1. Prevents Neural Tube Defects (NTDs):
   • Reduces the risk of spina bifida and anencephaly in newborns when taken during pregnancy (Mayo Clinic).
2. Supports Red Blood Cell Formation:
   • Prevents megaloblastic anemia, characterized by large, immature red blood cells (BNF).
3. Cardiovascular Health:
   • Lowers homocysteine levels, reducing the risk of heart disease and stroke (Harvard Medical School).
4. Cognitive Function:
   • May slow cognitive decline in older adults (Lange).
5. Cancer Prevention:
   • Adequate folate intake is linked to a reduced risk of certain cancers, particularly colorectal cancer (Lippincott).

1. Leafy Greens:
   • Spinach, kale, and broccoli.
2. Legumes:
   • Lentils, chickpeas, and black beans.
3. Fortified Foods:
   • Cereals, bread, and pasta.
4. Fruits:
   • Oranges, bananas, and avocados.
5. Animal Products:
   • Liver and eggs.

Deficiency can lead to:

• Megaloblastic Anemia: Fatigue, weakness, and pale skin.
• Neurological Symptoms: Irritability, memory loss, and depression.
• Gastrointestinal Issues: Loss of appetite, weight loss, and diarrhea.
• Pregnancy Complications: Increased risk of neural tube defects (Mayo Clinic).

Risk Factors:

• Poor diet, alcoholism, malabsorption disorders (e.g., celiac disease), and certain medications (e.g., methotrexate).

• Normal: 2.7–17.0 ng/mL (Mayo Clinic).
• Deficiency: <2.0 ng/mL.

1. Folic Acid Tablets:
   • 400 mcg, 1 mg, 5 mg.
2. Prenatal Vitamins:
   • Typically contain 400–800 mcg of folic acid.
3. Combination Formulas:

Often paired with iron or other B vitamins

1. Pregnancy:
   • Prevents neural tube defects; recommended dose is 400–800 mcg/day (BNF).
2. Megaloblastic Anemia:
   • Corrects folate deficiency anemia (Lippincott).
3. Cardiovascular Health:
   • Reduces homocysteine levels in high-risk individuals (Harvard Medical School).
4. Methotrexate Therapy:
   • Reduces side effects in patients taking methotrexate for rheumatoid arthritis or cancer (Lange).

Daily Requirements (RDA):

• Adults: 400 mcg/day.
• Pregnancy: 600 mcg/day.
• Lactation: 500 mcg/day.

Deficiency Treatment:

• Adults: 1–5 mg/day orally for 4 months (BNF).

Administration Tips:

• Take with food to enhance absorption.
• Do not exceed recommended doses unless prescribed.

Folic acid is generally safe but may cause:

• Mild: Nausea, bloating, or bitter taste.
• Rare: Allergic reactions (rash, itching).

• Vitamin B12 Deficiency: High folic acid doses can mask B12 deficiency, delaying diagnosis and treatment (Mayo Clinic).
• Pregnancy: Safe and essential for preventing neural tube defects (BNF Category: A).
• Cancer Risk: High doses (>1,000 mcg/day) may promote cancer growth in individuals with pre-existing lesions (Harvard Medical School).

1. Methotrexate:
   • Folic acid reduces toxicity but may interfere with efficacy in cancer treatment (Lippincott).
2. Antiepileptics (e.g., phenytoin):
   • Folic acid may reduce drug levels, increasing seizure risk (Lange).
3. Sulfasalazine:

Reduces folic acid absorption, requiring supplementation (BNF).

• Folic Acid: Most common form.
• Folinic Acid (Leucovorin): Active form used in chemotherapy rescue.