Folic Acid: Risks or Myths?

There are theoretical risks for isolated folic acid in high doses. But these supposed risks fly in the face of established science and are controversial, not at all conclusive. There is also confusion over the significance of the supposed risks of high dose isolated folic acid in test tube and animal studies which do not identify a danger for moderate level supplementation - or even higher dose supplementation if combined with multivitamins or vitamin B-12. In other words, if the theoretical risks do not reflect real world human activities and the way that people actually obtain essential vitamins from their diet, including supplementation, aren’t these improbable risks really irrelevant to us? On the other hand, these negative reports may stop people from taking essential vitamins in quite reasonable amounts even though they are known to promote human health. Published human clinical science has determined that folic acid can reduce birth defects and has been proven to do so. Clinical science has also found mechanisms by which folic acid can prevent cancers, as well as the theoretical possibility that very high doses given in isolation can stimulate colorectal cancers including prostate cancer. There is stronger evidence that taking B-12 or a multivitamin along with high folic acid actually reduces rates of prostate and colon cancers. For example, in one human clinical trial where food intake, blood and plasma levels of folic acid were considered, Multivitamin users had about 2/3 the risk of subsequent prostate cancer as Non-Multivitamin users; only the independent use of folic acid was considered a risk factor. The report concluded, “…on the whole, the biological and epidemiological evidence supports the potential for folate supplementation to prevent colorectal neoplasia in humans.” (Cole) This shows that single nutrient studies, especially if unpublished and not peer reviewed or subjected to subsequent comments by experts in the field, should not be given overinflated importance when they are merely preliminary studies that may conflict with more relevant published human clinical studies. In the case of such conflicts, the human clinicals should bear more weight and be seen as more convincing, especially those that mimic the full range of variables (nutrients) in the human diet. Folic acid itself is considered non-toxic. Also, “data from in vitro and in vivo studies indicate that folic acid is not genotoxic [damaging to genetic material]”. (UK Food Standards Agency) There have been reports of levels as high as 50,000 micrograms per day given with no signs of toxicity in humans. There are accepted problems associated with levels exceeding 5,000 micrograms a day, which resulted in a far more conservative Upper Limit of 1,000 micrograms daily being set. This effect has been demonstrated in patients suffering from pernicious anemia taken off of their successful medicine (vitamin B-12), which was replaced by 5,000 mcg/day of folic acid. The substitution of one vitamin for another was unsuccessful in treating pernicious anemia, but did mask some symptoms. This test – and a large safety margin - provided the rationale given for the current Upper Limit. But it does not logically imply danger to those who are not severely anemic and who obtain B-12 in adequate amounts. (Oakley) It is very uncommon for people to take folic acid singly in doses of thousands of micrograms daily, but this is the method which test tube and animal studies often use. Overemphasizing unproven cancer risks requires ignoring valid studies showing reductions of cancers by taking folic acid and multivitamins. Needlessly scaring people from taking their vitamins, which have in human clinical trials shown significant improvements in birth defect and cancer rates, is not helpful to our common goal of protecting