Folic acid supplements cause cancer

Folic acid supplements cause cancer. Avoid every supplement that contains folic acid. Instead, eat foods high in folate (folate is the natural form of folic acid) like green leafy vegetables.

People pride themselves on popping pills, especially when labeled as “nutritional supplements.” Don’t ask me why. But, just as I’ve reveled in swallowing nine shots of tequila in a dank, Mexican bar, American’s are proud to pop pills. I’m not sure which is worse. But, if I had to bet, I’d say “pill pride,” especially when it comes to nutritional supplements.
When I toss too many back, I know what I’m getting into. My ego goes from being really big to very big in the blink of an eye. This is partly why my book, Over-The-Counter Natural Cures, is so much fun to read (or offensive depending on your point of view). At times, I drank to break up the monotony of writing, and subsequently my ego took pot-shots at the pharmaceutical and supplement industries (essentially, one in the same the same). That’s a predictable outcome, and knowing that is awareness in motion, no matter how stupid the act might be.
In contrast, the outcome associated with popping nutritional supplements can be unpredictable. That’s bad, especially when your livelihood depends on it. Folic acid is a perfect example.
Just as counterfeit Rolex watches are sold to intoxicated teenagers on the streets of Mexico, the drug industry pushes counterfeits of Mother Nature to consumers dizzy with marketing spin. This is the best analogy for the “folic acid fallacy.” Folic acid is a cheap counterfeit isolate of the naturally occurring “folate.”
The term folate (not folic acid) encompasses a slew of naturally occurring chemical cousins – chemists call them isomers – that have a wide range of positive roles in the body. Without full-spectrum natural folate, our body becomes a breeding ground for Alzheimer’s disease, coronary heart disease, osteoporosis, neural tube defects, poor cognitive performance, depression, hearing loss and many types of cancer.
In one of the biggest natural heists in pharmaceutical history, Big Pharma has stolen the real folate from the marketplace and replaced it with their counterfeit: Folic acid. Known to chemists as pteroylglutamic acid monoglutamate, the drug folic acid is one of the best-selling counterfeits infiltrating nutritional supplement products such as multi-vitamins and prenatals. Adding injury to insult, the FDA mandated that grain-based foods such as bread and cereal, be fortified with it in 1996. The only thing missing is a “black box warning,” because the side effects are staggering.
The Unpredictable Outcome of Folic Acid Use
Today, an estimated 274 million people are being exposed to folic acid. Unbeknownst to them, the synthetic compound has proven adverse effects and according to the Food and Drug Administration (FDA), “no long term studies exist to evaluate the risks associated with prolonged use.” Supplement promoters usually hiss and snort when hearing this, insisting that “I’m missing vital studies.” Please. I have piles of research papers bigger than most midget thinkers who push cheap, nutritional supplement propaganda online –Ah, there goes my ego again, and I’m not even drinking.
Prenatal and postnatal supplementation of folic acid in mothers on a standard diet resulted in the occurrence of higher numbers of cancer tumors. The Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening trial linked folic acid intake with 20% to 32% increased risk of breast cancer in women consuming more than 400 microg/d supplemental folic acid.
Moms who supplement with folic acid face a drug induced illness known as MTHFR (methylenetetrahydrofolate polymorphism). Kinda like the shuffling of cards, folic acid can shuffle your genetic map leading to altered DNA activity, putting moms at risk for heart disease as well as colonic cancer and acute leukemia later in life. Writing for Nature magazine, scientists warned in 2005 that the use of folic acid in fortification programs worldwide could have, “the side effect of increasing the prevalence of some of the most significant, human life-threatening diseases.”
The Safe Alternative to Folic Acid
The history of folate dates back to 1931 when chemists concluded that anemia was caused by a dietary deficiency of the vitamin, based on their discovery of it in folate rich foods like liver and yeast. Big Pharma – smelling big money in a synthetic version – moved quickly to counterfeit the natural cure. Folic acid was created in a lab in 1941 and today has replaced natural folate consumption, but not without risk.
Fortunately, wiping out illness associated with a folate deficiency is simply a matter of adhering to “nutrient logic” rather than popping unpredictable pills. You can do this by bolstering your diet with foods rich in folate like liver, leafy green vegetables (such as spinach and turnip greens), fruits (such as citrus fruits and juices), eggs, dried beans and peas, and the forgotten master folate supplement, non-fortified brewer’s yeast.
This, like drinking tequila, has a predictable outcome. But unlike irresponsible tequila consumption (which I don’t condone), it’s an outcome that leads to health and longevity made simple by nature. Admittedly, Big Pharma will have to suffer a pay cut as this nutrient logic becomes a reality and natural folate stages a comeback. Pill trashing will then replace pill popping.

Dr. Fuhrman warns:

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DO NOT take multivitamins
that contain folic acid.
and
If you are pregnant,
DO NOT take prenatal vitamins
that contain folic acid!

Folic acid supplementation is dangerous – especially for pregnant women

Women who take supplemental folic acid increase their breast cancer risk by 20-30%, according to a study in the American Journal of Clinical Nutrition. Researchers collected data on women's folic acid intake from multivitamins over a 10-year period – they found that the women who took multivitamins containing folic acid were more likely to be diagnosed with breast cancer than those that did not. ^1,2
A study published earlier this year found a 163% increased risk of prostate cancer in men taking folic acid supplements.³
A new meta-analysis of folic acid supplementation and colorectal cancer risk found that those who took folic acid for more than three years increased their risk of having a colorectal adenoma by 35%.⁴ In the U.S., Canada, and most recently Chile, colorectal cancer rates have climbed since the advent of mandatory fortification of flour with folic acid.^10-11
Another new study, has found that folic acid supplementation by pregnant women increases the risk of childhood asthma by 26% ⁵, and yet another study linked folic acid supplementation during pregnancy to increased incidence of respiratory tract infections in infants, especially those resulting in hospitalization.⁶
This past month in Norway, where there is no fortification of flour with folic acid, researchers conducting a six-year study on the homocysteine-lowering effects of B vitamins in patients with heart disease made an unexpected finding: the patients whose supplement included folic acid had a greater risk of cancer incidence and cancer mortality.⁷ These patients were 43% more likely to die from cancer.
Most alarming was another study that compared women who took folic acid during their pregnancy to those that did not. Thirty years later those women who followed the typical recommendations to take folic acid were twice as likely to die from breast cancer.⁸ Shocking info huh!

If folic acid can have these dangerous effects, why is it included in most
multivitamins, prenatal vitamins and fortified grain products?

