What is vitiligo and how does it affect the skin. What causes vitiligo to develop. How is vitiligo diagnosed and what are the available treatment options. Can vitiligo be prevented or cured.

Understanding Vitiligo: A Comprehensive Overview

Vitiligo is a complex skin condition characterized by the development of white patches on various parts of the body. This depigmentation occurs due to the destruction of melanocytes, the cells responsible for producing melanin, which gives skin its color. While vitiligo affects people of all races equally, it tends to be more noticeable in those with darker skin tones.

How prevalent is vitiligo? It’s estimated that up to 2% of the global population is affected by this condition, translating to approximately 2 to 5 million Americans. Vitiligo can manifest at any age, but it typically emerges between the ages of 10 and 30, with most cases appearing before the age of 40.

The Underlying Causes and Risk Factors of Vitiligo

What triggers the onset of vitiligo? The exact cause remains unclear, but researchers believe it may be an autoimmune condition. In this scenario, the body’s immune system mistakenly attacks and destroys its own melanocytes instead of targeting harmful invaders.

Are certain individuals more susceptible to developing vitiligo? Several factors may increase one’s risk:

• Genetic predisposition: Vitiligo tends to run in families, suggesting a hereditary component.
• Premature graying: Individuals with a family history of early graying hair may be at higher risk.
• Autoimmune disorders: People with other autoimmune conditions, such as Hashimoto’s thyroiditis or type 1 diabetes, have an increased likelihood of developing vitiligo.

Recognizing the Symptoms and Types of Vitiligo

How does vitiligo manifest itself? The primary symptom is the appearance of white patches on the skin. These patches often develop rapidly across multiple areas of the body. While the progression may stabilize temporarily, the affected areas can expand over time.

Where does vitiligo commonly appear? Some frequently affected areas include:

• Body folds (e.g., armpits)
• Sites of previous injuries
• Sun-exposed areas
• Skin surrounding moles
• Areas around body openings
• Mucous membranes (lining of the nose and mouth)

In some cases, vitiligo may also affect the eyelids and hair. It’s important to note that once white patches have formed, it’s rare for pigmentation to return naturally.

The Five Types of Vitiligo

How is vitiligo classified? Medical professionals recognize five distinct types of vitiligo, each characterized by its distribution pattern:

1. Generalized: The most common form, featuring discolored patches across multiple body areas.
2. Segmental: Depigmentation confined to one specific body region, such as the face or hands.
3. Focal: Discoloration remains localized in a single spot without spreading.
4. Trichrome: Characterized by areas of heavy discoloration, lighter discoloration, and normal skin color in succession.
5. Universal: A rare and extensive form where at least 80% of the skin is affected by depigmentation.

Diagnosing Vitiligo: Medical Approaches and Techniques

How do healthcare professionals diagnose vitiligo? In most cases, a dermatologist can make a diagnosis through a thorough physical examination of the skin. However, additional tests may be conducted to confirm the diagnosis or rule out other conditions:

• Blood tests: To check for underlying autoimmune disorders or other health issues.
• Skin biopsy: A small sample of affected skin is examined under a microscope to confirm the absence of melanocytes.
• Wood’s lamp test: The skin is examined under ultraviolet light to highlight areas of depigmentation more clearly.

Treatment Options for Vitiligo: Medical Interventions and Home Remedies

Is there a cure for vitiligo? Currently, there is no known cure or preventive measure for vitiligo. However, various treatments can help improve the appearance of affected skin and potentially restore some pigmentation.

Medications for Vitiligo Management

What pharmaceutical options are available for vitiligo treatment? Several medications have shown promise in managing vitiligo symptoms:

• Ruxolitinib (Opzelura) cream: Recently approved by the FDA for nonsegmental vitiligo in patients 12 years and older. When applied twice daily for 6 months, it has demonstrated success in repigmentation of affected areas up to 10% of body surface area.
• Corticosteroid creams: These topical treatments may help restore some skin color, although results may take months to become visible.
• Oral or injectable corticosteroids: For rapidly progressing cases, systemic corticosteroids may be prescribed.
• Calcineurin inhibitor ointments: These immune-modulating medications may be recommended for small areas, particularly on the face and neck. However, they are used cautiously due to potential links to skin cancer and lymphoma.

