Folic Acid.--Part II

Wilkinson, John F.

doi:10.1136/bmj.1.4556.822

Cited by 9 publications

(5 citation statements)

References 17 publications

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“…Sixteen publications reported on prospective case series (Berk et al., 1948; Bethell & Sturgis, 1948; Chodos & Ross, 1951; Davidson & Girdwood, 1947; Hall & Watkins, 1947; Heinle et al., 1947; Israëls & Wilkinson, 1949; Meyer, 1947; Ross et al., 1948; Schwartz et al., 1950; Spies et al., 1948; Spies & Stone, 1947; Vilter et al., 1947; Wagley, 1947; Wilkinson, 1948; Will et al., 1959). The vast majority of cases were PA patients (Bethell & Sturgis, 1948; Chodos & Ross, 1951; Hall & Watkins, 1947; Heinle et al., 1947; Israëls & Wilkinson, 1949; Meyer, 1947; Ross et al., 1948; Spies et al., 1948; Wilkinson, 1948; Will et al., 1959), while a few cases were related to patients with gastric resection (Chodos & Ross, 1951; Heinle et al., 1947; Meyer, 1947; Ross et al., 1948; Wagley, 1947) or sprue (Chodos & Ross, 1951; Davidson & Girdwood, 1947; Spies et al., 1948; Wagley, 1947). Cases were patients treated with folic acid as an alternative to liver extract, which was the standard treatment for PA at that time (Berk et al., 1948; Bethell & Sturgis, 1948; Chodos & Ross, 1951; Davidson & Girdwood, 1947; Heinle et al., 1947; Ross et al., 1948; Will et al., 1959) or patients treated with folic acid as first therapy or after an interruption of the therapy with a liver extract (Berk et al., 1948; Bethell & Sturgis, 1948; Hall & Watkins, 1947; Heinle et al., 1947; Israëls & Wilkinson, 1949; Meyer, 1947; Spies & Stone, 1947; Wagley, 1947; Wilkinson, …”

Section: Assessmentmentioning

confidence: 99%

“…Sixteen publications reported on prospective case series (Berk et al, 1948;Bethell & Sturgis, 1948;Chodos & Ross, 1951;Davidson & Girdwood, 1947;Hall & Watkins, 1947;Heinle et al, 1947;Israëls & Wilkinson, 1949;Meyer, 1947;Ross et al, 1948;Schwartz et al, 1950;Spies et al, 1948;Spies & Stone, 1947;Vilter et al, 1947;Wagley, 1947;Wilkinson, 1948;Will et al, 1959).…”

Section: Prospective Case Seriesmentioning

confidence: 99%

Section: Assessmentmentioning

confidence: 99%

“…In the period following the substitution of liver extract by folic acid, the haematological status of the majority of patients was found to be maintained (Berk et al., 1948 ; Bethell & Sturgis, 1948 ; Chodos & Ross, 1951 ; Heinle et al., 1947 ; Ross et al., 1948 ; Wilkinson, 1948 ; Will et al., 1959 ), although deterioration (Bethell & Sturgis, 1948 ; Heinle et al., 1947 ) or, in contrast, further improvement were also described in some cases (Berk et al., 1948 ; Bethell & Sturgis, 1948 ; Heinle et al., 1947 ). An improvement of the haematological signs of PA was also observed in most patients who had not been previously treated with liver extracts (Bethell & Sturgis, 1948 ; Hall & Watkins, 1947 ; Heinle et al., 1947 ; Israëls & Wilkinson, 1949 ; Meyer, 1947 ; Spies et al., 1948 ;Wagley, 1947 ; Will et al., 1959 ).…”

Section: Assessmentmentioning

confidence: 99%

“…Several publications reported deterioration or onset of neurological manifestations during the period of folic acid treatment (Berk et al., 1948 ; Bethell & Sturgis, 1948 ; Chodos & Ross, 1951 ; Hall & Watkins, 1947 ; Heinle et al., 1947 ; Israëls & Wilkinson, 1949 ; Ross et al., 1948 ; Spies et al., 1948 ; Spies & Stone, 1947 ; Vilter et al., 1947 ; Wilkinson, 1948 ; Will et al., 1959 ). The neurological manifestations were characteristic of cobalamin‐dependent neuropathy (i.e.…”

Section: Assessmentmentioning

confidence: 99%

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Scientific opinion on the tolerable upper intake level for folate

Turck,

Bohn,

Castenmiller

et al. 2023

EFS2

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Following a request from the European Commission (EC), the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver a scientific opinion on the revision of the tolerable upper intake level (UL) for folic acid/folate. Systematic reviews of the literature were conducted to assess evidence on priority adverse health effects of excess intake of folate (including folic acid and the other authorised forms, (6S)-5-methyltetrahydrofolic acid glucosamine and l-5-methyltetrahydrofolic acid calcium salts), namely risk of cobalamin-dependent neuropathy, cognitive decline among people with low cobalamin status, and colorectal cancer and prostate cancer. The evidence is insufficient to conclude on a positive and causal relationship between the dietary intake of folate and impaired cognitive function, risk of colorectal and prostate cancer. The risk of progression of neurological symptoms in cobalamin-deficient patients is considered as the critical effect to establish an UL for folic acid. No new evidence has been published that could improve the characterisation of the dose-response between folic acid intake and resolution of megaloblastic anaemia in cobalamin-deficient individuals. The ULs for folic acid previously established by the Scientific Committee on Food are retained for all population groups, i.e. 1000 μg/day for adults, including pregnant and lactating women, 200 μg/day for children aged 1-3 years, 300 μg/day for 4-6 years, 400 μg/day for 7-10 years, 600 μg/day for 11-14 years and 800 μg/ day for 15-17 years. A UL of 200 μg/day is established for infants aged 4-11 months. The ULs apply to the combined intake of folic acid, (6S)-5-methyltetrahydrofolic acid glucosamine and l-5-methyltetrahydrofolic acid calcium salts, under their authorised conditions of use.It is unlikely that the ULs for supplemental folate are exceeded in European populations, except for regular users of food supplements containing high doses of folic acid/5-methyltetrahydrofolic acid salts. K E Y W O R D S folate, folic acid, 5-methyltetrahydrofolic acid salt, tolerable upper intake level 2 of 119 |

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