Folic acid deficiency is no joke!

Historical information

The discovery of folic acid is associated with the search for a method of treating megaloblastic anemia.

In 1931, scientists discovered that adding liver extracts and yeast to a patient’s diet helps eliminate the symptoms of the disease. In subsequent years of research, it was recorded that a condition similar to macrocytic anemia progresses in chimpanzees and chickens when fed refined food. At the same time, the pathological manifestations of the disease were eliminated by adding alfalfa leaves, yeast, and liver extracts to the feed. It was clear that these products contain an unknown factor, the deficiency of which, in the body of experimental animals, leads to impaired hematopoiesis.

As a result of three years of numerous attempts to obtain the active principle in its pure form, in 1941 scientists isolated substances of the same nature from spinach leaves, yeast extract and liver, which they named: folic acid, vitamin bc, factor U. Over time, it turned out that the resulting compounds were identical to each other to a friend.

The period from the discovery of folacin to its isolation in its pure form is characterized by intensive research of the compound, starting with the study of its structure, synthesis, and ending with the determination of functions, as well as metabolic processes in which the substance takes part.

Summarize

• Folate (folic acid) is an important vitamin that is found in abundance in your diet.
• Eating a variety of healthy foods, such as fruits, vegetables, nuts and seeds, and fortified foods is an easy way to increase your folate intake.
• These foods are not only rich in folate or folic acid, but also contain many other important nutrients that can improve other aspects of your health.

Folate, Folic acid

Chemical and physical properties

Composition of the vitamin B9 molecule:

• P-aminobenzoic acid;
• pteridine derivative;
• L-glutamic acid.

Due to the fact that the term “pteroylglutamic acid” refers to a broad group of compounds, this caused some inconvenience during research, since not all categories of substances represented biological activity for living organisms, in particular for humans. Therefore, scientists decided to specify the concepts. Thus, the committee of the International Society assigned the name “folates” to the group of compounds that contain pteroic acid nuclei, and the term “folacin” to substances with the biological activity of tetrahydropteroylglutamic acid.

Thus, the concepts “folic” and “pteroylglutamine” group are synonymous. At the same time, folate is the chemical name for “related” compounds to vitamin B9.

Folic acid is a yellow, finely crystalline powder, tasteless and odorless. When heated, the crystals of the compound slowly darken, but do not melt; a further increase in temperature to 250 degrees leads to their charring.

Vitamin B9 quickly decomposes in light. At a temperature of 100 degrees, 50 milligrams of a substance dissolve in 100 milliliters of water; at zero – one unit. Folacin breaks down easily in caustic alkalis, but poorly in dilute hydrochloric and acetic acids, ether, chloroform, alcohol, acetone, benzene, and organic solvents. Silver, zinc, and lead salts of vitamin B9 are insoluble in water.

Folacin is well adsorbed by fuller's earth and activated carbon.

The role of vitamin B9 in the human body

Let's look at the benefits of folic acid:

1. Participates in the production of red blood cells, namely in the export of carbon for protein synthesis in the hemoglobin molecule.
2. Stimulates the production of hydrochloric acid in the stomach.
3. Ensures the proper functioning of the nervous system (regulates the transmission of impulses, inhibition/excitation processes), brain and spinal cord. Part of the liquor.
4. Takes part in the synthesis of proteins, DNA and RNA, nucleic acids, as well as in the formation of purines, in particular, cell nuclei.
5. Stabilizes the emotional background. Folic acid affects the level of production of norepinephrine and serotonin, reduces the negative effects of stress on the body, improves mood, and helps get rid of postpartum depression.
6. Smoothes climacteric disorders.
7. Reduces the risk of premature birth.
8. It has a beneficial effect on the digestive system, liver health, and the functionality of leukocytes.
9. Reduces chromosomal defects in sperm, enhances the activity of male germ cells.
10. Necessary for women and men to improve fertility. Systematic intake of foods high in vitamin compounds helps to avoid deterioration in reproductive function.
11. Reduces the risk of developing heart disease, blood vessels, and metabolic syndrome in a child. However, in the presence of heart pathologies, uncontrolled intake of vitamin B9 can lead to myocardial infarction and angina.
12. Regulates the concentration of homocysteine, thereby reducing the risk of stroke. Taking 5 milligrams of folacin daily as a dietary supplement has a preventive effect on the body.
13. Reduces the likelihood of colorectal cancer. However, as a result of large-scale screening of the population, scientists found that the compound cannot be used to prevent breast cancer, since folates have a negative effect on the development of modified breast cells. Vitamin B9 plays an important role for men; regular consumption of the beneficial compound reduces the risk of developing prostate cancer by 4 times.
14. Reduces “bad” cholesterol in the blood serum.
15. Normalizes blood pressure.
16. Supports the immune system, increases the number of leukocytes.
17. Improves memory and absorption of B vitamins.
18. Increases performance.
19. What is especially important for women is that it delays the onset of menopause to a later date.
20. Accelerates mental activity.