Folic acid is the synthetic form of folate, a member of the family of B vitamins that is involved with DNA synthesis and DNA methylation, which essentially turns genes on and off. Because of these crucial functions, folate plays important roles in fetal development and nerve tissue health as well as cancer initiation and progression.
The protective effects of folate against neural tube defects (NTDs) have received much attention in the past. Unfortunately, this knowledge and public attention did not result in a campaign by the U.S. government encouraging women to get plenty of natural dietary folate from vegetables – instead, pregnant women are pushed to take folic acid supplements.
Folic acid is chemically different from dietary folate, which results in differences in uptake and processing of these two substances by the cells in the intestinal wall. Some folic acid is chemically modified to be more similar to natural folate, but the intestinal cells are limited in how much folic acid they can modify – excess folic acid often enters the circulation unmodified. Scientists do not yet know the implications of circulating synthetic folic acid. Many Americans, through multivitamin use and consumption of fortified foods, are taking in excessive amounts of folic acid, and thus may have unmodified folic acid circulating in their blood – this could contribute to the cancer-promoting effects.^9,10-11
The recommendation that pregnant women take folic acid supplements is especially troubling – these women could safely increase their folate status and prevent neural tube defects (NTDs) by eating green vegetables, but instead they are instructed to take folic acid supplements, which put them at risk for breast cancer later in life. The children are also put at risk –women who take folic acid supplements as a substitute for good nutrition fail to provide their unborn children with the additional nutrients in folate-containing foods. Maternal nutrition is a critical determinant of childhood health – there are inverse associations between maternal vegetable intake and childhood cancers.^12-13
Unlike synthetic folic acid, folate obtained from food sources – especially green vegetables – protects against breast and prostate cancer.
Paradoxically, in people who do not take folic acid supplements there is inverse relationship between dietary folate intake and breast and prostate cancer.^14,3 Folate is an essential nutrient with vital functions. It is probable that folate levels need to be tightly regulated by the body – that the timing and dose of folate is an important determinant of whether folate has positive or negative effects. Folate's actions on DNA may prevent cancer from initiating, but may also promote the proliferation of tumor cells that may already present.¹⁵ Luckily, getting our folate exclusively from food ensures that we do not get too much. It comes naturally packaged in balance with other micronutrients and the body regulates its absorption.⁹

Rich sources of food folate

As a reference point, the U.S. RDA for folate is 400μg.  Below is the approximate folate content for a 100-calorie serving.¹⁶

Spinach, raw	843 μg		Edamame	225 μg
Endive	835 μg		Tomatoes, yellow	200 μg
Romaine lettuce	800 μg		Tomatoes, orange	180 μg
Asparagus, cooked	750 μg		Chickpeas	150 μg
Mustard greens, raw	700 μg		Red peppers, raw	150 μg
Collards, raw	550 μg		Papaya	90 μg
Okra, cooked	520 μg		Snow/Snap peas, raw	100 μg
Bok choy, raw	500 μg		Summer squash	100 μg
Brocolli Rabe, raw	375 μg		Tomatoes, red	85 μg
Arugula, raw	340 μg		Strawberries	75 μg
Artichokes, cooked	330 μg		Oranges	70 μg
Brussels sprouts, cooked	300 μg		Beets, cooked	50 μg
Broccoli, cooked	300 μg		Blackberries	55 μg
Cauliflower, raw	225 μg		Avocado	50 μg
Red leaf lettuce	225 μg		Sunflower seeds	40 μg
Celery, raw	225 μg		Quinoa, cooked	35 μg

Clearly, we do not need synthetic folic acid supplements to meet our daily folate requirements.
Dr. Fuhrman's Multivitamins do not contain folic acid
Because folate is abundant in the nutritarian diet, and synthetic folic acid is so potentially dangerous, folic acid is not included in Dr. Fuhrman's Gentle Care or Gentle Prenatal multivitamin supplements.

Dr. Fuhrman does not recommend prenatal vitamins generally available on the market because of the potentially harmful ingredients that they contain, such as folic acid. Sensitive to the needs of women who are pregnant or of childbearing age, Dr. Fuhrman designed his own prenatal.

Dr. Fuhrman's special recommendations for pregnant women:

- Gentle Prenatal (delivers the iron and extra vitamin D needed by pregnant women)
- Osteo-Sun
- DHA+EPA Purity
- A nutrient dense diet, rich in green vegetables (and folate)

See Dr. Fuhrman's Vitamin Advisor for more recommendations.

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Gentle Care Formula (multivitamin and mineral) Too much of certain nutrients, including folic acid, has been shown to have negative health effects and may also promote breast cancer.^1,2,16 This formulation avoids potentially toxic ingredients, such as vitamin A¹⁷ , beta carotene^18-20, folic acid, copper and iron. All of the ingredients are selected for optimal quality, absorption, and gentleness. This balanced antioxidant blend also offers phytochemical and carotenoid concentrates from green food extracts.
Gentle Prenatal (multivitamin and mineral) contains the same carefully designed combination of vitamins and minerals present in Gentle Care Formula, but has been uniquely tailored to the needs of pregnant women with iron and more vitamin D.

References:
1. Stolzenberg-Solomon RZ et al. Folate intake, alcohol use, and postmenopausal breast cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Am J Clin Nutr. 2006 Apr;83(4):895-904.
2. Kim YI. Does a high folate intake increase the risk of breast cancer? Nut Rev; 2006; 64(10PT1) 468-75.
3. Figueiredo JC et al. Folic acid and risk of prostate cancer: results from a randomized clinical trial. J Natl Cancer Inst. 2009 Mar 18;101(6):432-5. Epub 2009 Mar 10.
4. Fife, J et al. Folic Acid Supplementation and Colorectal Cancer Risk; A Meta-analysis. Colorectal Dis. 2009 Oct 27. [Epub ahead of print]
5. Whitrow MJ, Moore VM, Rumbold AR, Davies MJ. Effect of supplemental folic acid in pregnancy on childhood asthma: a prospective birth cohort study. Am J Epidemiol. 2009 Dec 15;170(12):1486-93.
6. Haberg SE, London SJ, Stigum H, Nafstad P, Nystad W. Folic acid supplements in pregnancy and early childhood respiratory health. Arch Dis Child. 2009 Mar;94(3):180-4. Epub 2008 Dec 3.
7. Ebbing M et al. Cancer Incidence and Mortality After Treatment With Folic Acid and Vitamin B12. JAMA. 2009;302(19):2119-2126.
8. Charles D et al. Taking folate in pregnancy and risk of maternal breast cancer. BMJ 2004;329:1375–6
9. Harvard School of Public Health; The Nutrition Source: Keep the Multi, Skip the Heavily Fortified Foods; www.hsph.harvard.edu/nutritionsource/what-should-you-eat/folicacid/ Date accessed: 8/29/08.
10. Hirsch S et al. Colon cancer in Chile before and after the start of the flour fortification program with folic acid. Eur J Gastroenterol Hepatol. 2009 Apr;21(4):436-9.
11. http://www.medscape.com/viewarticle/591111
12. Kwan ML et al. Maternal diet and risk of childhood acute lymphoblastic leukemia. Public Health Rep. 2009 Jul-Aug;124(4):503-14.
Tower RL et al. The epidemiology of childhood leukemia with a focus on birth weight and diet. Crit Rev Clin Lab Sci. 2007;44(3):203-42.
Petridou E et al. Maternal diet and acute lymphoblastic leukemia in young children.Cancer Epidemiol Biomarkers Prev. 2005 Aug;14(8):1935-9.
Jensen CD et al. Maternal dietary risk factors in childhood acute lymphoblastic leukemia (United States).Cancer Causes Control. 2004 Aug;15(6):559-70.
13. Huncharek M et al. A meta-analysis of maternal cured meat consumption during pregnancy and the risk of childhood brain tumors. Neuroepidemiology. 2004 Jan-Apr;23(1-2):78-84.
Pogoda JM et al. An international case-control study of maternal diet during pregnancy and childhood brain tumor risk: a histology-specific analysis by food group. Ann Epidemiol. 2009 Mar;19(3):148-60.
14. Sellers TA et al. Dietary folate intake, alcohol, and risk of breast cancer in a prospective study of postmenopausal women. Epidemiology. 2001 Jul;12(4):420-8.
15. Kim YI. Folic acid fortification and supplementation--good for some but not so good for others. Nutr Rev. 2007 Nov;65(11):504-11.
16. http://www.nutritiondata.com/tools/nutrient-search
17. Bjelakovic G, Nikolava D, Gluud LL, et al. Antioxidant supplements for prevention of mortality in healthy participants and patient with various diseases. Cochrane Database Syst Rev 2008;16(2):CD00776.
18. Mayne ST. Beta-carotene, carotenoids, and disease prevention in humans. FASEB. 1996;10(7):690-701.
19. Goodman GE. Prevention of lung cancer. Current Opinion in Oncology 1998;10(2):122-126.
20. Kolata G. Studies Find Beta Carotene, Taken by Millions, Can't Forestall Cancer or Heart Disease. New York Times, Jan 19, 1996.