Therapeutic Approaches for Vitiligo

What non-pharmaceutical treatments can help manage vitiligo? Several therapeutic techniques have shown efficacy in addressing vitiligo symptoms:

• Phototherapy: UVA light therapy can help slow or halt the progression of vitiligo. This treatment is often combined with prescribed medications and may be administered in a clinical setting or at home using portable devices.
• Psoralen plus UVA (PUVA) therapy: This combination treatment involves taking psoralen orally or applying it as an ointment, followed by UVA light exposure. While effective, this approach requires careful administration due to its complexity.

Living with Vitiligo: Coping Strategies and Lifestyle Adjustments

How can individuals with vitiligo manage their condition in daily life? While vitiligo is not physically harmful, it can have significant psychological and social impacts. Here are some strategies to help cope with the condition:

• Sun protection: Use broad-spectrum sunscreen to protect both pigmented and depigmented skin from sun damage.
• Camouflage techniques: Cosmetic products like self-tanners or makeup can help even out skin tone and conceal white patches.
• Stress management: Practice stress-reduction techniques, as stress may exacerbate vitiligo symptoms.
• Support groups: Connecting with others who have vitiligo can provide emotional support and practical advice.
• Mental health support: Consider counseling or therapy to address any psychological distress related to the condition.

Emerging Research and Future Prospects in Vitiligo Treatment

What advancements are being made in vitiligo research? Scientists continue to explore new treatment options and gain a deeper understanding of the condition:

• Gene therapy: Researchers are investigating genetic factors that may contribute to vitiligo, potentially leading to targeted therapies.
• Immunomodulators: New drugs that regulate the immune system are being studied for their potential to prevent or reverse vitiligo progression.
• Combination therapies: Clinical trials are exploring the effectiveness of combining different treatment modalities for enhanced results.
• Melanocyte transplantation: Techniques to transplant pigment-producing cells from unaffected areas to depigmented patches are being refined.

As research progresses, individuals with vitiligo may have access to more effective and personalized treatment options in the future.

Dispelling Myths and Misconceptions About Vitiligo

What are some common misconceptions about vitiligo that need to be addressed? Despite increased awareness, several myths persist about this skin condition:

• Myth: Vitiligo is contagious.
• Fact: Vitiligo cannot be transmitted through physical contact or any other means.

• Myth: Vitiligo only affects dark-skinned individuals.
• Fact: Vitiligo can occur in people of all skin types and ethnicities.

• Myth: Vitiligo is caused by poor hygiene or dietary factors.
• Fact: The condition is believed to have autoimmune and genetic origins, unrelated to personal hygiene or diet.

• Myth: Vitiligo always spreads to cover the entire body.
• Fact: The progression of vitiligo varies greatly among individuals, and many people experience limited spread.

By dispelling these myths, we can foster a more accurate understanding of vitiligo and reduce stigma associated with the condition.

Vitiligo: Symptoms, Causes, Treatments – WebMD

Written by Melissa Conrad Stöppler, MD

• What Is Vitiligo?
• Vitiligo Causes and Risk Factors
• Who Is Likely to Get It?
• Vitiligo Symptoms
• Vitiligo Types
• Vitiligo Diagnosis
• Vitiligo Treatment and Home Remedies
• More

Vitiligo is a condition in which white patches develop on the skin. Any location on the body can be affected, and most people with vitiligo have white patches on many areas.

The skin doesn’t have its characteristic color because it has lost its melanin. For some reason, the pigment-forming cells known as melanocytes have been destroyed.

We don’t know why this happens. It might be an autoimmune condition, where your body’s defenses turn on your own cells instead of attacking invading germs.

Although vitiligo affects all races equally, it’s more noticeable in dark-skinned people.

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Up to 2% of the population and an estimated 2 to 5 million Americans have the condition. It doesn’t matter if you’re a man or a woman.

In most cases, it develops early in life, between ages 10 and 30. It will almost always show up before age 40.

Vitiligo may run in families. You’re more likely to get it when someone else in your family has it, too, or when people in your family get gray hair prematurely.

