Vitamin B9 or folic acid is an essential element in the prevention of neonatal malformations.
Known above all for its importance during pregnancy, vitamin B9, better known as folic acid, is actually essential at any time in life as it is involved inmany essential processes for the body, regardless of gender and circumstances.
Fortunately, taking it in adequate quantities is generally simple since this microelement is widely used in nature and present in numerous foods commonly consumed as part of a healthy and balanced diet. However, in pregnancy and other situations that increase its need or reduce absorption, it becomes necessary to provide targeted supplements.
In fact, we will see how there are numerous cases in which vitamin B9 needs to be taken more than daily, and how for this reason it may be necessary to modify one’s diet, and on some occasions also resort to food supplements.
Here’s everything you need to know about this important vitamin: how it works, what it accesses when it is missing, in which foods to find it and how to increase its intake when the body requires it.
What is it
Folic acid or vitamin B9 is a water-soluble vitamin essential for the synthesis of DNA and proteins, two processes essential for growth, metabolism and cell replication, without which it would be impossible not only to renew the tissues of the body, but also to guarantee the general functioning of the latter.
Being necessary for cell replication, vitamin B9 is particularly required by growing tissues and undergoing very rapid cell turnover. In particular, this micronutrient is an irreplaceable support for the synthesis of hemoglobin and the formation of red blood cells (which occurs almost constantly to replenish those aged or damaged, eliminated by the spleen), for the turnover of the mucous membranes, for the proliferation and differentiation of embryonic tissues and, above all, for the development of the nervous system of the fetus during pregnancy.
As mentioned in the introductory paragraph, it is thus understood how much this particular micronutrient plays a fundamental role for the correct growth of the baby during pregnancy. It follows that it is the woman who specifically benefits from this element at certain stages of life, and also suffers most from a possible deficiency.
Vitamin B9 continues to be important for the proper functioning of the nervous system at all times of life, as well as for the full efficiency of the sexual organs and the maintenance of both female and male fertility (production of mature eggs and sperm, suitable for fertilization).
In addition, folic acid could have a preventive action against cardiovascular disease and hypertension, which has yet to be precisely established in terms of the mechanism and extent of the protection offered. Currently, what is certain is that maintaining an adequate intake of vitamin B9 is useful for reducing homocysteine levels, an amino acid that, if present in excess in the blood, is associated with an increased cardiovascular risk.
What happens if folic acid is missing
The most critical period for a possible folic acid deficiency is undoubtedly that of pregnancy and the weeks preceding it.
Insufficient levels of this vitamin, in fact, affect the development of the central nervous system of the fetus (which is formed especially in the first month of gestation, but which continues to mature and perfect throughout the first year of the baby’s life) and expose to a high risk of spina bifida (incomplete closure of the lower part of the neural tube), anencephaly (incomplete development of the brain), encephalocele (cerebral malformation similar to a hernia) and also seems to other congenital malformations, starting from cleft lip and palate and some congenital heart defects. Folic acid levels should be monitored both before and after conception of the baby, especially in the first trimester of pregnancy through constant visits.
But not only: vitamin B9 deficiencies can lead to unpleasant consequences even in old age, outside of specific situations such as pregnancy or breastfeeding of the newborn, in addition to its first periods of activity. For a constantly healthy and fit organism, it is important to prevent deficits throughout life, respecting the daily requirement with a diet that is as healthy and balanced as possible, which allows you to have a normal intake of micronutrients.
In adulthood, folic acid deficiency may be associated with an increased cardiovascular risk, reduced fertility (especially male) and a renewal of red blood cells and tissues in general less efficient, resulting in anemia and suffering of the mucous membranes.
Food Sources of Vitamin B9
Before providing indications on food sources of vitamin B9 it is important to specify that folic acid is the oxidized form of the compound, not present in nature, but obtained by chemical synthesis and inserted as such in food supplements and enriched foods, generally together with other vitamins and mineral salts.
This, however, should not mistakenly suggest that it is not possible to take this specific element through daily nutrition. On the contrary, a diet rich in vitamins remains the first form of prevention against deficiencies and the onset of disorders related to them.
In natural foods without vitamin fortifications, vitamin B9 is present in the form of folate, equally effective for nutritional purposes, but not entirely comparable to the previous one.
Folate is mainly contained in green leafy vegetables (such as spinach, broccoli, asparagus, lettuce, arugula, cabbage, etc.) and tomatoes, legumes (beans, peas, lentils, chickpeas, etc.), fruit (mainly, kiwi, strawberries and oranges) and dried fruit (such as almonds and walnuts). Other interesting sources of vitamin B9 are wheat germ, brewer’s yeast and cereals.
A diet with a sufficient daily dose of plant foods therefore helps to keep the level of folic acid stable and sufficiently high.
As for foods of animal origin, to contain good amounts of folate are mainly liver and offal, as well as some cheeses and eggs.
