The metabolic processes of folic acid and Vitamin B12 deficiency Mahmood L - J Health Res Rev
STUDIES ON THE RELATIONSHIPS OF VITAMIN B12, FOLIC ACID, acid in the urine of this patient did not support the possibility of folic acid deficiency, and . Folate and B12 are both involved in the conversion of homocysteine to Along with their sidekick, vitamin C) they help with the break down, creation, and use. What relationship do vitamin B12 and folic acid share? Do you have to take them together? Why does a vitamin B12 deficiency cause a folic acid deficiency?.
Thus, vitamin B deficiency specifically results in increased methylmalonic acid MMA concentrations in both plasma and urine. Pernicious anemia and excessive intake of folic acid After studying malnourished pregnant women in India in the late s, Lucy Wills described a macrocytic anemia that shared some features with the blood abnormalities of elderly Europeans with pernicious anemia 6. For example, the cytologic properties of the 2 anemias were identical, and both types responded well to crude liver extract.
However, only the tropical illness responded to yeast extract. Furthermore, although purified liver extract had proved effective in the treatment of pernicious anemia, it did not cure the tropical form 6. This hypothesis was subsequently verified. However, the identification of vitamin B as the anti—pernicious anemia factor in liver 7 followed the isolation of folic acid from yeast 8 by several years, during which time folic acid was administered in large doses to patients with pernicious anemia 9.
What Is the Relationship Between Folate & Vitamin B12?
Because the inappropriateness of this treatment quickly became apparent, reports of cases thus treated in the late s and early s comprise the entire body of literature on the effect of folic acid administration on persons deficient for vitamin B 10 — Reviews of the historic case reports allude to rapid neurologic deterioration after improvement of anemia 10 Consequently, the idea has developed that excessive intake of folic acid can obscure or mask vitamin B deficiency and potentially delay its diagnosis until neurologic consequences become irreversible Food folic acid fortification and the debate on folic acid safety The move by the United States and other governments to fortify staple food products with folic acid for the prevention of neural tube defects rekindled the debate over the safety of folic acid for the elderly, who are at high risk of vitamin B deficiency.
The high degree of uncertainty led some to question the safety of fortification 1920 and inspired others to criticize the upper intake as too conservative 21 Particularly in light of continued demands for a higher level of fortification 2324clearly defining the benefits and risks of high folic acid intake assumes vital importance.
Writing about this challenge, Moore 25 observed that the current fortification program provides the perfect opportunity for epidemiologic study of the unanswered questions, including those related to the interaction between folate and vitamin B Folate status and intake in the era of folic acid fortification Mandatory folic acid fortification of enriched cereal grain products sold in the United States officially took effect in January Not surprisingly, the first report on the program's effect showed that fortification resulted in a marked increase in folate status 27 Specifically, mean plasma folate increased from 4.
Furthermore, the prevalence of folate deficiency decreased from To test the hypothesis that the high folate status achievable in the era of mandatory folic acid fortification affects the consequences of vitamin B deficiency, either by a masking phenomenon or by exacerbating neurologic effects, we used data collected in recent versions of the National Health and Nutrition Examination Survey NHANES to evaluate the interaction between high serum folate and low vitamin B status in relation to several outcomes linked to vitamin B deficiency; namely, anemia, macrocytosis, cognitive impairment, elevated homocysteine concentrations, and elevated MMA concentrations 31 We review and discuss the results of these studies here.
Of the subjects who met eligibility requirements, complete data for analyses pertaining to anemia were available for subjects, and complete data for analyses pertaining to cognitive function were available for subjects. J Health Res Rev ;1: They cannot be synthesized in sufficient amount by the human body, and therefore must be obtained from the diet.
Thirteen different types of vitamins are known that are classified by their biological and chemical activity; each one of them has a specific role in our body. The water-soluble vitamins easily dissolve in water and are excreted from the body rapidly since they are not stored for a long time, except for vitamin B As they are stored for a long time, they can lead to hypervitaminosis more than the water-soluble vitamins; some vitamins are vital for the body cell growth and development e.
Folic acid is known as vitamin B9 which has vital functions. Our body needs folic acid for the synthesis, repair, and methylation of DNA. Folate has an important role in cell division and it is especially needed during infancy and pregnancy. Human body requires folate in order to produce healthy red blood cells and prevent anemia, while vitamin B12 plays an important role in supplying essential methyl groups for protein and DNA synthesis.
