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.1 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.
A woman and her newborn infant experienced low blood levels of magnesium, which was possibly due to chronic use of docusate throughout and after pregnancy.2 Controlled research is necessary to determine whether people taking docusate for long periods of time need to supplement magnesium.
Taking docusate increases the amount of potassium excreted from the body in the stool.3 Whether people taking docusate for long periods of time need to increase their intake of potassium is unknown.
One controlled study showed that taking folic acid together with an antacid containing aluminum and magnesium hydroxide reduced the absorption of the vitamin.4 Therefore, individuals should take folic acid one hour before or two hours after taking antacids containing aluminum and magnesium hydroxide.
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.5 Therefore, people with elevated blood homocysteine levels should supplement with both folic acid and vitamin B6.
1. Campbell RC. How safe are folic acid supplements? Arch Intern Med 1996;156:1638–44 [review].
2. Schindler AM. Isolated neonatal hypomagnesaemia associated with maternal overuse of stool softener. Lancet 1984;2:822 [letter].
3. Moriarty KJ, Kelly MJ, Beetham R, Clark ML. Studies on the mechanism of action of dioctyl sodium sulphosuccinate in the human jejunum. Gut 1985;26:1008–13.
4. Russell RM, Golner BB, Krasinski SD, et al. Effect fo antacid and H2 receptor antagonists on the intestinal absorption of folic acid. J Lab Clin Med 1988;112:458–63.
5. Mansoor MA, Kristensen O, Hervig T, et al. Plasma total homocysteine response to oral doses of folic acid and pyridoxine hydrochloride (vitamin B6) in healthy individuals. Oral doses of vitamin B6 reduce concentrations of serum folate. Scand J Clin Lab Invest 1999;59:139–46.
Last Review: 05-01-2013
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