One of my July blood tests, the folate, or folic acid, test (I will use the two terms interchangeably), turned out to be quite low. When my family doctor saw that result, he told me that I should probably take a folic acid supplement. I followed his advice for a while. But recently I read some studies that made me stop taking it, while I do more research and ponder the matter.
First things first. Folic acid is a type of the water-soluble B-9 vitamin found the fruit and vegetables we eat–dark green and leafy veggies, nuts and seeds, lightly-cooked beans (folic acid is very susceptible to heat), oranges and grapefruit, etc.
Healthy cells need folates, which are essential for cell division…but, and here we get to the crux of the matter, cancer cells do, too. As we know, cancer cells divide and grow very rapidly. For this “divide and prosper quickly” process, they need folates. They gobble ’em up.
Now we will get into some technical stuff. DHFR (=dihydrofolate reductase) is an enzyme that is essential for cancer growth. Some chemotherapy drugs, such as methotrexate, target DHFR. When DHFR is inhibited, you see, cancer cells are not able to use folic acid to keep dividing, which means that tumour growth is slowed down (did I just hear a “wow!”? That was my reaction, too).
In sum, as I understand it, no DHFR=no folic acid=slowed tumour growth.
There is an obvious consequence, though: DHFR inhibitors can cause folate deficiency. And folate deficiency hinders not only cell division (and DNA synthesis, incidentally), but also the production of red blood cells, which means that folate-deficient folks could develop a sort of anemia called “megaloblastic anemia” (for a lot of info on this particular topic, see: http://www.emedicine.com/med/TOPIC1420.HTM)
So let me get this straight. If I don’t take a folic acid supplement, I risk developing megalobummer anemia. Not good. But if I do take a folic acid supplement, I will be feeding my myeloma cells. Hey, that’s a no-win situation.
And now we get to the second part of this post. What does folate deficiency have to do with EGCG?
Last week, I happened to come across a 2005 Spanish study (abstract: http://tinyurl.com/5g4o48; full study: http://tinyurl.com/a8crc) showing that people with a folate deficiency should probably not drink a lot of green tea or take too much EGCG in its supplement form. Furthermore, the study linked high levels of green tea consumption to birth defects caused by folic acid deficiency: specifically, spina bifida and anencephaly. Therefore, pregnant women and women even remotely thinking about conceiving should not drink green tea.
It seems, in fact, that EGCG behaves like the above-mentioned DHFR inhibitors (except that the green tea extract doesn’t attack healthy cells, only cancerous ones). Yes, it blocks folic acid. And it is precisely its folate-inhibiting activity that makes EGCG so successful in the fight against cancer cell growth. Makes sense, given what we know. But let’s not forget that healthy cells need folates, too. So green tea is good for you only in certain situations, not in others. Caution is the name of the game, as usual.
The EGCG-folate issue reminds me of the curcumin-iron “catch-22” situation. Curcumin is an iron chelator (in fact, I am about to read a recent “Blood” study on this very topic, so stay tuned), meaning that it “sucks” iron out of our blood. This is brilliant if you have high serum iron and are at risk of developing cancer. But let’s not forget that the “A” in the myeloma CRAB acronym stands for Anemia.
And here’s the “catch”: anemic curcumin-taking cancer folks who take an iron supplement risk inhibiting the anti-cancer activities of curcumin. So even though my serum iron is low, I have not added an iron supplement to my daily intake. I don’t want to swallow anything that might prevent curcumin from doing its job. For now, I am just trying to obtain a bit of iron from my diet (=red meat once a week, sigh, together with a salad with lots of lemon juice, since vitamin C helps us absorb iron from our food…). I will probably do the same for folic acid. That is, get it from my diet. Period.
Anyway, this folate dilemma presents me and perhaps others in my situation (=low folic acid folks) with a tough choice. To take or not to take a folic acid supplement? And how about drinking green tea or taking EGCG capsules?
It doesn’t help matters to know that low folic acid intake has been associated with high homocysteine levels, which increase the risk of heart disease and other undesirable conditions.
No easy solution, here.