In addition, do not forget about the importance of folic acid for conceiving and bearing a healthy child. Regular intake of the nutrient during the planning stages (200 micrograms per day) and during pregnancy (300 - 400 micrograms per day) reduces the risk of developing congenital pathologies in the embryo by 70%.

Vitamin B9 is a real panacea in cosmetology. It helps against acne, hair loss, and serves as a universal remedy for evening out skin tone, eliminating pigmentation, and red spots.

Why is folic acid prescribed to pregnant women?

Vitamin B9 is involved in the formation of amino acid and RNA structures, which are necessary for cell division and the subsequent development of a new organism. In addition, it ensures high-quality absorption of iron and other important elements for normal activity.

Folic acid deficiency poses a significant threat to reproducing cells: without it, hematopoiesis cannot occur and the correct formation of internal organs and tissues of the fetus will not occur.

Vitamin B9 promotes the production of hydrochloric acid, is involved in the metabolism of adrenaline and serotonin, and regulates the functioning of the nervous system.

If folic acid is supplied in small quantities during pregnancy, the fetus increases the risk of hydrocephalus, spinal pathologies, heart defects and brain diseases.

Signs of a deficiency of the active substance are weakness, fatigue, sleep disturbance, apathy, depression and irritability.

Signs of folate deficiency in the body

In case of a lack of vitamin B9, the human body experiences a deficiency of the beneficial nutrient in the brain, which leads to problems with vision, movements, coordination, and seizures begin. At the same time, in adults, the risk of anemia, glossitis, ulcerative colitis, psoriasis, gingivitis, osteoporosis, neuritis, atherosclerosis, early menopause (in women), stroke, heart attack and even cancer increases 5 times.

Deficiency of the compound in pregnant women can cause harm to the fetus. In particular, there is a risk of giving birth to a premature baby with low birth weight and with neurodevelopmental disorders.

A chronic lack of the compound in the body of children leads to a slowdown in overall development, and in adolescents – to a delay in puberty.

Characteristic symptoms of vitamin B9 deficiency in the body:

• forgetfulness;
• irritability due to insufficient production of serotonin and norepinephrine;
• headache;
• confusion;
• diarrhea;
• depression;
• loss of appetite;
• apathy;
• high blood pressure;
• fatigue;
• insomnia;
• labored breathing;
• red tongue;
• the appearance of gray hair;
• decreased cognitive function;
• anxiety;
• inability to concentrate;
• memory problems;
• digestive disorders due to insufficient production of hydrochloric acid;
• hair loss;
• separation of the nail plate;
• pallor due to insufficient oxygen transport to peripheral tissues and organs;
• weakness as a result of decreased hemoglobin;
• lack of muscle mass - occurs due to poor absorption of proteins due to low stomach acidity.

Folic acid hypovitaminosis is often observed in people with intestinal diseases in whom the process of absorption of nutrients is difficult. In addition, during pregnancy and breastfeeding, the need for the substance increases by 1.5 - 2 times.

A lack of vitamin B9 is aggravated by alcohol intake, which interferes with the metabolism of folate, preventing the transport of the compound to its destination (tissues).

The level of folic acid in a person's body is diagnosed through analysis. 3 micrograms of folate per liter of blood serum indicates a lack of vitamin and the need to replenish reserves of the beneficial compound.

Often the signs of deficiency of vitamins B9 and B12 in the body are identical. To distinguish a deficiency of one compound from another, methylmalonic acid (MMA) levels should be measured. An increased value indicates a lack of B12 in the body, a normal value (within normal limits) indicates a lack of folic acid.

How much vitamin B9 should you drink to compensate for the deficiency of the compound?