Autoimmune diseases, such as autoimmune thyroid disease (Hashimoto’s thyroiditis) or type 1 diabetes, can also raise your odds.

You’ll often lose pigment quickly on several areas of your skin. After the white patches appear, they may stay the same for a while, but later on, they might get bigger. You may have cycles of pigment loss and stability.

Vitiligo commonly affects:

• Body folds (like armpits)
• Places that have been injured in the past
• Areas exposed to sun
• Around moles
• Around body openings
• Mucous membranes (tissues that line your nose and mouth)

It can also affect eyelids and hair.

It’s rare for pigment to return once the white patches have developed.

There are five types of vitiligo. Which type you have depends on where you have it.

Generalized is the most common type. This is when discolored patches show up all over your body.

Segmental is when your vitiligo is confined to one area of your body, like your face or your hands.

Focal happens when the discoloration stays in one spot and doesn’t spread.

Trichrome is when there is an area of heavy discoloration, followed by an area of lighter discoloration, followed by regular-color skin.

Universal is a rare type. If you have this, at least 80% of your skin is discolored.

Your doctor can usually make a diagnosis of vitiligo by looking at your skin during a physical exam. You might also have other tests, including blood tests and:

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  Skin biopsy, where a sample of your skin is sent to a laboratory for further examination

• A Wood’s lamp test, where a doctor looks at your skin under UV light

There’s no known way to prevent or cure vitiligo. But you can make your affected skin look better. Which treatment may work best for you depends on how old you are, how much skin needs improving, and how much your vitiligo affects you.

Medications for vitiligo

The FDA has approvedruxolitinib (Opzelura) cream for the treatment of nonsegmental vitiligo in adult and pediatric patients 12 years of age and older. It has shown success in repigmentation when applied twice daily for 6 months on vitiligo areas up to 10% body surface area.

Otherwise, your doctor may prescribe a corticosteroid cream to put on affected skin to try to give it its color back. It may take months to see changes in your skin. You might also see some streaks or lines on your skin, or your skin may get thinner.

If your vitiligo is progressing quickly, your doctor might suggest a corticosteroid pill or injection.

In rare cases, they may suggest an ointment called a calcineurin inhibitor ointment. It affects your immune system to ease inflammation. You might get it if your vitiligo is in a small area, usually around your face and neck. Doctors don’t prescribe these often, as these medicines are linked to skin cancer and lymphoma.

Therapies for vitiligo

There are a few different techniques that can help.

Phototherapy, or light therapy, using UVA light can slow or stop the progression of your vitiligo. In most cases, you’ll do this in combination with any medicines your doctor prescribes. Usually, you’ll get this therapy a few times a week in a doctor’s office. But there are portable devices that can allow you to get treatment at home. Ask your doctor about it.

Sometimes, doctors use light therapy along with a substance called psoralen. You would take psoralen by mouth or as an ointment, then get light therapy using UVA light. While this therapy is effective, it’s much more difficult to give than regular phototherapy.

If other treatments haven’t worked and your vitiligo covers a lot of your body, your doctor may recommend a procedure called depigmentation. A substance goes on the unaffected areas of your skin once or twice a day for about 9 months. Gradually, that skin will permanently lighten so that it matches the rest of your skin.

Side effects can include:

• Swelling
• Redness
• Itching
• Dry skin

Talk to your doctor about which of these treatments might be right for you.

Alternative medicine forvitiligo

A few studies suggest that ginkgo biloba can give you some of your skin color back.

Some experts also say some supplements can help phototherapy be more effective, including:

• Alpha-lipoic acid
• Folic acid
• Vitamin C
• Vitamin B12

Be sure to talk with your doctor before you take any supplement. They could affect any medicines you’re already taking.

Home remediesforvitiligo

There are some things you can do at home to help your skin look better:

• Cover affected skin with makeup or tanning products.
• Use sunscreen (at least SPF 30) when you’re outside, and reapply it every 2 hours.
• Stay away from tanning beds.
• Don’t get tattoos. The damage they do to your skin can cause more vitiligo.

