The use of folic acid tablets is one of the measures to improve overall well-being and health. The popularity of this product is associated with a number of functions that the substance included in the composition performs. Vitamin B9 acts as an indispensable component in the reproduction of new cells and their division. It is necessary for the preservation and transmission of genetic information, as well as for rapid tissue repair. What else is folic acid used for and what can cause vitamin deficiency? Read more about this.
The role and benefits of vitamin B9
Many people wonder what folic acid tablets help with? To answer it, you need to study the properties of this substance. Vitamin B9 is one of the components of bone marrow. It is known that healthy blood cells are formed only in the presence of a sufficient amount of this B vitamin. Its lack can provoke megaloblastic anemia. Vitamin B9 will help compensate for the deficiency, which also contributes to:
- active production of neurotransmitters that help regulate sleep and appetite, cope with irritation or depression;
- improving reproductive function in women and men;
- launching protein production processes that provide effective protection of the body from pathogens;
- effective prevention of the development of pathogenic cells and their further spread;
- full development of the nervous system in children and adolescents;
- slowing down the onset of menopause in women and bringing the menstrual cycle back to normal;
- preventing the development of diseases of the digestive system.
Both men and women planning to become parents should start taking folic acid tablets several months before conceiving. This measure is an effective way to prevent fetal neural tube defect (). By replenishing vitamin B9 deficiency, the chances of conception also increase. This is facilitated by the appearance of more active sperm and an increase in their quality. Folic acid has also been shown to be effective in reducing the risk of stroke (). This effect is due to its ability to influence the synthesis of homocysteine.
Vitamin B12
Vitamin B12
- is a water-soluble vitamin that belongs to group B. Another name is cobalamins. Cobalamins represent a whole group of vitamins that take part in the metabolism of every cell, influencing the synthesis and regulation of DNA. Vitamin B can only be synthesized by bacteria and archaea (single-celled microorganisms), which have the unique enzymes necessary for its synthesis. The best food sources of vitamin B12 are animal products because they contain bacterial symbiosis.
Forms of Vitamin B12
What is commonly mistaken for vitamin B12 is cyanocobalamin. This form is found in almost most vitamin products. Cyanocobalamin is completely synthetic and does not occur in nature, but is widely used due to its low price and ease of production. When cyanocobalamin enters the body, it must be converted into active forms. The conversion releases toxic cyanide. Although toxic, the amount is negligible to have clear negative effects and therefore should not be considered a clear side effect.
Another problem with cyanocobalamin occurs when it is absorbed. In order for cyanocobalamin to be used by the body, it must go through a process that removes the cyanide molecule, which requires the antioxidant glutathione. The disadvantage of the deacyanation reaction is the unnecessary use of this valuable antioxidant, as well as the dependence of vitamin B12 metabolism on the availability of glutathione.
Unlike cyanocobalamin, two coenzyme forms of vitamin B12 - methylcobalamin and adenosylcobalamin - are biologically active. They take an active part in metabolic and enzymatic reactions.
Methylcobalamin is pre-methylated, which means it is ready to be absorbed by the body. Methylcobalamin is localized in the cell cytoplasm and is a cofactor in methylation reactions. Adenosylcobalamin is important in the oxidation of fatty acids and the main point of its action is the mitochondria of cells.
Metabolism and absorption of vitamin B 12
in the gastrointestinal tract
Vitamin B12 is bound to food protein and becomes available for absorption once released. The process of vitamin elimination occurs under the influence of hydrochloric acid produced by the gastric mucosa. The released cobalamin binds to the R protein and passes into the duodenum, after which the R protein is removed and the free cobalamin binds to intrinsic factor. Intrinsic Castle factor is formed in the glands of the fundus and body of the stomach; it helps convert B12 into an easily digestible form. Vitamin B12-Castle Factor Complex - Absorbed by the distal ileum and the vitamin enters the bloodstream.
Whey vitamin B12 is bound to transport proteins known as transcobalamins. Most of the vitamin, approximately 80%, is bound to an inactive protein called haptocorin. The active transport protein for vitamin B12 is transcobalamin II, which retains 20% of the vitamin in the bloodstream. Holotranscobalamin delivers vitamin B12 to all cells. Low serum vitamin B12 concentrations may be due to transport protein deficiency, while transcobalamin levels and vitamin B12 status remain normal.
Vitamin B deficiency problem12
The main problem with vitamin B12 is that it is difficult to absorb. Nutritional deficiency of vitamin B12 occurs in groups of people who eat only plant foods, minimizing animal products in their diet. Deficiency due to insufficient absorption of vitamin B12 or increased requirements against the background of normal absorption is also common.
A potential risk group includes pregnant women on a vegetarian, vegan or raw food diet.
