Shouting at vitamins

The end of the COVID-19 pandemic left a hole in the lives of two groups of people. The first are those who loved the pandemic because it allowed them to flaunt their hypochondria. They have largely disappeared but they can occasionally be spotted, fully masked up, sounding the alarm about things like monkeypox. The second are those who loved the pandemic because it allowed imbeciles to masquerade as contrarians. They graduated to taking photographs of contrails in the sky, but nothing could quite recapture the thrill of talking with ill-deserved confidence about Gompertz curves, spike proteins and false positives.

But now they’ve found a new target for their rage: vitamin B9, otherwise known as folic acid. It has been known for decades that consumption of folic acid at the start of a pregnancy prevents spina bifida, a neural tube defect that often condemns children to a life in a wheelchair. From December, most of the flour sold in Britain will be fortified with folic acid by law at a level of 250ug (micrograms) per 100g. 

 

As I mention in The Critic, the campaign against flour fortification is being run by "Pathological" Clare Craig who some readers will remember as a disinformation merchant during the pandemic. It took her four months, but she has managed to get 100,000 people to sign her online petition.

 

The whole panic is demonstrable nonsense. What I found interesting in researching that article was how long the UK government has waited and how eagerly the scientists have been looking for evidence of potential harm. Rightly so, I would say, given that folic acid becomes hard to avoid with fortification, but the only 'harm' it could find is a pretty dubious one. 

 

I don't go into this in the piece, but the evidence that folic acid pills can mask B12 vitamin deficiency comes almost entirely from people with a B12 deficiency being given folic acid as treatment between 1947 and 1951, not long after the B9 and B12 vitamins were isolated for the first time. As Wald et al. explain in this article, this is a problem of misdiagnosis and it wouldn't happen today because we have simple tests of B9 (folic acid) deficiency and B12 deficiency. And yet, because it happened in the past, the guidance level (which is taken to be the safe upper limit) is set at a fraction of the level at which folic acid has been known to mask the effects of B12 deficiency.   

 

That is the only reason there is a guidance level for folic acid. It is perhaps unsurprising that people infer that if they exceed that level then they are at risk of something, but they really aren't. As Wald et al. say, there doesn't need to be a limit at all. 

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