Empowering Women in Chiropractic -Neuro-nutrition for the Preconception and Prenatal Period!

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Elizabeth and I wanna thank ChiroSecure for giving us this platform and always looking out for the backs of chiropractors. So Elizabeth is gonna take a little bit of a nap as we hang out, and she'll be back at the end. So you have a good night nap there, Elizabeth Hi, I'm Dr. Monika Buerger, and I am super excited to bring you information regarding specific nutrients and preconception, prenatal, and neural developmental care.

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So this is number two in our series. We have covered vitamin D before, but now we're gonna cover a well-talked-about nutrient in the world of methylation, and we're gonna talk about something that drives me bonkers. So we're gonna talk about folate. We're gonna actually talk about folic acid versus folate.

So let's start there. Let's break it down for you. Folic acid is a synthetic form of folate that is hard for the body to break down, but has a high bioavailability, versus food forms of folate. This may surprise many of you. Food forms of folate, depending on the integrity of the microbiome, can be easy or difficult to break down, and its bioavailability is only about 50%.

So I know that's a surprise to some. Folic acid, if it's broken down and metabolized, its bioavailability is about 80%. Food forms of folate, its bioavailability is only about 50%. Now, we have a third choice, a third contender here, are supplemental forms of methylfolate, 5-methyltetrahydrofolate, 6L-methyltetrahydrofolate.

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You'll see those on supplement labels. Those are easier for the body to break down, easier than folic acid, and that bioavailability is about 80% as well. So those are three categories we're looking at. Now, why do we want to take a little keen eye to folic acid? There's a couple reasons there.

First of all, it's harder to break down. There is a gene or an enzyme that reduces it from that form down to a folate form. It's called the gene is DHFR. You don't need to know that But if that gene is stressed out, either because of mutation or not, just because you're stressed out, you're gonna have a hard time breaking down folic acid to even get to use it.

And the other thing that can happen is you can end up with this thing called unmetabolized folic acid. That's what I wanna focus on 'cause I just got an amazing new paper that I wanna share with you. So unmetabolized folic acid is linked with things that we don't want. First of all, it can go into the cell and it can block the folate receptors from being able to grab onto the good stuff and utilize it.

So that's one thing. The other thing is unmetabolized folic acid is associated with things like cancers, cardiovascular risks, and neurodevelopmental disorders, neurological neurogenesis and and d- basically ner- nervous system development in the fetal-- during fetal development. So it's important to understand that folic acid can clog the system, stay in the body called unmetabolized, and that can lead to health consequences and neural development consequences that we don't want.

The other thing that f- folic acid can do is it can hide, it can disguise a vitamin B12 deficiency. So when we're talking about folate, we're talking about the vitamin B9 It can disguise if we use folic acid and it stays unmetabolized. It can disguise a B12 deficiency. And why is that important? 'Cause B12 is needed to break down this thing called homocysteine, and if that stays too high, it can lead to miscarriages.

Okay, so I know that was a lot to take in, but we've kinda laid the foundation of why I want to have this conversation. Because so many times I've worked with patients, and I hear it all the time, e- especially if a woman has a hard time conceiving or has had a history of miscarriages or what have you, is they get tested for what we call MTHFR mutation.

And there's various forms of the mutation. You need to understand what they all mean. But what happens unfortunately is women get thrown... anybody that has that mutation, they get thrown on to extra B9 supplementation, whether it be folic acid or the more active form of folate. And that doesn't-- that's not necessarily the good answer because either form, folic acid or folate, basically B9 it's like a U-shaped curve.

Too little is not good, too much is not good Either end of the spectrum can, A, act as act as a gene mutation. It can, what we say, what is called hypomethylate. It leads to hypo, decreased, methylation. And when cells are forming, when g- every gene in the body needs to be methylated in order to work properly.

So either end of that spectrum, if people are just thrown excessive amounts of folate, the good form, or folic acid, the not so great form, it can lead to altered methylation. Okay? And unfortunately, people don't understand the nuances of methylation biochemistry, and they just throw them... they test them, and they throw at 'em extra folate, not necessarily what you want.

So it's important to be able to test to see if a person's too high or too low and to know what form to use. So this paper that just came out looked at prenatal vitamins, and specifically prenatal vitamins that had folic acid in it versus prenatal vitamins with folate. And what they found was those individuals, those-- the-- It was a mom dyad duo that they tested.

Those taking a prenatal with the folic acid had 31% of unmetabolized folic acid in the system. Okay? Those taking the form of folate had only 7% in their system. So that's incredibly important to understand. It's thought that b- in the United States, about 35% of individuals are taking a folic acid supplement.

About 95% of individuals in the United States are-- have been tested too high in the unmetabolized form of folic acid. And in Canada, that number is about 95% tested high for high unmetabolized folic acid 97% of pregnant women. Now mind you, this is related to neural developmental consequences especially things like autism.

And even i- in a study in Canada, they found 40% of adults were high in what we call red blood cell or RBC folate. So it's either form that can cause the disruption in neural development. Now a couple populations I want you to be mindful of: A the pregnant population. Many women are told to take extra folic acid for supplementation for neural tube defects.

We don't-- Too much can be detrimental. The other population I want you to be mindful of are those with autoimmune disorders, which are rapidly rising in the United States because many of those individuals are on a co- a prescription called methotrexate. A lot of M words, huh? And that methotrexate drives down B9, and they are often told to supplement with folic acid.

So your takeaways, I know that was a lot. Your takeaways. If you're working in the preconception prenatal care, do a deep dive history. Do they have a history of taking folic acid? Were they ever prescribed it or taking it over the counter? Look at their prenatal supplement or their daily vitamin supplement.

What form is in there? And let's switch to the methylated form. Teach them about diet Much of the folic acid in the United States comes from f- food, from our food sources, from processed foods because they started putting this in, folic acid in processed foods for preventive neural d- tube defects, I think back in the '70s.

So we can g- be getting an abundance of it through our diet. So we wanna do a history of the diet, switch them to whole foods with natural folates. Again, only about 50% of that is, is metabolically available. But it's working from preconception through prenatal through postnatal period on how to best tailor a lifestyle from diets, supplements, etc.,

in order to have that good balance. Not too little, not too much. You can test their blood levels if you're seeing excessive amounts of folate or folic acid in the blood or in the red blood cells. So lots to percolate on that story that I just gave you. But a must necessary need to know because we're seeing more and more neurodevelopmental challenges associated with too much of either of these substrates.

And the other thing I see is the issue with tongue tie. More and more kids, the number of kids with tongue tie, and they're throwing that into the same ball of wax with methylation and MTHFR and low folate. So people using excess fo- excess folate ha- Folate status and ankyloglossia really that's a myth of a story, but we can talk about that another time.

So lots to percolate on that. If you want to know more about neurodevelopmental challenges, what to look for how to support preconception, prenatal period, how to look at motor milestones that can be affected from poor nutrition, then I need you to scroll down, brrrt, scroll down now. Join our Six Pillars of Neural Development, and you will get everything you need to know to optimize the health of mom, baby, mom-baby dyad, and a future generation.

So don't be left out. Go down and get that right now And once again, Elizabeth and I want to thank ChiroSecure for giving us this platform and for really being in the trenches with us and helping us spread the word about kiddos and chiropractic. Until next month, you have an amazing rest of May

Today's Pediatric Show: Look to the Children was brought to you by ChiroSecure.

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