by Robert Crayhon, M.S.
FOLIC ACID—
Could Save Your Life
Heart bypass surgery is quite common
in what is supposed to be one of the
healthiest countries in the world.
Americans have a unique propensity to clog
their arteries, especially those that feed the
heart. And the idea that dietary or even
serum cholesterol can explain the heart disease
epidemic in America is close to being
filed under theories that did not work, right
next to communism. As the stunning book
The Cholesterol Myths by Uffe Ravnskov,
M.D., Ph.D., exposes, the cholesterol theory is
in the early stages of collapse, much like the
Soviet Union and Eastern Europe in the
mid-1980s. So what explanation can fill the
intellectual void?
Kilmer McCully, M.D., is a pioneer who
has shown that elevated levels of a compound
known as homocysteine in our blood
may be a major cause of heart disease. He
details this in his numerous research papers
as well as his recent book The Heart
Revolution. How can you lower homocysteine?
Simple: increase your intake of the B
vitamin folic acid.
Folic acid is one of the most difficult
nutrients to get every day. To start with, it is
fragile. Much of it can be lost in cooking,
and the green leafy vegetables which are the
main source of it in our diet lose much of
their folic acid simply after being taken out
of the field. Folic acid is also hard to digest
from food. First, you must eat plenty of
vegetables. Not even 10 percent of
Americans do this. Then you must chew
your food well. Next, to absorb it, you must
have plenty of stomach acid. It is rare than
someone can do all of this well.
Even healthy adults do not absorb folic
acid well from food, according to a landmark
study in the Lancet in 1996. Sixty-two
women of child-bearing age were divided
into various groups. The ones eating more
leafy greens experienced no increase in red
blood cell folic acid. Those taking supplements
were the only ones to see an increase
in folic acid levels.
Optimizing folic acid levels has many
benefits. Folic acid can prevent birth defects,
heart disease, stroke, bone loss and perhaps
even Alzheimer’s. As stated above, folic acid’s
benefits center around its ability to keep the
blood levels of a toxic metabolite, known as
homocysteine, low.
A study of 5,056 Canadian men and
women aged 35 to 79 years showed that low
serum folic acid levels are associated with an
increased risk of fatal coronary heart disease.
Folic acid may also be able to reverse artery
plaque. Folic acid supplementation at 2.5
mg, along with small amounts of B6 and B12,
caused a regression in carotid artery plaque
in patients with homocysteine levels both
above and below 14. The benefit of folic acid
supplementation on plaque regression
occurred in all those with a homocysteine
above 9. This and other research points to an
ideal level of homocysteine being 9 or lower.
Research also suggests that 650 mcg per day
of folic acid is the optimal dose to help lower
homocysteine. For this reason I recommend
that all adults try to consume at least 650
mcg per day of folic acid, preferably through
supplements. Supplements of folic acid, as
we have seen, are much better absorbed than
food folic acid. For prevention of birth
defects, all women of child-bearing age
should take 800 mcg of folic acid per day. For
women who have had a child with a neural
tube defect, the U.S. Food and Drug
Administration recommends an intake of 4
mg (4,000 mcg) daily during their next
pregnancy.
Diminished folic acid intake appears to
promote cancer of the cervix, lung, stomach,
esophagus, colon and rectum. The risk of
colorectal cancer is almost twice as high in
subjects with low serum folic acid. In the
Netherlands Cohort Study on Diet and
Cancer of 58,279 men, folic acid intake was
found to be inversely related to small cell and
squamous cell carcinomas and adenocarcinomas.
Low red blood cell folate levels increase
the risk for the precancerous condition
cervical dysplasia. Increasing folic acid may
help reverse cervical dysplasia, according to
research. In my practice, I have found optimal
folic acid intake an indispensable part of the overall management of this condition,
sometimes leading to its reversal.
Folic acid deficiency and subclinical deficiency
is common in older adults, even when
plasma folic acid levels are normal. The deterioration
of functional and mental capacity is
one of the major problems of the elderly, and
it may be due in part to folic acid deficiency.
Research suggests that intake of folic acid at
the level of 650 mcg per day would greatly
benefit the mental well-being and homocysteine
levels of the elderly.
Elevated homocysteine levels are associated
with an increased risk to Alzheimer’s disease.
Among 30 elderly Catholic sisters who
lived in one convent, ate from the same
kitchen, and were highly comparable for a
wide range of environmental and lifestyle factors,
low serum folic acid was strongly associated
with brain atrophy with aging.
Folic acid deficiency is tightly correlated
with the incidence of depression. Elevation of
serum folic acid, conversely, is associated with
increased mood. Folic acid is the first nutrient
I recommend to people who are feeling
down. Ten percent of the time their depression
will greatly improve on folic acid alone.
OTHERS WHO NEED AN OPTIMAL INTAKE OF FOLIC ACID:
- Those who consume alcohol regularly. They may need at least 100 mcg more folic acid than others, as alcohol increases the destruction of folic acid.
- Oral contraceptive users.
- Those who wish to prevent osteoporosis.
- Those who want optimal memory function. Elevated homocysteine is associated with poor cognitive performance, especially with regard to learning and recall.
- Optimal folic acid intake may also help prevent hearing loss in the elderly.
SAFETY
Folic acid supplements are safe, with few
reported side effects. Current evidence
shows that daily supplements, even as high
as 5–15 mg, are safe. Oral folic acid conceivably
could cause neurological injury if
given to patients with undiagnosed pernicious
(vitamin B12) anemia, though the
occurrence of this is quite rare. Since 1973
there have been no published studies or case
reports showing that folic acid corrected the
symptoms of pernicious anemia and in so
doing delayed the diagnosis of vitamin B12
deficiency. Ideally though, one should consider
taking B12 along with folic acid, as
these two B vitamins work together in the
body.
The most important thing you can do is
ask for a serum homocysteine test at your
next check up. Get your homocysteine to 9
or lower. Take a good B complex with at
least 650 mcg of folic acid per day. These
simple strategies alone could lower your
risk to heart and artery disease by 25 percent
or more. Read The Heart Revolution,
by Kilmer McCully, M.D., so you can take
advantage of this lifesaving information
now. Buy a copy for everyone you love,
your doctor, your babysitter, anyone who
can read. And when you are a spry grandparent
in your 80s and Dr. McCully wins
the Nobel in medicine, you can tell your
grandchildren, “Oh, I knew about that
homocysteine thing ages ago.”
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