The article “Is Your Breakfast Giving You Cancer?” in the April issue of Prevention magazine has generated attention and concern regarding folic acid in my San Francisco bay area community, and elsewhere.  The article brought up recent findings that folic acid, the synthetic form of folate, seems to cause an increase in colon, lung and prostate cancers.  Understandably this should rouse serious concern because folic acid is in the vast majority of folic acid fortified foods and off-the-shelf vitamins.  More importantly, pregnant woman are told to take folic acid. This article was released following recent studies reported in the November 18, 2009 issue of JAMA (Journal of the American Medical Association), along with some recent studies, that show that increased folic acid intake contains significant risks ^{1 2 3}.

San Francisco Doctor: Folic Acid Facts

As I’ve been telling my patients in the San Francisco bay area, you need to know that it is crucial to know the different forms of folic acid.

Folic acid is the synthetic form while folate is the natural form.  Technically, the oxidized form of folic acid is called Pteroyl-L- Glutamic acid, which does not naturally occur in foods.  There is no naturally occurring biochemical reaction that utilizes this form.  It must be converted using a particular enzyme in order to be used in your body.  It happens to be the most stable for adding in food, thus, it is often used in fortifying foods with folic acid.  However, an estimated 33 % of people are genetically deficient in this enzyme that converts this folic acid form for it to be used by your body.

On the other hand, L-5-methyltetrahydrofolate (L-5-MTHF) is the naturally occurring form of folic acid.  Technically, this is called folate.  It naturally occurs in foods.  It is referred to as the active form because it does not need to be converted to another form for used in your body.

What are the functions and benefits of L-5-MTHF?

• DNA repair
• amino acid metabolism
• biosynthesis of neurotransmitters
• involved in development of the myelin covering of nerve cells
• key detoxification reactions called methylation
• proper division of red blood cells
• reducing homocysteine
• regulation of gene expression; the control of healthful genes being “turned on” and harmful genes being “turned off”
• prevention of neural tube defects in developing embryos (spina bifida)

As I have mentioned in my other articles/blogs, the importance of folic acid in preventing neural tube defects was clearly proven by Drs. McCulley and Smithells from the 1960’s through the 1990’s in multiple studies.  Although synthetic form folic acid, was used in these studies, only 200 to 400 mcg were used, which is indicated as fairly safe.

San Francisco Doctor: Folic Acid Fallacies

Does excess intake of folic acid possibly increase the risk for cancer?

From the study by Cole ⁴, those people taking 1000 mcg of folic acid with a previous history of colorectal cancer had a 2.3 times increased risk of recurrence within 6- 8 years.  It is important to note that in this study folic acid, not folate, was used, and at the start of the study, the people participating in the study had significantly lower vitamin B12 levels.  Also note that each nutrient works synergistically with others, not in isolation from other nutrients.  Problems will likely occur when a study is designed where one nutrient is given at a high dose while excluding others.  Even more so, when synthetic forms are used.

Stolzenberg-Solomon, et al⁵ studied the effects of an average intake of 853 mcg/day of folic acid by postmenopausal women that consume alcohol. The result shows an increased risk of breast cancer for folic acid intake at higher doses.  Furthermore, those women with the higher intake of alcohol were at greater risk of breast cancer.  What’s the takeaway from this study?  The synthetic form of folate at high doses is a problem.

What studies show that folate form is protective against cancer?

In 2006, an article⁶ in The Journal of Nutrition and Cancer essentially reported that a diet with significant quantities of foods containing folate and vitamins B6, B12, C, E, selenium (a mineral) and lycopene (a phytonutrient) protects against various types of cancer, including colorectal cancer.

From careful reading of all the studies in this topic by nutritionists like myself, it is clear that the synthetic folic acid and the natural folate form are metabolized differently and used by the body differently. Therefore, it is a fallacy to equate the supplemental use of folate with folic acid regarding the increased risk of colon cancer or other cancers. I do not recommend taking supplemental folic acid at more than 400 mcg/day. Unfortunately, folic acid is what you get in most off-the-shelf supplements. Some of the professional nutritional supplement manufacturers have switched to folate in recent years since research on this started coming out.

How to avoid getting the synthetic folic acid:

• Avoid all highly processed grains.
• Look for “L-5 methyltetrahydrofolate” in the Supplement Facts table of the supplement bottle.  If “folic acid” is listed on the label, don’t use it!
• Do not buy a cheap multivitamin with folic acid thinking that it’s better than nothing, especially if you have a family history of colon cancer
• Eat plenty of dark green leafy vegetables daily, preferably organic
• Consult an experienced and knowledgeable nutritional expert who knows and understands the nuances of nutrition and keeps up-to-date with current research.  Test them: have them explain the differences between folic acid, folate and L-5 methyltetrahydrofolate. If they can’t, find someone else.