Surgery for vitiligo

If other treatments haven’t worked for you, your doctor may recommend surgery. The goal of these procedures is to even out the tone of your skin.

Skin grafting is where a surgeon transfers healthy portions of your skin to the discolored areas. Your doctor might suggest this if you have small patches of vitiligo.

In blister grafting, your surgeon will use suction to create blisters on your healthy skin, then move the top of those blisters to your discolored skin.

A cellular suspension transplant is when your doctor takes tissues of your healthy skin, puts them into a solution, and moves them onto your discolored skin. Results of this may take weeks to show up.

Your doctor will let you know if one of these procedures can help you.

Complications of vitiligo

If you have vitiligo, you may be more likely to get:

• Sunburn
• Eye issues
• Hearing loss

The changes in your appearance can also make you feel down, stressed, or self-conscious. A lot of things can help, including:

• Talking about it with friends and family
• Finding a support group, either in person or online, so you can talk with people going through the same things you are.
• Seeing a doctor who knows a lot about the condition, so they can find the best treatment and help for you.

Be sure to tell your doctor if you feel depressed. They can recommend a mental health professional who can help you feel better.

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Importance, deficiencies, and side effects

Folic acid is the synthetic form of folate, which is a naturally occurring B vitamin. Manufacturers add it to supplements and fortified foods because it helps produce red blood cells, among other benefits. It is especially important in prenatal health.

Folate, also called vitamin B-9, is a B vitamin that naturally occurs in certain foods. Folic acid is the form of folate that manufacturers add to vitamin supplements and fortified foods.

This article explores the functions of folic acid in the body, its benefits, some sources, the recommended intakes, the risks, and the effects of deficiency.

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Folic acid may reduce the risk of preterm birth.

Folate is important for a range of functions in the body.

It helps the body make healthy new red blood cells, for example. Red blood cells carry oxygen throughout the body. If the body does not make enough of these, a person can develop anemia, leading to fatigue, weakness, and a pale complexion.

Without enough folate, a person can also develop a type of anemia called folate deficiency anemia.

Folate is also important for the synthesis and repair of DNA and other genetic material, and it is necessary for cells to divide.

Getting enough folate during pregnancy is particularly important. This is because folic acid is crucial for early fetal development, particularly with regard to the spinal cord.

Because of its importance for health, the Food and Drug Administration (FDA) requires manufacturers to add folic acid to enriched bread, pasta, rice, cereals, and other grain products in the United States.

Learn more about folate.

Folate deficiency occurs when there is not enough folate present in the body. This can lead to a type of anemia called megaloblastic anemia.

During pregnancy, folate deficiency increases the risk of congenital irregularities.

Some symptoms of folate deficiency include:

• weakness
• fatigue
• trouble concentrating
• headache
• irritability
• heart palpitations
• sores on the tongue and inside the mouth
• a change in color of the skin, hair, or fingernails
• irritability, headache, heart palpitations, and shortness of breath

Some groups at increased risk of folate deficiency include:

• people with alcohol use disorder
• pregnant people
• people of childbearing age
• people with conditions that affect nutrient absorption, including irritable bowel disorder (IBD) and celiac disease
• people with MTHFR polymorphism, which is a genetic condition that impairs the ability to convert folate to its active form and leads to elevated levels of an amino acid called homocysteine in the blood.

The body absorbs folic acid from supplements and fortified foods better than folate from naturally occurring foods.

The Office of Dietary Supplements recommend that people get the following dietary folate equivalents (DFEs) from food or vitamin sources:

It is important to note that folic acid can interact with certain medications and may not be safe for everyone to take. A person should speak to their doctor before increasing their folic acid or folate intake.

Most people get enough folate from their diet, and folate deficiency is rare in the United States. However, some people in particular can still benefit from taking folic acid supplements.

Pregnant people

The spinal cord is one of the first parts of the body to form in an embryo, and folate deficiency can lead to spinal cord irregularities.

It can also lead to neural tube irregularities, such as spina bifida and anencephaly. The neural tube is what forms the embryo’s early brain and spine.

Folic acid may also reduce the risks of preterm birth, heart irregularities, and cleft palate, among other things.

