Can Folic Acid Prevent Down Syndrome?

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What Is Folic Acid?

Folic acid is the supplement form of Folate, or vitamin B9. It is a water-soluble vitamin that we get only from food or supplements and do not produce naturally. It requires an acidic environment, such as the stomach and small intestine duodenum or jejunum, which is high in stomach acid, for optimal absorption. It is converted to 5-methylTNF here which is taken up by the blood circulation and tissues. It is stored in the liver. We absorb 50% of the Folates we get from food and 85% of the supplement Folic acid, as this has been specifically engineered to enhance its absorption. The rest we excrete in urine and faeces.

5-methyLTNF’s main role is in the production DNA and RNA which are the genetic material in all living things. It converts a molecule called Homocysteine to Methionine which is used to make DNA, new cells and some neurotransmitters and to repair DNA. As red blood cells are the quickest dividing (dying and remade) cells in the body, it is also needed to make red blood cells and Folate or Folic acid deficiency causes megalobastic anaemia. Folate also makes up 30% of the insulating myelin sheath on all nerve cells and so deficiency causes demyelination and death of nerve cells (neurones). These are the cells which are in the brain and spinal cord and control how we feel (sensory nerve cells or neurones) and move (motor neurones). It also has a role in making Serine and Glycine which have a role in energy production and in metabolism. 


What Is Down’s syndrome?

Down’s syndrome is a genetic disorder caused by a genetic mutation (a change in the sequence of DNA or RNA) where the chromosomes (DNA molecules) do not divide properly and so there are three chromosomes at position 21, not two. This extra chromosome is why the disorder is also called Trisomy 21. It causes birth defects in a child, such as body features changes like dwarfism, a flattened head, short neck and small tongue and neurological disorder, congenial heart defects, endocrine disorder (such as thyroid and fertility abnormalities), and gastro-intestinal disorders. It also affects the musculoskeletal system and causes learning difficulties, excess flexibility, less concentration ability, can cause seizures, chronic constipation, early dementia and shorter expected lifespan. Mother’s who have children later in life are at increased risk of having a child with Down’s syndrome.


How Does Folic Acid Affect the Chance of Down's Syndrome ? 

Due to its role in DNA and RNA synthesis, and its role in DNA synthesis, Folates and Folic acid play a very important role in protecting against genetic defects and abnormalities such as those seen in Down’s syndrome. Folic acid is needed to make the genetic information that codes for new cells and helps prevent mutations such as those found in Trisomy 21 at chromosome 21. 

Recent studies into the role of Folic acid show that it plays a very important role in the production of the neural tube. This is a tube that forms the brain and spinal chord of a growing embryo. An embryo is made when a male sperm fertilises a female egg in sexual intercourse in conception and is implanted in the womb lining. It forms a ball of cells called a zygote and the womb lining becomes the placenta, which supports a pregnancy. The zygote becomes an embryo which becomes a baby. The neural tube production role of Folic acid and Folates vitamin B9 and also of vitamin B12 is why this vitamin is often prescribed in pregnancy. The supplement has also been shown to support the cognitive skills of children, due to its role in brain production, born where the other took supplements in the first 12 weeks of pregnancy. 


Should I Take a Folic Acid Supplement ?

Neural tube defects (NTD) affect roughly 100 children in the UK each year. They are the most common of all birth defects and also cause anencephaly (babies born missing parts of their skull) and spinal bifida (spine abnormalities). In 2018 it was decided that Folic acid would be added to UK flour to stop birth defects. Expectant mother’s are also advised to supplement during the first trimester, but to be careful as over supplementation of B9 can often mask a B12 deficiency, resulting in further biological problems in both the expectant mother and her child. 

It is important that rather than guess and supplement yourself, that a doctor checks your Folate B9 and vitamin B12 levels before supplements are taken, to ensure that no further harm is done. This can be achieved through a simple NHS blood test bio analysis and can help you make an evidence based, informed decision regarding your health in real time, rather than one size fits all guesswork. Each person is unique and supplements must be given based on an individual’s body and biochemistry. 

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