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This is an old revision of this page, as edited by 2a00:23c0:c384:be00:30f9:3949:522f:64d1 (talk) at 04:16, 10 May 2019 (→Dangerous and False Information). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

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Rename

The page ought to be renamed to 'Folate' with 'folic acid' redirected here. Currently it is the opposite. 115.117.45.34 (talk) 01:47, 6 July 2016 (UTC)[reply]

Why? Mlewan (talk) 06:09, 6 July 2016 (UTC)[reply]

As a lay person I find the reference to the radical - 'folate' - which I was taught does not exist in isolation, rather confusing. I may be wrong, but isn't folic acid 'hydrogen folate'; just as sulphuric acid which elsewhere is referred to simply as 'sulphate', is actually hydrogen sulphate? — Preceding unsigned comment added by Ripov (talk • contribs) 18:24, 1 December 2016 (UTC)[reply]

April 2017: Article renamed "Folate." A search on Wikipedia for "Folic acid" redirects to Folate. The rationale is clearly explained in the lede. David notMD (talk) 13:32, 15 May 2017 (UTC)[reply]

Pregnancy

This section needs better referencing and clearer descriptions of what is proven for folic acid and what is not. Reducing risk of neural tube defects is proven (see meta-analyses by Atta CA 2016 and De-Regil LM 2015 and others). All the others mentioned as possible benefits, such as stillbirths, small for gestational age, congenital heart defects, cleft palate/lip, pre-delivery maternal health, etc., need to be summarized using the best possible evidence. David notMD (talk) 20:42, 17 May 2016 (UTC)[reply]

So far as I can see folic acid is "associated with" reduced risk of NTD (which is not quite the same as "proven" reduced risk), and for everything else is of no benefit. That seems to be the state of knowledge per Cochrane reviews. Or are there newer MEDRS? Alexbrn (talk) 04:17, 19 May 2016 (UTC)[reply]
What I am going to start with are the meta-analyses that show no benefit. Will be conservative about adding any with conclusions for benefits (or increased risk, such as speculation about asthma and autism).David notMD (talk) 13:26, 1 January 2017 (UTC)[reply]
Added content about no benefits seen for preventing pre-term birth, also the Devakamar results. Those are all I found that I feel meet Wikipedia standards for secondary sources.David notMD (talk) 14:41, 1 January 2017 (UTC)[reply]

Cancer

I think it is reasonable to acknowledge that there is a debate about cancer and folic acid. As it is has been a subject in peer reviewed literature for over 20 years (PMID 14502840) I do not believe inclusion of the most recent peer reviewed meta-analyses qualifies as WP:OR. Ies (talk) 17:23, 20 February 2017 (UTC)[reply]

That 'debate' is more than 20 years old, now outdated (and should not be in the article), or rather updated with clearer understanding. In the amounts of the Daily Value (DV) for recommended intake, folate is a protective agent because chronic deficiency (below DV) increases risk of "several cancers, including cancer of the colorectum, breast, ovary, pancreas, brain, lung and cervix." PMID 20544289, PMID 22783992. Mega-doses well above the DV via "excessive intake of synthetic folic acid (from high-dose supplements or fortified foods) may increase human cancers by accelerating growth of precancerous lesions;" (from Duthie article). So we need editing of the cancer section; I'll proceed. --Zefr (talk) 17:50, 20 February 2017 (UTC)[reply]
It seems to be protective with some but harmful with others, I agree. This does not seem restricted to 'mega-doses', and some of the data really isn't that good at all. Probably safer to stick with meta analyses or secondary sources if possible. I included the most recent of these, which did not show an effect, either positive or negative, though it seems they used a different statistical method than earlier studies.
Though the debate is more than 20 years old, that does not mean it is not still active, and from looking through meta analyses it seems to have at least been mentioned more than once. Ies (talk) 18:11, 20 February 2017 (UTC)[reply]
Most of these references are primary. We will have to simplify to avoid original research. Please see WP:MEDRS. Ies (talk) 18:36, 20 February 2017 (UTC)[reply]
I agree there are insufficient MEDRS sources. You could edit to the degree you wish, and I will review. Thanks. --Zefr (talk) 18:52, 20 February 2017 (UTC)[reply]
I read through the actual articles and gave it my best attempt at being neutral and sticking with reliable refs. I think the 2017 meta analysis is probably the best of what limited info there is, but have a look. Ies (talk) 19:15, 20 February 2017 (UTC)[reply]
The second part about the doses showing effect being excessive needs to be revised. Ies (talk) 03:38, 22 February 2017 (UTC)[reply]
It's stated in each of refs 34-6. Also Jägerstad (ref 31): "U-shaped relationship, that is, higher cancer risks at low folate intakes (<150 μg/day) and highly elevated folate intakes (>1 mg/day), respectively." --Zefr (talk) 04:16, 22 February 2017 (UTC)[reply]
Yes I did notice that part, but some of the studies were not supraphysiologic doses, and I would to acknowledge the mixed results in the wording. Let me think on it. The rest is reasonable and fair. Ies (talk) 09:17, 22 February 2017 (UTC)[reply]

