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From: howard@metheus.UUCP (Howard A. Landman)
Newsgroups: net.med
Subject: Re: Folic Acid
Message-ID: <220@metheus.UUCP>
Date: Fri, 16-Mar-84 04:53:43 EST
Article-I.D.: metheus.220
Posted: Fri Mar 16 04:53:43 1984
Date-Received: Sun, 18-Mar-84 08:12:42 EST
References: <210@metheus.UUCP>
Organization: Metheus, Portland Oregon
Lines: 58

Thanks for the several replies I have gotten.  I have also done some further
research, and will try to summarize the results here.

The FDA is indeed the agency limiting folic acid.  All limits are expressed in
terms of "folacin", which is an imaginary compound having exactly the potency
of pure folic acid.  There are compounds other than folic acid which have some
potency to replace it, just as there are multiple forms of "niacin".

The principal reason for the limitation was the masking of pernicious anemia
mentioned earlier.  The specific symptom masked is megaloblasty, i.e., having
abnormally large red blood cells.  There is a special reaction that takes place
with red blood cells leading to the death of their nucleus, which is necessary
for them to mature into normal red blood cells.  This reaction involves
methylation, and requires B-12, folic acid, and methionine (an amino acid with
a methyl group attached to a sulfur atom).  If a developing red blood cell fails
to undergo this reaction, it becomes (stays?) abnormally large and also is less
able to perform its duties carrying oxygen.  One of the first symptoms of B-12
deficiency is megaloblasty, and it is easy to detect just by looking at a drop
of blood under a microscope.  For this reason B-12 deficiency is sometimes also
known as "megaloblastic anemia".

Large amounts of folic acid prevent the megaloblasty (but not the other effects
of B-12 deficiency!), and hence make B-12 deficiency harder to detect.  Thus
the FDA did have a difficult decision to make, and they effectively decided to
limit access to large amounts of folic acid by treating it as a prescription
drug except in small doses.  The difficulty with this is that it makes buying
folic acid much more expensive since you have to pay the costs of fillers,
pill-pressing, packaging, etc.  A pill with nothing (effective) in it except
800 ug of folic acid costs almost as much as a complete B-complex pill
INCLUDING the same 800 ug of folic acid.  So while the limit protects the
population-at-large from doing something potentially foolish, it also makes
life marginally more expensive for anyone who understands the rudiments of
human nutrition and tries to act on that knowledge.

More than one person strongly suggested I have my wife see a doctor.  Thanks,
but she has been seeing one since three months before we started trying to get
pregnant, seven months before we succeeded.  The vitamins he tried to sell us,
sold "through doctors only", were reasonably good but VERY expensive.  And
they didn't have as much folic acid as I wanted for myself, let alone for a
pregnant or lactating woman.  I appreciate the concern, but as a former
biochemisty major who has also taken a quarter course in Nutritional Science
I feel I am better equipped to calculate optimum vitamin levels than the
average MD.  A cardiologist friend of mine went through six years of medical
school (after four years of pre-med study at Berkeley) and in those ten years
had exactly TWO HOURS of lectures on nutrition.

One other item which may be of interest to the druggies on the net: it turns
out that nitrous oxide (NO,laughing gas) inactivates vitamin B-12, and in
fact is used in laboratories as a standard and relatively easy way of inducing
B-12 deficiency.  In some circles NO is a widely used intoxicant since it is
legally available in the form of "whippets" (the little cartridges sold to
make whipped cream).  If you use NO regularly you might seriously consider
taking supplements of B-12 and getting your blood checked once in a while
(when you see your doctor ASK THEM TO CHECK FOR THIS).  And, as you can see
from the above, you should not be taking large amounts of folic acid!

	Howard A. Landman
	ogcvax!metheus!howard