Can Lack of Folic Acid Cause Depression?

Studies identify a link between folate deficiency and depression; however, having low folate levels doesn't always result in depression.

Depression is a complicated disorder with numerous causes. Several studies have identified a link between low folate levels and depression. Folic acid is required for the formation of the neurotransmitters serotonin, norepinephrine, and dopamine, which are known to be deficient in depression.

According to the literature, depression is associated with folate deficiency, and patients with low folate are less likely to respond to treatment and more likely to relapse.

Some individuals benefit from folate supplementation, although the concept is a bit complicated.

• Folic acid does not, by itself, cure depression. Before the brain can produce enough serotonin, norepinephrine, and dopamine to treat depression, it must convert folic acid into L-methylfolate.
• However, some people cannot convert folic acid to L-methylfolate, making folic acid supplementation ineffective for them.
• The methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism, which is relatively frequent in people with depression, causes this processing deficit.
• Those people must avoid using folate and instead, supplement L-methylfolate.

Of course, this does not imply that having low folate levels will always result in depression, or having normal folate levels will avoid depression.

According to the Centers for Disease Control and Prevention (CDC), less than one percent of the population is truly deficient in folate. However, some people are more susceptible to folate deficiency than others.

Folic acid deficiency can result from one or more of the following factors:

• Lack of folic acid in the diet
• Poor folic acid absorption through the gut
• Increased need for folic acid usually due to pregnancy
• Medical treatment or medicine that is blocking absorption or increasing the need

Risk factors of folic acid deficiency

Factors that lead to poor intake include:

• Limited consumption of fresh, minimally cooked food
• The long-term need for intravenous nutrition (total parenteral nutrition)
• Alcoholism

Conditions that can lead to poor absorption include:

• Inflammatory bowel disease
• Celiac disease or other malabsorption disorders
• Certain medications, such as anticonvulsants and oral contraceptives
• Bariatric surgery

Increased need for folic acid because of:

• Pregnancy or breastfeeding
• Cancer

Other conditions that can affect folic acid levels are:

• Liver disease
• Chronic hemolytic anemia
• Kidney diseases
• Certain medications, such as methotrexate
• Elevated homocysteine levels in the blood

One of the most frequent vitamin deficiencies is a lack of vitamin B9, also called folate (a naturally occurring folate molecule found in foods) or folic acid (a synthetic folate compound utilized in vitamin supplements due to its greater stability). Folic acid is a B vitamin that helps the body produce red blood cells. Red blood cells transport oxygen throughout the body.

When organs do not obtain enough oxygen, they do not function well and may present with symptoms, such as:

1. Tiredness
2. Irritability
3. Dizziness
4. Diarrhea
5. Constipation
6. Loss of appetite
7. Ulcers in the mouth
8. Numbness and tingling sensations in fingers and toes
9. Sore tongue
10. Change in taste
11. Distorted or blurry vision
12. Muscle weakness, including muscle strain
13. Discoloration of the skin or nails
14. Premature gray hair
15. Hair loss
16. Headaches
17. Pale skin
18. Heart palpitations
19. Breathlessness
20. Depression
21. Feeling confused
22. Difficulty remembering things
23. Problems with understanding or judgment
24. Severe deficiency leads to a condition in which the bone marrow produces oversized immature red blood cells (megaloblastic anemia)
25. In pregnant women, folic acid deficiency can result in severe or even fatal birth defects, such as neural tube defects

A blood test will most likely be required to detect folic acid deficiency and help identify the underlying cause.

Depression is caused by a chemical imbalance in the brain; it is a treatable disorder. Depression is typically treated with antidepressants or other drugs, psychotherapy (talk therapy), or a combination of these approaches.

Antidepressants

• Selective serotonin reuptake inhibitors (SSRIs)
  • The most often prescribed antidepressants, SSRIs, raise serotonin levels in the brain, which are believed to help regulate body temperature, sleep, mood, appetite, and pain.
  • The term "selective" refers to the fact that SSRIs only affect serotonin and not norepinephrine or dopamine. They reduce serotonin reabsorption (i.e., reuptake) into neurons, making more serotonin available for enhanced neuron communication.
• Serotonin and norepinephrine reuptake inhibitors (SNRIs)
  • SNRIs increase the levels of the neurotransmitters serotonin and norepinephrine in the brain by preventing their reabsorption.
  • In addition to blocking serotonin uptake, SNRIs influence norepinephrine levels, which are known to control attention, emotions, sleep, and learning.
• Monoamine oxidase inhibitors (MAOIs)
  • They function by blocking the breakdown of neurotransmitters in the brain, such as serotonin, norepinephrine, and dopamine, by an enzyme called monoamine oxidase. These medications are not as often utilized these days because they have undesirable side effects.
• Tricyclic antidepressants (TCAs)
  • TCAs limit serotonin and norepinephrine reabsorption in the same way that reuptake inhibitors do. They influence other brain chemicals. TCAs are becoming less popular due to undesirable medication interactions and unpleasant side effects.
• Atypical antipsychotics
  • These "atypical" second-generation antipsychotics influence dopamine and other neurotransmitters and are less likely to cause adverse effects.
  • They are generally used to treat psychosis, but research suggests that they can help those with depression and anxiety disorders.
• Ketamine
  • Lower doses of ketamine, which were originally used as a kind of anesthetic, have been demonstrated to reduce symptoms of depression within hours.
  • One prevalent explanation holds that ketamine attaches to the N-methyl-D-aspartate receptor in the brain, increasing the activity of the neurotransmitter glutamate.
  • Glutamate has been demonstrated in studies to improve mood, mental patterns, and cognition.