I removed the Schwingshackl2017 ref and the sentence it referenced because "...the largest analysis to date...no cancer risk." is not supported. While it is truely a large meta-analysis, it cites no literature whatsoever on folic acid and cancer risk.David notMD (talk) 18:32, 4 March 2017 (UTC)[reply]

Ref says "No important effect on cancer mortality could be observed for selenium, zinc, vitamin D, β-carotene, vitamin C, folic acid, vitamin K, or EPA, respectively" so restored. Doc James (talk · contribs · email) 03:16, 5 March 2017 (UTC)[reply]
Yes, but Table 4 (cancer mortality) does not have any folic acid study cited, and Table 5 (cancer occurrence) cites one - ref #47, but that is an error, as Ref #47 is a cardiac ref. The authors' sentence "No important effect on cancer mortality could be observed..." implies that studies were found which did not support a connection between the nutrient and cancer, either positive or negative, whereas for folic acid, the reality was that no trials were included in the meta-analyses. A better reference: Qin X, Cui Y, Shen L, Sun N, Zhang Y, Li J, Xu X, Wang B, Xu X, Huo Y, Wang X. Folic acid supplementation and cancer risk: a meta-analysis of randomized controlled trials. Int J Cancer. 2013 Sep 1;133(5):1033-41. doi:10.1002/ijc.28038. Review. PMID 23338728. David notMD (talk) 13:49, 5 March 2017 (UTC)[reply]
The ref says "Previous meta-analyses showed that vitamin B supplements (one-carbon metabolites) lowered the risk of stroke, but not CVD, myocardial infarction, coronary heart disease, cardiovascular death, or all-cause mortality (10). It was shown that folic acid supplementation had no significant effect on cardiovascular events, overall cancer, or mortality in high-risk patients (104)." and that ref says "Allocation to folic acid was not associated with any significant difference in the overall incidence of cancer"[1]
They also reference this 2013 systematic review from the USPSTF[2] which stats "Limited evidence supports any benefit from vitamin and mineral supplementation for the prevention of cancer or CVD" which links to this RCT[3] among others
So they include a number of reviews that looked at folic acid and cancer risk. Doc James (talk · contribs · email) 02:57, 6 March 2017 (UTC)[reply]

How it's used in DNA synthesis?

I looked through this article and found that it mentions many times that folic acid is used in DNA and RNA synthesis, but does not say anything about How it is used or what function it has in these. Does anyone have any sources that talk about this? EditSafe (talk) 04:12, 11 March 2017 (UTC)[reply]

See Fig. 2 and content below. --Zefr (talk) 05:05, 11 March 2017 (UTC)[reply]
Thanks. EditSafe (talk) 19:45, 11 March 2017 (UTC)[reply]

Lead sentence

It currently says: "Folic acid, another form of which is known as folate, is one of the B vitamins." I think it's silly not to add two words: "Folic acid, another form of which is known as folate, is one of the B vitamins, namely B9." If we don't think B9 is a sufficiently common term, then don't put in bold, but to say folic acid is one of the B vitamins without saying which one just looks kind of incomplete. Moreover, putting both "folic acid" and "folate" in bold suggests that they are synonymous, and I don't think they are. The definition section of this article is pretty clear that they are not synonymous. So I suggest this lead sentence: "Folic acid, another form of which is known as folate, is one of the B vitamins, namely B9." Put only "folic acid" in bold. Anythingyouwant (talk) 17:02, 13 April 2017 (UTC)[reply]

Folate gets 248,000 hits on google books[4]
"vitamin B9" 12,500
How about "Folic acid, also known as folate and vitamin B9, is one of the B vitamins." Doc James (talk · contribs · email) 00:32, 14 April 2017 (UTC)[reply]
I already suggested this: "Folic acid, another form of which is known as folate, is one of the B vitamins, namely B9." You haven't said what's wrong with putting only "folic acid" in bold. "Folate" should not be in bold because it's not a synonym of "folic acid", and "B9" should not be in bold because it's a synonym but not an especially common one. Right? Anythingyouwant (talk) 00:58, 14 April 2017 (UTC)[reply]
The terms folate, folic acid, and vitamin B9 are often used interchangeably / as synonyms. The wording I have proposed is more straight forwards. We list synonyms together rather than one in the middle of the sentence and another at the end. Doc James (talk · contribs · email) 01:31, 14 April 2017 (UTC)[reply]