The therapeutic daily dose of folic acid depends on the severity of symptoms and the presence of other diseases caused by deficiency of the substance. To correctly establish the norm, you should undergo an examination and seek help from a doctor.

As a rule, vitamin B9 intake for medicinal purposes varies in the range of 400 – 1000 micrograms per day.

For megaloblastic anemia, treatment should also begin with checking the levels of B9 and B12 in the body. This is due to the fact that in case of cyanocobalamin deficiency, supplementation with folic acid may not only not alleviate the symptoms of the disease, but may also worsen existing neurological problems.

In 80% of cases, a lack of a beneficial compound is experienced by people with an active lifestyle, sunbathers, patients with celiac disease and obesity, with a body mass index over 50. In addition, B9 deficiency can lead to a lack of folate, which increases homocysteine ​​levels, creating favorable conditions for development of cardiovascular diseases.

Lack of folate contributes to changes in the bone marrow and peripheral blood.

Let us consider the process of development of these pathologies in detail.

Changes in peripheral blood and bone marrow

A characteristic sign of the appearance of megaloblastic anemia at an early stage is the formation of hypersegmented multinuclear leukocytes in the blood: basophils, eosinophils, neutrophils.

As a result of the experiment, when a person was transferred to a folate-deficient diet, after 7 weeks the subject developed a Pelger-Huet anomaly. Namely, an increase in the number of strands (threads) connecting the segments of the nucleus. Normally, this indicator is equal to one, in neutrophils with megaloblastic anemia - two or three.

In addition, folate deficiency anemia is accompanied by a sharp decrease in the number of red blood cells in the blood, and in the later stages of the disease macrocytosis appears.

There are cases when iron deficiency is combined with a lack of folate in the body; in this situation, there may be no abnormally large red blood cells in the peripheral blood. The only characteristic indicators of combined anemia (iron deficiency and folate) are metamyelocytes in the bone marrow and hypersegmentation of neutrophils. Severe stages of folate deficiency can lead to thrombocytopenia and leukopenia.

Typical forms of megaloblastic changes in the bone marrow appear in 3 lineages: megakaryocyte, myeloid, erythrocyte. Often in patients, deviations affect all three growths of maturation. In this case, the main change in the nuclear forms of the erythrocyte series is a clearer identification of chromatin.

Folic acid deficiency is no joke!

Folic acid

is a necessary element in the human body for the synthesis of DNA and immune cells; it is also necessary for the proper development and course of pregnancy.

In the 21st century, clinical trials have been conducted that have found that disturbances in the folate cycle lead to the accumulation of homocysteine ​​in cells and an increase in total plasma homocysteine ​​levels. Homocysteine ​​has a pronounced toxic, atherogenic and thrombophilic effect.

There are genetic factors when there is a defect in certain genes responsible for the synthesis of methylenetetrahydrofolate reductase (MTHFR, MTR and MTRR) - enzymes that metabolize folic acid, necessary for the conversion of homocysteine ​​into methionine (folate cycle).

Folate cycle gene polymorphisms are associated with the following phenomena:

• complications of pregnancy (fetoplacental insufficiency, premature abruption of a normally located placenta, late gestosis);
• fetal development defects (neural tube cleft, anencephaly, facial skeletal deformities);
• intrauterine fetal death, recurrent miscarriage;
• development of homocystinuria (repeated thrombosis and thromboembolism, ectopia of the lens, early osteoporosis and multiple bone deformities);
• cardiovascular diseases (coronary heart disease, myocardial infarction, atherosclerosis, atherothrombosis);
• carcinogenesis (colorectal adenoma, breast and ovarian cancer, prostate cancer);
• increased side effects during chemotherapy.

Nutritional factors (lack of folate in the diet) of folate deficiency and hyperhomocysteinemia are:

• long-term use of methotrexate, anticonvulsants, other medications (folic acid antagonists, aspirin, biseptol),
• taking oral contraceptives and estrogens;
• pathologies of the stomach and intestines with impaired absorption of vitamin B12;
• malignant tumors of the pancreas and intestines;
• long-term chronic infections;
• kidney pathologies.

Indications for genetic analysis:

• planned preparation for pregnancy;
• increased levels of homocysteine ​​in the blood (hyperhomocysteinemia);
• miscarriage, fetal death in the second and third trimesters of pregnancy;
• the birth of a fetus with isolated defects of the neural tube, heart or urogenital tract;
• antiphospholipid syndrome;
• prescription of oral contraceptives and hormone replacement therapy;
• family predisposition to cancer;
• administration of chemotherapy;
• the presence of coronary artery disease, arterial hypertension, atherosclerosis and atherothrombosis.