Elderly people are also a risk group. They are at greater risk of malnutrition due to comorbidities, have difficulty with self-care and food preparation, and tend to suffer from some degree of atrophic gastritis. Inflammatory processes in the gastric mucosa tend to increase in frequency with age, which leads to a decrease in the production of hydrochloric acid, one of the factors in the absorption of vitamin B12.
Castle factor deficiency -
one of the typical causes of vitamin B12 deficiency. The presence of autoantibodies to Castle factor is the leading cause of pernicious anemia against the background of autoimmune gastritis. Resection of the gastric antrum is also accompanied by a deficiency of vitamin B12.
The absorption of vitamin B12 can be impaired in any inflammatory bowel disease. For example, Crohn's disease, parasitic infestations, bacterial overgrowth syndrome - just a small list of the possible list of ailments.
Consequences of deficiency states
Typical manifestations of vitamin B12 deficiency. Disruption of the hematopoietic process with the development of megaloblastic anemia, as well as neurological disorders.
Long-term and chronic deficiency of vitamin B12 is considered as one of the factors in a number of other global medical problems.
The active form of vitamin B12 is directly involved in the metabolism of homocysteine, an independent factor in the development of cardiovascular pathology. By converting homocysteine into methionine, it enhances the synthesis of SAMe (S-adenosylmethionine), the most important donor of methyl groups in the body.
Assessing vitamin B12 status is part of the dementia screening process. Elevated concentrations of methylmalonic acid (MMA) are associated with cognitive decline and Alzheimer's disease. In older adults, low vitamin B12 levels and high serum folate concentrations are associated with increased odds of cognitive impairment. On the contrary, in patients with normal vitamin B12 status, high serum folic acid levels have a protective effect on memory, attention, perception, intelligence, etc.
Vitamin B12 deficiency is associated with the development of age-related macular degeneration (AMD) and the risk of frailty, which are the leading causes of disability in older people. AMD is the leading cause of vision loss in older adults. An increased risk of frailty and disability is associated with poor vitamin B12 status.
Low levels of vitamin B12 are considered a potential risk factor for neural tube defects. Vitamin B12 acts as a cofactor for methionine synthase in the folic acid cycle. When vitamin B12 supply is low, folate remains trapped in the methylation cycle, causing cell replication to fail.
A deficiency of vitamin B 12
can be suspected by such nonspecific symptoms as:
- forgetfulness;
- dizziness;
- pale skin;
- weakness and fatigue;
- tingling in the tips of the fingers and toes.
Laboratory tests can diagnose and confirm deficiency and insufficiency of vitamin B12.
Determination of vitamin B12 deficiency
Traditionally, vitamin B12 status is assessed by serum concentrations, but serum levels alone may not detect subclinical vitamin B12 deficiency or insufficiency.
Methylmalonic acid and homocysteine are recognized indicators of vitamin B12 status. Their measurement is of paramount importance in identifying vitamin B12 deficiency.
MMA is considered a specific indicator of cobalamin metabolism and reflects the availability of adenosylcobalamin in the cell. Homocysteine increases with vitamin B12 deficiency along with a lack of folate and vitamin B. It is the lack of such a coenzyme form as methylcobalamin that provokes an increase in homocysteine levels.
Plasma concentrations of MMA also increase with renal failure, polymorphisms in methylenetetrahydrofolate reductase (MTHFR), or with the use of certain drugs. Plasma MMA concentrations are elevated in renal failure, which is common in the elderly, so this marker is not appropriate for use in this group of patients.
The use of holotranscobalamin as a marker of vitamin B12 status increases the predictive value of identifying subclinical deficiency states. The level of holotranscobalamin reflects the availability of vitamin B12 to all cells of the body, and its determination is desirable when assessing the status of the vitamin in the body.
Conclusion
Vitamin B12 is a particularly important vitamin for women of childbearing age and older adults, but adequate vitamin B12 status throughout life is necessary for optimal health.
Symptoms, causes and consequences of deficiency
Vitamin B9 deficiency for the body is most often observed when it is insufficiently supplied with food or with the development of pathologies associated with digestion. A shortage of a substance is also provoked by an increase in the need for it. This condition is observed in pregnant and lactating women, adolescents, as well as in children during the period of active growth. A deficiency state in adults can be caused by excessive consumption of alcoholic beverages or long-term use of anticonvulsants.
The following symptoms may indicate the need to use vitamins in folic acid tablets:
- blanching of the skin and mucous membranes;
- fatigue after minor and short-term exertion;
- constant irritability;
- respiratory dysfunction;
- acceleration of heartbeat;
- drop in blood pressure in the arteries;
- loss of appetite;
- the appearance of tinnitus.