Folic Acid During Pregnancy May Be Dangerous To Child

There are many misconceptions regarding pregnancy and some require a bit of examination to determine if there is any truth in what a lot of them suggest.
Folic acid has been recommended for many years for the benefit of the growing baby in the womb.
However data from a recent study would seem to suggest that it might in fact create a bigger risk from cancer.
Taken in large doses it could mean that any child goes on to develop tumors in later life.
Diet is important not only in women but also the male population. The latter that consume less vegetables and fruits but have a preference for dairy and meat have a lower sperm count.
This would indicate that both partners should change their life style once they have decided to try for a baby.
Women that are very overweight when pregnant will definitely be affected. Not only will they be more prone to most conditions like high blood pressure and pre-eclampsia but also routine scans will be more difficult to perform.
Accurate pregnancy ultrasound, which is one of the main methods of monitoring the progress of any pregnancy, is difficult.
In India it was found that expectant mother of a short stature were more likely to lose their babies before the age of five than those taller than five feet. This statistic was surprisingly high and the reason must be more than just health but possibly the size of the womb etc.
There are so many versions of what is good for mother and baby, some handed through generations, that it is not surprising that scientists prefer to go on facts rather than what is usually just fiction.

Is supplemental folic acid harmful?

Folate is a member of the B vitamin family and is found naturally in foods, especially green vegetables. Folate is involved with DNA synthesis and DNA methylation, which essentially turns genes on and off.  Because of these crucial functions, folate plays important roles in fetal development and nerve tissue health as well as cancer initiation and progression.
Folic acid is the synthetic form of folate that is added to food or used as an ingredient in vitamin supplements. Folic acid is added to most enriched, refined grain products like bread, rice and pasta in the U.S. and Canada in an attempt to replace the nutrients lost during the processing of the whole grain. Since folic acid is added to so many refined grain products, it is very easy for a typical diet combined with a multivitamin to end up with high levels of folic acid, the synthetic form. Too much folate obtained naturally from food is not a concern.  It comes naturally packaged in balance with other micronutrients and the body regulates its absorption. Folic acid is not found in natural foods.
The protective effects of folate against neural tube defects (NTDs) have received much attention in the past.  Unfortunately, this knowledge and public attention did not result in a campaign by the U.S. government encouraging women to get plenty of natural dietary folate from vegetables.  Instead, because the Standard American Diet (SAD) is so nutritionally inadequate, the U.S. government and most physicians encourage women to take folic acid supplements, assuming that they are folate-deficient.  This actually perpetuates the widespread vegetable deficiency that does exist.
The problem is that folic acid is chemically different from dietary folate, which results in differences in uptake and processing of these two substances by the cells in the intestinal wall. Some folic acid is chemically modified to be more similar to natural folate, but the intestinal cells are limited in how much folic acid they can modify – folic acid often enters the circulation unmodified. Scientists do not yet know the implications of circulating synthetic folic acid. Many Americans, through multivitamin use and consumption of fortified foods, are taking in excessive amounts of folic acid, and thus may have unmodified folic acid circulating in their blood – this could contribute to cancer-promoting effects. ^1-3
Folate is abundant in all green vegetables. We do not need synthetic folic acid supplements to meet our daily folate requirements. Here are a few examples of folate-rich foods (as a reference point, the U.S. RDA for folate is 400µg):⁴

Food Source	Micrograms
Edamame (1 cup cooked)	482 µg
Broccoli (2 cups cooked)	337 µg
Asparagus (1 cup cooked)	268 µg
Romaine lettuce (3 cups raw)	192 µg
Brussels sprouts (2 cups cooked)	187 µg
Spinach (3 cups raw)	175 µg

Recently, there have been some troubling studies connecting folic acid supplementation with breast, prostate, and colorectal cancers:

• Women who followed the typical recommendations to take folic acid during pregnancy and were followed by researchers for thirty years were twice as likely to die from breast cancer.⁵
• Another study following women for ten years concluded that those who took multivitamins containing folic acid increased their breast cancer risk by 20-30%.⁶
• Folic acid supplementation by pregnant women has been associated with incidence of childhood asthma, infant respiratory tract infections, and cardiac birth defects.^7-9
• Men who had taken folic acid supplements for more than three years had a 35% increase in colorectal cancer risk, according to a meta-analysis of several randomized controlled trials.¹⁰
• In a 10-year study, folic acid supplementation was associated with more than double the risk of prostate cancer compared to placebo.¹¹
• In two trials comparing folic acid supplements to placebo, overall cancer incidence and all-cause mortality were increased in the folic acid group over the 9-year study period.¹²

In contrast, food folate is associated with protection from cancer and other benefits:

• Women with lower levels of food folate intake are more likely to be diagnosed with breast cancer.¹³
• Food folate intake is inversely associated with prostate cancer risk.¹¹
• The children of women who consumed more food folate during pregnancy were less likely to develop ADHD.¹⁴

Getting enough folate from natural foods may keep tumors from starting by repairing errors in DNA, but synthetic folic acid may feed tumor development and promote  carcinogenesis. In light of this research, I do not include folic acid in my multivitamin or prenatal.  I do not recommend that pregnant women take a prenatal that contains folic acid.  I do recommend a blood test for folate sufficiency before even contemplating pregnancy, and I do recommend a high-folate diet rich in green vegetables.  A diet rich in green vegetables is the safest way to achieve protection from cancer, heart disease and all-cause mortality.

