FOLIC ACID


  • Dosing
    		•
  • Therapeutic Uses
    		•
  • Sources
    		•
  • High-Risk Groups
    		•
  • Deficiency Consequences
    		•
  • Toxicity/Side Effects
    		•
  • Contraindications
    		•
  • Additional Information
    		•
  • Drug Interactions
    		•



    United States Recommended Dietary Allowances
    Men - 0.4 mg/day, Women - 0.4 mg/day, Pregnant women - 0.8 mg/day
    Nursing mothers - 0.8 mg/day, Children < 4 - Up to 0.3 mg/day, Infants - 0.1 mg/day







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    Therapeutic Uses
    Folic acid is needed in the making and metabolism of purines, pyrimidines (RNA, DNA), amino acids and choline. Essential for formation and maturation of blood cells in the bone m../arrow. Used in the treatment of megaloblastic anemia due to folic acid deficiency as seen in tropical or nontropical sprue, anemias of nutritional origin,
    pregnancy, infancy or childhood.





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    Sources
    Asparagus, oranges, peanuts, beets, spinach, legumes, broccoli, brussels sprouts, cantaloupe, egg, green leafy vegies, peas, grapefruit, tomatoes,
    bananas, brewers yeast, liver.





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    High-Risk/Increased Need Groups
    Pregnancy, alcohol abusers, malabsorption syndromes, celiac sprue, cirrhosis, low fresh-food diets, hospitalized patients.






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    Deficiency Consequences
    A reduced folic acid intake results in an altered DNA metabolism resulting in change in cellular nuclear structure and function. Possibilities include megaloblastic (macrocytic) anemia, impaired absorption, gastrointestinal disorders, glossitis, depression, growth retardation, neural tube defects.





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    Toxicity/Side Effects
    Folic acid can mask vitamin B12 deficiency. Allergic reaction possible, anorexia, nausea, abdominal distension, flatulence, bitter or bad taste, altered sleep patterns, difficulty in concentrating, irritability, overactivity, excitement, mental depression, confusion, impaired judgement.




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    Contraindications
    Treatment of pernicious anemia and other megaloblastic anemias where vitamin B-12 is deficient or not effective.






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    Additional Information/Precautions
    Required for the making of nucleoprotein and maintenance of normal blood cell production. Potential role in preventing heart disease, cancer and birth defects. May reduce the risk of cervical abnormal cells. Folic acid is readily destroyed by heat and air. Appreciable amounts are lost when foods are improperly stored, overcooked or reheated. It is water soluble.




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    Drug Interactions
    Aminosalicylic acid reduces serum folate levels. Birth control pills can interfere with folic acid metabolism resulting in reduced levels. Methotrexate and trimethoprim (Proloprim) can interfere with the use of folic acid. Signs of folic acid deficiency have been seen with sulfasalazine. Phenytoin (Dilantin) levels are reduced which can precipitate an increase in seizure frequency.




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    References
    1. Chiropractic Nutritional Reference 1987 Edition, James M. Gerber, DC
    2. Facts and Comparisons Drug Information, Updated Monthly, Loose-leaf drug information service
    3. The Merck Manual 15th Edition, 1987.