The Social Interaction of Folate and Drugs

Folic acid maintains emotional and mental health. It also helps in proper brain functioning. It is vital during the growth of cells, tissues, and organs. Folate plays a crucial role in DNA and RNA production. It also helps the proper functioning of iron in the body and combines with vitamin B12 to produce red blood cells.

It controls the levels of amino acid homocysteine by combining with other nutrients, vitamin B6 and B12.

Low levels of folic acid cause increased levels of homocysteine that indicate the sign of heart attack. Folic acid deficiency results from overconsumption of alcohol, celiac disease, and inflammatory bowel disease (IBD).

Certain medications may also cause the reduction of folic acid and causes various side effects.

Folic acid deficiency may restrict growth, inflammation of the tongue, loss of appetite, breathlessness, diarrhea, irritation, forgetting quickly, mental disorder, and gingivitis.

Folic acid is highly required for pregnant women to avoid neural tube congenital disabilities, cleft palate, spina bifida, and damaged brain.

Sources of folate are brussels sprouts, broccoli, green leafy vegetables, peas, chickpeas, cereals.

Metabolism of Folate in the Body
The important B-vitamin is folate or folic acid, which is responsible for preserving, creating the cell, and protecting DNA to avoid mutations that cause cancer. It is mainly present in green leafy vegetables, dairy products, fruits, eggs, and meat. Folate is a crucial element during pregnancy as its deficiency may lead to neural tube defects in the infant.

With the help of a proton-coupled folate transporter, the pathway begins in the extracellular space, where folic acid transports into the cell.

Folic acid is converted into dehydro-folic acid by dihydrofolate reductase. Dihydrofolate reductase converts dihydro-folic acid into tetrahydro-folic acid.

Many reactions, including purine metabolism and histidine metabolism, are initiated by tetrahydro-folic acid.

Tetrahydro-folic acid undergoes two reactions. The first reaction includes the catalyzation of tetrahydro-folic acid into tetrahydro-folyl-glucose-2. The enzyme named folylpolyglutamate synthase helps this reaction.

Then tetrahydro-folyl-glucose-2 becomes tetrahydro-folyl-glucose-(n) with the enzyme folylpolyglutamate synthase.

The enzyme gamma-glutamyl hydrolase helps tetrahydro-folyl-glucose-(n) regain its original state as tetrahydro-folyl-glucose-2 in the suicide bags of the cell where the cycle end.

In the second reaction, tetrahydro-folic acid converts tetrahydro-folic acid into 10-formyltetrahydrofolate by c-1 tetrahydrofolate synthase.

The whole loop is completed by converting 10-formyltetrahydrofolate to its original state as tetrahydro-folic acid by cytosolic 10-formyltetrahydrofolate dehydrogenase.

Interaction of Folate and Drugs
Drugs react with folate and reduce its absorption entirely in the body. Therefore, it is necessary to consult a licensed medical practitioner who may deduce if any previous medications may interfere with the folate supplements.

Anticonvulsants: Some anticonvulsants alter the activity of the liver enzyme and cause increased metabolism of folate. Fosphenytoin, phenytoin, and primidone decrease the folate concentration in the blood when consumed together.

Barbiturate: It is a central nervous system depressant. It may decrease the effectiveness of the drug when consumed with folic acid.

Methotrexate: It treats cancer. When consumed with folic acid, it may decrease the drug’s effectiveness.

Pyrimethamine: It is an antimalarial drug. The effectiveness of the drug decreases when consumed with folic acid.

Antibiotics, tetracycline: Tetracycline interferes with folic acid if consumed at the same time. It reduces its absorption and effectiveness. A time gap before or after consuming tetracycline is essential before consuming folic acid or other B vitamins.

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