1. Harvard School of Public Health; The Nutrition Source: Keep the Multi, Skip the Heavily Fortified Foods.  August 29, 2008]; Available from: www.hsph.harvard.edu/nutritionsource/what-should-you-eat/folicacid/.
2. Hirsch, S., et al., Colon cancer in Chile before and after the start of the flour fortification program with folic acid. Eur J Gastroenterol Hepatol, 2009. 21(4): p. 436-9.
3. Chustecka, Z. Folic-Acid Fortification of Flour and Increased Rates of Colon Cancer . 2009  [cited 2009; Available from: http://www.medscape.com/viewarticle/591111.
4. NutritionData.com: Nutrient Search Tool.  2009]; Available from: http://www.nutritiondata.com/tools/nutrient-search.
5. Charles, D., et al., Taking folate in pregnancy and risk of maternal breast cancer. Bmj, 2004. 329(7479): p. 1375-6.
6. Stolzenberg-Solomon, R.Z., et al., Folate intake, alcohol use, and postmenopausal breast cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Am J Clin Nutr, 2006. 83(4): p. 895-904.
7. Whitrow, M.J., et al., Effect of supplemental folic acid in pregnancy on childhood asthma: a prospective birth cohort study. Am J Epidemiol, 2009. 170(12): p. 1486-93.
8. Haberg, S.E., et al., Folic acid supplements in pregnancy and early childhood respiratory health. Arch Dis Child, 2009. 94(3): p. 180-4.
9. Kallen, B., Congenital malformations in infants whose mothers reported the use of folic acid in early pregnancy in Sweden. A prospective population study. Congenit Anom (Kyoto), 2007. 47(4): p. 119-24.
10. Fife, J., et al., Folic Acid Supplementation and Colorectal Cancer Risk; A Meta-analysis. Colorectal Dis, 2009.
11. Figueiredo, J.C., et al., Folic acid and risk of prostate cancer: results from a randomized clinical trial. J Natl Cancer Inst, 2009. 101(6): p. 432-5.
12. 12. Ebbing, M., et al., Cancer incidence and mortality after treatment with folic acid and vitamin B12. JAMA, 2009. 302 (19): p. 2119-26.
13. Sellers, T.A., et al., Dietary folate intake, alcohol, and risk of breast cancer in a prospective study of postmenopausal women. Epidemiology, 2001. 12 (4): p. 420-8.
14. Wiley-Blackwell (2009, October 28). Attention-deficit/hyperactivity Problems Associated With Low Folate Levels In Pregnant Women. ScienceDaily. 2009  February 5, 2010]; Available from: http://www.sciencedaily.com/releases/2009/10/091028134631.htm.

Adding folic acid to all our diets is a recipe for disaster

By PROFESSOR DAVID SMITH
Last updated at 10:42 27 September 2007

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'Fortifying all flour with folic acid is potentially a national health disaster'

Flour could soon be fortified with folic acid to reduce the number of babies born with spina bifida. But here, a pharmacologist and leading authority on folic acid claims many adults could die as a result:

Fortifying all flour with folic acid is potentially a national health disaster. Folic acid is the synthetic version of the B vitamin folate. But although it's vital for health, it has a dark side.
Giving extra amounts to everyone in the country ? whether they need it or not ? could lead to more than 3,000 new cases of colon cancer, a rise in prostate cancer and put as many as 150,000 elderly people at risk of anaemia and memory problems.
There is no question that folic acid is important. Pregnant women who don't get enough of it run the serious risk of their baby being born with spina bifida, a horrible condition which means that the spine hasn't closed up properly so that part of the spinal cord is exposed, leaving the child disabled for life and possibly in need of constant care.
The problem is that at present, only about 50 per cent of pregnant women get enough folic acid. Putting it in flour ? as the Food Standards Agency (FSA) is recommending ? is a fairly cheap and easy way of making sure at the start of a pregnancy that all women have adequate levels.
In America, they have been fortifying flour with folic acid since 1996 and the incidence of spina bifida has dropped by more than 20 per cent. In the UK, it's claimed the same move could prevent up to 160 spina bifida pregnancies a year.
A fortification programme might have other benefits, too. Folic acid can protect you against cancer because your cells need it to repair the daily damage to their DNA, damage that can otherwise lead to the disease.
Folic acid is also needed to reduce levels of a substance called homocysteine in your blood (high levels of homocysteine raise your risk of heart disease and strokes). Extra folic acid may cut the number of strokes by 18 per cent, according to research just published in The Lancet. Certainly, deaths from stroke in America have fallen since fortification of flour.
And there's yet another benefit.
My research suggests that keeping down homocysteine may also be a way of cutting your risk of developing Alzheimer's, and I'm currently running a trial in Oxford, giving extra folic acid to elderly people to try to prove it.
So fortification seems to make a lot of sense. Following a favourable report by the FSA earlier this year, the Government is now considering legislating to force food manufacturers to fortify all flour except wholemeal, which is being excluded to give people a choice.
But while I was once a passionate advocate of folic acid, I am now passionate about alerting people to the potential harm it can cause and about the importance of research to discover who will gain from it and who should not take too much.
The more we learn about folic acid, the more it's clear that giving it to everyone has very real risks.
Nearly all medicines involve a balancing act. If you're not getting enough folic acid (good sources include wholewheat, liver, eggs, beans, fruits and leafy green vegetables) then a boost from your daily bread intake could help.
But if your levels are already adequate, then the extra could be damaging. And that's why fortification is such a bad idea. It's like using a shotgun in a crowded place; bystanders are going to get hurt.
While folic acid can protect you against cancer, once a tumour has already started growing, it can switch sides. Cancer cells are greedy for folic acid; it helps them to keep reproducing.
Knowing that, now consider the fact that 20 per cent of middleaged people have pre-cancerous cells in their colon and that most middle-aged men have them in their prostate, too. Forcing them to eat something that is likely to encourage those cells to grow suddenly doesn't seem such a bright idea.
Indeed, when we look at what has happened in the U.S. and Canada, it seems positively reckless.
According to a study just published, fortifying flour over there has been followed by an extra five people in 100,000 developing colon cancer annually. That may not sound a lot but the same rate of increase in the UK would mean an extra 3,000 cases.
In fact, the rate might be higher since the FSA recommends that we fortify flour with more than twice the American amount.
But extra cancer cases won't be the only fall-out. Folic acid performs another of its Jekyll and Hyde routines with the elderly.
Ten per cent of them have low levels of another B vitamin ? B12. This makes them more likely to develop anaemia (not enough red blood cells). They also become confused and their memory gets worse.
Giving them extra folic acid can hide the blood symptoms of low B12, making it likely their deficiency will be missed. The combination of high folic acid and low B12 may also make those mental problems worse. Scaling down from American figures, we can predict that 150,000 elderly people could have more memory problems as a result of fortification of flour in the UK.
And there is one more problem fortification is likely to cause. A whole class of drugs are designed to block folic acid because it makes conditions such as cancer, rheumatoid arthritis and psoriasis worse.
Forcing extra amounts of folic acid on everyone suffering from these conditions might affect their health It is only in the past few years that the dangers of folic acid fortification have become clear. If the Americans had known in 1996 what we know now, they would never have introduced it.
So it is highly irresponsible for the UK Government to even be thinking about it. More research is needed to identify those who might be harmed by extra folic acid and to assess the balance between benefit and harm.
Fortification sets up a grim equation. We have 800 new cases of spina bifida each year, but there are 30,000 new cases of colon cancer and 30,000 of prostate cancer.
Currently, 500,000 suffer from rheumatoid arthritis and 900,000 from psoriasis.
Half a million people, some of whom might be harmed, would be exposed to extra folic acid for every spina bifida baby saved. It's not worth it.
Instead of this cruel equation, we need to be much more sophisticated.
We need to be a lot more proactive about getting folic acid to those who do need it ? it should be freely available to all women of child-bearing age, for instance ? and do a much better job of warning those who could be harmed against it.
Monitoring older people to see who has too little and who needs B12 could make a huge difference to the quality of life of our elderly population.
Just adding folic acid to flour is far too crude. It may seem like a cheap option to gain some health benefits but it could end up costing thousands of people dear.
If it happens, my family will be sticking to wholemeal bread.
INTERVIEW: Jerome Burne.

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Folic Acid is Hazardous to Your Health.  What About Food Folate?

