The connection between folic acid (folate) deficiency and neural tube defects (NTDs) in newborns was first noted in the early 1980s; hence the recommendation that all pregnant women take a Folic Acid supplement during pregnancy to prevent spina bifida. Because the risk of developing spina bifida occurs before most women know they are pregnant (usually within the first 3 weeks after conception), the Food and Drug Administration, in 1996, began requiring the addition of folic acid to “fortified” foods such as breads, pastas, and cereals in an attempt to decrease the incidence of spina bifida and other neural tube defects (Wikipedia, 2012).
With these interventions, the number of babies born with neural tube defects has decreased. The Centers for Disease Control (2010) estimate that 3,000 children are born with neural tube defects each year; but 50% to 70% of these could have been avoided if the mothers had taken a supplement of at least 400 mcg of folate during pregnancy.
However, a recent discovery has shown that women, in general, get enough folate to prevent neural tube defects, but still do NOT get enough to help with other health problems, especially cervical dysplasia (also called “proof of Abnormal Pap Smear”), the precursor to cervical cancer. According to Dr. Stanley J. Swierzewski III (2011), between 250,000 and 1 million women are diagnosed with cervical dysplasia each year.
What is cervical dysplasia?
Cervical dysplasia is a diagnosis given to women who have an abnormal Pap smear. When a woman has a Pap smear, cells are scraped from the cervix and sent to a lab for analysis. If they look abnormal, the diagnosis of Cervical Dysplasia is given.
Although having abnormal cervical cells is not harmful, the medical community believes that these cells are a precursor to a woman developing cervical cancer; the presence of it increases the risk of developing this cancer. According to Dr. Swierzewski (2011), almost 70% of these cases regress without becoming a problem, without turning into cancer.
The general treatment is to have another Pap test in 6 months and watch and wait. If the cells develop into cervical cancer in situ (an early cancer), then action is taken. It can take up to 10 years for this to happen.
What has been overlooked is that folic acid is essential for the health of the cervix.
Folic Acid – What is it?
Folic acid, also called folate, is a B vitamin, B-9 to be exact, but it’s not called a B vitamin; you’ll find it as folic acid for folate.
One of the properties of Folate is that it protects cells against changes in DNA and RNA that could cause cancer. The areas of the body that replicate cells are often at higher risk of developing cancer; when a cell replicates, it duplicates the genetic code of one cell and then makes two. Cancer occurs when this duplication process goes wrong. Cells are supposed to make an exact copy of themselves; cancer occurs when cells do not make an exact duplicate.
Folic acid ensures that the duplication process is exact.
One of the areas where there is a high turnover of cells is the cervix. As a note, the intestines are also a site of rapid cell turnover; a folate deficiency can lead to inflammatory bowel conditions, which are commonly found in people with cervical dysplasia.
Although the Centers for Disease Control considers Human Papillomavirus to be the leading cause of cervical cancer (and thus created the HPV vaccine), the incidence of cervical dysplasia has not decreased in those who are deficient. folate even with the vaccine (Cohen, 2011); this was confirmed in a 2009 study published in Epidemiology, biomarkers and cancer prevention (Flatley, 2009).
Causes of folic acid deficiency
After iron, folic acid deficiency is the second most common nutrient deficiency in the United States and Canada. Since our bodies do not make folic acid, it must come from the foods we eat or from supplementation. Before the FDA made it mandatory for foods to be fortified with folic acid in 1996 (CDC, 2010), folate was the leading deficiency.
Even with the fortification of processed foods, the rate of folate deficiency remains high. Natural dietary sources of folate are often not a food choice for many families. Add to that, alcohol and tobacco deplete the body of folate, as is the case with many of the commonly used medical drugs.
Some of the most common causes of folic acid deficiency:
>>Alcohol and tobacco: smoking and chewing tobacco deplete folic acid in the body; Alcohol also depletes folic acid stores, but it also interferes with the absorption of folic acid from ingested foods.
>>Inadequate dietary intake: Common foods that contain high levels of folic acid are often not consumed by Americans, most notably liver, spinach, lentils, and Brussels sprouts.
>>Medical drugs: Almost all medical drugs interfere with folate absorption or deplete it. Several of the drug classes that deplete folate or interfere with its absorption: antibiotics, antacids or acid blockers, pain relievers (all), birth control pills, diuretics, antidepressants, anti-anxiety medications, and vidovudine. This is only a partial list.
>>Deficiency in other B vitamins: Folate needs other B vitamins to be useful in the body. Two of the most needed are vitamins B-6 and B-12.
deficiency symptoms
The deficiency is often classified as “folic acid anemia” since red blood cells need folate, and the diagnosis of folic acid deficiency is usually seen first in the blood. Most of the symptoms of folate deficiency are related to the blood: paleness, headache, shortness of breath, palpitations, weakness, lack of energy, and loss of appetite.
As the deficiency worsens, other symptoms appear: irritability, forgetfulness, depression, confusion, apathy, hostility, paranoia; sore or red tongue; elevated homocysteine levels; Diarrhea; and weight loss.
Any level of deficiency can cause neural tube defects in newborns and increase the risk of developing cancer.
dietary sources of folate
Folic acid is found in many foods, including asparagus, avocados, beets, Brussels sprouts, cabbage, green leafy vegetables like spinach, lentils, liver, and wheat germ. It is also an additive in many processed foods in “enriched” products.
The Recommended Daily Allowance for all ages is 400 mcg daily. For pregnant women, it is recommended that you take 1,000 mcg (1 mg) per day.
Safety
A harmless side effect of folic acid supplementation is that urine often turns bright yellow. This does not affect health, it is just a change.
Since folic acid is a water-soluble vitamin that is not well stored in the body, the average person is unlikely to develop any reaction to taking folic acid supplements. However, in those with kidney disease, toxic levels can develop in the form of kidney stones and abdominal cramps.
For those with seizure disorders, taking folate might make seizures worse.
Also, for people with pernicious anemia (a deficiency of vitamin B-12), folate can increase the neurological symptoms associated with pernicious anemia.
Don’t take a folic acid supplement without first talking to someone who knows both natural supplements and medical conditions.
References
Centers for Disease Control (July 2, 2010). “Folic Acid Facts and Statistics” at http://www.cdc.gov/ncbddd/folicacid/data.html
Cohen, S. (2011). Drug Assailants: Which Medications Are Robbing Your Body of Essential Nutrients and Natural Ways to Restore Them. Emmaus, Pennsylvania: Rodale.
Flatley, me and. al. (2010). “Folate status and aberrant DNA methylation are associated with HPV infection and cervical pathogenesis”. Epidemiology, biomarkers and cancer prevention2009, Oct 18(10): 2782-89.
Swierzewski III, SJ (2011). “Cervical Dysplasia” at healthcommunities.com/cervical-dysplasia/overview-of-cervical-dysplasia.shtml
Wikipedia (June 29, 2012). “Abnormal Pap Smear” at http://en.wikipedia.org/wiki/Neural_tube_defect
Best wishes,
Dr. Ronda Behnke Theys
Homeopathic Centers of America
Disclaimer: The information provided by Dr. Ronda Behnke Theys is for educational purposes only. It is important that she not make any health decisions or stop any medication without first consulting her personal physician or health care provider.
