Folate and folic acid became a hot topic in the late ‘90s, when the USDA decided to fortify bread flours, cornmeal, pasta, rice, and other grain products with folic acid.
Why did they do that?
To decrease neural tube defects, like spina bifida and anencephaly, in new-born babies, both caused by too little folate in mothers at the time of conception.
Folic acid’s main job is to help replicate genetic materials like DNA and RNA, so it’s important during high periods of growth like infancy, adolescence, and pregnancy.
Fast forward to now, and neural tube defects in newborns have decreased by 25-50%.
This mandatory fortification has led to about 100mcg greater intake per day on average. That’s significant, considering average adult RDA is 400mcg per day.
You may need more than 400mcg, first, because most foods fortified with folic acid aren’t gluten free. And, folic acid is absorbed in the upper small intestine, where most celiac-related intestinal damage occurs. This decreases your ability to absorb nutrients.
What’s the Difference Between Folate and Folic Acid?
Folate and folic acid are often used interchangeably. For all intents and purposes, they are the same; they’re just different forms of vitamin B9.
Folate is the form naturally found in fruits, vegetables, grains, and other foods. Folic acid, on the other hand, is the synthetic version found in fortified foods and supplements.
The difference is that the body absorbs folic acid faster than it absorbs folate. However, your body must convert folic acid to folate to do its job.
Vitamin B9 Deficiency in Celiac Disease – What You Need to Know
Folic acid deficiency is common in celiac disease because the upper small intestine, where most celiac-related damage occurs, absorbs it.
Folic acid deficiency can slow cell growth and division and stunt growth. Its effects can be especially significant and long-term if experienced during any period of growth.
The biggest challenge with folic acid, as with other water-soluble B vitamins, is that your body can’t build up large reserves of it. You excrete it easily. It enters your body, does its job, and leaves. I wrote in an earlier post on B vitamins that they leave your body in 14-18 hours.
So, deficiency can show up quickly – within a couple weeks. This can display as diarrhea, depression, confusion, or anemia.
Since folic acid is easier absorbed than folate, supplementation is recommended. It’s the one way you can be sure what you’re getting and easily stay on top of it daily.
But nutritious, conscientious eating is recommended as well.
Green plants like spinach, broccoli, and asparagus are rich sources of folate, but many Americans do not get enough of these vegetables. (That’s part of the reason grains, much more widely eaten, are fortified). It can make a huge long-term difference to focus on the right foods and commit to eating them regularly.
Here’s a list of the top sources of folate, from the USDA:
- Half cup of lentils – 180 mcg
- Half cup of spinach – 132 mcg
- Half cup of black beans – 128mcg
- Ounce and a half of sunflower seeds – 101mcg
- Half cup of turnip greens – 85mcg
- Half cup of broccoli – 84mcg
- A cup of fresh squeezed orange juice – 74mcg
- Ounce and a half of peanuts – 62mcg
Beans, nuts, seeds, and leafy green veggies are the gluten free foods you should focus on for folate.
While this gives you some good ideas to get started, it should also give you an idea of how difficult it is to obtain enough folate daily to beat deficiency.
Folic Acid Deficiency and Anemia in Celiac Disease
Anemia is often diagnosed as a result of celiac disease and vice versa. They are highly correlated – anemia is deficiency of iron, vitamin B12, or folic acid. Anemia is a decrease in the number of red blood cells, which restricts blood flow. Upper small intestinal damage makes it difficult to avoid anemia, unless you are extremely conscientious of vitamin and nutrient intake.
If you are, you can avoid many problems down the road.
So, how do you make sure you’re on top of vitamins and deficiency? Are there any routines or tactics that you recommend? Let us know in the comments below!