The folic acid that protects the fetus: When can it hide a dangerous deficiency? | Dr. Itai Gal

Dr. Itai Gal explains that folic acid, essential for preventing birth defects in the fetus, can mask a dangerous vitamin B12 deficiency in at-risk individuals. High doses of folic acid may improve blood counts and conceal ongoing nerve damage caused by B12 deficiency, including tingling, weakness, and memory impairment.

Dr. Itai Gal warns in his article that uncontrolled folic acid intake can mask a dangerous vitamin B12 deficiency. While folic acid is essential for women before and during early pregnancy to prevent neural tube defects, high doses can improve blood counts in someone with B12 deficiency, making anemia less noticeable. The doctor sees a less dramatic blood count, and the patient feels fine, but the B12 deficiency may continue to damage the nervous system. Neurological symptoms include tingling in the feet and hands, burning sensation, reduced sensation, unsteady gait, weakness, memory disturbances, confusion, depression, and sometimes long-term neurological damage. The article details risk groups for B12 deficiency: vegans and vegetarians who do not supplement B12, the elderly, post-bariatric surgery patients, those with intestinal diseases or celiac disease, people with atrophic gastritis, long-term metformin users, chronic users of acid-reducing medications, and individuals with unexplained anemia or neurological symptoms. Proper diagnosis includes B12 testing, blood count, and sometimes methylmalonic acid and homocysteine levels. The article emphasizes that the longer nerve damage persists, the lower the chance of full recovery.