What do the results mean?

Recommendations:

1. Folate-rich diet. High levels of folic acid (vitamin B9) stabilize the altered enzyme or promote the activation of alternative remethylation pathways. Foods containing folic acid: dark green leafy vegetables (spinach, lettuce, asparagus), beets, carrots, Brussels sprouts, broccoli, tomato juice, yeast, liver, egg yolk, cheese, melon, apricots, pumpkin, avocado, beans, whole wheat and dark rye flour.

   Content of folic acid (Vitamin B9) in some foods

1. If polymorphisms associated with folate cycle defects are detected in a child’s genetic passport, a lifelong ban on a vegetarian diet and support for weakened vitamin metabolism are of great importance.
2. Excessive coffee consumption (more than 5 cups per day) is not recommended.
3. Use drugs that affect folate metabolism with caution. The level of folic acid in the blood serum is reduced by a number of drugs: aspirin, biseptol, anticonvulsants, estrogens, contraceptives, etc.
4. When using COCs, it is advisable to take prophylactic folic acid, vitamins B6 and B12.
5. Periconceptional (during the 3 months before and the first 3 months after pregnancy) intake of 400 mcg of folic acid daily. For patients carrying the 677T allele, up to 4 mg/day of folic acid may be recommended during preparation and throughout pregnancy. When taking folic acid, a relative deficiency of vitamin B12 may occur, so the administration of folic acid must be combined with the intake of vitamins B12 and B6.
6. It is important to draw the attention of doctors to the fact that in patients with unsuspected hyperhomocysteinemia, standard therapy used in hospitals and aimed at eliminating the manifestations of gestosis may not only be ineffective, but may even worsen the patient’s condition. This applies to drugs such as methionine and aminophylline, which are often used to treat gestosis. Taking methionine and aminophylline reliably leads to an increase in blood homocysteine ​​levels, which can include or complement a cascade of pathological reactions leading to the development of generalized microangiopathy and thrombophilic conditions.
7. In the first trimester of pregnancy, dihydrofolate reductase inhibitors that block folic acid from being converted into its active form (for example, trimethoprim, sulfasalazine) and other folic acid antagonists (for example, carbamazepine, phenytoin, valproic acid and cholestyramine) are not recommended.

Overdose of folic acid

Vitamin B9 has a low risk of toxicity; excess compounds are excreted in the urine. However, systematic intake of high doses of the substance (1000 or more micrograms per day) can lead to hypervitaminosis, which, like any disease, is best detected in the early stages of formation.

Let's consider what side effects hypervitaminosis causes in adults:

1. Hyperplasia of renal epithelial cells.
2. Increased excitability of the central nervous system.
3. Reducing the concentration of cyanocobalamin in the blood (in case of long-term use of large doses of pteroylglutamic acid).
4. Dyspepsia.
5. Sleep disorder.
6. Anorexia.
7. Disorders of the digestive system (intestinal upset).

An overdose of vitamin B9 in pregnant women can lead to asthma in the newborn.

Long-term use of folic acid above 500 micrograms per day reduces the concentration of B12 in the blood, so that an excess of one compound causes a deficiency of the other.

Indications for use and contraindications

Let's look at why you should drink vitamin B9:

1. In case of development of hypo- and avitaminosis B9.
2. During pregnancy. Often among women the question arises: how long should you take folic acid? Doctors recommend using it throughout pregnancy to prevent the development of neural tube defects in the fetus.
3. During lactation.

Contraindications to the use of pteroylglutamic acid:

• malignant neoplasms;
• cyanocobalamin deficiency;
• hemosiderosis, hemochromatosis;
• hypersensitivity (allergy) to the drug.

How much vitamin B9 should you consume per day?

If it is necessary to include folic acid in the diet of children under 3 years of age, the compound should be administered carefully in small doses. According to the conclusion of the FAO/WHO expert group, the daily norm for a child from birth to 6 months is 40 micrograms, 7 - 12 months - 50 units, from 1 to 3 years - 70, from 4 to 12 years - 100. From 13 years of age, the dose for adolescent and adult equals 200 micrograms per day.

