The relationship between folic acid and alcohol is well known, especially since prolonged alcohol exposure severely depletes stores of this vitamin. This article will discuss the importance of folic acid, symptoms of deficiency, and how to easily repair this deficiency while covering other nutritional bases as well.
This is one of a series of articles on Fit Recovery about basic nutrients that are depleted by alcohol. The mainstream addiction treatment industry all but ignores the role of nutrition in conquering alcohol addiction. This glaring omission causes an incalculable amount of preventable suffering.
Fortunately, you’re about to be well ahead of the curve!
- Why Do We Need Folic Acid?
- How Alcohol Depletes Folic Acid
- Symptoms Of Folic Acid Deficiency
- How Much Folic Acid Do Alcoholics Need?
- What Food Has the Most Folic Acid?
- Who is Most at Risk for Folic Acid Deficiency?
- Should I Take Folic Acid in the Morning or at Night?
- Potential Side Effects of Too Much Folic Acid
- Scientific Research
Why Do We Need Folic Acid?
Folic acid, also known as vitamin B9, plays an important role in supporting nervous system health and breaking down fats and carbohydrates into energy. While folate is found in small quantities in vegetables, folic acid is a synthetic form of the same vitamin that is found in supplements and fortified food products.
Because folic acid is extremely important for the development of fetal spinal and brain tissue, pregnant women often supplement with it. As we will see, folic acid deficiencies later in life can cause a variety of problems. Heavy drinking in particular is one of the most common causes of folate deficiency.
Folic acid is necessary for the following bodily processes:
- Building block for nucleic acid, found in all cells in the body
- Generation of new red blood cells
- Proper hearing function
- DNA and RNA repair
- Brain health
- Nervous system health
- Preventing a wide range of health problems
Because alcohol consumption markedly depletes folic acid levels, doctors often recommend that alcoholics take supplements containing the full range of B vitamins. However, folic acid is one of the few B-vitamins that can cause toxicity in high doses. Careful attention should be paid to dosage, which we will discuss below.
How Alcohol Depletes Folic Acid
Heavy drinking depletes folic acid through a number of mechanisms:
- Diuretic effect – Alcohol significantly increases urinary excretion of folic acid, which is taken from the blood and liver.
- Damaged gut lining – Alcohol directly damages the lining of the stomach and intestines, making it harder to absorb folic acid. Because folic acid is necessary for proper gut absorption, this deficiency makes it even harder to absorb every other nutrient, including folic acid.
- Damaged gut microbiome – Good bacteria that help break down nutrients in food are damaged by alcohol exposure, while harmful strains like candida yeast thrive from alcohol and sugar.
- Foregone calories – Alcoholics tend to make room for alcohol, rather than quality foods that are rich in folate.
- Overworked liver and pancreas – Many nutrients are made available to the body by the liver, but the organ cannot process vitamins and minerals when it is preoccupied with detoxifying alcohol (which it only does at about 1 drink per hour).
- Acetaldehyde – This is the most common toxic byproduct from alcohol, causing hangover symptoms, inflammation, and DNA damage that can lead to cancer. Inflammation further decreases nutrient utilization.
Folic acid is stored in the liver, and folic acid deficiency is a vicious cycle because low levels of this vitamin in the blood lead to increased excretion of folic acid. As chronic alcohol consumption continues, folic acid stores in the liver become even more severely depleted.
Before I quit drinking, I felt strange sensations in my bones and skin that could have been early signs of nerve damage. B-vitamins like folic acid are crucial in reversing nerve damage caused by alcohol addiction.
Symptoms Of Folic Acid Deficiency
In one study, eight out of ten alcoholics had severely depleted blood folate levels, while nearly half met the criteria for clinical deficiency in this crucial vitamin. (source)
Symptoms of folic acid deficiency include:
- Inability to absorb nutrients
- Liver problems
- Kidney problems
- Gut health problems
- Psychological problems
As we have already discussed, deficiency in folic acid and alcohol addiction usually go hand in hand. When I quit drinking, I was deficient in many vitamins and minerals despite being an otherwise active man in my twenties.
The fact that I had an uncharacteristically good diet for someone with severe alcohol dependence did not seem to matter. The B supplement that I took for six months after I quit drinking definitely helped me feel better, and fixing my folic acid deficiency probably helped in more ways than I understood at the time.
How Much Folic Acid Do Alcoholics Need?
People struggling with alcohol addiction need higher doses than the average person with a minor folic acid deficiency. The best way to repair an alcohol-induced folic acid deficiency is through supplementation.
If I were to quit drinking today, I would take Multi-Nutrient Formulas that contain a huge range of other important nutrients along with methylfolate, the natural form of folic acid.
Folic acid is just the tip of the iceberg with these supplements. Between them, they contain a lot of powerful nutrients for biochemical repair.