By Robert Thiel, Ph.D., Naturopath and Scientist
Folic acid gets a lot of press coverage.  There are many reports that folic acid should be taken by pregnant women and may prevent birth defects.  Folic acid has also been claimed to help prevent cardio- and cerebral-vascular diseases.  Yet few reports have mentioned that folic acid is unnatural, folic acid is synthetic, and that the body cannot properly convert much folic acid into a usable folate form.  Furthermore, concerns about folic acid feeding cancer are now a real concern in the 21st Century—too much folic acid may kill you.
“Folic acid is a synthetic folate form” [1] and was not developed until the 20th Century [2].  Folic acid is chemically known as pteroylglutamic acid (PGA) and is a crystalline substance (no food vitamins are naturally crystalline in structure) [2,3].  Folate, once also known as vitamin B9, exists in foods, yet crystalline folic acid does not [1-4].  Folates also differ from folic acid “in the extent of the reduction state of the pteroyl group, the nature of the substituents on the pteridine ring and the number of glutamyl residues attached to the pteroyl group” [1].
An Irish study found that the body has trouble converting more than 266 mcg of folic acid per day [2]. “(C)onsumption of more than 266 mcg of synthetic folic acid (PGA) results in absorption of unreduced PGA, which may interfere with folate metabolism for a period of years” [2].  A 2004 paper from the British Medical Journal confirmed what many natural health professional have known all along: since folic acid is unnatural and the body cannot fully convert large amounts of it into usable folate, this artificial substance can be absorbed and may have unknown negative consequences in the human body [4].  One of the biggest scientific concerns about folic acid is that even in amounts close to official daily recommendations, some of it is absorbed in unreduced form into the bloodstream with potentially dangerous results [2,4].  Also, “(i)n vitro studies do show that PGA derivatives act to inhibit certain enzymes, including those associated with nucleotide biosynthesis” [4].  In spite of this, the U.S. Food and Drug Administration has required that uncooked cereal grains and flour products be fortified with folic acid [1].
A JAMA study recently concluded that “studies have suggested that folate intake decreases risk of cardiovascular diseases. However…[f]olic acid supplementation has not been shown to reduce risk of cardiovascular diseases” [5].  This is because studies using folate (the natural form) show it works, yet folic acid (the synthetic form) does not.  Food folate is clearly superior.
Since food folate is natural and is absorbed through a different pathway than folic acid [2], long-term consumption of folate does not result in an accumulation of a foreign substance in the body, but instead has many benefits. 
Initially, food folate was given for people with a pregnancy-related anemia in the form of autolyzed yeast; later the synthetic form, folic acid, was developed [2].  Folic acid, as it exists in most supplements, is not found in foods, folates are [2].  USDA reports show that broccoli and alfalfa sprouts contain food folate [6,7] and they are considered to be the best food supplement source by some.  Furthermore, “folates are ubiquitous in nature, being present in nearly all natural foods…50 to 95% of folate in food may be destroyed by protracted cooking or other processing” [2].  Yeast, dark green leafy vegetables, and oranges have the highest folate content [1,2].
Folate is an important nutrient for healthy blood; the absence of any of it can trigger various forms of anemia (especially pernicious anemia) [2,8].  Subclinical deficiencies of folate may impair cognitive function [9].  Folate deficiency is the most important determinant in high homocysteine levels [9], and supplemental folate is effective in reducing homocysteine [10,11].  (Homocysteine is highly implicated in vascular diseases such as cardiovascular and other vascular disorders.)  “The major forms of folates found in food are methylTHF and formylTHF” [12]. 
While insufficient folate can result in fatigue, depression, confusion, anemia, reduced immune function, loss of intestinal villi, and an increase in infections [1,2,8], it is not totally clear what dangers long-term consumption of folic acid will cause [2,4].  Certain scientists believe that excessive consumption of folic acid may actually interfere with folate metabolism [2]—this could be expected to worsen conditions that would have otherwise benefited from real food folate.  Furthermore, “(v)ery large amounts of folic acid in its pharmacological oxidized (PGA) form may be noxious to the nervous system…and have provoked seizures in patients otherwise under control on anticonvulsant therapy” [2].
Excessive Folic Acid is Becoming a Health Concern
A 2010 report states, “"The more we learn about folic acid, the more it's clear that giving it to everyone has very real risks," says folic acid researcher David Smith, PhD, a professor of pharmacology at the University of Oxford in England…The risk experts worry about most: colon cancer. Last year, health officials in Chile reported that hospitalization rates for colon cancer among men and women age 45 and older more than doubled in their country since fortification was introduced in 2000. In 2007, Joel Mason, MD, director of the Vitamins and Carcinogenesis Laboratory at the Tufts University School of Medicine, described a study of the United States and Canada suggesting that rates of colon cancer rose — following years of steady decline — in the late 1990s (around the time our food was being fortified)” [13].
The same report also states, “Other research links high doses to lung and prostate cancers. In one study conducted in Norway, which doesn't fortify foods, supplementation with 800 mcg of folic acid (plus B12 and B6) daily for more than 3 years raised the risk of developing lung cancer by 21 percent. Another, in which men took either folic acid or a placebo, showed those consuming 1,000 mcg of folic acid daily had more than twice the risk of prostate cancer. And a new worry recently came to light when scientists discovered the liver has limited ability to metabolize folic acid into folate — which means any excess continues circulating in the bloodstream. "Unlike folate, folic acid isn't found in nature, so we don't know the effect of the excess," says Smith. Indeed, many scientists have grown increasingly concerned about mounting research — including a study published last winter in the Journal of the American Medical Association — suggesting that all the extra folic acid might increase your odds of developing cancer” [13].
Even foods “fortified” with folic acid may cause serious neurological problems in patients deficient in vitamin B12 [12].  Furthermore, “no folic acid dose can be considered as truly safe in the presence of untreated cobalamin deficiency” [12].
Laura Bell correctly reported, “We all need the natural folate found in leafy greens, orange juice, and other foods, and diets high in these foods are perfectly healthy; many researchers, though, believe that folic acid may be both friend and foe. When cells in the body are healthy, folate helps shepherd along the normal replication of DNA. But when cells are malignant or in danger of becoming so — and as many as half of adults older than 60 could already have precancerous colon polyps, while most middle-aged men have precancerous cells in their prostates — animal studies suggest excess folate in the form of folic acid may act like gas on the fire… lowering your intake to 400 mcg won't hurt — and might help save your life” [13].
It is clear that since folic acid is unnatural, is synthetic, is chemically different, is structurally different, and is not absorbed in the same pathways as folate, long-term folic acid consumption may be hazardous to human health.  Folate in foods is what is safe and is the preferred form of folate for human consumption. Excessive folic acid may make cancer worse. And unlike folic acid, humans have been safely consuming food folate for thousands of years. 
I have been warning people against folic acid for many years [3,14].  Now it is becoming clearer and clearer that those warnings should have been heeded by more people.  Everyone should be concerned about taking synthetic/isolated USP vitamins like those containing folic acid.
 
