Folic Acid. Ameer Saadallah Al-Zacko Ahmad Ausama Al-Kazzaz Ahmad Maan Al-Hajar

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1 Folic Acid Ameer Saadallah Al-Zacko Ahmad Ausama Al-Kazzaz Ahmad Maan Al-Hajar

2 Now with Ahmad Maan Al-Hajar

3 Folic acid Folic acid is a water soluble Vitamin which has many forms include folate, vitamin M, vitamin B9, vitamin Bc (or folacin), pteroyl-lglutamic acid, pteroyl-l-glutamate, and pteroylmonoglutamic acid). Folic acid is itself not biologically active, but its biological importance is due to tetrahydrofolate and other derivatives after its conversion to dihydrofolic acid in the liver.

4 The Folic acid is Composed of three parts : Pteridine ring p-aminobenzoic acid (PABA) Glutamic Acid The linkage of Pteridine ring to PABA give Pteroic acid. The Pteroic acid is then conjugated to Glutamic acid to give Folic acid

5 Sources Certain foods are very high in folate: Leafy vegetables such as spinach, turnip greens, lettuce Legumes such as dried or fresh beans, peas and lentils Egg yolks Baker's yeast Fortified grain products (pasta, cereal, bread) Sunflower seeds Liver and liver products contain high amounts of folate Kidney Other Foods contains Moderate amounts of Folate : Certain fruits (orange juice, pineapple juice, grapefruit juice, banana, and strawberry) and vegetables (corn, tomato juice, broccoli)

6 Absorption and Transport of Dietary Folate Dietary folate (Predominantly as polyglutamate) Faeces Intestinal Lumen (jejunum) conjugase Enterohepatic circulation Bile Enterocytes (monoglutamate form) Plasma (predominantly as 5-CH 3 FH4) Liver Systemic Circulation Urine Kidney Peripheral Tissues

7 Folic Acid Importance Vitamin B9 (folic acid and folate) is essential to numerous bodily functions such as DNA synthesis, a cofactor in certain biological reactions. It is especially important in aiding rapid cell division and growth. Children and adults both require folic acid to produce healthy red blood cells and prevent anemia.

8 Metabolic functions Coenzyme in single carbon metabolism Amino acid metabolism Serine-glycine interconversion and metabolism Homocysteine methylation and methionine synthesis Histidine catabolism Nucleotide metabolism Thymidylate synthesis Purine synthesis Disposal of one-carbon units Mitochondrial protein synthesis

9 Now with Ahmad Ausama Al-Kazzaz

10 Folic acid effect on Pregnancy Adequate folate intake during the preconception period (which is the time right before and just after a woman becomes pregnant) helps protect against a number of congenital malformations, including neural tube defects (which are the most notable birth defects that occur from folate deficiency). It also contributes to oocyte maturation implantation, placentation, in addition to the general effects of folic acid and pregnancy. Therefore, it is necessary to receive sufficient amounts through the diet to avoid subfertility.

11 Folic Acid effect on Cancer In addition, folic acid may not be helpful, and could even be damaging, in Many people cancer already cells suffering have a from high cancer requirement or from for a folic precancerous acid and condition. overexpress the Likewise, folic acid it has receptor. been suggested This finding excess has folate led to may the promote development tumor of anticancer initiation. drugs Folate thathas target shown the folic to play acid a dual receptor. role in cancer Some development; investigations low folate have intake proposed protects good against levels of early folic carcinogenesis, acid may be related and to high lower folate risk intake of esophageal, promotes stomach, advanced and carcinogenesis. ovarian cancers, Therefore, but the public benefits of health folic recommendations acid against cancer should may depend be careful on not when to it encourage is taken and too much on individual folate intake. conditions.

12 Folic acid Toxicity The risk of toxicity from folic acid is low, because folate is a watersoluble vitamin and is regularly removed from the body through urine. One potential issue associated with high dosages of folic acid is that is has a masking effect on the diagnosis of pernicious anemia (vitamin B 12 deficiency), and a variety of concerns of potential negative impacts on health. [

13 Folate Deficiency A serum folate of 3 μg/l or lower indicates deficiency. common symptoms of folate deficiency include : diarrhea forgetfulness Megaloblastic mental depression anemia with weakness or shortness of breath sore or swollen tongue nerve peptic damage or mouth with ulcers weakness and limb numbness (peripheral headaches neuropathy) pregnancy heart palpitations complications, mental irritability confusion

14 Folate deficiency Folate deficiency is treated with supplemental oral folate of 400 to 1000 μg /day. Patients with megaloblastic anemia need to be tested for vitamin B 12 deficiency before Folate folate treatment, deficiency because is accelerated if the patient by alcohol has vitamin consumption B. Folate deficiency is 12 deficiency, folate diagnosed supplementation by analyzing can remove CBC the ( anemia, Complete but blood can also picture) worsen and neurologic plasma vitamin Bproblems. 12 and folate Morbidly levels. obese CBC patients may indicate with BMIs megaloblastic of greater anemia than 50 but are more this could likely also to be a develop sign of folate vitamin deficiency B 12 deficiency.. Cobalamin Increased deficiency homocysteine may lead to level folate suggests deficiency, tissue which, folatein deficiency turn, increases but homocysteine levels is also and affected may result by vitamin in the development,vitamin B 6, renal of cardiovascular function, and disease genetics. or birth One defects. way to differentiate between folate deficiency from vitamin B 12 deficiency is by testing for methylmalonic acid levels. Normal MMA levels indicate folate deficiency and elevated MMA levels indicate vitamin B 12 deficiency.

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