Folic Acid Overdose – Symptoms, Dosage, and Treatment
Folic Acid Overdose
Folic acid or otherwise known as folate or vitamin B9 is an essential vitamin belonging to the group of B vitamins. Folic acid is important in the embryonic development of the central nervous system. It is also essential in energy production of cells, metabolism of proteins, synthesis of DNA as well as in the formation of normal red blood cells. Deficiency in folic acid may produce symptoms, but taking folic acid in excess may also result in significant problems.
Folic acid is found in foods such as nuts, green leafy vegetables and organ meats. Those who require high amounts of folic acid include pregnant women to ensure normal CNS development of their babies. Patients with megaloblastic anemia may also require folic acid supplementation. When folic acid supplementation is taken, possibilities for folic acid overdose are also present. However, with cautious and prudent intake of folic acid,folic acid overdose is usually prevented.
Folic Acid Overdose Amount
The recommended intake of folic acid is up to 400 micrograms in a day for adults. For pregnant and lactating women, the recommended daily intake is 600 micrograms to support the growing fetus as well as provide folic acid for the newborn.
Although folic acid overdose is rare because the body may eventually excrete the high amounts of folic acid, a dosage of more than 1,000 micrograms in a day may lead to rare symptoms of folic acid overdose. However, some people who may take more than 1,000 micrograms of folic acid may still not produce symptoms.
Symptoms of Folic Acid Overdose
As discussed earlier, folic acid overdose is rare, but in cases where it develops due to excessive intake of the supplement, the following symptoms may be experienced:
1. Hypersensitivity Reactions
Allergic reactions are common symptoms of folic acid overdose. Patients may experience swelling of the lips, tongue, mouth, itching, and development of hives on the skin.
2. Gastrointestinal disturbances
People suffering from folic acid overdose may also experience nausea, flatulence, distention of the abdomen, loss of appetite, and metallic taste in the mouth as signs of high levels of folic acid in the GIT.
Insomnia may also be experienced in folic acid overdose. People usually have difficulty sleeping with feelings of hyperactivity, excitability, irritability and inability to concentrate as emotional symptoms of folic acid overdose.
4. Cognitive disturbances
People may also experience psychotic behaviors and depression; however, it tends to be rare and occur in individuals with history of the conditions.
5. Masking of vitamin B12 deficiency
Taking too much folic acid usually corrects the anemia that is caused by vitamin B12 deficiency without correcting the deficiency of vitamin B12. Because of this, health care providers may not be able to detect the presence of vitamin B12 deficiency because of being asymptomatic.
6. Decreases the action of anticonvulsant drugs in those taking it
There may also be indirect effects of folic acid overdose. Those taking anticonvulsant medications may suffer from seizures, despite the medication because folic acid reduces the action of the anticonvulsant drugs.
7. Zinc deficiency
Folic acid overdose may also lead to problems in the absorption of zinc in the gut.
Treatment of folic Acid Overdose
Treatment of folic acid overdose is usually supportive. There is no definite cure for folic acid overdose because it is eventually excreted in the kidneys in normal individuals. However, in individuals with problems in kidney function, additional managements such as dialysis may be employed to remove the excess folic acid from the blood. Supportive managements may involve:
1. Medications for gastrointestinal symptoms
Anti-diarrheals, gastric stimulant, and other medications may be given.
2. Seizure Medications
Other anticonvulsant’s may be given in cases of seizures in those taking anticonvulsant medications.
3. Anti Psychotics
People experiencing mental disturbances may also receive anti-psychotics as a temporary management for the symptoms.
In order to prevent folic acid overdose, it is essential to adhere to the recommended dosage of the drug. In addition, consider taking folic acid in natural forms such as in orange juice, spinach, cereals, fruits and vegetables in order to prevent folic acid overdose.
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2 thoughts on “Folic Acid Overdose – Symptoms, Dosage, and Treatment”
this is erroneous. levels 5mg to 15mg are not known to deplete zinc absorption
Well I found it helpful especially when dealing with patients who are running serum levels >20ng/ml in folate due to supplementation! We have been taught that there is no danger of getting overdosed on B Vitamins as they are water soluble. However, clinical experience is showing us that high dose supplementation of B vitamins, in many cases, causes problems! When will we learn that while some is good and and necessary, more isn’t necessarily better!