References
[1] Hendler SS, Rorvik D, eds.  PDR for Nutritional Supplements.  Medical Economics, Montvale (NJ), 2001
[2] Shils ME, Olson JA, Shike M.  Modern Nutrition in Health and Disease, 9th ed.  Williams & Wilkins, Balt., 1999
[3] Thiel R.  Natural vitamins may be superior to synthetic ones.  Med Hypo, 2000;55(6):461-469
[4] Lucock M.  Is folic acid the ultimate functional food component for disease prevention?  BMJ, 2004;328:211-214
[5] Bazzano LA, Reynolds K, Holder KN, He J.  Effect of folic acid supplementation on risk of cardiovascular diseases: a meta-analysis of randomized controlled trials.  JAMA. 2006;296(22):2720-2726
[6] Broccoli, raw. USDA National Nutrient Database for Standard Reference, Release 18 (2005)
[7] Alfalfa seeds, sprouted raw.  USDA National Nutrient Database for Standard Reference, Release 16-1, 2004
[8] Whitney EN, Hamilton EMN.  Understanding Nutrition, 4th ed.  West Publishing, NY, 1987
[9] Gonzalez-Gross M, Marcos A, Pietrzik K.  Nutrition and cognitive impairment in the elderly.  Br J Nutr 2001;86:313-321
[10] Verhoef P.  Homocysteine metabolism and risk of myocardial infarction: Relation with vitamin B6, B12, and Folate.  Am J Epidemiol 1996;143(9):845-859
[11] Brattstrom L.  Vitamins as homocysteine-lowering agents: A mini review.  Presentation at The Experimental Biology 1995 AIN Colloquium, April 13, 1995, Atlanta Georgia
[12] Carmel R.  Folic Acid.  In Modern Nutrition in Health and Disease, 10th ed.  Lippincott Williams & Wilkins, Baltimore, 2006:470-481
[13] Bell L. Is your breakfast giving you cancer? Research links too much folic acid to certain cancers.  Prevention. March. 29, 2010.  http://www.msnbc.msn.com/id/35874922/ns/health-diet_and_nutrition// 
[14] Thiel R. Is Folic Acid Hazardous to Your Health?  The Original Internist, 2004;11(2):39-40
Above article is expected to be published as Thiel R.  Is Folic Acid is Hazardous to Your Health.  What About Food Folate?  The Original Internist, June 2010.
Some of these studies (or citations) may not conform to peer review standards, therefore, the results are not conclusive.  Professionals can, and often do, come to different conclusions when reviewing scientific data.  None of these statements have been reviewed by the FDA.  
Doctors’ Research, Inc.  ”Nutrition from food, what a concept!”
1248 E. Grand Avenue, Suite A, Arroyo Grande, CA 93420 WEB: www.doctorsresearch.com   FAX: 1-805-489-0334

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B vitamin supplements

Folic acid may increase cancer risk, study shows

Carly Weeks

From Wednesday's Globe and Mail

Published Tuesday, Nov. 17 2009, 7:26 PM EST
Last updated Wednesday, Mar. 16 2011, 11:43 AM EDT

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More questions are being raised about the safety of folic acid supplementation after new research has found links between the B vitamin and increased cancer risk.
Researchers in Norway found that heart-disease patients treated with a combination of folic acid and vitamin B12 had an increased risk of cancer and death compared to patients who didn't receive the vitamins as treatment.
Unlike Canada and the United States, Norway doesn't require folic acid to be added to any food. The market for vitamin supplements is also relatively small and study participants were discouraged from taking them, which gave researchers a unique ability to assess the effect folic acid could have on a group who receive it in high doses. The study, appearing Nov. 18 in the Journal of the American Medical Association, fuels fears that mandatory fortification of the food supply with folic acid could yield unintended consequences.
“Folic acid fortification and supplementation may not necessarily be as safe as previously assumed,” Marta Ebbing, the study's lead author and a physician at Haukeland University Hospital, said in an interview yesterday.
The issue has come under increasing scrutiny and debate in the medical community in recent years as a growing number of studies have suggested that high amounts of folic acid can potentially speed up the progression of cancer in genetically predisposed individuals.
The debate is complicated by the fact that folic acid, when taken by expectant mothers, significantly reduces the risk of children being born with neural tube defects, such as spina bifida.
Researchers caution that much more work needs to be done to understand the potential risks and whether any changes in public health policy are needed.
Folic acid is the synthetic form of folate, a vitamin found naturally in leafy greens and other fruits and vegetables. The federal government has required food manufacturers to add folic acid to white flour, enriched pasta and cornmeal products since 1998 as a way of ensuring women receive enough of the vitamin to curb the incidence of neural tube defects in the population. But some food makers may also add folic acid to other items, such as cereals, on a voluntary basis.
Although the amounts added to food aren't very high, some researchers are worried Canadians who also consume multivitamins or supplements containing folic acid may be getting too much.
“We are concerned about folic acid supplementation actually promoting existing cancer,” said Young-In Kim, professor of medicine and nutritional sciences at the University of Toronto and gastroenterologist at St. Michael's Hospital. “[But] we need to be careful because fortification did wonderful things.”
The new research combines two studies of more than 6,000 heart disease patients who received some combination of folic acid and B vitamins or patients who received a placebo. Patients who took vitamins received 0.8 milligrams of folic acid, 0.4 milligrams of vitamin B12 and 40 milligrams of vitamin B6 a day. While some patients received a combination of vitamins, others took vitamin B6 or folic acid alone.
After more than six years of follow up, the researchers found a heightened incidence of cancer and death among those who received folic acid and vitamin B12. Vitamin B6 wasn't associated with any increased risk of health problems.
Dr. Ebbing said the findings suggest that folic acid – and not vitamin B12 – is likely responsible for any increased cancer risk because it was present in higher concentrations.
After the follow-up period was over, researchers found that 10 per cent of those who received folic acid had been diagnosed with cancer, compared to 8.4 per cent of the group that didn't take any B vitamin.
Most of the increased cancer risk was attributed to higher rates of lung cancer. Researchers found that 56 people who took folic acid were diagnosed with lung cancer, compared to 36 people in the group that didn't receive that vitamin.
Canadian women who could become pregnant are told to consume at least 0.4 milligrams a day, although some women's health advocates are urging the government to recommend even higher levels.
But it's not hard for average Canadians to meet or even exceed the 0.8-milligram dose of folic acid given in the study, Dr. Kim said. He is concerned about people who take supplements that typically contain 0.4 milligrams of folic acid. Add to that the folic acid contained in grain products, and an individual could easily consume the dose used in the study.
Although the increase in cancer incidence noted in the study may appear small, the rates are significant when applied across a country's entire population. It's one of the reasons a growing number of experts are sounding the alarm about folic-acid fortification and potential for overconsumption.
“You can't fix everything just by taking a pill,” Dr. Ebbing said. “It's not always as simple as more of a good thing will be a good thing.”

Is Too Much Folic Acid Giving You Cancer?

Research links too much Folic Acid--a staple in multivitamins, as well as cereal and bread--to colon, lung, and prostate cancers. What news about this B vitamin means to you.

By Laura Beil

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Chances are, you started your day with a generous helping of folic acid. For more than a decade, the government has required enriched grains -- most notably white flour and white rice--to be fortified with folic acid, the synthetic form of the B vitamin folate. Many food manufacturers take it further, giving breakfast cereals, nutrition bars, and beverages a folic acid boost too. The extra nutrient isn't meant for you, though -- it's added to protect fetuses from developing rare but tragic birth defects. The fortification effort appears successful: Since 1998, the number of these birth defects dropped by about 19%. But for women past the years of having children, as well as for men of any age, unnatural dosages of this nutrient don't seem to be helpful--and may even be harmful. Indeed, many scientists have grown increasingly concerned about mounting research--including a study published last winter in the Journal of the American Medical Association--suggesting that all the extra folic acid might increase your odds of developing cancer. "The more we learn about folic acid, the more it's clear that giving it to everyone has very real risks," says folic acid researcher David Smith, PhD, a professor of pharmacology at the University of Oxford in England.