public health. Neil E. Levin, CCN, DANLA QUOTES & REFERENCES: Dr. Gideon Koren, director of the Motherisk Program at the Hospital for Sick Children in Toronto , note that rates of birth defects such as spina bifida and cancers such as neuroblastoma have plummeted since folic acid supplementation was begun. He believes that the known benefits outweigh theoretical risks. "I think it is very important to remember that the scares about cancer are mostly from animal studies and laboratory studies, not from human experience," he says. "We are still awaiting to see such human experience." http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20090417/folic_acid_090418/20090419?hub=SciTech Health Canada recommends all women of childbearing age take 0.4 mg of folic acid a day, but says taking more than 1 mg a day of folic acid without the advice of a doctor is not recommended. "We continue to encourage all women who could become pregnant to take a daily supplement," the agency says on its website. "We caution against taking more than one multivitamin tablet a day, as excess amounts of certain vitamins can be toxic." http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20090417/folic_acid_090418/20090419?hub=SciTech “All women who could become pregnant should take a multivitamin containing 0.4 mg of Folic Acid every day. To help reduce the risk of NTDs, you should start taking the vitamin supplement at least three months before you get pregnant and continue through the first three months of your pregnancy. Talk to your health professional to find the supplement best for you…If you have had a previous pregnancy affected by an NTD or have a family history of this problem, see your doctor. You may be advised to take a higher dosage of Folic Acid. If you have diabetes, obesity or epilepsy, you may be at higher risk of having a baby with an NTD, and you should see your doctor before planning pregnancy… Do not take more than one daily dose of vitamin supplement as indicated on the product label. Increasing your dose of Folic Acid beyond 1 mg per day without the advice of a doctor is not recommended.” (Public Health Agency of Canada , 2/27/08; http://www.phac-aspc.gc.ca/fa-af/index-eng.php) The NIH’s Office of Dietary Supplement reports on the prevention of cancer with the use of supplemental folic acid as part of a multivitamin: “Over 88,000 women enrolled in the Nurses' Health Study who were free of cancer in 1980 were followed from 1980 through 1994. Researchers found that women ages 55 to 69 years in this study who took multivitamins containing folic acid for more than 15 years had a markedly lower risk of developing colon cancer.” (Giovannucci E, et al. Multivitamin use, folate, and colon cancer in women in the Nurses' Health Study. Ann Intern Med 1998;129:517-24; http://ods.od.nih.gov/factsheets/folate.asp) Cole BF, et al. Folic acid for the prevention of colorectal adenomas: a randomized clinical trial. Polyp Prevention Study Group. JAMA. 2007 Jun 6;297(21):2351-9. PMID: 17551129 Figueiredo JC, et al. Folic acid and risk of prostate cancer: results from a randomized clinical trial. J Natl Cancer Inst. 2009 Mar 18;101(6):432-5. Epub 2009 Mar 10. PMID: 19276452 Folic Acid, CASRN: 59-30-3. NLM TOXNET Hazardous Substances Database accessed online 28 March, 2009. http://toxnet.nlm.nih.gov/cgi-bin/sis/search/r?dbs+hsdb:@term+@na+folic+acid Lonn E, Yusuf S, Arnold MJ, Sheridan P, Pogue J, Micks M, McQueen MJ, Probstfield J, Fodor G, Held C, Genest J Jr; Heart Outcomes Prevention Evaluation (HOPE) 2 Investigators. N Engl J Med. 2006 Apr 13;354(15):1567-77. Epub 2006 Mar 12. Erratum in: N Engl J Med. 2006 Aug 17;355(7):746. PMID: 16531613 Oakley GP Jr. When will we eliminate folic acid-preventable spina bifida? Epidemiology. 2007 May;18(3):367-8. PMID: 17435446 http://www.food.gov.uk/multimedia/pdfs/evm_folicacid.pdf