Most folic acid supplements contain 400 mcg, and the maximum dosage is 1,000 mcg per day. A common brand is Sundown Naturals folic acid, which contains 400 mcg of folic acid.
I took various B-complexes bought from supermarkets after I quit drinking. None of them are nearly as powerful for repairing the vast spectrum of alcohol-induced nutrient deficiencies as Multi-Nutrient Formulas now on the market.
What Food Has the Most Folic Acid?
Fortified cereals and breads contain folic acid, although I personally avoid these foods for other reasons. Dark, leafy greens and cruciferous vegetables like Brussels sprouts are good natural sources of folate.
Since most alcoholics already have poor gut health, it is difficult for them to absorb enough folic acid from foods alone. Supplementation and in some cases IV infusions can more reliably increase levels of folic acid.
With this said, here are some foods that are rich in folate:
- 1 cup of lentils – 90% DV
- 1 cup of raw beets – 37% DV
- 1/2 cup of asparagus – 34% DV
- 3 eggs – 18% DV
- 1 cup of raw spinach – 15% DV
- 1 large orange – 14% DV
- 1/2 cup raw broccoli – 14% DV
- 1/2 cup Brussels sprouts – 12% DV
Who is Most at Risk for Folic Acid Deficiency?
While alcohol-dependent people are known to commonly suffer from folic acid deficiency, other groups are at risk as well:
- Pregnant or lactating women
- People over age 65
- People with gastrointestinal disorders
- People with highly restrictive diets (source)
While the recommended intake of folic acid is 400 mcg to prevent a deficiency, alcoholics typically benefit from much more than this amount to reverse an alcohol-induced deficiency.
When I recovered from alcohol addiction, I got nearly 1,000 mcg per day of folic acid from supplements and even more folate from my healthy diet.
Should I Take Folic Acid in the Morning or at Night?
Most people prefer to take B-vitamins in the morning because they can increase energy. Folic acid is commonly included in B-complexes that are most often taken in the morning. As it turns out, digestion is faster in the morning than at night, meaning that absorption in the morning may be enhanced.
However, folic acid is not just an energizing compound. It’s necessary for proper neurotransmission, and night time is when our brains “reset” and recalibrate levels of important neurotransmitters. Therefore, taking folic acid at night is not necessarily a bad thing.
During early recovery and beyond, I’ve taken a multivitamin containing folic acid in the morning and night. I’ve never had any issues sleeping due to the consumption of B-vitamins before bed.
Potential Side Effects of Too Much Folic Acid
Supplemental intake of over 1 mg per day may cause toxicity. Symptoms of excessive folic acid intake can include:
- Stomach ache
- Skin changes
- Behavior changes
If you’re struggling with any of the above symptoms of folic acid toxicity, speak to your doctor right away.
A newer concern is the long-term buildup of unmetabolized folic acid (UMFA) in the blood. This occurs from taking too much supplemental folic acid over time, but it cannot occur from folate derived from foods. It also cannot occur from taking methylfolate, which is a superior and natural form of folic acid.
UMFA’s can result in some unpleasant side effects:
- Masking of vitamin B12 deficiency
- Accelerated age-related mental decline
- Insulin resistance and slower brain development in children
- Increased risk of cancer re-occurrence
These problems can be prevented by taking supplements that contain methylfolate.
Note: I did not learn about the UMFA issue until well after I finished my own nutrient repair regimen. My bloodwork is great, even after several years of taking high doses of folic acid (as opposed to methylfolate). I suspect that this issue results from taking very high doses of folic acid in the absence of dietary or supplemental folate.
There’s a lot of scientific research that supports the use of folic acid supplementation for alcoholics:
- Chronic alcohol consumption leads to folic acid deficiency and increased folate excretion in the urine (source)
- Folic acid deficiency accelerates alcohol-induced liver damage by lowering antioxidant defenses (source)
- Heavy drinkers who are the most deficient in folic acid have a significantly higher incidence of cancer and heart disease (source)
- Folic acid and thiamine may be the two most important B-vitamins for people experiencing alcohol withdrawal (source)
- Folic acid supplementation may reduce the incidence of some cancers for former alcoholics (source)
Unfortunately, most research money in the U.S. goes to studying prescription drugs instead of basic nutrients like folic acid that we need to function properly – yet which cannot be patented.
I hope you’ve learned something useful from this article about folic acid and alcohol.
With nutritional repair and natural remedies, trial and error is the best approach. I’ve never had a bad reaction to vitamins or natural supplements. Some have simply worked much better than others. The best ones have worked so well that they’ve seriously changed my life.
Basic (high quality) supplements are much safer than prescription drugs that mask the symptoms of underlying nutrient deficiencies. Taking medications for symptoms caused by a nutrient deficiency might even be detrimental, because untreated nutrient deficiencies can cause much more serious complications down the road.
If you have any questions about the links between folic acid and alcohol, please post them in the comment box below.