How important is folate? That’s easily answered by looking at four health risks associated with folate deficiency: heart disease, stroke, cognitive decline and birth defects.
Another health risk linked to low folate levels is oral leucoplakia, a precancerous condition caused by any type of tobacco use or chronic irritation from teeth that rub against the inside of the mouth. With leucoplakia, white patches may appear on the gums, tongue or inside the cheeks. The condition is called laryngeal leucoplakia when the patches occur in the throat or larynx (the voice box). About half of all leucoplakia patients eventually develop oral cancer.
The question is: Can folate supplements treat existing leucoplakia by raising folate levels? This question was recently put to the test by researchers at the Universita Cattolica del Sacro Cuore in Rome.
The Roman team enrolled 43 patients who had not yet been treated for laryngeal leucoplakia. For six months, each subject received 5 mg of folic acid every eight hours. That’s a high dose, considering that the recommended daily allowance (RDA) for folate is 400 micrograms. HSI Panelist Allan Spreen, M.D., recommends folic acid supplementation of 1,600 mcg per day, and as much as 5 mg for those who want to address cardiovascular problems. Dr. Spreen explains: “Folate isn’t effective in low doses except in a limited percentage of cases.”
After monthly videolaryngoscopy screenings during the six-month trial period, researchers reported these results:
- 12 patients were completely free of laryngeal leucoplakia
- 19 patients had improved symptoms
- 12 patients showed no response
In the journal Cancer, researchers also stated: “The mean increase in serum folate levels and the mean decrease in homocysteine serum at the end of the study were highly significant.”
Dr. Giovanni Almadori, the lead author of the study, told Reuters Health that the next phase of their research will test folic acid supplements in the prevention of head and neck cancer for patients who have undergone surgery to remove laryngeal leucoplakia. He noted that the condition commonly recurs in a more advanced form, increasing cancer risk.
Boost that folate!
I hope Dr. Almadori also supplies his future study subjects with B-12 supplements.
As I’ve mentioned in past e-Alerts, a high folate intake can mask vitamin B-12 deficiency. So when taking high does of folic acid, Dr. Spreen recommends 1,000 mcg of B-12 per day in sublingual form (dissolved under the tongue). And to get the most out of folic acid, he also suggests 100 mg per day of B-6, as well as 400-500 mg of magnesium per day to make the B-6 more effective.
Talk with your doctor or a health care professional to determine if extra folic acid, B vitamins and magnesium supplements would be beneficial for your specific health concerns.
Add two to the mix
Oral leucoplakia prevention has been featured in two previous e-Alerts.
In “Testing123” (8/29/05), I told you about a study that followed 30 people with oral leucoplakia. For one year, half the group drank three cups of black tea daily, while the others abstained from drinking black tea. Samples of leucoplakia mouth plaque cells showed that precancerous cellular damage was significantly reduced in the black tea subjects compared to those who didn’t drink tea.
And in the e-Alert “WomenStart Your Engines” (5/18/04), I looked at a study in which a daily 8 mg supplement of the antioxidant lycopene completely wiped out white patch lesions in more than half of a group of 20 oral leucoplakia patients. There was no response in a placebo group. A five-ounce tomato contains about 8 mg of lycopene.
“Pilot Phase IIA Study for Evaluation of the Efficacy of Folic Acid in the Treatment of Laryngeal Leucoplakia” Cancer, Published Online 6/12/06, interscience.wiley.com
“Folic Acid May Help Prevent Certain Throat Cancers” Megan Rauscher, Reuters Health, 6/12/06, reutershealth.com