Trending Clinical Topic: Folic Acid

Ryan Syrek

Disclosures

January 15, 2021

Each week, we identify one top search term, speculate about what caused its popularity, and provide an infographic on a related condition. If you have thoughts about what's trending and why, share them with us on Twitter or Facebook.

The rollout of COVID-19 vaccinations and coronavirus mutations remain among the top concerns of clinicians, but online misinformation regarding a commonly used supplement resulted in folic acid becoming this week's top trending clinical topic. Folic acid is among the best studied and most widely endorsed nutritional supplement  for childbearing-aged women. It is a vital tool in preventing neural tube defects in unborn babies. However, various groups have begun promoting poorly supported reports claiming that folic acid is dangerous for women with common variations in a gene known as MTHFR (methylenetetrahydrofolate reductase).

Genetics experts from the Centers for Disease Control and Prevention (CDC) have stated that daily consumption of folic acid in women is helpful in preventing neural tube defects in children, regardless of MTHFR genotype (see infographic below). No clinical recommendations have been made regarding testing for MTHFR status or consuming different amounts of folate or folic acid based on genotype, despite extensive investigation.

Experts have expressed concern about misinformation that may lead women to avoid appropriate supplementation. In the United States alone, fortification prevents approximately 1300 neural tube defects from occurring. A recent study in BMJ Global Health found that weekly supplements containing 2.8 mg of folic acid were safe and were more effective in achieving red blood cell folate and preventing neural tube defects vs supplements containing only 0.4 mg of folic acid.

Folic acid has been shown to aid in other conditions as well. A recent study found that high intake was associated with a significant decrease in colorectal cancer risk. Folate deficiency has also been associated with elevated homocysteine levels, a known marker for increased arteriosclerosis risk. Evidence has also shown that folic acid supplementation may improve cognitive function, prevent stroke, and reduce the incidence of autism and diabetes-associated birth defects as well as the risk for childhood leukemia. High-dose folic acid is also being considered as a potential treatment for pulmonary hypertension associated with COVID-19 pneumonia.

Experts, including those at the CDC, are working to disprove and discredit misinformation regarding MTHFR variations and folic acid supplementation, as well as other poorly substantiated claims against the well-investigated vitamin. As the controversy continues, folic acid is likely to remain a top trending clinical topic.

Read more clinical information about folate deficiency.

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