Folic acid and vitamin B12 deficiency: What you should know

In this blog post, we'll give you an overview of what vitamin B12 and folic acid, or rather a deficiency of these nutrients, can do to your body. Vitamin B12 belongs to the cobalamin group of substances . Methylcobalamin is a bioactive and natural form of vitamin B12. Folic acid, also known as vitamin B9 or folate, is also called pteroylglutamic acid .

It is found in both plant and animal foods. However, it is lost through prolonged cooking. In natural food components, folic acid is bound to polyglutamic acids. During folic acid metabolism, enzymes in the small intestine convert the polyglutamine form into monoglutamine and diglutamine. These are then absorbed in the upper part of the small intestine, the jejunum.

In the blood, folates are present exclusively as monoglutamate (the free form of folic acid) , mostly in the form of 5-methyltetrahydrofolate , which binds to albumin. High-affinity folic acid receptors in all types of body cells bind to this structure. 5-Methyltetrahydrofolate is then converted by a vitamin B12-dependent enzyme into tetrahydrofolate and finally into polyglutamate so that a folate-dependent enzyme reaction can take place.

Folate and vitamin B12 are excreted via the bile and absorbed in the small intestine . Both nutrients can also be excreted in the urine. So much for folic acid metabolism, but how does a folic acid deficiency develop?

Folic acid deficiency: causes, treatment, consequences and diagnosis

A folic acid deficiency doesn't happen by chance and carries undesirable risks. However, it can usually be treated effectively. But what causes it, how can it be diagnosed, and how can it be combated?

What are the causes of a folic acid deficiency?

Folic acid deficiency usually results from a poor diet and the resulting insufficient intake. Healthy people who eat a balanced diet and do not suffer from impaired intestinal absorption generally do not have a folic acid deficiency. A mixed diet in Germany contains approximately 200 to 500 µg of folate daily . On average, we lose 50 to 100 µg of this per day. The following groups of people, among others, may still be affected by a folic acid deficiency due to increased consumption:

• chronic alcoholics (excluding beer drinkers, as beer is rich in folic acid and vitamin B12)
• Pregnant women and breastfeeding mothers
• older people, due to increased risk of diseases such as dementia and stroke
• People with increased metabolic activity (hypermetabolism)
• People with skin and intestinal diseases
• Patients suffering from chronic hemolytic anemia, diabetes, or cardiovascular diseases
• Affected individuals with a disease of the small intestine
• People who are taking medications such as sulfonamides (chemotherapeutic agents) or anticonvulsants (antiepileptics).
• People with intolerances such as celiac disease

Those suffering from intestinal diseases or celiac disease also have impaired vitamin B12 absorption in the intestine , which promotes a vitamin B12 deficiency.

Therapy: Supplementation with nutrients B9 and B12

The need for vitamin B9 increases not only during pregnancy and breastfeeding, but also in older adults and individuals with specific medical conditions. In people with food intolerances, the number of tolerated foods is often severely limited, which can also lead to folic acid and vitamin B12 deficiencies. We therefore recommend that the aforementioned individuals, as well as those with histamine intolerance, take dietary supplements to counteract not only a B9 deficiency, but also a B12 deficiency (provided they cannot meet their daily requirements through their diet).

What happens when there is too little folic acid and vitamin B12 in the body?

Monohydrocarbon groups such as methylene, formyl, or methyl groups are transferred by folic acid to various substrates via numerous enzymatic reactions. These reactions support the synthesis of proteins, RNA, and DNA . A folic acid deficiency or inhibited dihydrofolate reductase results in insufficient folate compounds in body cells, which can impair both the growth and maturation of rapidly growing cells, such as bone marrow cells. Folate plays a role in cell division and also contributes to the following important processes in the body :

• for the growth of maternal tissue during pregnancy
• to normal amino acid synthesis
• to normal blood formation
• to a normal homocysteine ​​metabolism
• normal psychological function
• to a normal function of the immune system
• to reduce tiredness and fatigue

A folate deficiency can cause anemia, loss of appetite, weight loss, miscarriages, breathing difficulties, heart disease, weakened immune system, or an increased tendency to bleed.

Diagnosis of folate deficiency

A test that examines the excretion of formiminoglutamic acid after histidine exposure can determine whether you have a disorder of folic acid/vitamin B12 metabolism. Elevated excretion can indicate a folic acid deficiency, but also liver disease or anemia. Possible causes include:

• Reduced production of the enzymes (tetrahydrofolate synthesis and (formiminoglutamic acid degradation)) in the liver
• Diseases that increase the need for tetrahydrofolic acid and stimulate cell regeneration and nucleic acid synthesis
• Too little tetrahydrofolate due to inhibited dihydrofolate reductase (due to a deficiency of folic acid or vitamin B12 or folic acid antagonists)

Which foods are rich in folic acid and vitamin B12 and suitable for a low-histamine diet?

To ensure you get enough folic acid, we have compiled a list of foods containing folic acid and low in histamine :

• Lamb's lettuce
• potatoes
• Egg yolk (also rich in B12)
• sour cherries
• Kale
• Quinoa
• Brussels sprouts
• Cauliflower
• Endive salad
• Leek (1)
• asparagus
• fennel
• Almonds (1)
• Sesame (1)

Vitamin B12 is mainly found in animal products and foods high in histamine .

You might like these products