If there's a nutrient it's easy to overdose on, it's folic acid. The vitamin is all around us, slipped into the cereal we eat for breakfast, the bread we eat for lunch, the energy bars we snack on, and the supplements that over one-third of us take regularly. Women are supposed to get 400 mcg a day, the amount that protects fetuses. Some cereals, though, contain more or have a serving size that makes it easy to pour a double dose. Add to that a vitamin washed down with your vitamin-fortified drink, and you may get a megadose before walking out the door.

Read more: http://www.prevention.com/food/healthy-eating-tips/your-breakfast-giving-you-cancer#ixzz2EPPr1A6p

http://www.prevention.com/food/healthy-eating-tips/your-breakfast-giving-you-cancer

Do supplements with folic acid cause cancer? Should they be avoided?

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So I want to take Vitamin B12 supplements and I can't find a single one without folic acid. Here's some claims that says taking supplements which contain folic acid causes cancer. I'm 22, male and follow a vegan diet and I have not been taking any supplements. I might change my diet in the future. Is this true ? If yes, are there vitamin B12 supplements without folic acid ? Here's a passage from the book Eat to live by Dr. Joel Fuhrman http://www.amazon.com/dp/031612091X/ Avoid taking supplements that contain these ingredients: vitamin A, high-dose (200 IU or greater) isolated vitamin E, folic acid, beta-carotene, and copper. Ingesting vitamin A or beta-carotene from supplements instead of food may interfere with the absorption of other crucially important carotenoids, such as lutein and lycopene, thus potentially increasing your cancer risk. (1) Folic acid is the synthetic form of folate added to food or used as an ingredient in vitamin supplements. Folate is found naturally in fruits, vegetables, grains, and other foods. Too much folate obtained naturally from food is not a concern. It comes naturally packaged in balance with other micronutrients, and the body regulates its absorption. (2) Everyone, including pregnant women, should be getting adequate amounts of folate from natural plant sources. Recently, there have been some troubling studies connecting folic acid supplementation and cancer. More and more evidence suggests that folic acid supplementation may significantly increase the risk of cancer. (3) (1) Mayne ST. Beta-carotene, carotenoids, and disease prevention in humans. FASEB J. 1996;10(7): 690–701; Goodman GE. Prevention of lung cancer. Curr Opin Oncol. 1998;10(2):122–26; Kolata G. Studies find beta carotene, taken by millions, can’t forestall cancer or heart disease. New York Times. 1996 Jan 19. Omenn GS, Goodman GE, Thornquist MD, et al. Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. N Eng J Med. 1996;334(18);1150–55; Hennekens CH, Buring JE, Manson JE, et al. Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. N Eng J Med. 1996;334(18):1145–49; Albanes D, Heinonen OP, Taylor PR, et al. Alpha-tocopherol and beta-carotene supplements and lung cancer incidence in the alpha-tocopherol, beta-carotene cancer prevention study: effects of baseline characteristics and study compliance. J Natl Cancer Inst. 1996; 88(21):1560–70; Rapola JM, Virtamo J, Ripatti S, et al. Randomized trial of alpha-tocopherol and beta-carotene supplements on incidence of major coronary events in men with previous myocardial infarction. Lancet. 1997;349(9067): 1715–20; Bjelakovic G, Nikolova D, Gluud LL, et al. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Cochrane Database Syst Rev. 2008 Adr 16;(2):CD007176. (2) Harvard School of Public Health. The Nutrition Source. Keep the Multi, Skip the Heavily Fortified Foods. http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/folic-acid/. (3) Yi K. Does a high folate intake increase the risk of breast cancer? Nutr Rev. 2006; 64(10 Pt 1): 468–75; Cole B, Baron J, Sandler R, et al. Folic acid for the prevention of colorectal adenomas. JAMA. 2007; 297(21):2351–59; Stolzenberg-Solomon R, Chang S, Leitzman M. Folate intake, alcohol use and postmenopausal breast cancer risk in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Am J Clin Nutr. 2006;83:895–904; Smith AD, Kim Y, Refsuh H. Is folic acid good for everyone? Am J Clin Nutr. 2008;87(3):517; Kim Y. Role of folate in colon cancer development and progression. J Nutr. 2003;133(11) (suppl 1):S3731–39; Guelpen BV, Hultdin J, Johansson I, et al. Low folate levels may protect against colorectal cancer. Gut. 2006;55:1461–66. Here's another passage by Steven Novella on Vitamins and Mortality. But it seems to contradict with what Joel Fuhrman says. http://www.sciencebasedmedicine.org/index.php/vitamins-and-mortality/ In the latest issue of The Archives of Internal Medicine is a population based observational study looking at health outcomes and vitamin use as part of the larger Iowa Women’s Health Study. The authors looked at 38,772 older women and asked them to self-report their vitamin use. This is a long term study and their vitamin use was reports in 1986, 1997, and 2004, and mortality was followed through 2008. They found a small but statistically significant increase in mortality for those taking multivitamins, B6, folic acid, iron, copper, magnesium and zinc. There was also a small decrease in mortality for those taking calcium. The strength of this study is that it is large with a long term follow up. There are many weaknesses, however. Vitamin use was self-reported. Further, this is a correlational study only. Therefore possible confounding factors could not be controlled for. For example, it is possible that women who have an underlying health issue that increases their mortality were more likely to take vitamins or to report taking vitamins.In fact, other studies suggest there is such a “sick-user effect” with vitamins. It is therefore not possible from this study to draw any conclusions about cause and effect – that vitamin use increases mortality. But it does provide a cautionary reminder that it is not reasonable to assume that vitamin supplementation is without any risk. We still need to follow the evidence for the use of specific vitamins at specific doses for specific conditions and outcomes. More references: http://www.sciencedaily.com/releases/2009/11/091117161013.htm http://www.webmd.com/cancer/news/20091117/folic-acid-b12-may-increase-cancer-risk

 

Too much folic acid a cancer risk

LISA PRIEST

The Globe and Mail

Published Friday, Feb. 11 2011, 8:32 PM EST
Last updated Thursday, Aug. 23 2012, 5:01 PM EDT

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A vitamin considered so beneficial that pregnant women are instructed to take it and many foods are laced with it, may be too much of a good thing: scientists have found folic acid at elevated levels can cause cancer in a rat's offspring.
"There's a concern," said Young-In Kim, staff gastroenterologist at St. Michael's Hospital in Toronto. "But we don't want to panic the general public about this."

