New Culprit: Folic Acid Deficiency

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Hot off the presses! Folic acid taken during pregnancy may (or may not) lower the risk of having a child with autism.  Good right? Maybe.  As with all scientific studies, I urge caution as the population that was studied, might not be representative of every woman.  In this case that population was 85,000 Norwegian kids, whose mothers and mothers’ obstetricians filled out surveys.  The study also excludes AS and PDD-NOS.  Do any of you know how much folic acid is in your multivitamin? Anyone? Anyone?  Not the best study design, you have to admit.  Also, check out the ‘critical window’ period; from 4 weeks before conception to 8 weeks gestation.  

What happened to other recently touted ’causes’ for autism: pollution, maternal obesity, autism in other/older siblings, some of the above, or all of the above.  Just another shot in the dark about the multitude of possible etiologies of Autism.  Can you envision a soon-to-be-mom taking mega doses of vitamin B-9 (that’s folic acid) because she worries about her child being diagnosed with autism?  In case any of you are wondering: yes, you can overdose from folic acid, which is also found in food sources, and that information is listed in the second article below.  

I’m not really trying to pooh-pooh this study; just looking at it with my own perspective.  Take a deep breath, read up on it, talk it over with your doctors, and take your vitamins. -Ed



Women who took folic acid supplements before and during pregnancy were about 40% less likely to have a baby later diagnosed with autism, according to a provocative new study generating high interest in the scientific community.

The dramatic increase in the prevalence of autism spectrum disorders, which affect one in 88 children, has generated intense interest in learning the causes of autism, as well as better ways to treat and prevent the condition.

In the new study, which included more than 85,000 Norwegian children, doctors asked pregnant women to fill out a questionnaire about supplement use, both before and during their pregnancies. Researchers then followed the children, born between 2002 to 2008, for an average of six years. The study was published online Tuesday in the Journal of the American Medical Association.

Doctors have encouraged women to take folic acid before and during pregnancy for years, because it can reduce the risk of birth defects.

In this study, the critical window for folic acid consumption was four weeks before conception through the eighth week of pregnancy. Overall, women who took supplements during this window were 27% less likely than others to have a baby with any autism spectrum disorder, which includes autism disorder — the most severe form — as well as Asperger’s syndrome and pervasive developmental disorder-not otherwise specified (PDD-NOS).

Women who took folic acid during that window were about 40% less likely to have a child later diagnosed with autism disorder.

Taking folic acid in mid-pregnancy, measured at week 22, was not associated with a decreased risk. Researchers also found no link between fish oil supplements and autism risk.

In addition, researchers found no decrease in the individual risk of two milder subtypes of autism — Asperger’s syndrome or pervasive developmental disorder — which tend to be diagnosed later. It’s possible that children in the study, at an average age of 6, were too young for these disorders to have been diagnosed, says study co-author Pal Suren, of the Norwegian Institute of Public Health in Oslo.

The study’s results confirm findings from earlier, more preliminary studies linking folic acid and autism risk, says Craig Newschaffer, director of Drexel University’s Autism Institute in Philadelphia. Other studies also have found that children whose mothers took folic acid were less likely to have language delays.

While scientists will need to confirm the results with additional studies, Newschaffer says “it provides additional evidence that we may eventually be able to develop solid strategies to effectively prevent some forms of autism.”

Folic acid, a B vitamin, is essential for synthesizing and repairing DNA, Suren says. It appears to play a key role in the first days and weeks of embryonic life, before women even know they’re pregnant. Scientists can’t explain, however, exactly how folic acid prevents birth defects.

Folate, the natural form of folic acid, is found in lentils, spinach, black beans, peanuts, orange juice, romaine lettuce and broccoli. Most people don’t get enough folic acid from food, however. Two-thirds of women don’t even know it’s important, according to the March of Dimes.

For that reason, doctors recommend all women of childbearing age take 400 micrograms of folic acid a day. In the USA, grains such as flour, rice and cereal have been fortified with folic acid since 1998. Norway does not add folic acid to foods.

Many women wonder what they can do to reduce the risk of autism, especially if they already have one autistic child.

