A Vitamin that Prevents Birth Defects and Helps Sickle Cell Patients
The Benefits of Folic Acid

Our mothers often told us to “Take Your Vitamins.”  As usual, they were right.  Not all vitamins, however, are created equal.  Are you taking a vitamin that contains folic acid? 

Folic acid is a vitamin that everyone needs.  For years, health professionals have been recommending this B vitamin to women of childbearing age to reduce the risks of certain types of birth defects in their babies should they become pregnant.  But, in addition to preventing birth defects, folic acid is an important vitamin supplement for sickle cell patients.  In recognition of National Folic Acid Awareness Week, celebrated in early January, this issue of iNCite looks at how folic acid helps those with sickle cell disease.

What is folic acid?

Folic acid is a B-vitamin that is necessary for cell production and growth.  It helps the body break down, use and create new proteins.  Folic acid supplements (including multivitamins with folic acid) can be taken to treat folic acid deficiency, certain menstrual problems and leg ulcers. Taking folic acid before pregnancy can prevent certain birth defects.  Folic acid is an important vitamin for people with sickle cell anemia because it is essential in the production of red blood cells.

What is sickle cell anemia?

Sickle cell anemia is an inherited lifelong condition in which red blood cells can become sickle-shaped, causing them to get stuck in blood vessels.  In sickle cell anemia, there are fewer-than-normal numbers of red blood cells because sickle cells die faster than normal red blood cells, usually after about 10 to 20 days. The bone marrow cannot make new red blood cells fast enough to replace the dying ones.  While sickle cells die at a rapid rate, folic acid works to help produce new blood cells. 

Folic acid produces red blood cells

According to Dr. Rupa C. Redding-Lallinger, Pediatrics Hematology-Oncology, UNC Healthcare, “Folic acid is an essential nutrient for individuals with sickle cell disease.  The requirement for folic acid in sickle cell disease is higher than in people without the disease.  This increased requirement is caused by the increased rate of production of red blood cells that occurs in sickle cell disease.  Although frank folic acid deficiency has not been demonstrated often in people with sickle cell disease in the U.S., deficiency can develop over a relatively short period of time of inadequate food intake, such as during a period of illness.  A folic acid supplement of 400 to 1,000 micrograms/day will prevent any period of deficiency.” 

Folic acid, sickle cell disease and pregnancy

Women with sickle cell anemia who are pregnant or considering getting pregnant should consult with their healthcare provider to determine their daily recommended amount of folic acid.  A 2005 March of Dimes Gallup survey showed that only 33 percent of women of childbearing age in the U.S. take a vitamin with folic acid daily.  From the Centers for Disease Control and Prevention, women with sickle cell disease are more likely to have problems during pregnancy that can affect their health and the health of their unborn baby. During pregnancy, the disease can become more severe and pain episodes can occur more frequently. A pregnant woman with sickle cell disease is at a higher risk of preterm labor and of having a low birthweight baby. However, with early prenatal care, including the right amount of folic acid, and careful monitoring throughout pregnancy, women with sickle cell disease can have a healthy pregnancy. 

During pregnancy, there is a test to find out if the baby will have sickle cell disease, sickle cell trait or neither one. The test is usually done after the second month of pregnancy.  Women with sickle cell disease should seek genetic counseling to learn information about the disease and the chances that sickle cell disease will be passed to the baby.

Food rich is folic acid

The following foods can help women reach their recommended amount of folic acid:

• Liver
• Eggs
• Broccoli
• Greens (collard, mustard, turnip, kale)
• Black-eyed peas
• Dried beans
• Whole-grain breads
• Nuts
• Strawberries
• Corn
• Okra
• Green peas
• Butternut squash
• Spinach
• Orange juice

Some foods are fortified with extra folic acid, so it’s important to check the food label.