Folic Acid

Dec 2, 2014

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

How fast do cows run? Seriously, if there are any cowboys and cowgirls out there, I want to know. Late in the summer, I was sitting around a fire with a bunch of people swapping stories. One guy I didn't know was trying to impress his girlfriend with cattle speed. He said he was chasing cows that day, and cows could run up to 77 km/h. That sounded too quick to me, so I Googled it. The answers I got varied from 20-60 km/h. Not very definitive. I do know how fast the cattle went when I started a stampede. Okay, stampede might be a bit of an exaggeration. I was riding my bike to Ashville junction and back with a couple friends. There were some cattle on the north side of the highway. As we approached, the cattle started loping along. As the mini-stampede came across solitary bovines, those cows were swept up in the cacophony of dust and hooves. I think we had 6-10 cows loping beside us for about 10-15 minutes. Those cows didn't have any trouble keeping a 20-25 km/h pace. Although no 77 km/h, this display of cattle speed impressed me.

Since pharmacy school, it has impressed me how important folic acid is. Folic acid is a B vitamin. Like most vitamins and minerals, it is best to get it from the food we eat. Folic acid is in beef liver, oranges, legumes and dark green vegetables. Folic acid is required for new cell growth, formation and maintenance especially during periods of rapid growth. Some people on the arthritis medication called methotrexate may need extra folic acid supplements. However, maybe the most important group of people that should watch their folic acid intake are women of child bearing age. While planning a pregnancy, and BEFORE becoming pregnant, it is important for women to start taking folic acid. It can prevent certain birth defects from occurring.

Birth defects, or congenital defects, can be defined as physical abnormalities that are present at birth. About 3 to 4 percent of babies are born with a major birth defect, although some may not be discovered until a child grows. By age five, 7.5 percent of all children are diagnosed with a birth defect, although many of these are minor. The type of birth defect that is associated with a folic acid deficit is called a neural tube defect. Neural tube defects (NTD) include such conditions anencephaly and spina bifida. Anencephaly is when the child is born with most of its brain missing, or the brain does not develop at all. The infant cannot survive and is either stillborn or dies within a few days of birth. Spina bifida is where one or more of the vertebrae fail to develop completely leaving a portion of the spinal cord unprotected. Spina bifida is strongly linked with folic acid deficiency in the diet, especially early in pregnancy. Symptoms can vary, where some children have few or no symptoms, whereas others are weak and paralysed in all areas reached by nerves below the level of the spinal cord defect.

To prevent neural tube defects, folic acid supplements should be taken before becoming pregnant, and continue throughout the first trimester. The neural tube forms and closes in the first four weeks of pregnancy. This is often before pregnancy tests can tell if you are pregnant. That is why it is important to start folic acid before you are pregnant. A minimum of 0.4 mg of folic acid daily is recommended for women who are planning to become pregnant. Higher doses up to 5 mg are recommended for women who have a high risk of having a child with a neural tube defect. If you think you are at high risk, consult your doctor before starting high dose of folic acid. Prenatal vitamins, such as Materna, contain as much as 0.8 to 1 mg of folic acid, and these vitamins should be used in pregnancy rather than regular vitamin formulations.

A new study out of the UK says there is another reason to start folic acid before one becomes pregnant. Hodgetts et al. published a paper in the November 2014 British Journal of Obstetrics and Gynaecology that linked folic acid and low birth weight. Their study showed that women who started taking folic acid before they got pregnant had less small for gestational age babies. These small babies have a greater risk of developing diabetes, high blood pressure, obesity, heart disease and mental health issues as adults than normal sized babies.

Another study that came out in February 2014 in JAMA done by Pal Suren et al. looked at newborns in Norway between 2002 and 2008. Their study showed that if mothers started folic acid before becoming pregnant their children were less likely to have autism.

Riding my bike on the highway as cattle loped beside me is the closest I've ever come to rounding up cattle like a true cowboy. But I think that is a far better story to impress girls with than 77 km/h sprinting cows. That speed just doesn't ring true. You shouldn't try to impress girls with cattle speed. You should try to impress girls with B.S. You know, Believable Stories. Believable Stories, like my mini-stampede, are the only things coming out of cows that should be shovelled at an audience.

If you are thinking about starting a family, talk to your family doctor. Talk about folic acid and the other things that should be done to prepare for your future family before becoming pregnant. That is a far more important conversation than listening to stories of cattle speed.

As always if you have any questions or concerns about these or other products, ask your pharmacist.

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

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