood cell production, the metabolism of homocysteine, the maintenance of amino acid levels and preventing changes to DNA that may result in cancer. Perhaps the most important role of folic acid is the prevention of incomplete development of the spinal cord and brain in infants when taken by pregnant women. Folic acid is also used to treat deficiencies and anemia caused by a lack of folate in the body.
Recommended Dietary Allowance
The Food and Nutrition Board of the Institute of Medicine has established recommended dietary allowances for folate. Infants from birth to 6 months of age need 65 mcg per day and infants from 6 to 12 months require 85 mcg per day. Children 1 to 3 years old require 150 mcg daily and children 4 to 8 years old need 200 mcg per day. Form the age of 9 to 13, children need 300 mcg of folate daily. Adolescents through adulthood require 400 mcg daily. Pregnant women need 600 mcg per day and breastfeeding women require 500 mcg each day. Folic acid needs increase when individuals are under physiological stress, consume excessive amounts of alcohol, have a high metabolism or suffer from conditions such as hypothyroidism.
Green leafy vegetables, citrus fruits and juices, legumes, eggs, fish and organ meats are rich sources of folate. Folic acid is added to fortified breakfast cereals, bread products and orange juice. Folic acid fortification significantly helps individuals meet their recommended daily allowances. In some cases, however, supplemental folic acid is recommended. It is available as a single ingredient vitamin or in combination products such as in multivitamins and B complex vitamins. A dose of 1 mg or higher requires a prescription.
There is no health risk associated with folate intake from food. However, there is risk of toxicity from folic acid found in dietary supplements and fortified foods. Folic acid is used to treat a folate deficiency. However, a folate deficiency is virtually indistinguishable from a vitamin B12 deficiency. Large doses of folic acid given to an individual who has a vitamin B12 deficiency and not a folate deficiency can cause irreversible neurological damages. The Food and Nutrition Board of the Institute of Medicine has established a tolerable upper intake level for folate. For children 1 to 3 years the limit is 300 mcg daily, for children 4 to 8 the limit is 400 mcg daily, for children 9 to 13, the limit is 600 mcg daily, for adolescents 14 to 18 the limit is 600 mcg and for those 19 and older the limit is 1,000 mcg per day. Intakes above recommended limits increase the risk of adverse health effects.
Signs and Symptoms
Having too much folic acid in the body can result in a variety of signs and symptoms. Less serious side effects include digestive problems, nausea, loss of appetite, bloating, gas, a bitter or unpleasant taste in the mouth, sleep disturbances, depression, excessive excitement, irritability and a zinc deficiency. More severe signs include psychotic behavior, numbness or tingling, mouth pain, weakness, trouble concentrating, confusion, fatigue and even seizures. An allergic reaction to folic acid may cause wheezing, swelling of the face and throat or a skin rash.