Vitamin B9 is a water soluble vitamin that we get from our diet each day as we cannot store it. It is also known as Folate in its natural form, or Folic Acid as the dietary supplement form. The vitamin plays a vital role in the body. The natural form is 50% absorbed from our gut in digestion and the artificial supplement form 85%, as it has been engineered to have a higher bioavailability (the proportion of a chemical that gets to its site of action to have impact).
Why Do We Need Vitamin B9?
Folates and folic acid, are needed to help us make red blood cells which carry oxygen in the blood. As oxygen is required to make energy in a process called respiration, they also play a vital role in vitality and metabolism. Red blood cells are made of molecules called haem which contain iron. Low levels of this key vitamin can thus cause a form of anaemia (low iron) levels called megalobastic anaemia, which can cause fatigue and low mood.
Folates and Folic acid, also are required to make genetic information in the form of DNA and RNA through the production of Methionine, an amino acid (the molecules that make up proteins). Methionine is essential for making Cysteine, one of the biological bases of DNA and RNA. Low B9 levels can thus play a role in infertility as DNA production is required for the formation of an egg and sperm, and the growth of new cells into a baby. A baby will also require its own blood supply and the mother will need a good blood supply with lots of new red blood cells and iron, to support a pregnancy.
Therefore, low Folate and Folic acid levels are associated with infertility, premature abortion of a foetus (a foetus grows into an embryo which grows into a baby), preterm delivery or miscarriage, pre-eclampsia (a condition where blood pressure gets too high in the mother affecting the success of a pregnancy), low birth weight and growth defects in the child. It can also help prevent a condition called neural tube defect (NTD). A neural tube is a tube that is made in the growth of a child, to support the growth of the brain and spinal chord). Decreased Vitamin B9 can cause incomplete closure of the NTD, Anencephaly and Spina Bifida . These are most common of all birth defects. There are approximately 100 children born with NTD every year in the UK (600 - 1200 affected pregnancies). This is also associated with low levels of Vitamin B12, as the two vitamins are closely linked.
Can Taking Folic Acid Make You Fertile?
Folic acid is a supplement which potential mothers can take in pregnancy to support the development of a child. Folate is essential for DNA production, and is particularly important during pregnancy. It helps the rapid growth of conceptus (placenta/foetus), and formation of new red blood cells. Studies have also shown it helps neural tube defect, NTD, (MRC Vit Research Group, 1991).
Doctors advise that 400 μg/d supplements should be taken prior to conception to end of 1st trimester (Dept of Health, 2000). The 2022 advice is to take a 400 μg/d supplement within the first 12 weeks of conception to support a pregnancy. Alternatively, you can acquire Folate through the diet, as it is found in rich supply in green leafy vegetables, wholegrains, Brussel sprouts, peas, potatoes, orange juice, yeast extract, liver, broccoli and is fortified in some breakfast cereals (as Folic acid).
Can You Overdose on Folic Acid?
Too much Vitamin B9 can mask a B12 deficiency (a lack of B12). This is because to activate folate, vitamin B12 removes part of the molecule, which activates vitamin B12. As low B12 can also cause anaemia, infertility and NTD as well as other problems in pregnancy, it is important that both key vitamin levels are maintained to support a successful pregnancy. The Recommended Dietary Allowance (RDA) for folate is 400 mcg for those who are pregnant and those who have had a child and are breastfeeding should take approximately 500-600 mcg. Supplement doses range from 400–800 mcg. A B12 and Iron supplement is also advised during pregnancy to help support the DNA growth, prevent premature miscarriage and prevent anaemia, low iron levels.
Both iron deficiency (IDA) anaemia and vitamin deficiency anaemia (VDA) such as megaloblastic anaemia caused by low B12 and B9, impact the development of a successful pregnancy and the health of the mother and child. Low mean red blood cell count (rBC count) as a result of B9 deficiency, which folic acid supplements can help prevent, is thus an important biomarker for analysis by medical professionals when monitoring a pregnancy and attempting to improve fertility.