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Just how bad is folic acid?

bigmillz

Senior Member
Messages
219
Location
NYC
I was visiting some family out of town over the weekend, and didn't realize how much food (especially outside of NYC) contains folic acid! I literally couldn't get through a single meal without being presented with some cheap, heavily processed grain product.

So based on my methylation report, just how big of a deal should I treat folic acid as? I know @Freddd has presented suggested mFolate doses based on overcoming various blocks/obstacles, but I'm not sure how much folic acid I'd have to take in to make this a real threat. Is a little here and there (i.e. if I go get a wrap from the deli a couple of times a week) fine generally? I assume it varies from person to person, but is there any rule of thumb?

Thoughts?
Screen Shot 2016-10-04 at 4.32.38 PM.png
 

alicec

Senior Member
Messages
1,572
Location
Australia
I assume it varies from person to person, but is there any rule of thumb?

Any adverse effect would need to be determined empirically. The best rule of thumb that I can think of is avoid folic acid if possible.

There have been limited studies but it seems that unmetabolised folic acid accumulates in the blood of everyone eating fortified foods.

Folic acid has a higher affinity for the folate receptor than natural forms of folate so can out compete them for uptake into the cell.

The enzyme dihydrofolate reductase (DHFR) processes folic acid once inside the cell in a two step reaction. First it converts folic acid to dihydrofolate (DHF), then it converts DHF to THF. This latter reaction is the normal reaction for this enzyme but structural similarities mean that it can recognise folic acid and do the first conversion also.

The first step, ie processing of folic acid, is very slow in everyone and particularly so in some people. In other words, the enzyme has more trouble with the folic acid substrate than it does with its normal substrate DHF. This is probably the reason that folic acid accumulates.

Folic acid also inhibits this second step, ie conversion of DHF to THF, so DHF accumulates. DHF in turn inhibits other enzymes in the folate cycle, eg MTHFR, SHMT1, TS and enzymes involved in purine metabolism.

Also it is only by converting DHF to THF that folate becomes available for feeding in to all aspects of the folate cycle.

Everyone has some degree of trouble processing folic acid but possibly there might be more impact on other aspects of folate metabolism if enzymes are already slowed because of SNPs. There is a lot of speculation about this but I'm not aware of specific studies.

In your own case, you have a modest slowing of MTHFR so maybe you could be a bit more susceptible. Furthermore you have some slowing at MTR/MTRR so possibly this could exacerbate the effect.

It is not possible to predict.
 
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Hip

Senior Member
Messages
17,824
Like some people say about their relationships: it's complicated.

Some studies show folic acid fortification of foods increase the risks certain cancers, others show folic acid fortification reduces cancers.

For example in bowel cancer, folic acid fortification increases the rate of growth of existing bowel cancers, but has a preventative effect on the development of new bowel cancers (so in other words, if you have bowel cancer, folic acid can speed it up; but if you don't have bowel cancer, folic acid can help prevent you from getting it in the future).

Which is why when you first introduce folic acid food fortification to a country, you may get a spike in the number of bowel cancers, as people with existing bowel cancers have their disease accelerated; but thereafter, you find folic acid has a preventative effect, so that in the long term, bowel cancers go down.

But that's just one cancer. You'd have to look across the whole spectrum of cancers and other conditions affected by folic acid to try to come to any conclusion of whether you want to embrace or avoid folic acid. Good luck with that research project!
 

bigmillz

Senior Member
Messages
219
Location
NYC
Any adverse effect would need to be determined empirically. The best rule of thumb that I can think of is avoid folic acid if possible.

There have been limited studies but it seems that unmetabolised folic acid accumulates in the blood of everyone eating fortified foods.

Folic acid has a higher affinity for the folate receptor than natural forms of folate so can out compete them for uptake into the cell.

The enzyme dihydrofolate reductase (DHFR) processes folic acid once inside the cell in a two step reaction. First it converts folic acid to dihydrofolate (DHF), then it converts DHF to THF. This latter reaction is the normal reaction for this enzyme but structural similarities mean that it can recognise folic acid and do the first conversion also.

The first step, ie processing of folic acid, is very slow in everyone and particularly so in some people. In other words, the enzyme has more trouble with the folic acid substrate than it does with its normal substrate DHF. This is probably the reason that folic acid accumulates.

Folic acid also inhibits this second step, ie conversion of DHF to THF, so DHF accumulates. DHF in turn inhibits other enzymes in the folate cycle, eg MTHFR, SHMT1, TS and enzymes involved in purine metabolism.

Also it is only by converting DHF to THF that folate becomes available for feeding in to all aspects of the folate cycle.

Everyone has some degree of trouble processing folic acid but possibly there might be more impact on other aspects of folate metabolism if enzymes are already slowed because of SNPs. There is a lot of speculation about this but I'm not aware of specific studies.

In your own case, you have a modest slowing of MTHFR so maybe you could be a bit more susceptible. Furthermore you have some slowing at MTR/MTRR so possibly this could exacerbate the effect.

It is not possible to predict.

Appreciate it Alice - very detailed. When I'm at home in NY, I generally don't eat a lot of fortified grains, as most every meal comes with rice or veggies instead - not endless bread or pasta.

I've heard elsewhere that my MTHFR status is somewhat in my favor for this, so that I can process a little more at least.

I keep a log, and it includes other tests I'd like to do. An upcoming on is increasing my mFolate dose to see if there's any benefit. Although not strictly related to folic acid intake, we'll see if it has any correlation.

Like some people say about their relationships: it's complicated.

Some studies show folic acid fortification of foods increase the risks certain cancers, others show folic acid fortification reduces cancers.