Folic acid is the form which causes the issues around cancer. This is because it is widely available in 5mg tablet form for use by pregnant women. 2A00:23C0:C384:BE00:30F9:3949:522F:64D1 (talk) 04:06, 10 May 2019 (UTC)[reply]

Dangerous and False Information

As currently written, this article contains false information that is potentially dangerous and may potentially cause harm to people who act on certain information. This preliminary note is to suggest collaborative discussion on amending this article rather than immediately making an edit. One of the problems in the worlds of food, health, and nutrition is that folic acid, folate, and Vitamin B9 are used interchangeably. That is false. They are not the same thing. Folic acid is synthetic. These things are not semantics. They are fundamental matters with ramifications for food and nutrition intake, along with different needs for various people and conditions. It is essential this article be made accurate, and I would prefer to see knowledgeable people discuss edits. Uberveritas (talk) 00:22, 16 April 2017 (UTC)[reply]

Are you saying that vitamin B9 is not folate? This ref appears to disagree.[5]
Folate is simply a naturally occurring conjugate of folic acid.[6] Doc James (talk · contribs · email) 00:45, 16 April 2017 (UTC)[reply]
New Talk topics go to the bottom of the page. Sources used in the article, particularly this authoritative source, explain clearly that folate is a generic term identifying the natural folate sources in food and in metabolic intermediaries, and as a synonym for folic acid, the synthetic compound. Both are identified as vitamin B9. Here is another review where the introduction and chemistry are displayed. Folic acid has to be converted into folate in vivo to become metabolically active, as explained in this review. If Uberveritas has a WP:SECONDARY source that presents a different case, you should bring it to this Talk discussion first for others to review. --Zefr (talk) 00:55, 16 April 2017 (UTC)[reply]
That "authoritative source" does not say that "folic acid" and "folate" are synonymous. It says: "Folate, formerly known as folacin, is the generic term for both naturally occurring food folate and folic acid, the fully oxidized monoglutamate form of the vitamin that is used in dietary supplements and fortified foods." Thus "folate" is a broader term than "folic acid" according to that source. The word "building" can sometimes refer to a "skyscraper" but that doesn't mean they're synonymous. Anythingyouwant (talk) 01:06, 16 April 2017 (UTC)[reply]

In common usage people use the terms interchangeably. We can explain the minor differences within the body of the article. Doc James (talk · contribs · email) 01:24, 16 April 2017 (UTC)[reply]

I think we agree that there are forms of folate that are not folic acid. It would be very easy for us to work that fact into the lead sentence. A zillion books and websites about dietary supplements recommend ingesting forms of folate that are not folic acid, because folic acid is not naturally occurring. Studies have also shown that folic acid is not as good as natural folate in preventing birth defects.[7] Anythingyouwant (talk) 01:32, 16 April 2017 (UTC)[reply]
As folate is the broader term how about we move the article from "folic acid" to "folate" Doc James (talk · contribs · email) 17:15, 16 April 2017 (UTC)[reply]
Support moving article to broader term which is "folate". Anythingyouwant (talk) 17:31, 16 April 2017 (UTC)[reply]
Support for title as "Folate". --Zefr (talk) 17:36, 16 April 2017 (UTC)[reply]
Okay done. Doc James (talk · contribs · email) 18:06, 16 April 2017 (UTC)[reply]

I find this article somewhat confusing as currently written. It seems to support the "common usage" notion that folate and folic acid are synonyms. I agree that it is reasonable to mention that synonymous usage, but I don't think the article makes it sufficiently clear that they are two different substances. By "different" I mean that they are treated differently by the body. Folate is assimilated after treatment by enzyme action, while folic acid must undergo transformation by the liver in a less efficient process.[8] The potential health risks from accumulation of excess folic acid aren't present with folate.[9] In other words, ingesting folate-rich foods and ingesting folic acid have very different effects. On that basis, that article appears to be potentially misleading (and possibly harmful) in not emphasizing the difference between folate and folic acid. -- Freevito (talk) 21:45, 6 July 2017 (UTC)[reply]