As promised, key reasons why “eat your vegetables” is absolutely one of the best piece of advice:

1. Dark green leafy vegetables such as kale, Swiss or rainbow chard, mustard greens and collard greens, contain folate in high amounts.
2. Nutrients work synergistically.  Vegetables have various nutrients that work together in your body.

If you have any questions regarding folic acid or help with where to buy multivitamins/supplements that contain folate, contact me whether or not you are in the San Francisco bay area.

Dr Douglas Husbands is a chiropractor, functional medicine doctor, nutritionist and anti-aging practitioner in the San Francisco bay area.  His chiropractic and wellness clinic is located in San Carlos, CA.

Copyright 2010. Douglas Husbands, DC, CCN, ABAAHP. All rights reserved.

References:

The chiropractic method I am referring to is called Cox Flexion Distraction. Statistics show the success rate of the use of Cox Flexion Distraction for eliminating the lower back pain and resolving the following causes of lower back pain is between 89% and 95% within about 8 to 10 weeks of treatment:

• disc protrusions, disc bulge, herniated disc
• stenosis (narrowing of the spinal canal)
• lateral recess stenosis (narrowing of the canal where the spinal nerves exit)
• lower back facet syndrome (lumbar facet syndrome)

It is so effective for treatment of the above conditions that many patients were saved from having surgery.  Surgeries are not only expensive, they come with great risks.  Having used this method for over 18 years, I’ve saved my patients from the discomfort, temporary disability and expense of low back surgery.  One patient I am currently treating using Cox Flexion Distraction shared with me that her primary care doctor recommended that she stop her treatments with me and see a neurologist for the stenosis.  She responded by saying, “Why would I do that?  I’m getting better with this treatment.  The pain is decreasing…”

Cox Flexion Distraction is performed by using a specially designed chiropractic table.  To perform the procedure the patient lays either face down, or even on their side if in extreme pain. The doctor then gently and slowly moves a section of the table below the patients waist, which has the effect of “suctioning” the bulging disc material away from the nerve being irritated.  The term “suctioning” might lead you to believe that this is a painful procedure.  It is actually a gentle and safe procedure.    It gently opens up space in the irritated segment.  It gently provides controlled motion so that any inflammatory byproducts can be mobilized from the area.  I’ve used this on patients with severe acute pain and frail osteoporotic women with excellent results.

Click the link here for additional information on this particular chiropractic procedure.  If you have questions regarding this procedure, or to schedule an appointment at our office, contact us.

Dr Husbands is a Chiropractor, a Certified Clinical Nutritionist, an Anti-Aging Healthcare Practitioner and a Functional Medicine Doctor. For more information, visit http://www.drhusbands.com.

Copyright © 2009; Douglas Husbands, DC, CCN, ABAAHP. All rights reserved.

1. Pharmaceutical Therapies
2. Nutritional Support
3. Manual Therapies
4. Rest, Recovery and Energy Therapies 

Pharmaceutical Therapies

The over-the-counter and prescription drugs for pain (pain killing or pain blocking) are widely used, primarily due to the mass-marketing of drug manufacturers.  However, their side effects have to be dealt with sooner or later.  The most commonly reported side effect is gastrointestinal bleeding caused by aspirin and ibuprofen-based drugs.  These are also called NSAID’s (non-steroidal anti-inflammatory drugs).  It’s estimated that 41,000 people each year are hospitalized from the side effects of NSAID’s and 6,000 people each year die from complications directly related to NSAID’s.

Nutritional Support

Foods

Chronic pain is very often associated with chronic inflammation.  Anti-inflammatory foods are those which have the effect of being less acidic, and more alkaline.  Examples of foods that are highly alkaline are: pumpkin seeds, lentils, brocoflower, sea vegetables, sweet potatoes, yams, garlic, asparagus, kale, mustard greens nectarines, and limes (yes, limes are also highly alkaline).  To get the most effective pain-reducing diet consult a Certified Clinical Nutritionist.

Dietary Supplements, Nutrient Cofactors, Herbs

B-vitamins, inositol, zinc and antioxidants are critical for healing nerve-oriented pain (neuropathies).  Magnesium, B-vitamins, antioxidants, zinc, iodine, selenium and malic acid are critical for muscle pain.  Fish oil has powerful anti-inflammatory properties, therefore pain decreasing effects.  Co-enzyme Q10 is critical for anyone taking cholesterol lowering medications which often cause muscle pain and weakness.  D-Ribose is necessary for making energy in the cells and decreasing pain.  Proteolytic enzymes are highly beneficial for decreasing chronic pain, as well as acute pain.  Turmuric (Curcuma longa), Tetrahydro-iso-alpha acids from hops (Humulus lupulus), Boswellia serrata, Ginger (Zingiber officinale), Cayenne pepper (Capsicum annuum) are herbs very beneficial for pain.   Arnica is a homeopathic remedy highly useful for pain relief.  To safely and effectively use any combination of the above, consult a doctor trained in Functional Medicine.

