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cognition, but the role of folate is unclear, and effects on dementia have not been
demonstrated. Still, folate is a promising neuroprotectant. B vitamins should be part of any
strategy to maintain healthy thinking and feeling as our brains age.
- DRUG INTERACTIONS: The Natural Standard cites reduced serum folate levels in women
taking conjugated estrogens (Premarin) or birth control pills and (theoretically) with
estrogenic herbs and supplements. Alcohol, smoking, aspirin, antacids, antibiotics,
carbamazepine (Tegretol), especially in pregnant women, cholestyramine (Questran),
Colestipol (Colestid), cycloserine, diuretics, h2 blockers such as cimetidine (Tagamet),
famotidine (Pepcid), nizatidine (Axid) and ranitidine (Zantac), proton pump inhibitors such
as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole
(Protonix), and rabeprozole (Acip-Hex), methotrexate, pancreatic enzymes, Phenobarbital
(Luminal), primidone (Mysoline), pyrimethamine (Daraprim), sulfasalazine, triamterine
(Dyrenium) and trymethoprim all may reduce serum folate levels, though in different ways.
Taking folic acid with vitamin B-12 may increase the risk of B-12 deficiency (because it may
be screened by folic acid).
- SIDE EFFECTS:
Aside from allergic reactions, folate and B vitamins are described by Brown et al. as
“generally quite safe.”
The Natural Standard states that folate is “generally well tolerated in standard doses.”
However, stomach upset, hair loss, myelosupression (bone marrow suppression), zinc
depletion, erythema (skin inflammation), pruritus (skin itch), urticaria (hives), nausea,
bloating, flatulence, cramps, bitter taste, diarrhea, anemias caused by vitamin B12
deficiency, irritability, excitability, malaise, altered sleep patterns, vivid dreaming,
overactivity, confusion, impaired judgment, increased seizure frequency and psychotic
behavior have been reported. Significant central nervous system side effects have been
observed with high doses.