Most of the medications to treat depression have side effects, which may include:

• Nausea
• Diarrhea
• Irritability
• Insomnia
• Decrease sexual desire
• Headache
• Weight changes
• Constipation
• Mania

However, these adverse effects vary with people, and doctors frequently tailor treatment to the individual, which increases the likelihood of success.

Besides medical treatment, patients can try a combination of the treatment methods, such as:

• Psychotherapy includes cognitive behavioral therapy, family-focused treatment, and interpersonal therapy.
• Exercise can help prevent and treat mild-to-moderate symptoms.
• Brain stimulation techniques can be tried if psychotherapy and medicines are ineffective. Example treatments include electroconvulsive therapy for significant depression with psychosis and repetitive transcranial magnetic stimulation for severe depression.
• Light therapy is a method of regulating the hormone melatonin by exposing a person to full-spectrum light via a lightbox.
• Acupuncture, meditation, and a balanced diet can be used in conjunction with a comprehensive treatment plan.

Depression is a serious illness that necessitates careful, continuing treatment with talk therapy, medication, or a combination of the two. The research on folic acid and depression is still in its early stages.

• Inquire about folic acid with the doctor because it may be beneficial when taking depression medications.
• There have been a few extensive studies on whether folic acid supplements can help people who are depressed.
• A meta-analysis of several clinical trials revealed no benefit to short-term use. Long-term use, however, may reduce or postpone relapses in certain people.

If there is a lack of folic acid, the doctor may advise taking a multivitamin and mineral supplement regularly, as well as increasing the intake of foods high in this vitamin, such as:

• Fortified breakfast cereals
• Spinach
• Chickpeas, pinto beans, and lima beans
• Papaya
• Avocado

Dietary nutrients are necessary for the structure and function of the brain. Dietary changes can reduce the likelihood of developing any psychiatric disorder. A few studies show that certain foods and nutrients influence a wide range of neurochemicals. However, mental health problems can be severe. In that case, contact the doctor and family.

1. Omega 3 fats (polyunsaturated fats): Essential for good health and help maintain neuronal structure and function. Using omega-3 supplements can help with symptoms of depression, bipolar disorder, post-traumatic stress disorder, and anxiety.
   • Omega-3 is found in foods such as:
     • Nuts
     • Seeds
     • Oysters
     • Sardines and salmon
2. B vitamins: Vitamin B is required to produce many brain chemicals and carry out cellular and metabolic processes. Many people with depression are found to have folate (B9) deficiency. Many studies show that the synthetic form of folate, folic acid, has antidepressant properties.
   • B vitamins, including folates, are found in foods such as:
     • Eggs
     • Cheese
     • Dairy
     • Whole grains
     • Nuts
     • Leafy green vegetables
     • Legumes
     • Meat
     • Whole grains
     • Brewer's yeast
3. Minerals: Zinc, magnesium, and iron are important for the neurological functions of the brain. Zinc is necessary for the immune system to function properly. A lack of these can lead to an increase in depressive and anxiety symptoms.
   • Foods that are rich in these minerals include:
     • Lean meats
     • Oysters
     • Whole grains
     • Pumpkin seeds
     • Nuts
     • Unprocessed meats and organ meats, such as liver
     • Leafy greens
     • Dark chocolate
     • Cacao nibs
     • Spinach
     • Soy
     • Fruits
4. Amino acids: Neurotransmitter deficiency can lead to illness and disease. An imbalance can cause panic attacks and insomnia. However, these neurotransmitters are made from amino acids obtained from protein consumption. These amino acids serve as a foundation for enzymes that convert the amino acids into the most needed neurotransmitters. Some evidence suggests that amino acids can help people suffering from bipolar depression, schizophrenia, trichotillomania, and other psychological disorders.
   • The amino acid can be obtained from any protein source, such as:
     • Meats
     • Seafood
     • Eggs
     • Nuts
     • Legumes
5. Vitamin D:
   • It is a lipid-soluble vitamin. Aids in bodily functions, such as the bones, heart, brain, and mental health. It has been suggested that a lack of vitamin D can contribute to depression.
   • Vitamin D alone will not treat or cure depression, but a lack of it increases the likelihood of depression.
   • It is an indicator of overall good health, but more research is required to prove that vitamin D can affect a person's mood.
   • The best source of vitamin D is the early morning sunlight. Other sources are fatty fish, eggs, red meat, liver, and fortified foods.

A well-balanced diet is the best way to get all the nutrients. When this is not possible, supplements can come in handy. This article is not intended to be a substitute for medical advice. Before using any supplements or herbal medicines, please consult a doctor.