However, it is worth considering that the daily requirement of folic acid is purely individual. The minimum dose for an adult is 200 milligrams, the maximum is 500. During pregnancy, this figure increases to 400 units, during breastfeeding – to 300.

Distribution of vitamin B9 in nature

Folic acid can be included in a multivitamin complex or produced separately. Synthetic forms of vitamin B9 are 2 times more active than natural ones.

What is the difference between “medicinal” and “natural” folate from foods?

Tablets containing 600 micrograms of folic acid are equivalent to food products containing 1000 units of the beneficial substance.

Interestingly, plants and most microorganisms are able to synthesize folates, while birds and mammals do not produce these compounds. A small part of pteroylmonoglutamic acid is found in plant and animal cells. The main amount of folates in them is part of conjugates (di-, tri-, polyglutamates), which have additional molecules of glutamic acid. They, in turn, are united by a strong amide bond, similar to a peptide bond.

In bacteria, the predominant form of folate is pteroyltriglutamic acid, containing 3 molecules of glutamate; in yeast, it is a complex with 6 particles called heptaglutamate.

Often, “bound” folacin included in food products is represented by polyglutamates, while the “free” group (casei mono-, di- and triglutamates) makes up no more than 30%.
What foods contain folic acid?

The list of foods that contain vitamin B9 is useful for creating a balanced daily diet that provides the body with the necessary amount of nutrients.

In the process of creating a menu, important nuances should be taken into account:

• when cooking vegetables and meat, 80–90% of folates are destroyed;
• when grinding grains – 60 – 80%;
• when frying offal and meat – 95%;
• when freezing fruits and vegetables – 20 – 70%;
• when boiling eggs – 50%;
• when canning vegetables – 60 – 85%;
• when pasteurizing and boiling fresh milk - 100%.

Thus, cooking foods high in folic acid leads to partial or complete loss of the beneficial compound. To enrich your diet with vitamin B9, greens, vegetables and fruits should be eaten raw. In addition, during the winter season it is recommended to nourish the body with nutritional supplements and vitamin complexes, which include a daily dose of folate.

In order for the intestinal flora to better synthesize B9, it is recommended to consume yogurt, biokefir, and preparations with bifidobacteria daily.

Absorption of folic acid

Let's take a closer look at the way folate is absorbed.

Observations of people and experiments on animals have established that vitamin B9 taken per os (orally) is almost completely absorbed into the body as quickly as possible. With the introduction of 40 micrograms of labeled pteroylglutamic acid per kilogram of body weight, the level of absorption of the substance in 5 hours reaches 98.5% of the administered dose. 50% of the absorbed amount is excreted in the urine one day after taking the drug.

Absorption of folic acid occurs in the proximal small intestine and duodenum.

Of particular interest is the process of absorption of dietary folates, which are mainly contained in the form of polyglutamates produced by them (methyl, formyl).

Monoglutamates are easily absorbed in the body. In this case, polyglutamates are absorbed by enzymes produced in the intestines (conjugases, gammaglutamyl carboxypeptidase) only after eliminating excess glutamic acid.

In the intestine, B9 is first reduced to tetrahydrofolic acid (THFA) under the influence of dihydrofolate reductase, then methylated. In some gastrointestinal diseases (malabsorption syndrome, childhood non-infectious diarrhea, sprue, idiopathic steatorrhea), folate absorption is impaired. This leads to impaired absorption of the substance, the development of folate deficiency, which can subsequently lead to a decrease in enzyme-forming and juice-secreting functions, and destruction of the intestinal epithelium.

In the process of studying the absorption of tetrahydrofolic acid derivatives (formyl and methyl), the following was established: N-methyl-THFA is absorbed by simple diffusion without changing during the absorption process. When N-formyl-THFA (folic) acid enters the human body, during absorption it is almost completely converted into methyltetrahydrofolate in the intestine.

After absorption, folates enter the liver, where they gradually accumulate and are transformed into active forms. The human body contains about 7–12 milligrams of this compound. Moreover, 5–7 milligrams of them are concentrated directly in the liver. Some of the folates are polyglutamates, of which more than 50% of folic acid derivatives are presented in the form of methyltetrahydrofolic acid. Scientists call it the reserve form B9.