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Published in the February edition of the journal Cancer Research, the study found that rats given folic acid supplements before conception, during pregnancy and while breastfeeding, produced female offspring with breast cancer rates that were twice as high as the control group.
"We actually assumed that giving folic acid to moms will reduce the level of breast cancer in their offspring," said Dr. Kim, a University of Toronto medical professor. "To our surprise, a folic acid supplementation to mothers is the opposite of what we expected."
Indeed, the female rat offspring also had more tumours and faster-growing tumours, suggesting the folic acid supplement created a rat susceptible to cancer.
"That's what science is all about," said Dr. Kim. "You have unexpected findings."
Though it is a study of rats, not people, Dr. Kim said he is concerned enough to suggest women of childbearing age be careful not to ingest too high a level of the B vitamin.
Earlier research has shown that at modest levels, folic acid prevents birth defects and some cancers, such as neuroblastoma and pediatric leukemia in humans, in addition to colon cancer in rats. At higher levels, however, Dr. Kim's research found it can actually promote the growth of breast cancer in rats.
"Folic acid supplementation can do two things: It can protect against certain cancers, but it can promote other cancers," said Dr. Kim. "It has a dual effect, depending on when you take it."
The findings have broad implications not only for pregnant women but also to a general public that may be unwittingly overdosing on it through multivitamins, protein bars, vitamin drinks and breads, cereals and pastas. Even some cancer survivors are told to take folic acid, the synthetic form of folate, a B vitamin that occurs naturally in leafy greens, grains and other foods.
Dr. Kim's study adds to a growing body of evidence and feeds concerns that a large number of Canadians are being needlessly exposed to high levels of a vitamin that could have deleterious health effects. A Norwegian study published in the Journal of the American Medical Association two years ago found heart disease patients treated with folic acid and B12 were more likely to be diagnosed and die from cancer than patients who did not receive those vitamins as treatment.
How the superstar vitamin made its way into boxes of enriched pasta, bags of white flour and packages of cornmeal can be traced back to 1998 when the Canadian and U.S. governments required food producers to add it to those products. That was done to ensure that women of child-bearing age consumed enough of the vitamin to prevent neural-tube defects such as spina bifida in their offspring.
With half of pregnancies unplanned and defects occurring in the first trimester, folic acid fortification was a smashing success, dramatically reducing neural-tube defects. That's because women who didn't know they were pregnant were consuming adequate levels of a vitamin they didn't know they needed.
As for what Canadians should do, Dr. Kim said they should consume folic acid at the recommended dose: 400 micrograms a day from all sources, whether natural or a supplement, adding that "anything above that, I'd be quite concerned about."
Part of the problem, however, can be trying to reach that recommended number. Some prenatal vitamins, for example, contain one milligram of folic acid, which is 2½ times the recommended daily dose and the same amount used in the animal study.

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Folic Acid, B12 May Increase Cancer Risk

Study Shows Slight Increase in Cancer Risk From Large Doses of Supplements

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By Salynn Boyles
WebMD Health News

Reviewed by Louise Chang, MD

Nov. 17, 2009 -- There is new evidence that folic acid, taken in large doses, may promote some cancers.
Heart patients in Norway who took folic acid and vitamin B12 supplements were found to have a slightly increased risk for cancer and death from all causes, compared to heart patients who did not take the supplements in a study published in TheJournal of the American Medical Association.
Unlike the U.S., Norway does not fortify flour and grain food products with folic acid, which is the synthetic form of the B vitamin folate.
Because of this, Norwegians tend to have much lower blood folate levels than Americans, making the population a good one for studying the impact of folic acid supplementation on cancer risk, study researcher Marta Ebbing, MD, of Norway's Haukeland University Hospital tells WebMD.

Folic Acid, B12, and Lung Cancer

Ebbing and colleagues analyzed data from two studies that included almost 7,000 heart patients treated with B vitamin supplements or placebo for an average of three and one-half years between 1998 and 2005.
The original intent of the studies was to determine if taking vitamin B supplements improved cardiovascular outcomes, which it didn't do.
During treatment, blood folate levels among patients who took 0.8 milligrams a day of folic acid plus 0.4 milligrams a day of vitamin B12 increased more than sixfold.
The patients were followed for an average of three years after supplementation ended, during which time 341 patients who took folic acid and B12 (10%) and 288 patients who did not (8.4%) were diagnosed with cancer.
Folic acid and B12 supplementation was associated with a 21% increased risk for cancer, a 38% increased risk for dying from the disease, and an 18% increase in deaths from all causes.
This finding was mainly driven by an increase in lung cancer incidence among the folic acid and B12-treated patients.
Seventy-five (32%) of the 236 cancer-related deaths among the study participants were due to lung cancer, and the cancer incidence among the study group was 25% higher than in the population of Norway as a whole.
Roughly 70% of all the patients in the study were either current or former smokers, including more than 90% of those who developed lung cancer.

Other Views

In a statement issued in response to the study, a spokesman for the supplement-industry trade association Council for Responsible Nutrition (CRN) noted that the lung cancer finding has not been seen in other studies.
"The real headline of this study should be that smoking increases the risk of lung cancer -- the study found that a total of 94% of the subjects who developed lung cancer were either current or former smokers," CRN Vice President for Scientific and Regulatory Affairs Andrew Shao, PhD, says in a news release.
In the U.S., mandatory folic acid fortification of flour and grains has been in effect for just over a decade, and fortification has succeeded in dramatically lowering the incidence of neural tube birth defects.
Shao says the fact that lung cancer rates have also dropped during this time in both men and women suggest folic acid and B12 do not promote lung cancer.
Bettina F. Drake, PhD, of Washington University in St. Louis School of Medicine, says it is not likely that fortification has led to an increase in cancers in the U.S. In fact, several studies suggest just the opposite.
"We would expect to see an excess in cancers within a few years after folic acid fortification began, and we have not seen that," she tells WebMD.
Drake says it is possible that folic acid protects against cancer at certain points in life and promotes the growth of cancers at other times. It may also be true that too little folate in the blood or too much of the B vitamin are both associated with an increased risk for cancer.
In an editorial published with the study, Drake and Graham A. Colditz, MD, write that it may take decades to fully understand how folic acid fortification affects health.

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Folic Acid in Dietary Supplements Could Increase Risk of Breast Cancer, Swedish Research Suggests

Apr. 7, 2010 — In most women folate, a type of B vitamin, reduces the risk of breast cancer. However, in women with a certain genetic make-up it has shown to be the opposite: folate raises the risk of breast cancer.

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"Therefore I think it is too soon to introduce a general fortification of foodstuffs with folic acid," says nutrition researcher Ulrika Ericson of Lund University. Neither does she think it is a good idea to take multivitamin tablets and other dietary supplements containing folic acid (the synthetic form of folate) without special reason.
"It is better to eat a diet containing a lot of fruit, vegetables, legumes and wholemeal products. Then you get sufficient quantities of the natural form of folate, other vitamins and dietary fibre."
In her doctoral thesis, Ulrika Ericson has taken as her starting point the major study from the 1990s, Malmö Diet and Cancer, which gathered information and blood samples from over 17 000 women. At the end of 2004, just over 500 of these women had developed breast cancer. Folate levels, genetic make-up and food habits in the breast cancer patients have then been compared with the corresponding data from the healthy women.
Those women whose intake of folate corresponded to the level recommended in Sweden had only half as great a risk of getting breast cancer as those who had the lowest intake of folate. This was the overall finding, which shows that folate generally protects against breast cancer. However, the breast cancer risk increased in line with folate levels for a specific sub-group among the women -- those who had inherited a certain variant of an enzyme that affects how folate is used in the body. The ten per cent of the women who had inherited this variant from both of their parents had the highest risk of breast cancer, particularly if they also took vitamin tablets containing folic acid.
"No-one knows which genetic variant of this enzyme they have. This is why I think people should only take dietary supplements if there is a particular reason to do so, not just because 'it's probably a good idea'," says Ulrika Ericson.
She considers that there are two groups who could have a particular reason to take a folic acid supplement. These are people with a certain type of anaemia and low folate levels and women who are trying to become pregnant (folate reduces the risk of naural tube defects in babies). To be on the safe side, others should avoid vitamin tablets containing folic acid while it is still unclear what the link is between folate and different types of cancer. Mandatory folic acid fortification of foodstuffs, which has been discussed in many countries including Sweden, is not appropriate in the current situation, according to Ulrika Ericson.