For Patients & Caregivers
Folate is used to prevent certain types of anemia and birth defects. It may also reduce the risk of certain cancers.
Folate is a vitamin of the vitamin B complex. The main food sources of folate include fortified breakfast cereals and breads, liver, Brussels sprouts, potatoes, spinach, chickpeas and brewer’s yeast. It is also available in supplemental form as folic acid. Folate deficiency can result in the reduction of essential cell division and can lead to anemia. The vitamin has been shown to reduce the risk of neural tube defects and is vital for pregnant women. Higher levels of folate have been shown to reduce the risk for breast cancer, pancreatic cancer and colon cancer.
- To treat Alzheimer’s disease
Studies have linked low folate levels with Alzheimer’s disease. Research also shows a possible link between the intake of folate and decreased risk of Alzheimer’s.
- To prevent cancer
Clinical studies have shown that higher levels of folate reduce the risk for breast, pancreatic and colon cancers. Folic acid supplementation does not appear to affect the risk of prostate cancer.
- To prevent heart disease
- Low folic acid levels have been linked to higher homocysteine levels, a risk factor for death caused by diseases of the heart and blood vessels. However, further studies are needed to understand this association.
- To treat chronic fatigue syndrome
Folic acid was ineffective in treating chronic fatigue syndrome.
- To prevent neural tube birth defects
Studies have shown a significant decrease in the risk of neural tube (tissue in the embryo that develops into the brain and the spinal cord) defects as a result of increased dietary folate.
For Healthcare Professionals
Folate and folic acid are water-soluble vitamins of the vitamin B complex. Folate is naturally available in green leafy vegetables, whereas folic acid is the synthetic supplemental form and has higher bioavailability than folate (1). Folate is essential during pregnancy and has been shown to reduce the risk of neural tube defects (10). Data also suggest a nearly 50% reduction in risk of medulloblastoma in children born to women who took folic acid supplements during pregnancy (11). Folate supplementation may benefit women with polycystic ovary syndrome (PCOS) (42). High folate intake was also found to reduce chromosomal aberrations in sperm of healthy men (12).
In other studies, folic acid has been shown effective in decreasing levels of homocysteine, a risk factor for cardiovascular disease mortality (13) (14) (15), and reducing blood pressure in smokers (5) (16). However, trials on the risk of stroke yielded mix results (17) (18) (19) (20). Folic acid supplementation was ineffective in the treatment of chronic fatigue syndrome (21). Due to its antagonistic effects, folic acid can reduce the side effects of methotrexate when used for rheumatoid arthritis (22) (23). However, it may decrease the efficacy of methotrexate in the treatment of acute lymphoblastic leukemia (24) and psoriasis (25). Folic acid supplementation improved cognitive function in older adults (26) and response to cholinesterase inhibitors in patients with putative Alzheimer’s disease (27). In individuals chronically exposed to arsenic, folic acid supplementation lowers blood arsenic concentrations by facilitating urinary excretion (28).
Low levels of folate in the blood are associated with certain forms of cancer (9), whereas higher levels of dietary folate have been shown to reduce the risk of breast (2), pancreatic (3) and colon cancers (4) (5) (6) (32) (35). However, folic acid supplementation does not seem to affect the risk of prostate cancer (7) or colorectal adenoma in patients with a history colorectal adenoma without carcinoma (8). A combination of folic acid, and vitamins B6 and B12 had no effect on overall of invasive cancer or breast cancer (33). Recent data, however, suggest higher cancer incidence and mortality in patients with ischemic heart disease following supplementation with vitamin B12 and folic acid (34). In children aged 0 — 4 years, folic acid-fortification was associated with a reduction in the incidence of Wilms tumor and primitive neuroectodermal tumors (PNET), but not other childhood cancers (36). Findings of a meta analysis indicate that folic acid supplementation does not have a significant effect on total cancer incidence, colorectal cancer, prostate cancer, lung cancer, breast cancer, or hematological malignancy, but reduces the risk of melanoma (37).
Folic acid supplementation has been shown to reduce the risk of colon cancer (32); and dietary folate intake was more strongly associated with reduced breast cancer risk in women who also consumed high levels of folate cofactors (methionine, vitamin B12, and vitamin B6) (2).