Folic acid, a water-soluble B vitamin, occurs naturally in food and can also be taken as a food supplement. Naturally occurring sources of folic acid include green leafy vegetables (spinach, turnip), poultry, pork, shellfish, peas, beans, liver, cereal, and citrus fruits. Folic acid is one of the necessary elements required for the production and maintenance of human cells.
Folic acid deficiency and diseases:
Folic acid deficiency may cause various disorders. Some of these are highlighted below.
• Folic acid deficiency may cause weakness, poor growth, graying hair, inflammation of the tongue, palpitations, and behavioral disorders.
• Folic acid deficiency is also linked to common stomach problems such as diarrhea, mouth ulcers, peptic ulcers, loss of appetite, and weight loss.
• Premature birth, low birth weight infants, and babies with neural tube defects (NTDs) can all result from a folic acid deficiency in pregnant women.
• Anemia is sometimes associated with the advanced stage of folic acid deficiency.
• You may need to increase your folic acid intake if you are anemic, have kidney or liver disease, are pregnant, or breastfeeding. In all such cases, you should consult your doctor before taking folic acid supplements.
• The maximum daily folic acid intake should be limited to 1000 micrograms unless otherwise directed by a health care provider.
• Epilepsy medications, blood sugar control medications, methotrexate (cancer treatment medications), and diuretics are examples of medications that may interact with folic acid. If you are taking any of these medicines, you should contact your doctor.
•If you are 50 years of age or older, you should check your vitamin B12 level before beginning a folic acid supplementation diet, as there is a possibility of interaction between B12 vitamins and folic acid.

Folic acid’s role during pregnancy:
Neural tube defects (NTDs) are major defects of the brain and spine in babies, causing damage to the brain or spine. The major NTDs include spina bifida ( spine problem).
Anencephaly (brain problem) and up to 70% of these NTDs can be prevented by taking enough folic acid every day before conception and during pregnancy.
A woman is likely to be at higher risk of delivering an NTD-affected baby if she has a previous NTD-affected pregnancy, is diabetic, takes medicine to treat epilepsy, and is of Hispanic ethnicity.

Every woman who is likely to become pregnant should take 400 micrograms of folic acid every day. Consuming supplemental folic acid in addition to a healthy folic acid-rich diet before and during pregnancy significantly reduces the risk of having neural tube defects in babies.
Spina bifida and anencephaly disorders:
Spina bifida is a spine disorder where part of the spine at the lower end is damaged and a sack of fluid is entrapped in the baby’s back. The majority of children born with this spinal disorder survive to adulthood, but they frequently have lifelong symptoms such as inability to move lower parts of the body, loss of bowel and bladder, and fluid pressure in the brain.
Anencephaly is a brain disorder in which parts of the brain and skull bones may not form in babies. Most babies with these defects die before or just after birth.

Heart Disease: Role of Folic Acid
The low concentration of folic acid may increase the amino acid homocysteine in the blood levels and consequently increase the risk of heart disease. High levels of homocysteine may damage the coronary arteries or cause blood clots, but there is no evidence that supplemented folic acid will reduce the risk of heart disease.

Folic acid’s role in cancer:
Folic acid is one of the essential elements involved in the synthesis of DNA, and its deficiency may cause defects in DNA and, consequently, may lead to cancer. There is enough evidence to conclude that the deficiency of folic acid is associated with an increased risk of breast, colon, and pancreatic cancer. However, it is not advisable to supplement folic acid to reduce the risk of such cancers.
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