Studies have shown that when pteroylglutamic acid is added to the diet of animals, the amount of folate in the liver increases significantly. Liver folacin, unlike derivatives of other tissues, is very labile. The accumulated reserves of liver folate are able to replenish the lack of useful compounds in the body for 4 months, preventing the development of anemia. In addition, the human body (in the intestinal mucosa, kidneys) contains a certain reserve of vitamin B9.

The amount of folate in the liver is 4 times greater than in the urinary organs. However, its ability to accumulate and consume beneficial compounds directly depends on the body’s supply of vitamins, amino acids, and proteins. For example, as a result of an experiment conducted on rats, scientists discovered that a deficiency of cyanocobalamin (B12), methionine, and biotin in the diet leads to a decrease in folates, especially polyglutamates, as well as the ability to convert them into THFA.

Do not underestimate the important properties of the liver in the metabolism of folic acid derivatives. The functional state of the organ affects the level of folate absorption and the course of reactions involving vitamin B9 coenzymes. Fatty infiltration and cirrhosis of the liver disrupt its ability to accumulate and consume the compound. Often, as a result of such lesions, a serious disease develops - megaloblastic anemia.

From the human body, processed folic acid residues are excreted in urine and feces. At the same time, the amount of folate in urine, in most cases, does not correspond to its intake from food. Namely, more is output than is received.

FOLIC ACID - VITAMIN B9

*Bifidobacteria and propionic acid bacteria synthesize folic acid...

What is folic acid?

Folic acid is a water-soluble vitamin B9 necessary for the growth and development of the circulatory and immune systems. Almost no one currently argues that “the new is the well-forgotten old.” This happened with folic acid (synonyms: vitamin B, vitamin B9, vitamin M, pteroylglutamic acid, folacin, folamin, cytofol, folsan, riofolin, milafol, etc.). When in 1941 folic acid was isolated from green spinach leaves, which is how it got its name (from the Latin folium

- “leaf”), no one could have imagined that decades later the close attention of scientists around the world would turn to this chemical compound with a very intricate name

N-4-2-amino-4-hydroxy-6-pteridyl‑methyl-aminobenzoyl-L-glutamic acid. Chemical formula: C19H19N7O6

Folic acid is not synthesized in the human and animal body; it comes from outside along with food. Another source of folic acid is the natural intestinal microflora .

Importance of folic acid (vitamin B9)

The coenzyme functions of folic acid are associated not with the free form of the vitamin, but with the reduced pteridine derivative. Reduction involves the breaking of two double bonds and the addition of four hydrogen atoms to form tetrahydrofolic acid (THFA) and occurs in animal tissues in two stages with the participation of specific enzymes containing reduced NADP. First, with the participation of folate reductase, dihydrofolic acid (DHFA) is formed, which, with the participation of a second enzyme, dihydrofolate reductase, is reduced to THFA. The coenzyme functions of THFA are directly related to the transfer of one-carbon groups, the primary sources of which in the body are derivatives of well-known amino acids (serine, glycine, methionine, choline, tryptophan, histidine), as well as formaldehyde, formic acid and methanol. THFA derivatives play an extremely important role in the biosynthesis of proteins and nucleic acids, so the profound metabolic disorders that are often observed with folic acid deficiency are understandable. Folic acid has hydrogen acceptor properties, which determines its participation in redox processes. folic acid takes an active part in the processes of regulation of the functions of the hematopoietic organs, has an antianemic effect in macrocytic anemia, and has a positive effect on the functions of the intestines and liver, preventing its fatty infiltration. Therefore, folic acid is present in all tissues of animals and humans and is very important for the normal processes of growth, development and proliferation of tissues, including erythropoiesis and embryogenesis. In addition, folic acid is necessary for the formation of adrenaline, the catabolism of nicotinic acid, and has an estrogen-like effect. According to some data, taking folic acid reduces the risk of developing cervical cancer in women taking hormonal contraceptives.

Therapeutic doses of vitamin B9

The best way to prevent folate deficiency is a diet that includes fresh vegetables and fruits in the daily menu. If there is a lack of folate in food, it is recommended to consume an additional 150–200 micrograms of the vitamin daily.

If pteroylglutamic acid deficiency is caused by impaired absorption of the vitamin due to gastrointestinal disease, the amount of the compound should be increased to 500 - 1000 units per day. Often, this dose ensures that the required level of the drug is absorbed. An example of this kind of deficiency is a severe disease called sprue (non-tropical, tropical), in which the absorption of nutrients sharply deteriorates and atrophy of the mucous membrane of the small intestine develops. The introduction of folic acid into a patient’s diet has a positive therapeutic effect, which helps to improve the clinical picture and alleviate the person’s condition.