Manual Therapies

Rest, Recovery and Energy Therapies

Examples of Pain Relief or Getting Rid of Pain

“After several years and several different approaches to finding relief for neck and shoulder pain, I found Dr. Doug. With a new approach and better understanding of the source of my pain came new relief.  To this day I can better manage the pain and my over all health has remained high.  At 57 I still race motocross and play high level tennis three nights a week. Thanks again Dr. Doug.” -LC from Northridge, CA

“I’ll never forget how when I was in so much pain… We will always remember the considerate way you cared for us and the excellent treatment you always gave us.  I tell the story all the time about how you diagnosed my (low back) disk problem, identifying the exact spot, with just an x-ray–something the doctors never did, until finally an MRI confirmed what you had already found!  And how you gave me such relief from pain! Thank you very much.” -JB from Northridge, CA

“I have suffered from GI problems my entire life.  It eventually got to the point where I wasn’t sleeping, couldn’t eat any raw food, and was generally exhausted all of the time.  What I liked most about Dr. Husbands’ approach was that he conducted tests that identified the issues and put me on the path to resolution. With a combination of diet modifications and supplements I now sleep well every night, can eat raw food, and have significantly more energy.” -JB from Redwood City, CA

Contact me to assist you or a loved one for chronic pain relief or to get rid of your pain.

Here are some tips for controlling your insulin response.

1. Always eat breakfast containing some proteins, fat and carbohydrates within 30 minutes of waking up.

Your cortisol levels are highest when you wake up in the morning. Your energy upon awakening before breakfast is produced mostly by cortisol which breaks down lean tissue (bones, muscles, joints, skin) to make glucose to keep your brain and body running. Decreased lean body tissue will lead to accelerated aging.

2. Don’t have coffee first thing in the morning before breakfast.

Caffeine stimulates cortisol output. See #1.

3. Exercise an hour a day 5 or 6 days a week, preferably in the morning.

Besides insulin release, exercise is the only way food is used for energy rather than stored as fat or glycogen. With excess carbohydrate consumption, the excess is rapidly converted into triglycerides and then stored in fat tissue, and a little stored as glycogen in the liver and muscles. When you exercise in the morning, your body cannot store fat as easily because it is using more energy for the rest of the day. This increases your body’s sensitivity to insulin.

4. Eat small, frequent, healthy, well-balanced meals and snacks about every 3 hours throughout the day.

Your pancreas release insulin when you eat. Eating smaller frequent, healthy meals and snacks causes gradual fluctuations in insulin release, more stable glucose levels, and more stable energy and moods. It also helps your body burn calories more efficiently. In comparison, when you eat every 6 hours or more, you get a meteoric spike of insulin. This makes the pancreas work harder, and causes greater fluctuations in glucose and your energy level. Furthermore, your body will store fat more easily.

5. Eat at least 7 to 9 servings of dark green leafy and brightly colored vegetables and fruit each day (a serving of fruits and vegetables is about the size of a baseball, before cooking).

Vegetables and fruits contain a wide variety of vital nutrients that have properties which balance hormones, help prevent infections, help your body’s recovery from stress and injury, help your body burn calories efficiently and help you maintain stable insulin output and glucose levels. In general, the deeper the color, the more nutrient dense it is.

6. Drink at least 1/2 ounce of water for each pound of body weight each day.

All processes in the body occur in the presence of water.

7. Have 2 to 3 bowel movements each day (if you do the above regularly, this will likely happen)

Besides urinating and sweating, our body cleans itself of toxins through bowel movements. If you do not have 2 to 3 bowel movements each day, you are consistently and slowly building up toxins in your system. Over time, this has harmful effects to all body systems, including insulin levels.

8. Keep a stable temperament and a positive attitude.

Our brains and nervous system are the master control regulators of all bodily functions. Negative dispositions, such as moodiness, irritability, anger, bitterness, unforgiveness and ingratitude negatively affect all hormones and digestive processes, accelerate aging and makes us more susceptible to harming ourselves or others.

9. Get 7 to 8 hours of sleep each night and don’t stay up later than 10 PM at night.

Melatonin (the sleep hormone) is released in response to decreased light. Melatonin is a very powerful antioxidant for the brain cells. Growth hormone (the main recuperative, repair and recovery hormone) is released in 10 to 20 minute pulses about every 1-2 hours during deep sleep at night. The longer you stay asleep the more total growth hormone output and the more repair and recovery from daily stress. With consistent, good night’s sleep, less cortisol is produced. This results in less stress on your body, less fat deposited around your waist and less aging. All these hormones coordinate with insulin response.

Dr Husbands is a Doctor of Chiropractic, a Certified Clinical Nutritionist, an Anti-Aging Healthcare Practitioner and a Functional Medicine Doctor. For more information, visit http://www.drhusbands.com.

Copyright © 2009; Douglas Husbands, DC, CCN, ABAAHP. All rights reserved.