For example in bowel cancer, folic acid fortification increases the rate of growth of existing bowel cancers, but has a preventative effect on the development of new bowel cancers (so in other words, if you have bowel cancer, folic acid can speed it up; but if you don't have bowel cancer, folic acid can help prevent you from getting it in the future).

Which is why when you first introduce folic acid food fortification to a country, you may get a spike in the number of bowel cancers, as people with existing bowel cancers have their disease accelerated; but thereafter, you find folic acid has a preventative effect, so that in the long term, bowel cancers go down.

But that's just one cancer. You'd have to look across the whole spectrum of cancers and other conditions affected by folic acid to try to come to any conclusion of whether you want to embrace or avoid folic acid. Good luck with that research project!

Yea, definitely not something I'm trying to consume more of. Sucks we're subjected to so many altered foods in this country, but that's an entirely different can of worms.
 

Hip

Senior Member
Messages
17,824
Sucks we're subjected to so many altered foods in this country, but that's an entirely different can of worms.

My father spend his early years in Italy, where in some areas there is a natural deficiency of iodine in the soil. This was in the days before salt was routinely fortified with iodine, and when food was still locally farmed, and as a result, at that time in Italy, he said he would often see people with goiter, an iodine deficiency disease in which you neck can swell up to the size of a football, like this.
 
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Hip

Senior Member
Messages
17,824
There's also currently a controversy in Scotland, about whether this country, which has a high rate of multiple sclerosis (like many northern latitudes do), should fortify their food with vitamin D, which is believed will have a preventative effect on the development of MS.

All Scots have been advised to take vitamin D all year round, and there are people pushing for the mandatory fortification of food with vitamin D, but there are also people against the idea.
 

alicec

Senior Member
Messages
1,572
Location
Australia
I've heard elsewhere that my MTHFR status is somewhat in my favor for this

I would have thought the opposite was more likely. MTHFR status is not likely to affect your ability to process folic acid but it could affect the effect of folic acid on the activity of the MTHFR enzyme. You might be more susceptible to the inhibitory effects of folic acid since your MTHFR enzyme is already somewhat slow.
 

bigmillz

Senior Member
Messages
219
Location
NYC

Pretty terrifying to read. I wish it were easier to eat while avoiding it!

That said, how common do you folks think it is for smaller restaurants (not chains) to use enriched flour in their food? I'm assuming less, but still happens (based on finding their products in stores, where they have to list ingredients).
 

caledonia

Senior Member
Pretty terrifying to read. I wish it were easier to eat while avoiding it!

That said, how common do you folks think it is for smaller restaurants (not chains) to use enriched flour in their food? I'm assuming less, but still happens (based on finding their products in stores, where they have to list ingredients).

I don't eat out that much, but did run into folic acid used in rice at a mom and pop type Mexican restaurant that has two locations. The rice was ok at another small local chain with 4 locations.

I did some googling. It looks like all wheat from the US, except organic or whole wheat, is fortified. Baked goods (made from wheat) are fortified. Rice may or may not be depending on the source. If it's from the US, probably fortified. If it's from outside the US, like Thailand, probably not.

If you want to be absolutely sure, you need to either go organic or grain free.

ps. Looks like corn masa has recently become fortified in the US.
http://www.seattletimes.com/seattle...olic-acid-in-corn-masa-to-stop-birth-defects/

The problem with this is Hispanics eat a lot of masa, and they have a high rate of neural tube defects (due to a high rate of MTHFR). The folic acid supplementation will cause issues for Hispanics and backfire.http://www.seattletimes.com/seattle...olic-acid-in-corn-masa-to-stop-birth-defects/
 

bigmillz

Senior Member
Messages
219
Location
NYC
I don't eat out that much, but did run into folic acid used in rice at a mom and pop type Mexican restaurant that has two locations. The rice was ok at another small local chain with 4 locations.

I did some googling. It looks like all wheat from the US, except organic or whole wheat, is fortified. Baked goods (made from wheat) are fortified. Rice may or may not be depending on the source. If it's from the US, probably fortified. If it's from outside the US, like Thailand, probably not.

If you want to be absolutely sure, you need to either go organic or grain free.

ps. Looks like corn masa has recently become fortified in the US.
http://www.seattletimes.com/seattle...olic-acid-in-corn-masa-to-stop-birth-defects/

The problem with this is Hispanics eat a lot of masa, and they have a high rate of neural tube defects (due to a high rate of MTHFR). The folic acid supplementation will cause issues for Hispanics and backfire.

I actually just read about the corn. Sucks.

I'd cook at home, but it's literally cheaper and to eat out here - it's pretty crazy. Plus the variety of food has benefited my health as well, probably from the assortment of ingredients I wouldn't normally work with on my own. But I digress.

What you said about whole wheat and organic makes sense. Most of the bread products that I would prefer from a general health perspective are devoid of folic acid, which is awesome. As for rice, it's much harder to say. But when I used to make dishes with rice, I did generally buy high quality rice that was imported (hell, it was only $10 for a huge bag that lasted months).
 

bigmillz

Senior Member
Messages
219
Location
NYC
Additional question: does enough methylfolate "overcome" folic acid? That is, if you eat a slice of white bread, rated at 25% RDA for folate (approx 100mcg in the US), then would taking a daily dose of methylfolate compensate for it? I've heard the 10:1 methylfolate to folic acid rule of thumb thrown around. While I don't know if there's any truth to that, would the rest still apply?

I ask as the more conscious I become of this, the harder I'm finding it to avoid enriched flour & rice.