Folic Acid Deficiency Anemia
Folic Acid: How Much Is Too Much?
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I have had gastric bypass surgery and have trouble drinking coffee and other acid-based drinks, and the nutritionist said folic acid would help. She has me taking 800 mcg three times a day, plus I get 400 mcg in my multivitamin. How much folic acid is too much?
— Karen, Texas
Folic acid is a water-soluble vitamin needed by our bodies to make red blood cells and form and breakdown various amino acids. When you say that you are having "trouble drinking coffee and other acid-based drinks," I assume you mean that you are having some discomfort or diarrhea shortly after consuming these beverages; this is a common problem with people who have undergone gastric bypass surgery. However, folic acid would not help with this issue. Depending on the type of gastric bypass surgery and how long ago you had the surgery, a couple of things could be causing your discomfort: 1) you may not have fully healed from the surgery; 2) the lining of your stomach or small intestine may be irritated or have an ulceration; or 3) the amount of time that anything that you eat or drink spends in your now-smaller stomach is now significantly decreased, which can lead to diarrhea.
The required amount of daily folic acid replacement would depend on your current health status. If you are easily fatigued and feel weak most of the day, these symptoms are indicative of a low level of red blood cells (hematocrit) in your body. I am sure that your nutritionist and your doctor are checking your blood count as needed and can help to adjust the amount of folic acid if necessary.
Additionally, with your gastric bypass surgery, you will probably need other important nutritional replacements, such as iron and vitamin B12. If you are not already taking these supplements, they should also be considered, but only your doctor can assess whether they are necessary.
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