Folate Levels Influence Depression Symptoms

By , SparkPeople Blogger
Previous studies have found an inverse relationship between B vitamins and homocysteine levels. Likewise, higher homocysteine levels have been linked to atherosclerosis and higher risks of fatal coronary heart disease (CHD) and strokes. CHD studies have found a reduction in the average level of homocysteine since folic acid fortification was instituted in the U.S. A new study ties low serum folate levels with increased risk of depression symptoms as well. The cross-sectional population-based study is one of the first conducted among U.S. adults since the mandatory fortification of folic acid. The study also looked at vitamin B12 and total homocysteine (tHcy) levels as well.

Folate is a water-soluble B vitamin naturally occurring in food. Folic acid is the synthetic form added to foods for fortification or in supplements. Diets rich in whole foods typically are rich in folate since leafy green vegetables, citrus fruits and dried beans and peas all provide natural sources. Since the 1996 FDA requirement of folic acid fortification, enriched breads, cereals, flours, pastas, rice, and other grain products, provide other popular sources to the American diet. Since depression is a common medical condition, surrounded by myths and misconceptions about its causes, symptoms and seriousness, learning more about its relationship with folate levels could be beneficial for those that are trying to cope.

Researchers for the study, published online last month in Psychosomatic Medicine, used cross-sectional information from NHANES data collected from 2005-2006. Data from more than 2,500 adults between 20-85 years of age were included. In addition to folate, vitamin B12, and total homocysteine levels, researchers also looked at data related to demographics, diet, physical activity, smoking habits, blood pressure, and depressive symptoms. The study indentified a significant association between folate levels and elevated depressive symptoms as well as elevated homocysteine levels especially in people over the age of 50.

So what do these results mean for those dealing with depression issues?

Blood tests to evaluate folate and homocysteine levels may be of benefit. Identified out of balance levels would suggest dietary strategies could be beneficial to mood improvement. It is also important to be aware of medical conditions or medications that could be interfering with folate metabolism, which could result in low serum levels despite adequate intake amounts.

Medical conditions which increase need for folate or increased losses of folate include:

  • pregnancy and lactation
  • alcohol abuse
  • Malabsorption syndromes

  • Kidney dialysis
  • Liver disease
  • Certain types of anemia
Medications that may interfere with folate utilization include:

  • Anticonvulsants
  • Metformin
  • Sulfasalazine
  • Triamterene
  • Methotrexate
  • Barbiturates
Common subtle signs of folate deficiency include:

  • Diarrhea
  • Loss of appetite
  • Weakness
  • Sore tongue
  • headaches
  • heart palpitations
  • Irritability
  • Forgetfulness
  • Behavioral disorders
The Bottom Line

A new study found a correlation between depression symptoms and low serum folate levels. There are a variety of medical conditions and medications that can negatively influence folate absorption. The RDA for folate for adults is 400 ug/day for both males and females with an increase for woman who are of child bearing age to a minimum of 600 ug/day. To be sure you have a diet rich in folate or folic acid, eat a balanced diet. Include natural sources of folate such as beans, lentils, orange juice, and leafy greens as often as possible. Fortified sources of folic acid also supply a well balanced diet through enriched breads, cereals, flour, corn meals, pastas, rice, and other grain products. Be aware of the folic acid content of vitamins and supplements and your overall folic acid intake from those and other fortified and enriched foods and speak with your medical professional regarding any symptoms you may be experiencing especially if you have a medical condition or take a medication that could reduce folate use by the body. Serum blood evaluation may be beneficial in those situations.

Have you dealt with depression issues at any time in your life? Do you have any medical conditions or take medications that could be influencing body folate use? What are some of your favorite folate rich foods or meals?

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I'm just sayin'... my mom used to make sure we had extra B's in our diet, especially around "that time" of the month... smart woman! Report
I meant... the approach is NOT the same as one would expect from Scientology. Report
#15 Yes, good point about correlational studies, but I think you may have misinterpreted the quoted excerpt. Saying that it's surrounded by myths is not the same as saying that depression itself is a myth. Whatever the merits of the study, I don't believe the overall approach was not the same as Scientology. Report
That's striking to me, because in the late '60s and early '70s, I was in a boarding school where, if you showed a lack of appetite or other signs of depression, you were put on a course of daily vitamin B shots that invariably stimulated appetite -- and weight gain. And that was long before the studies. Since all of the food came fresh from the local countryside, it was probably already rich in folate. (It was in Italy, by the way) Report
Nutrition is absolutely connected to depression. I have used a protocol consisting of nutritional supplementation combined with adequate sunlight and excercise for twenty years to control my depression. The amounts of nutrients that I use are much higher than the RDA amounts. Folate alone will not do it. A book by Dr. Patricia Sleigle, The Way Up from Down saved my life by providing me with the protocol. My son also uses the protocol as he has inherited my serotonin deficiency. It requires alot more work than just taking a medication once a day, but all of the side effects are good. Report
I have a hereditary blood disorder AND take Metformin, so I know I'm at risk. B vitamin supplements have made a big difference for me. If anyone has a question of whether or not they NEED more Bs, take the supplements. They're water soluble, so it's very difficult to get too many, and you'll be able to sort out if it helps you or not. Homocystine levels play a huge role in so many areas of our health, and scientists are just beginning to understand some of the complex relationships within our bodies that lead to health or illness. Report
A big mistake people seem to make is to think correlation means causation. In some cases there may be a link, but most often the link is coincidental. Low folate levels may be due to depressed people not eating a balanced diet (a much more likely scenario).