Vitamin B12 is bound to the protein in food and hydrochloric acid in the stomach releases B12 from protein during digestion. Once released, B12 combines with a substance called intrinsic factor.
Folic acid is a B vitamin that helps the body make healthy new cells. Human body needs folic acid, especially those women who may get pregnant.
Getting enough folic acid before and during pregnancy may prevent major birth defects of baby's brain or spine. It is also known as vitamin B9, folate, or folic acid. All B vitamins help the body to convert the food carbohydrates into fuel glucosewhich is used to produce energy. These B vitamins, often referred to as B complex vitamins, help the body use fats and protein.
B complex vitamins are needed for healthy skin, hair, eyes, and liver. Also, they help the nervous system function properly. Folic acid is the synthetic form of B9 which is found in supplements and fortified foods, while folate occurs naturally in foods.
Vitamin B12 And Folic Acid
It helps in the production of DNA and RNA, the body's genetic material, especially when cells and tissues are growing rapidly, such as during infancy, adolescence, and pregnancy. Folic acid works closely with vitamin B12 in making red blood cells and helps iron function properly in the body.
Vitamin B9 works with vitamins B6 and B12 and other nutrients in controlling the blood levels of the amino acid homocysteine. High levels of homocysteine are associated with heart disease, although some researchers are not sure whether homocysteine is a cause of heart disease or just a marker that indicates the presence of heart disease. In addition, all grain and cereal products in the US are fortified with folic acid.
These folic acid congeners are transported by receptor-mediated endocytosis across cells where they are needed to maintain normal erythropoiesis, interconvert amino acids, methylate tRNA, generate and use formate, and synthesize purine and thymidylate nucleic acids. Using vitamin B12 as a cofactor, folic acid can normalize high homocysteine levels by remethylation of homocysteine to methionine via methionine synthetase. Since the body becomes deficient in folic acid, all cycles will become ineffective and lead to many problems such as megaloblastic anemia, cancer, and neural tube defects.
Vitamin B12 And Folic Acid | Dr. Schweikart
Urocanic acid is involved in many metabolic processes in order to generate formiminoglutamate which is known as "FIGLU" and is involved in generating glutamate with the help of formiminotransferase. In folic acid deficiency, the catabolism of FIGLU is impaired and glutamate cannot be generated from formiminoglutamate; therefore, formiminoglutamate accumulates in the blood and is excreted in elevated amount in urine.
Low glutamate level increases the likelihood of having schizophrenia, cognitive disorders, neuropsychiatric and anxiety disorders. Also, glutamate plays an important role in the body's disposal of excess or waste nitrogen. Glutamate undergoes deamination, an oxidative reaction catalyzed by glutamate dehydrogenase.
Some tissues are considered as glycine producers, while others, e. Both serine and glycine are transported across the mitochondrial membrane rapidly. Also, many processes inside the body are impaired, such as impaired function of RNA and DNA, fat and fatty acid metabolism, and muscle formation.
Low level of either serotonin or tryptophan has been linked to depression, confusion, insomnia, and anxiety. Moreover, low serine level leads to decreased performance of the immune system since serine is involved in antibody formation.
It is involved as 5-methyl tetrahydrofolate methionine in the methylation process where the methyl group is transferred to homocysteine to form methionine in the presence of methionine synthase enzyme. Methionine synthase is one of the only two enzymes known to be Bdependent enzymes. This process depends on both folic acid as well as vitamin B This reaction needs ATP and vitamin B12 and also the presence of methionine adenosyl transferase [Figure 1].
Methionine is also known to be essential for the formation of collagen that is involved in the formation of skin, nails, and connective tissues, and low methionine level has negative effects in these processes and functions. Thymidylate synthase is involved in catalyzing the transfer of formaldehyde from folate to dUMP in order to form dTMP.
Thymidylate synthase It is an enzyme that plays a role in the replication of cells and tissues. From this cycle, the role of folate can be linked to cancer.
Thymidylate synthase is a metabolic poison that is involved in causing functional folate deficiency, and body's cells grow rapidly as a result of increase in DNA synthesis. Many anti-cancer drugs act indirectly by inhibiting DHFR or directly by inhibiting thymidylate synthase. Purine has many important roles in cell growth, division, and development, since it is considered to be along with the pyrimidine base of the DNA helix.