BMJ 1995;311:257 (22 July)

Letters

Folate has potential to cause harm

EDITOR,--Nicholas J Wald and Carol Bower favour a population strategy rather than a selective strategy to prevent 1000 neural tube defects annually in the United Kingdom, with compulsory fortification of flour with folic acid.1 They could perhaps have strengthened their case by referring to other potential benefits of their proposal--for example, in mental health, especially in psychiatric and geriatric populations.2 Instead, however, they rather undermine their case by inaccurately minimising the disadvantages of their policy.

Their statement that "even in large doses folic acid has not been shown to cause harm" should not pass unchallenged. Although they acknowledge that folic acid may mask the anaemia of pernicious anaemia, they fail to emphasise that it may precipitate neurological complications in this context, as colleagues and I have shown.3 This can occur in the absence of anaemia, macrocytosis, or even a low serum vitamin B-12 concentration. The authors suggest that the problem . . . [Full text of this article]


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Relevant Article

Folic acid and the prevention of neural tube defects
Nicholas J Wald and Carol Bower
BMJ 1995 310: 1019-1020. [Extract] [Full Text]

This article has been cited by other articles:

  • Sharples, A., O'Neill, M., Dearlove, O. (1996). Children are still transferred by non-specialist teams. BMJ 312: 120c-121 [Full text]  
  • Dickinson, C J. (1995). No reliable evidence that folate is harmful in B-12 deficiency. BMJ 311: 949a-949 [Full text]  
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