Folic Acid and Health Risks

Folic acid deficiency may lead to an increased risk of numerous diseases, such as cardiovascular disease, neoplasms, and cognitive impairment. Vitamin B9 deficiency might also result in hyperhomocysteinemia and disorders of protein and DNA synthesis.

In a recent review article, researchers have reported that IBD patients present a higher risk of folic acid deficiency and require particular supervision. The article was published in the journal Nutrients on 12 November 2021.

Folic Acid in IBD

Folic acid plays an important role in IBD patients. In a meta-analysis, Yun et al. demonstrated that the level of folate in IBD patients was significantly lower when compared to that of healthy groups. Studies have shown that the supplementation of folic acid may decrease the occurrence of side effects, mainly:

• Gastrointestinal disease
• Inflammation of the mucosa
• Myelotoxicity

Dr. Alicja Ewa Ratajczak and team noted, "In the case of IBD, folic acid deficiency is one of the most common causal agents of non-iron deficiency anaemia (NIDA), which may decrease the quality of life in patients. Simultaneously, patients suffering from IBD are at a higher risk of folic deficiency (e.g., with inflammation in the small intestine or following resection) and require adequate supervision."

Folic Acid in Colorectal Cancer

Patients with long-term ulcerative colitis or Crohn's Disease present an increased risk of colorectal cancer (CRC) associated with inflammation and dysplasia. Additionally, CRC related to IBD is associated with:

• Chromosomal instability
• Microsatellite instability
• Hypermethylation

In the experimental study by Biasco et al., a three-month-long supplementation of folic acid resulted in decreased cell proliferation. A meta-analysis indicated that the supplementation of folic acid plays a protective role against the development of colorectal cancer. However, Dr. Alicja Ewa Ratajczak et al. noted that there is no large, randomized study on the role of folic acid in the prevention of CRC in patients suffering from IBD.