If you discover these signs, you need to consult a doctor to make a diagnosis. If vitamin B9 deficiency is confirmed, measures must be taken to eliminate the problem. Otherwise, you may encounter consequences such as a decrease in the amount of iron in the blood, disruption of the functioning of the musculoskeletal system, delayed sexual development in adolescents and infertility in men. Taking folic acid tablets in case of deficiency is also necessary, since a lack of vitamin provokes disruptions in the functioning of the nervous system. In this case, disorders associated with defective brain function are noted.
Indications for the purpose of the study
Folic acid (from the Latin folium - “leaf”) is a water-soluble vitamin B9, part of the group of folates, which can be of both natural and synthetic origin.
When entering the body, folic acid and other folates are converted into biologically active substances involved in metabolism. The terms "folate" and "folic acid" are often used interchangeably. The composition of medications and vitamin complexes in the vast majority of cases includes folic acid (vitamin B9).
The level of folate in the body depends on food preferences, cooking methods and the state of the gastrointestinal tract.
The largest amount of folic acid is found in leafy vegetables (lettuce, spinach), legumes, mushrooms, eggs, organ meats (liver, kidneys), and yeast.
During cooking, some folates are destroyed - when cooking vegetables and meat, the loss of folic acid reaches 70-90%, when cooking eggs - 50%. Folate starvation occurs in newborns who are fed goat's milk.
Folic acid is absorbed in the duodenum and proximal jejunum. In blood plasma it binds to transport proteins. Vitamin B9 is included in the composition of red blood cells, and its main depot is the liver, where it is in an inactive state and turns into an active form as the body needs.
In the human body, folate is contained in an amount of 5-10 mg. The daily requirement is 50-100 mcg, increasing during pregnancy, lactation, and heavy physical labor. Folic acid reserves are depleted 1-4 months after it stops entering the body.
Folic acid is necessary for the full development of the embryo, hematopoiesis, renewal of the intestinal mucosa, and for wound healing.
With folic acid deficiency, megaloblastic anemia, leukopenia (decrease in the number of white blood cells), growth retardation, impaired renewal of the small intestinal mucosa, and slow wound healing develop. Vitamin B9 is also necessary for the synthesis of substances that transmit nerve impulses from one neuron to another, and the functioning of the immune system.
Impaired folate metabolism leads to an increase in the total level of homocysteine in the plasma, which can cause an increased risk of thrombosis and the development of coronary heart disease, myocardial infarction, and stroke. There is a connection between high levels of homocysteine and pregnancy complications (recurrent miscarriage, placental insufficiency, developmental delay and intrauterine fetal death, placental abruption, premature birth), fetal development defects (Down syndrome, encephalomeningocele, myelomeningocele, etc.).
Folic acid testing is prescribed:
- to determine the sufficient level of vitamin B9 in the body;
- pregnant women to determine the risk of congenital defects of the fetus;
- as part of the diagnosis of anemia;
- to monitor folic acid levels during treatment.
You need to know that independent and uncontrolled intake of folic acid is unacceptable, since an overdose of the drug can lead to serious consequences.
Thus, pregnant women with an overdose of folic acid may give birth to children with weak immunity and a tendency to bronchial asthma and colds. Long-term intake of high doses of folic acid provokes digestive disorders, causes disturbances in kidney function, leads to a decrease in the level of vitamin B12 and the development of anemia.
How to take folic acid tablets correctly?
The dosage of folic acid in tablets is calculated based on the patient’s age and gender, as well as taking into account his state of health. For children, the drug is prescribed in case of deficiency after breastfeeding. So for children under 3 years of age, the required daily intake of the drug corresponds to 70 mcg. In the period from 4 to 6 years it is 0.1 mg. The dosage of the drug is gradually increased. So, to make up for the deficiency, every 3 years another 0.05 mg is added to 0.1 mg, and by the age of 18 the recommended norm reaches 0.3 mg.
The daily dose of folic acid in tablets for women varies from 0.2 to 0.4 mg. The norm of vitamin B9 for men whose body is prone to microelement deficiency is 1 mg. In old age, it is recommended to take 0.4 mg of the drug. Speaking about how many folic acid tablets to take per day, it is worth noting that each of them most often contains approximately 2 daily doses. The concentration of the active substance in them may vary depending on the manufacturer.
Contraindications and side effects
According to the instructions for use of folic acid, the use of the drug should be discontinued if an allergic reaction is detected or estrogen levels are exceeded. This drug should not be taken by patients with bronchial asthma or those who have symptoms indicating malignancy. If you violate the instructions for use of vitamin B9 and use it in excess of the recommended dosages, you may encounter side effects such as increased body temperature, nausea, vomiting, stool disorders, bloating, bronchospasms, excessive irritability and the appearance of muscle cramps. Sometimes allergic symptoms are observed in the form of itching and rash on the skin.
