Meta Information
ID:folate
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/class/anticonvulsants
Target name:
Enzyme-Inducing Anticonvulsant Medications
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Certain anticonvulsants (e.g., phenytoin, carbamazepine) can deplete folate levels, while high-dose folate supplementation can lower the concentration of these drugs, potentially increasing seizure risk.
Actionable advice:
Consult your doctor before combining; dose adjustments and close monitoring of drug levels are essential.
Target id:
/condition/vitamin-b12-deficiency
Target name:
Vitamin B12 Deficiency
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
High doses of folate can correct the anemia caused by vitamin B12 deficiency without addressing the deficiency itself, masking the condition and allowing potentially irreversible nerve damage to progress.
Actionable advice:
Rule out or address Vitamin B12 deficiency before starting high-dose (over 1000 mcg) folate.
Target id:
/intervention/methotrexate-cancer
Target name:
Methotrexate (for Cancer)
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Folate can counteract the mechanism of methotrexate, a folate antagonist, potentially reducing its effectiveness in cancer chemotherapy.
Actionable advice:
Avoid folate supplements completely unless specifically directed by your oncologist.
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
null
Description:
Folate is essential for rapid cell division and growth, and adequate levels are required to prevent major birth defects of the baby's brain and spine (neural tube defects).
Actionable advice:
Women of childbearing age should ensure an intake of at least 400-800 mcg of folic acid daily.
Target id:
/intervention/vitamin-b12
Target name:
Vitamin B12
Severity:
major
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
null
Description:
Vitamin B12 is an essential cofactor for the MTR enzyme, which uses methyl-folate to remethylate homocysteine back to methionine. They work together to control homocysteine levels.
Actionable advice:
For homocysteine management, ensure adequate intake of Vitamin B12 alongside folate.
Target id:
/intervention/methotrexate-autoimmune
Target name:
Methotrexate (for Autoimmune Disease)
Severity:
moderate
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
24
Hours after target:
24
Description:
Low-dose folate is often prescribed with methotrexate for conditions like rheumatoid arthritis to reduce its side effects, but it should not be taken on the same day to avoid interfering with efficacy.
Actionable advice:
Take folate as prescribed, but skip the dose on the day you take methotrexate.
Target id:
/intervention/sulfasalazine
Target name:
Sulfasalazine
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Sulfasalazine, used for inflammatory bowel disease and arthritis, can inhibit the intestinal absorption of folate, potentially leading to lower folate levels over time.
Actionable advice:
If taking sulfasalazine long-term, discuss folate supplementation with your doctor.
Target id:
/class/bile-acid-sequestrants
Target name:
Bile Acid Sequestrants
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
1
Hours after target:
4
Description:
Bile acid sequestrants (e.g., cholestyramine) can bind to folate in the intestine, preventing its absorption into the bloodstream.
Actionable advice:
Take folate at least 1 hour before or 4 hours after taking a bile acid sequestrant.
Target id:
/dietary/alcohol-chronic
Target name:
Chronic Heavy Alcohol Consumption
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Chronic heavy alcohol use interferes with folate absorption, metabolism, and storage, and increases its excretion, frequently leading to deficiency.
Actionable advice:
Individuals with heavy alcohol consumption should be assessed for folate deficiency and may require supplementation.
Target id:
/intervention/trimethoprim
Target name:
Trimethoprim
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
The antibiotic trimethoprim inhibits an enzyme in the folate pathway, and its use in folate-deficient individuals can increase the risk of blood disorders like megaloblastic anemia.
Actionable advice:
Ensure adequate folate status before or during treatment with trimethoprim, especially if long-term.
Target id:
/intervention/vitamin-b6
Target name:
Vitamin B6
Severity:
moderate
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
null
Description:
Vitamin B6 is a required cofactor for enzymes in the homocysteine metabolic pathway, working alongside folate and B12 to maintain healthy levels.
Actionable advice:
For homocysteine management, ensure adequate intake of Vitamin B6 alongside folate.
Target id:
/condition/mthfr-polymorphism
Target name:
MTHFR Gene Polymorphism
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Common genetic variations in the MTHFR enzyme can impair the conversion of synthetic folic acid to its active form (L-methylfolate), potentially reducing its effectiveness.
Actionable advice:
Individuals with known MTHFR variants may benefit more from the L-methylfolate form of the supplement.
Target id:
/biomarker/homocysteine
Target name:
Homocysteine Levels
Severity:
moderate
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
null
Description:
Folate, along with vitamins B12 and B6, is essential for the metabolic pathway that converts homocysteine to methionine, thereby lowering plasma homocysteine levels.
Actionable advice:
Ensure adequate folate intake to maintain healthy homocysteine levels.
Target id:
/intervention/zinc
Target name:
Zinc
Severity:
minor
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
High doses of folic acid (over 1000 mcg) may form a complex with zinc in the gut, potentially reducing the absorption of zinc.
Actionable advice:
Separate high-dose folate from zinc supplements by at least 2 hours.
Target id:
/dietary/meal
Target name:
Any Meal
Severity:
minor
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Taking folate with food can enhance absorption and reduce the chance of mild stomach upset.
Actionable advice:
Take folate with a meal for best results.
Target id:
/condition/cancer-history-or-high-risk
Target name:
History of or High Risk for Cancer
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
There is a theoretical concern that high levels of unmetabolized folic acid from high-dose supplementation could accelerate the growth of existing but undiagnosed cancerous cells.
Actionable advice:
Avoid very high doses of folic acid (over 1000 mcg) unless medically indicated; consider using methylfolate.
Target id:
/class/nsaids
Target name:
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Chronic, long-term use of NSAIDs may interfere with folate metabolism, although the clinical significance is generally low for most people.
Actionable advice:
If you use NSAIDs daily for a prolonged period, ensure your dietary folate intake is adequate.
Target id:
/intervention/green-tea-extract
Target name:
Green Tea Extract / High-Dose Green Tea
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Concentrated green tea catechins may weakly inhibit dihydrofolate reductase (DHFR), an enzyme crucial for folate metabolism, potentially reducing folate availability.
Actionable advice:
If taking high-dose green tea extract, ensure your folate intake is sufficient.
Target id:
/class/acid-suppressors
Target name:
Gastric Acid Suppressors (PPIs, H2 Blockers)
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Reduced stomach acid may slightly impair the release and absorption of folate from food sources, though the effect on supplemental folic acid is minimal.
Actionable advice:
Long-term users of acid suppressors should ensure adequate folate intake through diet or supplements.