Folic acid and folate have been used interchangeably, although the most stable form that is used by the human body is folic acid. This water-soluble, B-complex vitamin occurs naturally in foods and in metabolically active forms (Food and Nutrition Board 1998). Since 1998, the fortification of cereal with folate has decreased the prevalence of folate deficiency significantly (Cembrowski et al. 1999). Excess folate intake has not been associated with any significant adverse effects.
Patients taking large amounts of non-steroidal antiinflammatory drugs (NSAIDs) such as aspirin or ibuprofen experience interference in folate metabolism, although regular use shows no significant changes. Patients suffering from seizures that use phenytoin for therapy may report decrease in seizure threshold when taking folate supplements (Lewis et al. 1995). The body's ability to absorb or utilize folate may be decreased if taking nitrous oxide, antacids, bile acid sequestrants, H2 blockers, certain anticonvulsants, and high-dose triamterene. Supplementation of folic acid may also correct for megaloblastic anemia due to B12 deficiency, but the neurological damage will not be prevented. In these cases, one must be careful to pinpoint the true cause of the anemia to prevent neurological complications (Queiroz et al. 2000).
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