“We get questions from women all the time, asking, ‘What can I do? What can I do?’ ” says Alycia Halladay, senior director for environmental and clinical sciences for Autism Speaks, an advocacy group.

But Halladay notes that taking folic acid doesn’t guarantee that women won’t have a child with autism. Some women in the study still had an autistic child after taking the supplements.

“I do worry that women who didn’t take folic acid during that critical time period might feel somewhat responsible, that it’s the ‘mother’s fault’ again,” Halladay says.

And although the symptoms of autism often become clear only after a child’s first birthday, this study is one of many suggesting that the biological changes driving autism occur either before conception or during pregnancy, Suren says.

Doctors have isolated genetic causes for only about 15% of cases of autism, according to the National Institutes of Health, although studies show couples with one autistic child are at increased risk of having another.

Additional factors contributing to autism include premature birth, low birth weight, prenatal exposure to certain medications or air pollution and maternal infections during pregnancy. Children are also more likely to develop autism if they’re born to older fathers or they’re born less than a year after an older sibling, studies show.

Doctors say the condition should really be called “autisms.” That’s because research strongly suggests that autism is not a single condition, but a group of conditions with similar symptoms and different causes, says co-author Deborah Hirtz, of the National Institute of Neurological Disorders and Stroke, which helped fund the study.

Autism is an incredibly diverse diagnosis. Some severely disabled children are unable to speak and prone to injuring themselves, while many adults with Asperger’s syndrome have successful careers in science.

Both doctors and parents have wondered why the prevalence of autism has grown so dramatically in recent decades.

The new study raises additional questions, says Cathrine Hoyo, a professor of epidemiology at Duke University School of Medicine in North Carolina. These include:Could changes in American diets — which now include fewer fruits and vegetables than in the past — affect folic acid levels, influencing autism rates? Could rising rates of overweight and obesity, which may affect how much folic acid women need, contribute to the problem?

“We’re certainly not going to be able to find any one environmental factor that will be the cause of autism,” Hirtz says. “I’m sure there will be multiple causes that interact with genetic susceptibilities.”



Folic Acid Overdoses in Pregnancy

Folic acid, or vitamin B-9, is a water-soluble vitamin available in food and supplement form. Orange juice and tomato juice contain folic acid. Women need folic acid during pregnancy but should ideally be taking folic acid prior to pregnancy, the American Pregnancy Association explains. Folic acid helps to prevent neural tube defects that may happen within the first 28 days of pregnancy in women if they have not been taking the recommended dose of folic acid.


Your body uses folic acid together with vitamins B-12 and C to break down, use and synthesize protein, “The New York Times Health Guide” explains. Folic acid helps your body create red blood cells and synthesize DNA. Your body uses folic acid to grow tissue and keep cells functioning within normal parameters. Folic acid also protects the DNA of your cells from changes that can cause cancer, notes. Folic acid can be combined with other medications to treat pernicious anemia.


Women over the age of 18 should take about 400 mcg of folic acid daily, notes. Pregnant women should take 600 mcg of folic acid per day. Breastfeeding women need about 500 mcg of folic acid daily. The tolerable daily upper intake level for women between 14 to 18 years of age is 800 mcg of folic acid. Women who are 19 years old and older can take up to 1,000 mcg of folic acid daily without suffering adverse effects. These tolerable upper intake doses apply to both breastfeeding and pregnant women in these age groups.

Overdose Effects

Exceeding 1,000 mcg of folic acid daily can hide the symptoms of vitamin B-12 deficiency, the American Pregnancy Association explains. Taking 15,000 mcg or more of folic acid daily can damage the central nervous system of developing babies. Other overdose symptoms include numbness or tingling of the mouth, pain in the tongue and exhaustion, notes. Folic acid overdose can also cause a general sense of confusion and difficulty concentrating. Nevertheless, excessively high levels of folic acid don’t usually cause harm because your body routinely purges excess amounts when you urinate, “The New York Times Health Guide” notes.

Food Sources

Leafy green vegetables such as spinach, broccoli and lettuce contain folic acid, explains. Cereals and bread also contain folic acid. Bananas, melons, citrus fruits, legumes and mushrooms have folic acid. You can also get folic acid from poultry, pork, shellfish and liver, “The New York Health Guide” notes.


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