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Though some studies indicate that supplementing with folic acid reduces blood levels of zinc, most show no interaction between the two nutrients when folic acid is taken at moderate levels. Therefore, until more convincing evidence is available, people taking moderate amounts of folic acid do not need to supplement with zinc. Zinc supplementation is recommended when folic acid intake is high. A doctor should be consulted to determine the appropriate time to add zinc supplementation to folic acid therapy.
In various studies of children treated with valproic acid for epilepsy compared with control groups, serum zinc levels remained normal or decreased, serum copper levels remained normal or decreased, and red blood cell zinc levels were decreased. The importance of these changes and how frequently they occur remain unclear.
Folic acid and vitamin B6 have been used to reduce elevated blood levels of homocysteine, which has been associated with atherosclerosis. One controlled study showed that taking 0.3 mg of folic acid together with 120 mg of vitamin B6 reduced homocysteine levels more than taking either vitamin alone. The study also revealed that long-term supplementation with vitamin B6 alone might reduce blood folic acid levels. Therefore, people with elevated blood homocysteine levels should supplement with both folic acid and vitamin B6.
One controlled study showed that taking folic acid together with an antacid containing aluminum and magnesium hydroxide reduced the absorption of the vitamin. Therefore, individuals should take folic acid one hour before or two hours after taking antacids containing aluminum and magnesium hydroxide.
Last Review: 03-24-2015
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