​According to Healthline, folic acid is a water-soluble vitamin used in different supplements and foods that have been fortified. The naturally occurring form is called folate, while the synthetic form of this is called folic acid. This vitamin exits the body quickly and needs to be replenished daily, especially if you take medications that deplete this vitamin from the body. Your body converts the folic acid back to the active form of folate for your body to use, but some people have a genetic inability to activate this nutrient when it is consumed. This issue causes high homocysteine levels in the body, which is not ideal for your overall health and wellness. Folate also plays a vital role in cardiovascular disease. Folate, Coenzyme Q10, and many other B vitamins protect your heart; if you run out of these nutrients, your heart struggles.
 
Blood tests allow you to see your current levels - you want them below seven micromoles per liter of blood. Levels above thirteen give way to high-risk circumstances for heart attack, stroke, inflammation, Alzheimer's and Parkinson's diseases, autoimmune disorders, pain, cervical and uterine, and cancer. (*confirmed by a 2009 study published in Cancer Epidemiology, Biomarkers, and Prevention)
 
Folate is necessary for the body's detoxification process, which is referred to as methylation. The methylation process involves deactivating and clearing toxins from the body. Low folate levels mean more toxins in the body. DNA methylations slow down about 1700 cancer-promoting genes. Your body must methylate, but some are not able to because of their genetic makeup. These people need extra folate in the 5-TMHF form, which is available at our pharmacy.
Here are some great sources of this nutrient: 

• Romaine lettuce
• Spinach
• Asparagus
• Turnip greens, mustard greens, collard greens
• Broccoli
• Cauliflower
• Beets (boiled)
• Lentils
• Pinto beans
• Black beans
• Chickpeas
• Summer squash
• Papaya
• Lima beans
• Strawberries
• Flaxseed

*make sure these are cooked in a healthy way, of course.
 
Folate deficiency can also cause atherosclerosis (hardening of the arteries), depression, irritability, pale skin, megaloblastic anemia, low energy, confusion, forgetfulness, and diarrhea. Folate also plays an essential role in cardiovascular disease. Folate, Coenzyme Q10, and many other B vitamins protect your heart. Suppose you run out of these nutrients, your heart will struggle. Freedom Pharmacy puts unique stickers on the bottles of medications, indicating the need for supplementation. We know the importance of correcting drug-induced nutrient depletions to keep disease states from getting worse or others from occurring. 
Medications that can deplete this nutrient: 

• Acid Blockers
• Analgesics (pain medications)
• Antacids
• Antibiotics
• Anticonvulsants
• Anti-Inflammatory drugs
• Antimetabolites (Methotrexate)
• Antivirals, Barbiturates
• Blood Pressure Drugs
• Cholesterol Agents
• Corticosteroids
• Diabetes Medications
• Hormone Replacement Therapy & Birth Control Pills
• Muscle relaxant (Soma)
• Drugs used for breast cancer (Aromatase inhibitors and estrogen receptor modulators)
• Aspirin
• SSRI Antidepressants
• Alcohol
• Estrogen Dominance (from foods and environmental factors)

What is vitamin B12?
Vitamin B12 is a water-soluble vitamin, which also goes by the name cobalamin. Vitamin B12 is imperative to our health and serves a diversity of roles in the body, including: 

• Assisting with DNA creation 
• Helping generate red blood cells
• Supporting the body in forming nerves 
• Nervous system regulation

​What are some sources of Vitamin B12?
Our bodies do not make vitamin B12. Instead, we must get this nutrient from food sources or supplements. Unfortunately, this attributes to the fact that many are not getting enough of this nutrient, which leads to vitamin B12 deficiencies. 
Animal foods, such as grass-fed beef, fish, dairy products, cage-free eggs, and poultry, contain naturally occurring vitamin B12. Some other sources of this vitamin come from foods that have been fortified with vitamin B12. These include plant-based milks and different types of bread. We suggest reading nutrition labels to check if your food has been fortified with vitamin B12. 

Who is at risk for a vitamin B12 deficiency? 
According to health professionals, there are many ways in which a vitamin B12 deficiency originates. Those who are most at risk for a vitamin B12 deficiency include: 

• Elderly populations
• Those who have had surgery that removes a portion of the bowel that absorbs this nutrient 
• Diabetes patients who take Metformin (*Note: The drug Metformin depletes your body of this nutrient, so be sure to speak with one of our pharmacists or your healthcare provider about replenishing your body of this.)
• Those who are practice vegan-based diets

Other populations potentially at risk for vitamin B12 deficiencies include those who have: 

• Gastritis
• Pernicious anemia 
• Conditions affecting the small intestine, e.g., Chron’s disease and Celiac disease
• Alcohol misuse
• Immune system disorders including Lupus or Grave’s disease 

Aside from Metformin, what other medications affect the body’s ability to absorb vitamin B12? 
Certain heartburn medications: 

• Esomeprazole (Nexium)
• Pantoprazole (Protonix)
• Rabeprazole (Aciphex)
• Lansoprazole (Prevacid)

H2 blockers including: 

• Cimetidine (Tagamet)
• Famotidine (Pepcid AC)

What are some signs and symptoms of a vitamin B12 deficiency? 
Warning signs and symptoms of a vitamin B12 deficiency may take months or even years to appear, making the diagnosis process even more difficult. Some significant signs and symptoms of a vitamin B12 deficiency include: 

• Jaundice or pale skin
• Elevated temperature
• Dizziness or Breathlessness
• Weakness
• Fatigue
• Blurred or impaired vision
• Changes in mood
• Pins and needles sensation in the body
• Mobility issues
• Mouth ulcers or Glossitis

If you, a family member, or a friend are experiencing signs and symptoms of a vitamin B12 deficiency, please consult with your healthcare provider. Freedom Pharmacy has a dedicated team ready to assist you with your health and wellness journey. Our pharmacists are prepared to suggest daily lifestyle changes, supplements, and more for you to start feeling like your best self! Stop by today to talk with a pharmacist about creating a healthier lifestyle plan personalized just for you. We are conveniently located at Midtown in Hattiesburg at 3902 Hardy Street.


Sources: 
Smith, M. W. (2021, May 3). Vitamin b12 deficiency: Causes, symptoms, and treatment. WebMD. https://www.webmd.com/diet/vitamin-b12-deficiency-symptoms-causes#1. 

West, H. (2017, October 7). 9 signs and symptoms of Vitamin B12 deficiency. Healthline. https://www.healthline.com/nutrition/vitamin-b12-deficiency-symptoms#Supplements-101:-Vitamin-B12.