The Office on Women’s Health recommends that people who are or might become pregnant take 400–800 micrograms (mcg) of folic acid or L-5-Methyltetrahydrofolate, which is the natural form of dietary folate, per day. People with spina bifida or a family history of neural tube irregularities should take 4,000 mcg per day. Those who are breastfeeding or chestfeeding should aim to take around 500 mcg per day.

Since the FDA required adding folic acid to food in 1998, the number of babies born with neural tube irregularities has decreased.

Learn more about folic acid for pregnancy.

People with mood disorders

People with lower levels of folate may be more likely to experience depression. Research indicates that as many as 30% of severely depressed patients have a folate deficiency.

According to a 2021 study, having less than 6.0 nanograms per milliliter (ng/mL) of serum folate was associated with increased suicidal behavior in patients with depressive disorders.

However, whether taking folic acid supplements could improve depression symptoms is unclear. Studies from 2019 and 2018 seem to indicate that it may not. More research is necessary to determine the impact of folate on mood disorders. A person living with depression should discuss folate supplementation with their doctor.

Autism spectrum disorder

Some research suggests that taking folic acid before and during early pregnancy could reduce the baby’s chance of developing autism spectrum disorder (ASD). However, the research on this subject is contradictory.

For example, in a 2022 study, researchers found that taking in at least 400 micrograms (mcg) of folic acid from both food and supplements while pregnant was associated with a reduced chance of the offspring developing ASD.

On the other hand, another 2020 study found that high levels of folate during pregnancy may actually be associated with the development of ASD in the offspring.

More research will be necessary to determine the potential role of folic acid in this area.

People with rheumatoid arthritis

Doctors may use folic acid to support a methotrexate prescription for rheumatoid arthritis.

Methotrexate is an effective medication for this condition, but it may remove folate from the body, causing gastrointestinal symptoms.

Studies suggest that taking folic acid or L-5-Methyltetrahydrofolate supplements could reduce these side effects by around 79%.

Folic acid is present in dietary supplements and fortified foods, including bread, flour, cereals, and grains. It is also a common addition to B-complex vitamins.

Many foods are naturally high in folate. The best sources include:

• beef liver
• boiled spinach
• black-eyed peas
• asparagus
• Brussels sprouts
• lettuce
• avocado
• broccoli
• mustard greens
• green peas
• kidney beans
• canned tomato juice
• Dungeness crab
• orange juice
• dry-roasted peanuts
• fresh orange and grapefruit
• papaya
• banana
• hard-boiled egg
• cantaloupe

The following are answers to additional questions about folate and folic acid:

What are the side effects of folic acid?

There has been a consensus among many medical professionals that no serious side effects are associated with taking too much folic acid. Folic acid is water soluble, so the belief is that any excess will naturally pass through the urine. In very rare cases, people may report an upset stomach.

However, there are some studies that may contradict this belief. While the various results are conflicting, there is some evidence that too much unmetabolized folic acid in the blood may be associated with certain types of cancer and conditions such as anemia or insulin resistance in some cases.

Who should not take folic acid?

A person should speak to a doctor before taking folic acid if they have any of the following:

• epilepsy
• type 2 diabetes
• rheumatoid arthritis
• lupus
• inflammatory bowel disease (IBD)
• celiac disease

Certain medications used to treat these conditions can interact with folate. People undergoing kidney dialysis may also consider avoiding taking folic acid.

Are there alternatives to folic acid supplements?

There is some evidence that taking supplements containing L-5-Methyltetrahydrofolate, the active form of folate or folic acid, can have some benefits. It may work better for people taking drugs that interact with regular folate or people with MTHFR polymorphism, for example. However, a person should always ask their doctor before taking any supplement.

Folic acid is the synthetic form of folate, an important B vitamin. Most people get enough folate from their diet, but people at risk of deficiency and people who are pregnant or may become pregnant may need to take folic acid supplements.

Folic acid may also have additional health benefits, but there may also be risks. Certain people should avoid folic acid. A person should speak to their doctor before changing their diet to get more folate naturally or before starting any folic acid supplements.