"Since depression is a common medical condition, surrounded by myths and misconceptions about its causes, symptoms and seriousness, learning more about its relationship with folate levels could be beneficial for those that are trying to cope."

This is an unfortunate inflammatory statement that reflects opinion rather than science. To suggest depression isn't serious is absurd. This reads more like Scientology propaganda rather than an accurate reporting of a study. Cherry picking evidence to support a worldview is not at all useful and in some cases downright harmful. Report
I suffer from severe, persistent depression, so this study is of great interest to me. I also take Metformin for diabetes, which is listed as possibly interfering with folate levels. In addition to taking a daily multi-vitamin, I eat a lot of baby spinach and drink orange juice, so hopefully my levels are okay. I don't seem to be having any of the symptoms listed, aside from those caused by the depression itself. This is an interesting study, thanks for providing us the information in an easy to understand format. Report
I take FLINSTONE Chewable Vitamins, since the absorb completely. I took Prozac for about 15 years and it helped me to feel NORMAL, as I had gotten so I felt like I was walking through MUD and going get anywhere. It just made me feel normal. I quit drinking COKE, so I feel much better now. I drink TEAS and Lemon water. Report
I've suffered with clinical depression all of my life. I'm not currently taking any medications that could interfere with folate levels. I am not terribly surprised that nutrition and mood are related, and I try really hard to eat/exercise for my mental health as well as my physical health. Fortunately, I eat a lot of beans, so I imagine my folate levels are pretty darn good. Report
I dealt with depression after the birth of my first son. I didn't know that is what it was then and now that I look back at it, I just remember being in a deep fog. I do remember wanting to harm my son in a terrible way. Fortunately, a friend's mom told me that it was normal (she didn't know what awful thoughts I was having) but after asking the usual "how are you?", she went on to describe how she was after giving birth and described in detail everything I was feeling and could not put into words. When I did admit that I was indeed feeling that way, she comforted me, told me that it would go away in 6 weeks, and encouraged me to hold on. I did. 6 weeks to the day the "fog" lifted. However, I think if I knew about the connection with folate, I would have made sure to eat lots of kale, spincach, and collards during this time to at least lessen the density of that fog. Report
gee i do not know how to treat depression . I know it is real . and not all in thier heads. Report
I would definitely lean to not taking grains or "fortified" anything if you could help it (if you have to "fortify" it's not very healthy IMO). I suffered a lifetime of depression from damage to my intestines from eating "healthy whole grains" ... your gut health is paramount to mental health. It doesn't matter if you take more supplements; that's like a hamster on an exercise wheel trying to keep up.

No doctor ever checked my folate, though they did check B12, which was "borderline" normal, so nothing was done. My RDW or "red cell distribution width" was for years ABnormal and large (megoblastic anemia I now know)- an indication of low B vitamins. I kept asking about it, and they brushed it off. I was diagnosed with celiac disease 10 years later (no gut pains, but LOTS of depression and fatigue). I have learned to take my health into my own hands, to not rely on doctors.

Some people might also have pernicious anemia, another autoimmune condition where the body doesn't make "intrinsic factor" which helps make and absorb B12. Some people might also have gastritis - eating too much "acid" foods (ie grains, meat, dairy, legumes) can cause this IMO and experience.

Eat green. ;0)
I can believe that folate levels really do influence depression. Since I've started taking extra folic acid along with a B complex vitamin with folic acid added and my multivitamin I've felt less depressed, more energetic and focused. I am taking all of this under a doctor's supervision because I take methotrexate weekly. Report
Pregnancy & depression isn't a good example since there are MASSIVE hormonal changes and body changes going on.

METFORMIN taking people SHOULD BE ON folate supplementation. Many drugs affect folate. I'm surprised Doctor didn't say anything.

Linda, R.N. Report
It's only one study, but the sources for folate are also healthy foods so increasing them sounds like win-win. Personally, I've never suffered from clinical depression but I tend to respond to stress with depressive symptoms, especially insomnia. Since I've been eating healthier and including some of these foods, I'm able to sleep better. Coincidence? Report
I'd like to know more about Metformin's possible interference with folate. I've been on Metformin for months now. And apparently, according to the SP nutrition tracker, my intake of folate is deficient, so I've just recently started taking a multivitamin again. But since I've struggled with anxiety and depression in the past, I'd definitely like to find out more about this possible connection! Guess it's time to eat a huge salad and get researching! Report
SUZYMOBILE - The tracker is set up to track percentages so that it's in line with nutrition labels that indicate % not milligrams, micrograms or other units of measure, depending on the nutrient. Report
How come, if the most recent RDA is 400, the goal in the SparkPeople Nutrition Tracker is only 100-250?? Should I go in and increase it manually? Wouldn't it be better to set it where it should be? Report
My doctor has me on B100's. Since starting to take them I do have more energy and I feel better. I'm also taking Vitamin D3 everyday. I do notice a difference! Report
I'm not sure about this...during the early part of my pregnancy I was depressed beyond belief and eating massive amounts of folate. Report
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