By the ANH Team

Recent work by a team from the Universities of Manchester and Lancaster in the UK, and published in the Journal of Neuropathology and Experimental Neurology showed that a combination of folates dramatically reduced the rates of hydrocephalus, a common birth defect, in which fluids build up in the brain’s chamber.

The team are hoping to begin clinical trials in pregnant women with babies diagnosed with the condition. A BBC health news item states that ‘the supplement itself is not currently available, so they are also seeking the support of a pharmaceutical company willing to produce it as a pill’.  So whilst its encouraging to see research showing that folates (the way nature intended) may have the answer to tackle hydrocephalus in babies—its unfortunate that big Pharma holds the patents on both synthetic AND natural folates!

Read the full BBC health news article.

The reference and abstract for the paper is given below:

Cains S, Shepherd A, Nabiuni M, Owen-Lynch PJ, Miyan J. Addressing a Folate Imbalance in Fetal Cerebrospinal Fluid Can Decrease the Incidence of Congenital Hydrocephalus. J Neuropathol Exp Neurol. 2009 Mar 12 [Epub ahead of print].

Which folate?  Food-form or synthetic?

Folates, which are part of the B vitamin ‘family’ of nutrients and are sometimes referred to as vitamin B9, are found in polyglutamate forms in green leafy vegetables, oranges, beans, asparagus and rice. They have long been known to play a role in the prevention of serious birth defects, as well as in that of a whole host of other conditions ranging from the prevention of cancer and heart disease to depression.

Around 90-95% of the folate in green leafy vegetables is typically evenly divided between methyl and formyl polyglutamate forms. The amount of monoglutamate folic acid—the sort found in the majority of multivitamin supplements—is actually trivial.

Pharma control

Isn’t it interesting that the most important formyl form, folinic acid, is already reserved for medicinal use (the generic name for it is Leucovorin), and it is widely used as an adjunct to chemotherapy both because it reduces the toxicity of chemotherapeutic agents and has tumour protective effects in its own right. At the same time, the most important methyl form of folate, the calcium salt of 5-methyltetrahydrofolate (5-MTHF) has been tied up by the dominant pharmaceutical company in the game of manufacturing synthetic forms of vitamins and minerals, namely the German giant Merck. 

Merck has several patents out on 5-MTHF and it is almost impossible for any company to use this product in a food supplement, unless the patented version of the product is supplied by Merck. We have heard of several companies being refused supply of 5-MTHF by Merck! Whilst the nutrient form of 5-MTHF was added to the positive list of the EU’s Food Supplements Directive in 2006, the fact that a drug company controls its supply, while being protected by a patent, means the market is hardly a free one.

Folic acid (in its monoglutamate form) is widely used as a supplement ingredient—it can be found in the vast majority of multivitamin and multi-vitamin/mineral products. It is currently recommended both for pregnant women, and for women planning pregnancy, specifically to prevent the birth defect, spina bifida. Most GPs recommend levels of 400 micrograms for women of child-bearing age, with higher levels for women at particular risk of giving birth to an infant with the condition.

Used in isolation, the new research tells us that folic acid ‘does not appear to promote brain cell growth in the same way as the combination (of folates). This finding is of course hardly surprising to those familiar with the way that folates—like so many other nutrients—work synergistically in the body. Research has always shown the importance of the synergies associated with nutrients present in nature and the food matrix and it is these synergies that lead to the profound effects on maintaining health and preventing disease that has been associated with particular diets and supplemental regimes.

What is conspicuously absent in the recent clutch of studies on ‘combinations’ of nutrients, is that these have not been ‘intelligent' combinations based on the state-of-the-art knowledge of nutrient science. This is why such studies consistently give the impression that they are designed to fail! (See our earlier ANH news item: ‘Cancer prevention study or study designed to prevent vitamin sales?’)

In conclusion

What the University of Manchester and Lancaster study has also aptly demonstrated, is the fact that nature actually has most of the answers already! That is why using the monoglutamate form of folate, i.e. folic acid only addresses a small part of the problem. While the study also shows that nature has the answer with its delivery system of multiple forms of folate, it's not hard to appreciate that there is a real risk that drug companies like Merck will continue their bid to control life-saving nutrients using their two favoured tools: patents and control of the supply chain.

See also the ANH's Health Choice campaign.

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