Folic acid: benefits, harms, advice from a nutritionist

In the middle of the 20th century, American biochemists struggled with the secret of a substance that helps pregnant women with megaloblastic anemia. In 1941, they managed to obtain folic acid from spinach leaves, and by 1945 they were able to synthesize it chemically.

• What is
• What is

for?

• Dosage
• Benefits
• Restrictions and side effects
• Expectant mothers: advice from a gynecologist
• Expert commentary

The material was commented by Maria Volchenkova, nutritionist at Best Doctor, clinical psychologist, member of the Russian Union of Nutritionists, Nutritionists and Food Industry Specialists, an expert in working with DNA tests.

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What is folic acid

Folic acid is a scientifically developed water-soluble analogue of vitamin B9essential for the proper development of the circulatory and immune systems. In 1931, the existence of an unknown substance that helps pregnant women overcome megaloblastic anemia was reported by doctor and researcher Lucy Wills. She noticed that her patients recovered after taking the yeast extract.

Only ten years later, scientists were able to establish that this substance was folate, and remove it from spinach leaves. And for the first time it took 4 tons of plants. The drug was called folic acid – from the Latin word folium (leaf). K 19In 1945, they learned how to synthesize it chemically [1].

Folic acid and all its derivatives are classified as folates. However, there are some differences between the artificial vitamin and B9 found in foods in how they are absorbed and act on the body.

Folate is found in beans, broccoli, leafy vegetables, eggs, beef liver, etc. Remember: the more processed the products are, the less useful substances remain in them. Folic acid supplements are not necessary if a person leads a healthy lifestyle and eats a balanced diet.

Why folic acid is needed

We store most of our folate in the liver, and the rest in the blood and tissues. This substance is critical for a wide range of functions in the body [2], [3], [4], [5]:

• production and maintenance of new cell health;
• DNA replication process;
• cell division;
• metabolism of nucleic and amino acids;
• maturation of erythrocytes.

Folate deficiency is associated with an increased risk of megaloblastic anemia, heart disease. Vitamin B9 deficiencyin pregnant women can lead to various developmental disorders of the child [6].

Nearly half of vitamin B9 is lost during cooking

© shutterstock

Folic acid dosage

Synthetic folic acid is almost completely absorbed by the body, while folate, which a person receives from food, is absorbed by about 50%.

Recommended intake for folate:

• Birth to 6 months: 65 mcg/day
• Up to 1 year: 80 mcg/day
• 1-3 years: 150 mcg/day
• 4-8 years: 200 mcg/day
• 9-13: 300 mcg/day
• From 14 years old: 400 mcg/day
• Pregnant (with an uncomplicated obstetric history): 400–600 mcg/day
• Nursing mothers: 500 mcg/day.

Although folic acid overdose is extremely rare, excess folic acid can lead to a number of negative health effects. The daily intake of folate should not exceed 1000 mcg/day [7].

The Benefits of Folic Acid

Since its discovery, folic acid has been considered primarily a “women’s vitamin”. It plays an important role in the maturation of eggs, the normalization of the menstrual cycle, and the development of the fetus. However, further medical research has shown that this substance has many beneficial properties for all.

May prevent pregnancy complications

Sufficient folate in the expectant mother’s body is essential for egg quality, implantation and fetal maturation [8]. Often, folic acid supplements are prescribed to pregnant women to prevent birth defects in the development of the child, as well as complications associated with pregnancy, in particular preeclampsia [9]. In addition, high levels of vitamin B9 in the body are associated with a lower risk of preterm birth [10], [11].

Helps control blood sugar levels

Folic acid can reduce the chance of blood sugar spikes and increase the sensitivity of body cells to insulin. A folate-rich diet may reduce the risk of diabetic complications, including neuropathy [12], [13], [14].

Helps prevent cancer

In the late 1980s, evidence emerged that a diet based on green leafy foods rich in folate, fiber, calcium, magnesium and other nutrients could prevent colon cancer. In those years, the concept of “folic anti-cancer diet” became popular [15].

A diet rich in foods rich in vitamins B9, B6 and B12 reduces the risk of breast cancer. Also, with the help of folate, it is possible to slow down the process of tumor growth if it has already appeared [16].

