Folic acid overdose
Folic acid (vitamin B 9) is a water-soluble substance that, like other vitamins, is not synthesized in the human body, but is necessary for the normal course of vital biochemical reactions. It is especially important that the body is provided with folic acid during pregnancy.
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Folic acid enters the body with food (parsley, cabbage, lettuce, cucumbers, beans, oranges, meat, eggs, black bread) or in the form of vitamin preparations.
Taking folic acid tablets, it should be borne in mind that these are not harmless "vitamins", but a medicinal product, its overdose can pose a health hazard.
How much folic acid is needed for an overdose?
The daily requirement of an adult for folic acid is 200 mcg. In women during pregnancy, the need for vitamin B 9 doubles and reaches 400 μg. Considering that at the stage of pregnancy planning, few women take folic acid, which is why many have a pronounced deficiency in the body, doctors recommend that pregnant women take up to 1 mg of vitamin B 9 daily.
Folic acid deficiency is widespread and very common. But an overabundance (hypervitaminosis of vitamin B 9) practically does not occur. The fact is that folic acid dissolves easily in water and therefore is quickly excreted from the body without accumulating in it. Therefore, even if you take folic acid in therapeutic doses for many months, an overdose will not develop.
An overdose of folic acid can occur only if a person simultaneously takes a dose of this substance a hundred or more times higher than his daily requirement. In practice, this means taking more than 25-30 folic acid tablets over a period of several hours.
Signs of overdose
When taking a toxic dose of folic acid, there are characteristic signs of an overdose:
- a metallic or bitter taste in the mouth;
- increased nervous irritability;
- irritability;
- hyperactivity;
- nausea and vomiting;
- bloating;
- diarrhea;
- abdominal pain;
- rash;
- sleep disorders;
- unusual or frightening dreams;
- disorders of renal excretory function;
- muscle twitching or, in particularly severe cases, seizures resembling epileptic seizures.
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First aid for folic acid overdose
If no more than 2-3 hours have passed since the intake of a high dose of folic acid, first aid should begin with gastric lavage. The patient should drink about 1 liter of cool water, and then induce vomiting, irritating the root of the tongue. It is a mistake to use warm water, since in this case the rate of absorption of folic acid from the stomach will increase dramatically. Do not wash the stomach of children in the first years of life at home.
After gastric lavage, it is necessary to take a drug with absorbing properties (Filtrum STI, Smecta or Activated Carbon). This allows you to bind folic acid that has already entered the intestine and thereby prevent its further absorption into the bloodstream.
Given that folic acid is excreted by the kidneys, the victim is provided with plenty of drink. It can be still mineral water, warm unsweetened tea. You need to drink in small portions, but as often as possible.
Antidote
There is no specific antidote to folic acid.
When is medical attention needed?
In case of accidental or deliberate intake of large doses of folic acid, after providing first aid, the victim should call a doctor or take him to a hospital.
To accelerate the elimination of excess folic acid from the body, forced diuresis is shown: solutions of glucose and electrolytes are injected intravenously, and after creating a certain water load, diuretics are prescribed, most often Furosemide.
According to some reports, the elimination of folic acid is promoted by corticosteroid drugs (Prednisolone, Dexamethasan). Acetylsalicylic acid (Aspirin) helps to lower the concentration of folic acid in the blood serum.
For convulsive seizures, sodium thiopental, sodium oxybutyrate, Seduxen are used.
Possible complications
An overdose of folic acid during pregnancy increases the risk of having a baby with reduced immunity, with a tendency to bronchial asthma and other allergic diseases.
It is dangerous to develop an overdose of folic acid and for people suffering from chronic diseases of the cardiovascular system, in them it can provoke the development of a sharp attack of angina pectoris and even cause myocardial infarction.
Long-term use of high doses of folic acid can mask the symptoms of megaloblastic anemia. In such a situation, the disease proceeds with minimal changes in the picture of peripheral blood, and neurological disorders come to the fore, which complicates the diagnosis.
Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
