Folic acid and risk of autism

AlwaysAforeigner · May 2016

Hello ladies!

I was wondering if this has already been discussed here:
https://www.jhsph.edu/news/news-releases/2016/too-much-folate-in-pregnant-women-increases-risk-for-autism-study-suggests.html
And if anyone had a chance to talk about this with her OB.

A little about me. I had two healthy pregnancies, but in my third pregnancy we discovered that there was no heartbeat at 15 weeks. Apparently the fetus had what's called Encephalocele, which is a neural tube defect. I had a D&C and since we wanted to start again right away, the doctor recommended to start taking 4mg of folic acid (instead of the recommended 400mcg), which I understand is a common practice for women who had a history of neural tube defects. I started doing that, but this recent study got me worried, since I am basically taking 10 times more than the normal amount. I asked my doctor about this and basically he said that he doesn't know enough about this to recommend one way or the other and referred me to a high risk doctor, who I plan on seeing soon.
I was wondering if anyone on this board has had a history of neural tube defects and are taking the increased dosage and whether they have discussed this with their OBs.

Thanks!

RiverSong15 · May 2016

I don't have any personal experience with neural tube defects, but 4mg is the common dosage that I've seen. (I've read a bit about folic acid supplementation while researching MTHFR). I just looked through that article, and what I'm struck by is that the researchers observed a correlation, but they haven't proved causation yet. They just looked at blood levels after birth - not during pregnancy or any other time. Correlation does not mean causation. Autism, and all the potential things that cause it, is still an area where more research is needed. There are a LOT of other things that could be going on here. In comparison, the link between neural tube defects and folic acid deficiency has been proven and the evidence is strong.

MWoodside · May 2016

I am sorry for your loss.

I have no idea about the correlation to autism, but please make sure you don't have an MTHFR mutation before taking that much folic acid.

catiecatp · May 2016

@riversong15 - you're absolutely right (and correlations are among the topics I'll be covering with my intro students tomorrow), that said with this sort of a topic we'll never see a true experimental study - the best we're going to get is a correlation. You might see some animal studies - but I don't know if they've developed an animal model of autism. What we'll have to hope for are replication studies.

What irks me about this report is the lack of a citation for the article - the findings are being presented at a conference, but without an article we just don't know enough. I know from first hand experience that the media release from a university can be skewed and that the researchers don't necessarily have control over what is in the media release.

In terms of dosage - I suspect that folate versus folic acid (synthetic version) matters (it certainly does for vitamin A) under the care of a naturopath - I'll trust her over a media release. I'm on a relatively high dose of folate to help with my depression.

RiverSong15 · May 2016

@catiecatp I agree with you. It's hard to do randomized controlled trials in a case like this, so proving causation is hard. If they managed to do it with things like neural tube defects, though, it's possible to have good studies without a true experimental study, but it will take time and more studies. I guess my point was just that these are clearly very early findings (your case in point that they are presenting at a conference and there is no article to look up!). They don't even say how many women were in the study. Does "1 in 10 women" mean 10, 20, 200, or 1000? Sample size (and potential bias) matters a lot. I think I remember you being a stats professor, so I'll defer to you here. You're more of an expert than me

Personally, I'd defer to the most scientifically established data - based on a study like this, it seems like it's a connection worth following up on. But it wouldn't be enough to make me stop taking folic acid to prevent neural tube defects.

catiecatp · May 2016

@RiverSong15 - stats is one of the things I teach - but medical research is not one of my fortes - I don't know how they managed to link neural tube defects to folate, so I don't know how they'd go about doing it with this topic. My instinct is replication. And like you mentioned, with something as complex as Autism I doubt that there is a single major cause...

MooFish2364 · May 2016

I'm not a doctor or scientist by any means, but I speak from experience working with children with autism for 8 years and their families. I have seen families where 1/4 children have autism, 3/3 children have autism, and even identical twins where one had it and one didn't. I know it's not by any means a scientific study, but I believe that here might be a genetic disposition with and environmental/external trigger. I found it very interesting that one twin had it and one didn't when they both experienced identical condition as and DNA.

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