Folic acid (supplement form of folate) is a vitamin most commonly associated with pregnancy. Its importance in cancer treatment and cognitive functions for surviving cancer are becoming increasingly apparent. Folic acid deficiency is likely to be a major contributor to the disorder we know as chemo brain.Why you need folate/folic acid if you are a cancer survivor:
- Helps form and maintain new cells (this is why many chemotherapies deplete it)
- Needed to make DNA and RNA, and helps to preserve DNA changes that can lead to cancer
- Needed in the formation of normal red blood cells
- Helps prevent anemia
- Helps maintain normal levels of the amino acid homocysteine (cardiovascular disease is associated with elevated levels)
- Needed by hippocampus (brain structure) for new cells and memory
- Deficiencies associated with cognitive problems and decline, and some cancers
Chemotherapy side effects: Certain chemotherapies deplete folate
Methotrexate (MTX) or Alimta (Premetrexed) chemotherapies deplete levels of folate, which is one reason these therapies are associated with chemo brain, fatigue, anemia, and cardiovascular problems.
f you are currently taking one of these chemotherapies, consult your oncologist before supplementing with folic acid.
Quick facts cancer patients need to know:
1. Methotrexate and Alimta chemotherapies lead to folate deficiencies
2. Over-the-counter drugs, such as anti-inflammatory drugs and antacids can also interfere with or deplete folate
3. Folate deficiencies are associated with poor memory, irritability, certain forms of anemia, and elevated homocysteine levels.
4. The recommended amount is 400 mcg per day, but for deficient individuals, the amount is higher.
5. Folic acid, the supplement, needs vitamin B-6 for proper utilization
6. Studies have shown that folic acid supplementation of 800 mcg daily helps to reverse or slow cognitive decline.
7. Low red blood cell counts are likely related to low folate levels.
For more information, consult the Office of Dietary Supplements at the National Institutes of Health. Also, check this blog for more updates on folic acid research.
If you are currently in chemotherapy treatment, consult your oncologist before supplementing with folic acid. If you have fatigue, have your B-12 level checked when supplementing with folic acid.
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Thank you, Dr. Hardwicke, for this valuable info on folic acid/folate. I had to take a special pre-natal supplement with folic acid, but I never thought about it for my oncology patients.
What foods have folic acid, and would they provide enough after chemo?
Folate, the natural form of folic acid, is derived from the word for leaf. That's a good way to remember foods rich in it: leafy green vegetables, such as spinach, kale, and collards. Also, fish or animals that eat greens: salmon.
Some processed foods, such as enriched breakfast cereals, have it, but I don't recommend consuming all of the artificial ingredients that come with it.