Behind the Mirror

"Pay no attention to the drugs behind the mirror." What some physicians do in excusing drug side effects while pointing fingers at dietary supplements; with apologies to the Wizard of Oz.

To Age is Human, To Mature Divine

To Age is Human, To Mature Divine a new phrase, coined today, 4/13/2009 by Neil E. Levin

Gluten issues, allergies vs sensitivities vs digestive issues

All grains contain gluten; some forms are just more allergenic or more difficult to process than others, which can vary from individual to individual. Wheat is the most common gluten reaction; which is also possible for rye, oats, barley and buckwheat. Some people are sensitive to certain proteins because of leaky gut, a condition where digestion is impaired because of GI tract disorders. Non-allergenic "delayed sensitivity reactions" to proteins may be caused by leaky gut and the specific immune cells reacting to these specific proteins can be reprogrammed to be non-reactive to them by completely avoiding these specific foods for at least 6 weeks. Not so for true food allergies, which can be permanent and trigger ever-increasing reactions with every occasional exposure. People's abilities to digest proteins vary with genetics, immune system capacity and probiotics present in the gut. There is even current research on specific bacteria that prevent the damage caused by wheat in susceptible people's guts. Only about 1% of the population tests as truly allergic to wheat protein, between 1-2% for dairy protein. Obviously, many more are (temporarily) sensitive to these proteins based on gut dysbiosis and leaky gut tissues failing to completely digest these foods. The issue of lactose intolerance is another possible cause of gas or bloating after consuming non-fermented dairy products (except for low-lactose products like whey protein isolate). The use of antacids is a major factor reducing digestion of proteins and minerals in the stomach, as well as reducing the essential acidic barrier against pathogenic organisms that may be present in our food and water; even from dirty hands that we use to eat. Stress and improper chewing may also contribute to the presence of extra undigested proteins in the gut, composed of undigested food and undesirable microbes. Who's left to clean up the mess and try to get some badly needed nutrients into the bloodstream? The immune system, though imperfectly. A major part of immune cell counts and activity is in the GI tract for exactly this reason, consuming a lot of energy. If digestion fails and the GI tract contains an unhealthy mixture of organisms and large protein masses, the result is a significant immune challenge by every measure, leading to inflammation and fatigue. Glutamine is an amino acid present in most protein-containing foods that is essential to brain and nerve function. Magnesium, other amino acids (ie taurine) and antioxidant co-factors render it far less overexciting to neurons. MSG and aspartame are additional proteins that can cause nerve overstimulus in some circumstances. There are ways to reduce these reactions, as described thoroughly by Dr. Russell Blailock in his books, lectures and articles. The bottom line: No need for most people to avoid soy, milk or grains if they can maintain the intregrity of their digestive and GI tracts properly. Most of those whose systems aren't in such good health can utilize fairly effective means of correcting these issues and eventually resuming the use of these foods in their diets, unless they are the relatively few with true allergies.

Price Lookup Codes Identify Organic and Genetically Engineered Produce

The International Federation for Produce Coding (IFPC) creates Price-Look Up (PLU) codes for fresh fruits and vegetables. These four-digit codes are put on stickers and applied to the produce items. Organic and genetically engineered produce are identified by a fifth PLU digit on the sticker. You can identify organic items by the number "9" leading the five-digit PLU, and you can identify genetically engineered items by the number "8" leading a five-digit PLU number. Both of these categories will have five digits instead of the standard four. The four-digit code remains the same even if a fifth digit (8 or 9) is added. In the following example, conventional bananas have a standard PLU code of 4011. Organic bananas are coded 94011 and genetically engineered bananas are coded 84011. For me, the 9 prefix (for organic produce) is desirable and the 8 (for genetically engineered) is not. I use this rhyme to remind myself of the difference: “I hate eight, but nine is fine.” For more information about PLU codes, visit www.plucodes.com/plucodesfaq.asp

Stress and Sleep, melatonin and cortisol

Sleep allows an overactive adrenal to rest overnight, also allowing your melatonin to give you a good night's sleep. Cortisol and melatonin are agonists, and fight for dominance. Cortisol is a stress hormone made by the adrenal gland and melatonin is an antioxidant sleep hormone produced by the pineal gland at night, in darkness. Normally melatonin takes over the night, slowing down cortisol production in the adrenal gland and encouraging proper rest and repair cycles. Then it wanes and cortisol and other adrenal hormones take over during the day, giving you energy. They should switch off in a normal daily cycle. If the adrenal won't shut down properly overnight due to stress, one may have inadequate melatonin resulting in an improper rest and repair cycle wearing you down. High cortisol levels are also associated with encouraging the depositing of fat in the abdomen, specifically. So reducing cortisol may also inhibit the formation of abdominal fat.

testing dietary supplements

My experience with dietary supplements is that analysis of products with multiple ingredients, especially those at low concentrations, is very difficult and requires experience with the particular supplement matrix (formula plus excipients). Random testing of products off the shelf is fraught with technical difficulties. In addition, many ingredients lack standard, universally accepted testing methods within a dietary supplement matrix, which can result in confusion. These are sophisticated issues, whose resolution sometimes is difficult for anyone trying to ascertain product quality based on limited testing and lack of relevant experience. That is why most labs prefer to test single ingredient products, a tacit admission of the uncertainties involved in testing complex formulations. Testing is not as black and white as news releases often indicate or imply. Further, extrapolation of analytical results to nutrition, health and safety issues also requires expertise in these sometimes controversial areas, which very few labs have. It is important to verify label claims, but sometimes the manufacturer's validated procedures for qualification of an individual ingredient - combined with appropriate quality controls to assure that a proper mixture has been made - may more accurately represent the quality and quantity of that ingredient in a formula than any lab results obtained by applying a single analytical test to vastly different formulations containing that ingredient.