By Garret Condon / Hartford Courant
Depressed? Maybe you need more liver, chickpeas, fortified breakfast cereal or a multivitamin.
All are good sources of folate, a B vitamin that occurs naturally in many foods. The synthetic version is called folic acid. It has been added to some foods since the late 1990s to help prevent certain birth defects. The current recommendation for pregnant women is 600 micrograms per day. Women who lack adequate folate around the time of conception are more likely to have a child with birth defects and are at higher risk for low-weight and premature babies, according to the National Institutes of Health.
Some studies have shown supplemental folate also helps depressed people. A recently published study suggests how this might work.
Martha Morris, an epidemiologist with the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, and four colleagues studied data on nearly 3,000 people, ages 15 to 39. They found that those who had experienced major depression had lower concentrations of folate in their bloodstream and red blood cells than those who had never been depressed. In addition, those with chronic low-level depression — also known as dysthymia — had lower red blood cell levels than the nondepressed.
Morris says folate levels were not particularly low among people who said they were currently depressed. “Low folate didn’t occur until some months after the symptoms had disappeared,” she says. “It does tend to suggest that low folate status is a consequence of depression.” She notes that low levels of folate can cause such symptoms as fatigue, which is often part and parcel of depression. Improving such conditions using folate or folic acid, she says, might help lift the spirits.
The study, published in the March-April (2003) issue of Psychotherapy and Psychosomatics, was accompanied by an editorial written by Dr. Ingvar Bjelland and two colleagues from the University of Bergen, Norway. They say that while studies on folate and antidepressant treatment are promising, scientists do not yet know which patients should receive folate supplements, in what dose or for how long.
Furthermore, the safety of high-dosage supplementation has not been established. The information analyzed by Morris and her associates was gathered before folic acid was added to many foods.
Morris says she’s not sure what result she’d get from the post-fortification population. The National Institutes of Health reports adult diets now contain recommended amounts of either folate or folic acid. In other words, most Americans are probably getting enough. The Institute of Medicine’s Food and Nutrition Board recommends 400 micrograms, or 0.4 milligrams, per day for adult men and women, 600 micrograms for pregnant women and 500 for lactating women.
Some medicines and medical conditions — including alcohol abuse — can cause folate deficiency. Doctors may put such people on folic acid supplements. For those not identified as low on folate, a multivitamin with folic acid or an extra helping of folic-acid-fortified foods might make sense.
However, some individuals may be at risk from folic acid supplements. People with vitamin B12 deficiency, for example, can develop both anemia and damage to the central nervous system. Taking folic acid can cure the anemia but not the central nervous system effects. The folic acid supplement, therefore, could mask the B12 deficiency and delay diagnosis. The National Institutes of Health’s Office of Dietary Supplements recommends people 50 or older have their doctors check their B12 status before they begin using a folic-acid supplement.