In addition to trying to maintain a varied and balanced diet, to take an adequate amount of folate every day it is important to consume the foods that contain them when they are fresh, preferably in season, and pay attention to how they are prepared, cooked and stored. Folates, in fact, belong to the group of water-soluble vitamins which, in addition to being dispersed in the cooking water in case of boiling, are destroyed by heat, light and acidity and are quickly dispersed in the air.
Remember, therefore, that, to preserve their nutritional properties and obtain the maximum vitamin intake, fruits and vegetables should be eaten as raw as possible (or freshly blanched in a pan) and whole or immediately after cutting, blending or centrifuged.
Recommended doses: how much and to whom
The daily requirement of folic acid varies according to age, gender and, for women of childbearing age, whether or not they are pregnant, about to undertake it or breastfeeding.
In general, the average folic acid requirement of a healthy adult (from 15 years) corresponds to 400 μg per day, an amount that can be obtained from the balanced consumption of fresh plant foods, properly cooked and preserved, and from any supplements with enriched foods (breakfast cereals, rusks, biscuits, milk, yogurt, fruit juice, etc.) or targeted supplements, in case of nutritional difficulties and/or insufficient intake.
During pregnancy the daily requirement of folic acid increases by about 200 μg / day, (reaching a total of 600 μg / day) due to the additional quota required by the developing fetus, and remains high after delivery, if you choose to breastfeed, since a share of vitamin B9 is transferred to breast milk. In this second case, to the 400 μg/day of folic acid required basic must be added another 100 μg/day, for a total daily requirement of 500μg/day.
Given that the daily amounts of folic acid recommended during pregnancy and lactation are difficult to obtain with diet alone, the Italian Network for the promotion of folic acid for the primary prevention of congenital defects established by the Ministry of Health recommends that all women of childbearing age who intend to become pregnant or who do not exclude it take specific folic acid supplements.
Obviously, in the case of a planned pregnancy, it is always important to consult first with your doctor, who will be able to advise on the best supplementation for your needs, evaluating doses and content. Vitamin supplements are of many types, and for this reason it is essential to take it correctly and consciously, also to avoid interactions with any secondary drugs.
Supplementation with targeted supplements should begin at least months before conception if pregnancy is planned, so that pregnancy begins when blood folate levels have already reached optimal concentrations.
In some special situations involving reduced absorption or increased need for folic acid, the extent of supplementation of this micronutrient must be even greater. Needs of this type are found during therapies with certain drugs (such as anticonvulsants, chemotherapy, estroprogestin), high alcohol consumption, comorbidity for insulin-dependent diabetes mellitus, celiac disease, intestinal malabsorption disorders or the presence of specific polymorphisms in genes involved in folate metabolism.
Additional risk factors for pregnant women, worthy of special attention by the doctor and a more intensive folic acid supplementation, are represented by the presence of family history for neural tube defects and by the fact of having had a previous pregnancy characterized by fetal alterations related to folate deficiency. Medical advice is always recommended to rule out any possibility of a harmful predisposition
All this must necessarily be associated with greater attention to other elements, which could interfere with the action of folic acid and with the correct development of the nervous system of the fetus during pregnancy. Among these there is certainly alcohol, which should not be taken under any circumstances, even in small doses.
An important aspect to consider is that, in order for folates to exert their support action on DNA synthesis and, therefore, on cell replication, it is also essential to ensure an adequate supply of vitamin B12, also called cobalamin. It is therefore very important to pay attention not only to vitamin B9, but also to a correct balance of all the essential micro-nutrients that could support the correct action of folic acid.
This vitamin is quite easy to obtain in adequate doses through food, as long as you follow a varied diet and includes foods of animal origin, since fish, eggs, dairy products and meat are the only ones that contain this essential micronutrient.
Those who follow lacto-ovo vegetarian diets and who admit the consumption of brewer’s yeast, in general, do not have problems of vitamin B12 deficiency, if the diet is planned in a rational way, while vegans who exclude all animal derivatives from the diet must provide targeted vitamin B12 supplements to avoid a significant deficiency (which in pregnancy can seriously endanger the health of the child).
Deficiency and overdose
Folic acid deficiency is the most often found among the B vitamins and can cause poor growth during childhood and adolescence, inflammation of the tongue, gingivitis and reduced appetite.
Among the most common warning signs of a significant deficiency of folic acid there are also the onset of anemia, sleep disorders and difficulty concentrating: if you start to suffer from disorders of this type without there being clear causes it is good to undergo some tests, evaluate vitamin B9 levels and, if necessary, integrate the daily contribution. Specific analyses can help in assessing the condition and verifying whether the disorders present may be due to an actual vitamin deficiency.
In general, a vitamin deficiency can lead to blood changes, which can however be easily detected by a specific test. Attention also to the health of the skin and hair, which could show signs of malaise in case of more or less serious deficiencies. A rebalancing of the diet and foods taken is certainly the first weapon of defense against this type of eventuality.
It should be considered that excessive vitamin B9 supplementation could mask the symptoms of a possible vitamin B12 deficiency: respecting the recommended daily intake dosages and following a varied diet allows you to avoid both deficits and excesses of both compounds.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
The blog covers a wide range of topics related to health and wellness, with articles organized into several categories.