Have a question about women’s health or menopause? Dr. Patricia Yarberry Allen may have the answer. Click here to send in your question to be posted on WVFC.

Question: I am over 50 and have high-risk HPV. I have had several mildly abnormal pap smears. My gynecologist has followed this carefully and has performed a special test called a colposcopy to make sure that there are no microscopically abnormal areas that the pap smear missed.

Two years ago he suggested that I take a high-dose folic acid supplement that contains B12. He explained that there was some information that it might help the promotion of normal cell growth and that it had been used to reduce the risk of cardiovascular disease for some time. Recently I read that folic acid might not be safe. What do you suggest I do? – Susan

Dr Pat: Even though folic acid has been used as a supplement that has been touted to lower the risk of heart disease and stroke, and possibly lower the risk of breast cancer in women who drink more than three glasses of wine a week, there is now news that this ubiquitous vitamin found in fortified foods, multivitamins and special supplements may increase the risk of colon cancer.

Red blood cells and nerve cells need B vitamins (folate, B12 and B6) to
develop and function properly. Most American women are aware of the
benefits of folic acid in the prevention of neural tube disorders in
the developing fetus, and the food industry has filled our foods to
capitalize on this issue. In addition, there are special prenatal
vitamins designed with extra folic acid to lower the risk.

Researchers last year published a study in Cancer Epidemiology Biomarkers and Prevention (July 2007) hypothesizing that all this folic acid fortification may be at least partly responsible for the slight increase observed in the 1990s of colon cancer that occurs on the right side.

The theory, which is discussed in this very good Boston Globe article, is that while folic acid does protect noncancerous cells from becoming cancerous, an estimated 35 to 50 percent of people over 50 already have precancerous polyps, and giving them extra folic acid can be harmful instead of helpful.

So far it’s just a theory, but once again, doctors and patients must be vigilant about news that may change their decisions about the risk/benefit analysis of any supplement, drug or therapy. In this case, it seems prudent since you are over 50 to avoid all supplements of folic acid until we have more information.

Keep in mind, however, that folate, the naturally occurring vitamin that is present in dark green leafy vegetables, asparagus, legumes, beets and some fruits, is beneficial for your health.

It is important to read the latest articles on this issue and bring any information or questions that you have to your doctor. The world of medicine is complex, and doctors and patients who work together as a team have the greatest chance of evaluating the best course of treatment.

Ed. note: A ranking of foods by their folate content is available here.

* * * * *
Dr. Patricia Yarberry Allen,
director of the New York Menopause Center, is a gynecologist affiliated
with New York-Presbyterian Hospital and a board certified fellow of the
American College of Obstetrics and Gynecology.
Have a question about sex, women’s health or the menopausal transition? Write to askdrpat@womensvoicesforchange.org.

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  • mhanna September 15, 2009 at 5:18 pm

    i am over 50 and take deplin which contains folate to make an antidepressant work better. Is this a mistake at my age?

    Reply