Preventive daily folic acid intake for pregnant women is 400-800 mcg/day

© shutterstock

Promotes brain health

Low blood folate levels are associated with impaired brain function and an increased risk of dementia. Older people even have low levels of B9within the normal range are associated with an increased risk of mental disorders [17], [18].

Folic acid supplements may improve brain function in people with psychiatric and cognitive impairments. The substance helps to slow the progression and help in the treatment of Alzheimer’s disease [19], [20].

Combats mental disorders

Studies have shown that people with depression have low levels of folic acid in their blood [21]. Vitamin B9 supplementation in combination with antidepressants is more effective in managing depressive symptoms than antidepressant treatment alone [22]. In addition, folic acid supplementation in combination with antipsychotics has been shown to improve symptoms in patients with schizophrenia [23].

Reduces the risk of heart disease

Folate plays an important role in the metabolism of homocysteine. An excess of this amino acid increases the likelihood of developing cardiovascular diseases [24].

Research has shown that folic acid supplementation can reduce the overall risk of heart disease by 4% and stroke by 10% [25].

Vitamin B9 supplementation has been associated with improved blood flow and reduced high blood pressure [26], [27]. Both factors have a positive effect on the health of the cardiovascular system.

Limitations and side effects

Intake of high doses of synthetic folic acid may mask B12 deficiency. The fact is that with a lack of both vitamins, megaloblastic anemia develops, and folate effectively copes with this condition. However, it does not correct the neurological problems that occur with B12 deficiency, and the deficiency of an important substance may go unnoticed until irreversible consequences appear [28].

Also, high doses of B9 can reduce the activity of protective immune cells, including natural killer (NK) cells [29], [thirty]. It is not recommended to combine folic acid with certain prescription drugs, in particular drugs for epilepsy, ulcerative colitis, and some types of cancer and autoimmune diseases [31].

Gynecologist’s advice

Elena Lyubimkina, obstetrician-gynecologist at GMS Clinic, ultrasound doctor, integrative medicine doctor

In pregnant women, folic acid and folate deficiency increases the risk of miscarriage, partial or complete placental abruption, spontaneous abortion. If mothers experienced a lack of folate during pregnancy, the risk of mental retardation in their children increases later.

Patients often have latent folate and folic acid deficiencies before pregnancy and in the first trimester. It is during this period that it is especially dangerous, since the formation of the neural tube in the fetus begins from the first days of conception and ends at the 28th week of pregnancy. At this stage, a woman may not yet know about the deficiency of her much-needed vitamin and the possible consequences.

That’s why it’s ideal to take folic acid 9 months before conception. This is how much an egg is formed in a woman’s body.

Even if pregnancy is known at a later date, it is never a good idea to start taking folic acid. The expectant mother will have enough folate reserves for about 4 months, so do not panic. As soon as you find out you’re pregnant, start taking folic acid.

During pregnancy, the consumption of this vitamin increases greatly. However, with adequate pharmacological support, the level of folate in the body remains at the proper level during all three trimesters and during breastfeeding.

With folate deficiency, weakness, headache, fainting, pale skin, red tongue, diarrhea are noted. If the balance is not replenished on time, a disease such as folate deficiency anemia may develop.

The main source of folate for humans is food. The degree of absorption and utilization of folates depends on the nature of the products, the method of their preparation and the state of the gastrointestinal tract. For example, accelerated technologies for growing leafy vegetables do not allow plants to accumulate vitamin B9 in the proper amount.. At the same time, in pregnant women, the need for folate almost doubles. It is impossible to hope that the expectant mother will be able to make up for this shortage only with food, without synthetic additives.

Laboratory diagnostics (clinical blood count with formula calculation, total serum folates, plasma homocysteine, segmented macrocytes) is very important for the prevention of the development of clinical manifestations of folate deficiency. Ideally, the genetics of folate cycle metabolism. Depending on the results of the studies, the doctor selects an individual dosage and form of the drug.

General advice for pregnant and lactating women: Take 400-800 micrograms/day of folic acid. This dose should not be exceeded without indications and a doctor’s appointment. In case of an overdose, the risks of impaired carbohydrate metabolism in the fetus and neurotoxicity increase.

