The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Avoid folic acid supplements if hypersensitive or allergic to any of the product ingredients.
Side Effects and Warnings
Folate may cause low blood pressure. Caution is advised in patients taking herbs or supplements that lower blood pressure.
Folate may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.
Folate appears to be well-tolerated in suggested doses. Stomatitis, alopecia, myelosupression, and zinc depletion have been reported.
Use cautiously in combination with aspirin based on human studies suggesting folic acid reversed the beneficial effects of aspirin on C-reactive protein (CRP) levels.
Use folic acid injections containing benzyl alcohol (1.5%) as a preservative only under the advice of a healthcare provider.
Use folic acid cautiously in individuals living in a high malaria area due to findings that routine prophylactic supplementation with iron and folic acid increased the risk of dying or needing in-patient treatment for an adverse event
An intravenous loading dose of folic acid, vitamin B6, and vitamin B12 followed by oral administration of folic acid plus vitamin B6 and vitamin B12, taken daily after coronary stenting, might actually increase restenosis rates. Due to the potential for harm, this combination of vitamins should not be suggested for patients receiving coronary stents.
Erythema, urticaria (hives), skin flushing, rash, and itching have been reported.
Nausea, bloating, flatulence, cramps, bitter taste, and diarrhea have been reported.
The color of urine may become more "intense" (further details are lacking).
Folic acid may mask the symptoms of pernicious, aplastic, or normocytic anemias caused by vitamin B12 deficiency and may lead to neurological damage.
Irritability, excitability, general malaise, altered sleep patterns, vivid dreaming, overactivity, confusion, impaired judgment, increased seizure frequency, and psychotic behavior have been reported. Very high doses may cause significant central nervous system (CNS) side effects. Supplemental folic acid might increase seizures in people with seizure disorders, particularly in very high doses.
Wheeze and asthma incidence may be increased in infants following use in pregnancy. Anaphylaxis and bronchospasm have also been reported.
Other potential adverse effects to folic acid supplementation include increased cancer incidence and mortality and increased restenosis following stenting. The effects of folic acid itself are not clear. Unmetabolized folic acid (not converted to folate) has been found in the blood of supplement users.
Use supplemental levels above 400 micrograms cautiously.
Pregnancy and Breastfeeding
Pregnancy : It is suggested that all women capable of becoming pregnant consume folate in order to reduce the risk of the fetus developing a neural tube defect. Folic acid supplementation in higher than suggested doses is categorized as U.S. Food and Drug Administration (FDA) Pregnancy Category C.
Breastfeeding : Folic acid is present in the breast milk and is likely safe to use during breastfeeding under the supervision of a qualified healthcare provider.
Wheeze and asthma incidence may be increased in infants following use in pregnancy.
Severe clinical and hematological manifestations of folate deficiency occurred in a previously healthy, fully breastfed, 10 month-old infant whose mother took oral contraceptives.