Wednesday, February 3, 2010

ivf day 23 - let's talk folate

Folate has nothing to do with snow-covered firewood, but I wanted to post a photo anyway.

I would assume that most people have heard about folic acid for years and its importance in preventing birth defects, specifically, neural tube defects. Folic acid has been so well-marketed that it is added to so many foods. Even flour is fortified with folic acid these days.

What I would assume you haven't heard is that folic acid is a synthetic substance. 100% man-made. When you eat a green vegetable (good for you!), you aren't eating folic acid, you're consuming folate.

So, you might think, to-MAY-toes ta-MAH-toes, what's the big deal.

Let's start with a little lesson in basic pharmaceuticals. And, like all good lessons, it comes with a cool acronym which is why I can remember it: DAM.
  • Dissolution: For a drug or vitamin to be used by our bodies, it must dissolve, otherwise, it would just go straight through our disgestive tract and out the other end and not do us any good. To see if your vitamin or drug dissolves, simply place it in a cup of water and watch it for an hour or so. With folate, it's important that the vitamin dissolves within 1 hour because by that point it's reached the small intestine and it's absorbed in the first section (in layman's terms), which brings us to the next letter of our acronym.
  • Absorption: All drugs or vitamins are absorbed in the small intestine. That's where they enter the bloodstream and get exchanged with waste. Each drug is different in where it is absorbed along the small intestine, and as mentioned previously, folate is absorbed first along that pathway, so it needs to dissolve relatively quickly.
  • Metabolism: The last portion of this pathway is metabolism and it's a bit more complicated. Once the drug or vitamin is absorbed into the bloodstream, it has to be broken down and changed a bit to be usable by the body. Different enzymes act during this process and this is why folate versus folic acid is so important.
Since folic acid is synthethic, it has to go through lots of steps to be broken down. That normally wouldn't be a problem, except that up to 50% of some ethnicities (Italian, Hispanic, Caucasian) have a genetic mutation and don't have the necessary enzyme to break down folic acid. You can read more about this mutation here. If you're concerned you might have this mutation, there is a genetic test for it, but it costs about $300. Otherwise, you could just take a prenatal vitamin that contains folate instead of folic acid, which is a lot less expensive.

The only prenatal that I'm aware of that contains folate has it patented as "Metafolin" short for 5-methytetrahydrofolate (although I used to say it the long way when talking to physicians just because I liked to sound like I knew what I was talking about). Metafolin is sold as part of Prenate DHA or Prenate Elite and also over the counter as "Folate", but it will likely have the word "Metafolin" underneath it.

Yes, I used to sell this drug, and while I was selling it, I wouldn't be allowed to talk about it on my blog due to regulations of the pharma industry. But now, I think it's important information for ladies to know, so there you have it.

Let me know if you have any questions and I'll do my best to answer them or refer you to someone who can.

Last, as an update on my IVF process, I just took my last birth control pill today, so another milestone has been reached.


Ashley Harris said...

Hey April! I think this is very interesting that you are posting about this and I will tell you why. My first born, Andrew, was born with a cleft lip and palate. We don't know why he was born with it. Later we did genetic testing and basically it was fluke. After beating myself up about what I did wrong, I did research and found that the lack of folic acid is a contributor to this deformation. After going through 3 surgeries in his first year of life, Andrew is amazing. However, I have religiously taken a higher dosage of folic acid along with my prenatal with my other pregnancies. The next 3 children came perfectly healthy and no abnormalities. Anywho, thanks for sharing this with us. I think it is very important that women know this information. Have a great day!!

april said...

Ashley, you are absolutely right. The main treatment that most doctor's prescribe is extra folic acid...they think they are going to "get some through" past that enzyme. That's definitely been the way to treat in the past, but the more researchers learn, the more doctors are leaning to folate instead of folic acid. It's a slow conversion process, but one that would certainly save a lot of heartache if learned faster

Unknown said...

I think it's really cool that you're sharing your journey. I find it fascinating and I can't wait for the news that you and Greg are adding to your family!!!

Christa said...

I really appreciate you sharing this piece April. My 14 year old niece has spina bifida and is a bright light in our family. When I was trying to conceive, of course lots of folic acid was pushed my way as a preventative measure. I had no idea about the difference until right now. I luckily have 2 perfectly healthy little girls, but it's still information that would have been nice to know and I appreciate you getting the message out!

Ally said...

Wow, what an interesting post. I love learning important new stuff to add to my repertoire of knowledge! Thank you!!! I of course am not planning on having any babies, but still being in early childhood and often working with pregnant moms, this is good stuff to know!

Sara*P said...

April, are there over the counter supplements that you could recommend that contain folate? I get so overwhelmed when I go in to that aisle at Target that I just end up taking my kids Flintstone chewables. Hee! Thanks!

stephanie howell said...

april, thank you .i had no idea. and we are definitely having another baby. thank you!

Kimber-Leigh said...

so very interesting. thanks april :) i'm learning a lot!