In women with congenital defects in the genes for folate metabolism and homocysteine ​​metabolism, if they eat a lot of methionine-rich foods (meat, eggs, coffee, cottage cheese), homocysteine ​​detoxification slows down, especially in the brain. They may develop a condition such as chronic hyperhomocysteinemia, which is dangerous primarily for the fetal brain. Women with mutations in the folate cycle genes are recommended to take vitamin B9in the form of methylfolate (5-methyltetrahydrofolate, metafolin) at a dose of 400-800 mcg / day.

Expert comment

Maria Volchenkova, nutritionist at Best Doctor, clinical psychologist, member of the Russian Union of Nutritionists, Nutritionists and Food Industry Specialists, expert in working with DNA tests

folic acid”. These are different forms of vitamin B9 and their names are often mistakenly used as synonyms.

Folates are the natural form of vitamin B9 found most in leafy greens. In addition, folate is found in avocados, Brussels sprouts, broccoli and some other foods.

Vitamin B9 deficiency increases the risk of cardiovascular disease, pregnancy disorders and fetal developmental disorders. To prevent these risks, a person should receive vitamin B9 in an absorbable form.

The absorption of vitamin B9 depends on the so-called folate cycle genes. With mutations in these genes, there are difficulties with the absorption of folic acid, a synthetic form of vitamin B9.. The active (that is, well absorbed) form of vitamin B9 is called 5-methylenetetrahydrofolate. Interestingly, most dietary folates are converted into the active form, which is easier for the body to absorb.

Excess intake of the synthetic form of vitamin B9 can result in folic acid constantly circulating in the blood, which is not converted to its active form. This happens, for example, with the constant unreasonable intake of multivitamins with too high dosages of vitamin B9.. That is, the body is not able to use it for its own needs.

Since vitamin B9 is involved in the process of cell division, theoretically, an excess of unabsorbed folic acid increases the risk of cancer. If you do not have direct indications (pregnancy and its planning), then for the prevention of vitamin B9 deficiency, it is best to use food sources of folate. Feel free to add leafy greens to your daily salad serving. Avocados will provide you, in addition to folate, potassium, which is also important for the cardiovascular system. Broccoli provides the body with a powerful antioxidant – sulforaphane. Cause an excess of vitamin B9only due to food sources is very difficult. A person simply cannot eat such a quantity of food.

See also

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• What is nicotinic acid and how can it be used

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Doctors have shown that taking high doses of folic acid increases the risk of death from COVID by 2.6 times – Gazeta.Ru

Doctors have shown that taking high doses of folic acid increases the risk of death from COVID by 2.6 times – Gazeta.Ru | News

07 September 2022, 10:48

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Scientists at the University of California, Davis found that the risk of infection and death from COVID-19 was significantly higher in people who took high doses of folic acid. The work was published in the journal BMJ Open .

The authors used medical records from more than 380,000 Britons aged 45 and over. Of more than 26,000 patients infected with the coronavirus, 820 have died. Those patients who were prescribed high doses of folic acid (5 times the legal limit) had a 1.5 times greater risk of contracting coronavirus and a 2.6 times greater risk of death compared to the control group. Folic acid levels in the blood of participants in this study were not measured.

Doctors have also found that taking methotrexate, a drug that lowers folic acid levels, does not pose additional risks for patients with COVID.

Scientists’ findings may have implications for patients taking folic acid. Although its use is clearly indicated in some cases, doctors still need to be careful when prescribing high doses. The safe upper limit for folic acid is 1 milligram.

Another study published in 2021 in Nature Communications showed that the SARS-CoV-2 virus uses human folic acid to reproduce. This means that the virus may be susceptible to both folic acid and its inhibitors, including methotrexate. The findings of this study prompted the authors to test the association between folic acid intake and clinical outcomes in COVID.

Low folic acid levels in pregnant women are associated with an increased risk of birth defects in infants. Also known as vitamin B9, folic acid is prescribed for a number of conditions, including sickle cell anemia and people taking anticonvulsants. Some patients taking methotrexate, a drug used to treat certain cancers and autoimmune diseases, also take folic acid to reduce side effects.

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