Is folic acid supplement good or bad ?

Folic acid or folate supplementation is considered part of alternative medicine.Folate/folic acid is involved in numerous vital biochemical reactions in the body. Multiple studies have documented that folic acid supplementation during pregnancy reduces the risk of neural tube defects.

Folate/folic acid in cancer

Since folate deficiency may contribute to abnormal DNA synthesis, it has been widely believed that folic acid supplementation may help prevent certain cancers. Multiple previous studies including the Nurses Heart Study found beneficial effect of folic acid in colon but not breast cancer.

In contrast to the observational studies, results from a recent randomized controlled trial suggest that folic acid may actually be harmful and increase the risk of colon cancer. Cole and colleagues studied the role of folic acid supplementation in 1021 men and women with a recent history of colorectal adenomas. Repeat colonoscopy was done at 3 years and than 3 or 5 years later.

The authors found that there was an increased risk of cancer/advanced colon lesions in the folic acid group. Interestingly, the investigators also found there was an increased risk of non-colonic cancers, primarily prostate cancer.

Interestingly, Lashner and  colleagues reported (1993) that higher folic acid levels increase risk for colon cancer in patients with ulcerative colitis. Subsequently, the same investigator based on his two other studies suggested that folic acid supplementation probably reduces risk of colon cancer in ulcerative colitis. Folic acid supplementation has been recommended in patients with ulcerative colitis.

In recent years, the wheat flour and other grains have been fortified with folic acid. Interestingly, there has been a concommitant increase in colon cancer during the same period.

While pregnant females should continue to get folic acid supplementation, the policy of adding folic acid to wheat flour and grains may need to be re-evaluated. However, so as to temper our enthusiasm for denigrating folic acid supplementation altogether, we have another recent study that documents that folic acid supplements reduce risk of stroke by 18 percent.

Do you take vitamin, mineral or other nutritional supplements? What are your thoughts on the literature about folate or folic acid and cancer. Certainly, one size does not fit all!