Evaluating How Specialty Compounding of Folic Acid May Help Reduce Risk of Stroke
Most women of childbearing age know that taking folic acid supplements before, during and after pregnancy is essential in preventing a range of birth defects in newborns. Researchers have long suspected folic acid has other benefits as well, not just for younger women but also for men and patients of all ages. In fact, folic acid is a key ingredient in both over-the-counter multi-vitamins as well as those prepared via specialty compounding.
Low levels of folic acid have been associated with risks for heart disease and stroke, but studies investigating the benefit of folic acid supplements have shown mixed results. It turns out that many of those studies were conducted in patients who already had high levels of folate in their diet.1
A new study conducted in patients with high blood pressure but low folate intake confirms that folic acid intake does indeed play a significant role in reducing stroke.2 Nutritional studies further suggest Americans have low folic acid levels. So how can specialty compounding pharmacies help reverse that trend?
How Does Folic Acid Change the Risk of Stroke?
Stroke is often described as a heart attack in the brain, and can be due either to a burst aneurysm or leaking blood vessel (hemorrhagic stroke) or a blood clot that migrates to the brain (ischemic stroke). Stroke is the fifth leading cause of death in America, occurs roughly every 40 seconds, and affects 800,000 people per year. Eighty percent of strokes can be prevented, which makes compounding for the brain essential.3
Some risk factors for stroke, such as gender, age, ethnicity, and family history, cannot be avoided. However, there are many ways in which patients can control their risks, including diet and exercise as well as tobacco and alcohol use. Folic acid, called folate when occurring naturally or Vitamin B9 in synthetic form, is a key factor because it is involved in many basic functions essential to the body. In the brain, folic acid is critical for healthy brain function, with low levels associated with depression and memory. Folic acid also helps in the production of DNA and RNA, especially during rapid tissue growth as with infancy and pregnancy.
In terms of stroke risk, folic acid works with other B vitamins to break down homocysteine, which then reduces the chance of damage to the inner walls of arteries, reducing the risk of both hemorrhagic and ischemic stroke.
How Can Patients Increase Their Folate Intake Naturally?
The recommended daily amount of folic acid is 400 micrograms (mcg) for healthy males over 13 and 400-600 mcg for healthy females over 13, with a maximum daily amount not to exceed 1,000 mcg.4 Most of us get about a quarter of that, says Dr. Walter Willett, professor of epidemiology and nutrition at Harvard T.H. Chan School of Public Health3, with those who use a lot of corn flour, or who are on a gluten-free diet, getting even less. “Fruits and vegetables are important sources of folate in the diet,” he further explains, “and they also bring lots of other benefits, such as potassium and phytonutrients, that also help lower cardiovascular disease.” Food high in folate include:
- Dark leafy greens, asparagus, and okra
- Broccoli and Brussels sprouts
- Citrus fruit, papaya, and banana
- Berries, grapes, and cantaloupe
- Avocado, nuts, and seedsBeans, peas, and lentils
Even with a diet high in fruits and vegetables, Dr. Willett advises that “it still makes sense for most people to take a multivitamin, multimineral supplement every day.”
How Can Specialty Compounding Help Even More?
Pharmacists should definitely keep their patients aware of how health and exercise can keep their brain and whole bodies healthy. Everyone likely knows that tobacco and alcohol carry health risks and that a healthy diet and exercise are key to living well. But most probably don’t know how diet relates to folic acid, and how that in turn affects the risk of stroke. Patients almost may not know that all vitamin Bs are water soluble, meaning those vitamins aren’t stored in the body. Getting the daily required amount of folic acid really is necessary to do every day. This is where speciality compounding comes in. Pharmacists can offer a good OTC multivitamin, or compound a patient-specific supplement with the amount of folic acid and other nutrients needed for those who are planning to get pregnant, have high blood pressure, heart disease, or other conditions.
Specialty compounding pharmacies should also be on the lookout for nutritional supplements needed because of the other medications patients take, especially those that cause folic acid deficiency:
- Nonsteroidal anti-inflammatory drugs
- Cholesterol medications
- Anti-seizure medications
- Proton pump inhibitors
- H2 blockers
- Some antibiotics
Simple steps to increase folic acid intake can bring about large change in risk of stroke and other medical conditions—we just have to let our patients know how to make that change.
Stroke is a concern for many Americans, with incidence and risk on the rise. New studies offer important insight into how to treat the disease or better, how to prevent it in the first place. Pharmaceutica North America evaluates new regularly, and is committed to providing specialty compounding pharmacies with safe and high-quality compounding materials that make a real difference in patient health. Let us help your patients. Contact us today for more information.
- “Does folic acid reduce stroke risk?” August 10, 2015, http://drugtopics.modernmedicine.com/ ↩
- “Folic acid, a B vitamin, lowers stroke risk in people with high blood pressure,” March 18, 2015, http://www.health.harvard.edu/blog/folic-acid-a-b-vitamin-lowers-stroke-risk-in-people-with-high-blood-pressure-201503187810 ↩
- “What is stroke?” 2015, http://www.stroke.org/understand-stroke/what-stroke ↩
- “Folate dosing,” February 1, 2014, http://www.mayoclinic.org/drugs-supplements/folate/dosing/hrb-20059475 ↩