Gah there is so much misinformation out there. It is almost impossible to overdose on folic acid in food because you would have to eat so much you would probably just throw up; on the other hand supplements are the pure stuff and yes it is not hard to take too much. There is also a bunch of confusion out there between the very basic chemistry stuff (a salt with its ion and without-it), which are always designated "Xic acid" and "Xate" - see Acid#Nomenclature) and the (yes somewhat confusing) use of "folate" to mean the whole family of biologically relevant congeners of folic acid/folate -- and so folic acid is a folate under that 2nd meaning of "folate". Jytdog (talk) 03:31, 7 July 2017 (UTC)[reply]

Another piece of misinformation - sadly for us avocado-lovers, according to 'McCance and Widdowson's The Composition of Foods' avocados aren't a great source - they only contain 11μg/100g of folate.[1] Rowan Adams (talk) 09:39, 8 July 2018 (UTC)[reply]

Folic acid is the artificial form of folate. Folic acid is not the same as folate. Folic acid causes precancerous growths particularly in the large intestine and rectum. 86.187.163.191 (talk) —Preceding undated comment added 07:44, 3 April 2019 (UTC)[reply]

In the article, two reviews identify folic acid supplementation as increasing risk of prostate cancer, but not other types. A subsequent review reported no significant increases for any type of cancer. David notMD (talk) 12:53, 3 April 2019 (UTC)[reply]

Folic acid 5mg tablets are not uncommonly prescribed by psychiatrists for clinical depression. Such huge daily doses have led to rectal growths in their patients. 86.187.163.59 (talk) —Preceding undated comment added 02:56, 4 April 2019 (UTC)[reply]

The differences between folate and folic acid seem not to be so minor. Folic acid, but not other forms of folate, seems to significantly increase the risk of prostate cancer. [2] Therefore I recommend a section clarifying the difference and discussing the controversy.

The folic acid and prostate cancer question is already covered in the cancer section, supported by two review articles from 2012 and 2014. No gain in adding a ref for a clinical trial from 2009. David notMD (talk) 19:29, 3 May 2019 (UTC)[reply]

Folic acid tablets cause precancerous rectal growths. Folate is not the same as folic acid; folate degrades easily; folate is not available in large dosages. Folic acid however is commonly available in huge doses and does not degrade or break down easily. 2A00:23C0:C384:BE00:30F9:3949:522F:64D1 (talk) 04:15, 10 May 2019 (UTC)[reply]

RDA and UL measure folate differently

Article amended and referenced to address fact that all micrograms are not equal. For Recommended Dietary Allowance (RDA), micrograms are a combination of food folate and folic acid expressed as micrograms DFE (for dietary folate equivalents) Folic acid is more bioavailable, so each microgram of folic acid counts as 1.7 micrograms DFE. For Tolerable Upper Intake Limit (UL) purposes, only folic acid matters, so the UL of 1000 micrograms refers to actual micrograms of folic acid rather than DFEs. David notMD (talk) 13:10, 30 August 2017 (UTC)[reply]

US recommendations

IMO "The recommended daily intake of folate in the US is 400 micrograms from foods or dietary supplements."

The FDA only makes recommendations for the US not for the rest of the world and therefore IMO it was fine before. Doc James (talk · contribs · email) 13:59, 21 November 2017 (UTC)[reply]

Upgrade to GA?

Starting work on bringing this article to level at which it can be nominated for Good Article. Some of that will be reordering the sections to match what has been done for other vitamin articles. All opinions on what the article needs are welcome here. David notMD (talk) 14:31, 26 September 2018 (UTC)[reply]

Entire Food fortification in process of being rewritten and all references checked. David notMD (talk) 14:59, 12 October 2018 (UTC)[reply]
Checking references David notMD (talk) 14:38, 15 October 2018 (UTC)[reply]
Replaced Sources section. Nominating for GA. David notMD (talk) 11:26, 30 April 2019 (UTC)[reply]
  1. ^ Cite error: The named reference McCance and Widdowson was invoked but never defined (see the help page).
  2. ^ Figueiredo, Jane C.; Grau, Maria V.; Haile, Robert W.; Sandler, Robert S.; Summers, Robert W.; Bresalier, Robert S.; Burke, Carol A.; McKeown-Eyssen, Gail E.; Baron, John A. (18 March 2009). "Folic Acid and Risk of Prostate Cancer: Results From a Randomized Clinical Trial". JNCI Journal of the National Cancer Institute. 101 (6): 432–435. doi:10.1093/jnci/djp019. ISSN 0027-8874. Retrieved 3 May 2019.
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