With complete gastrectomy and atrophy of the gastric mucosa, megaloblastic anemia is observed, caused by a deficiency of cyanocobalamin rather than folate. Daily intake of 200 - 500 micrograms of B9, in combination with a one-time intramuscular injection of 300 - 500 micrograms of B12, has a beneficial therapeutic effect. To eliminate megaloblastic anemia that occurs due to alcohol intoxication, pregnancy, infection, the patient is prescribed an increased dose of folic acid - from 500 to 1000 micrograms per day.

During treatment of leukemia with vitamin B9 antagonists, folate absorption is impaired. These substances block the conversion of the beneficial compound into the active tetrahydroform. As a result, prolonged use of drugs causes severe complications and poses a potential threat to human life. To treat patients, active forms of folate are used: injections of N5-formyl-THFA (300 micrograms per day). In case of disruption of the formation of the enzyme dihydrofolate reductase, it is recommended to use folic acid.

Let's look at how to drink folic acid for specific diseases (indications for use):

1. Aphthous stomatitis. A deficiency in the body of micronutrients and vitamins (iron, B9, B12) involved in hematopoiesis leads to the formation of cracks on the lips and ulcers on the oral mucosa (aphtha). To eliminate the disease, it is recommended to take 500 micrograms of folic acid and 100 milligrams of iron glycinate 3 times a day. The duration of treatment depends on the severity of the disease and varies from 120 to 180 days. During this period, once a month, the patient should receive injections of 100 micrograms of cyanocobalamin. During treatment, it is important to monitor the level of vitamin B12 in the blood.
2. Gingivitis and periodontitis. To relieve gum inflammation, folic acid should be consumed orally at 100 micrograms per day. At the same time, treatment should be supplemented with daily rinsing of the mouth with a 1% vitamin solution in the morning and evening. The course of therapy is 2 months.

Remember, regardless of the type of disease, the therapeutic dose of vitamin B9 depends on the patient’s condition and is selected individually by the attending physician.

What if it's not enough?

With a normal diet, as a rule, a serious deficiency of folic acid does not occur. But if there are not enough fresh vegetables and fruits in the diet, or a person regularly drinks alcohol, which interferes with the absorption of folic acid, folic acid deficiency occurs. Vitamin B9 deficiency can also be observed in women in the third trimester
of pregnancy, when the child is actively growing.
A lack of folic acid leads to increased fatigue, decreased mood, irritability and loss of appetite. If it is constantly missing from your diet, your risk of stroke and certain types of cancer increases. Vitamin B9 deficiency leads to a significant decrease in sperm production in men, and also increases the risk of depression
and memory impairment.

Vitamin B9 and men's health

Folic acid is needed not only for children under one year of age and women to become pregnant and bear a child, but also for men. Chronic nutrient deficiency in the body of the stronger sex increases the risk of developing megaloblastic anemia, as well as pathologies of the reproductive system, including infertility. Daily intake of vitamin B9 in a therapeutic dose completely eliminates these complications.

The main indicator of men's health is the condition of sperm. So, for the synthesis of germ cells, nucleic acids and protein are needed. A lack of folate leads to impaired production, deterioration of the condition, and a decrease in the concentration and motility of sperm. In addition, a deficiency of a vitamin compound can cause the formation of an incorrect number of chromosomes in germ cells, which can lead to the appearance of hereditary diseases in a child (for example, Down syndrome).

Why is folic acid needed in the male body?

Vitamin B9 promotes the proper development of sperm. Folates play a particularly important role during puberty, when the intensive process of development of sexual characteristics begins (appearance of hair on the face, body, deepening of the voice, intensive growth).

Why is it needed?

The most important role of folic acid in the body is participation in the process of synthesis of nucleic acids, which ensure the transfer of genetic information
in any cell.
Therefore, getting enough of this substance is very important for women who are expecting a baby. Folic acid helps prevent birth defects
of the brain and spine in the unborn child. Vitamin B9 is involved in the production of red blood cells in the body. It also improves brain health. Research has shown that regular intake of folic acid can improve the speed of information processing in the brain and memory function. Together with vitamin B12 and vitamin C, folic acid helps the body break down proteins from food and build new proteins.