Folic Acid Supplements may Benefit Patients with IBD

Inflammatory bowel disease patients present an increased risk of low BMD, leading to osteoporosis. Among others, risk factors of osteoporosis in IBD include malnutrition, low body mass, malabsorption, or use of corticosteroids. Although the studies describing the association between IBD and homocysteine focused on non-IBD individuals, the researchers suggest that hyperhomocysteinemia may constitute a potential additional factor of low BMD among IBD patients.

Microbiota and Folate Metabolism in IBD Patients

Many factors can affect the gut microbiota in patients with inflammatory bowel disease, such as age, inhabitable environment, culture, habits, medical history, and the applied treatment.

The researchers reported that the probiotic supplementation containing Bifidobacterium and Lactobacillus Plantarum strains may increase folic acid production in patients with IBD and have a protective function for colonocytes in the course of this disease. Additionally, they noted that microbial folate synthesis may also be affected by certain drugs such as metformin and sulfonamides.

They wrote, “a proper supply of folic acid has a beneficial impact on the development of the gut microbiota, and certain bacteria strains provide an optimal level of folate in patients suffering from IBD.”

The authors concluded, “Folic acid is a water-soluble group B vitamin, and its deficiency may lead to clinical complications, especially among patients suffering from IBD. Folic acid participates in the metabolism of homocysteine, high levels of which are associated with an increased risk of cardiovascular diseases and osteoporosis. Additionally, vitamin B9 is essential for the synthesis of nucleic acids and proteins. Therefore, providing adequate amounts of folic acid may prevent complications in this specific group of patients.”

They further added, “Nevertheless, research regarding the association between folic acid, IBD, and bone mineral density is scarce. Therefore, future studies are necessary in order to investigate the potential benefits of folic acid use among IBD patients, which may improve both the course of the disease and the quality of life.”

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DOI: https://doi.org/10.3390/nu13114036