Vitamin B9

Folic (pteroylglutamic) acid is another name for the water-soluble, vital compound B9 (BC) that scientists refer to as the “feel good vitamin.” This is due to the fact that folacin is necessary for the production of "happiness hormones" that provide an excellent psycho-emotional state.

Given the fact that the substance is contained in a significant amount in the leaves of plants, it acquired its name from the word “folium”, which means “leaf” in Latin.

The structural formula of vitamin B9 (M) is C19H19N7O6.

Folic acid is involved in the synthesis of DNA, hemoglobin, metabolic processes, hematopoiesis, maintaining immunity, affects conception.

The compound plays an important role during the pregnancy of women, as it is necessary for the formation of the neural tube of the fetus, preventing the development of its defects.

Lack of a substance can lead to serious abnormalities in the baby's nervous system from the second week of pregnancy. Often during this period, women are not yet aware of the conception of a child, while B9 deficiency in the mother's body negatively affects the development of the fetus.

Scientists have proven that pteroylglutamic acid is involved in DNA replication. Its lack in a growing body increases the risk of congenital abnormalities of mental activity. Therefore, when planning a pregnancy, a woman should take 200 milligrams of the substance daily in advance of conception.

The systematic intake of folic acid for 9 months in the mother's body reduces the likelihood of preterm birth by 35%.

Healthy gut microflora is able to synthesize some vitamin B9 on its own.

Historical background

The discovery of folic acid is associated with the search for a method for the treatment of megaloblastic anemia.

In 1931, scientists discovered that adding liver extracts, yeast to a patient's diethelps to eliminate the symptoms of the disease. In subsequent years of research, it was recorded that a condition similar to macrocytic anemia progresses in chimpanzees, chickens when fed with refined food. At the same time, the pathological manifestations of the disease could be eliminated by adding alfalfa leaves, yeast, and liver extracts to the feed. It was clear that these products contain an unknown factor, the deficiency of which, in the body of experimental animals, leads to impaired hematopoiesis.

As a result of three years of numerous attempts to obtain the active principle in its pure form, in 1941 scientists isolated substances of the same nature from spinach leaves, yeast extract and liver, which they called: folic acid, vitamin bc, factor U. Over time, it turned out that the resulting compounds are identical to each other.

The period from the discovery of folacin to its isolation in its pure form is characterized by intensive studies of the compound, starting with the study of its structure, synthesis, and ending with the definition of functions, as well as metabolic processes in which the substance takes part.

Chemical and physical properties

The composition of the vitamin compound B9 molecule:

  • P-aminobenzoic acid;
  • pteridine derivative;
  • L-glutamic acid.

Due to the fact that the term “pteroylglutamic acid” refers to a large group of compounds, this caused some inconvenience during research, since not all categories of substances were biologically active for living organisms, in particular for humans. Therefore, scientists decided to specify the concepts. Thus, the group of compounds that contain pteroic acid nuclei was given the name "folates" by the committee of the International Society, and the term "folacin" was given to substances with the biological activity of tetrahydropteroylglutamic acid.

Thus, the terms “folic” and “pteroylglutamine” group are synonyms. At the same time, folates are the chemical name of “related” compounds to vitamin B9.

Folic acid is a yellow fine crystalline powder, tasteless and odorless. When heated, the crystals of the compound slowly darken, but do not melt, a further increase in temperature to 250 degrees leads to their charring.

Vitamin B9 decomposes rapidly in the presence of light. At a temperature of 100 degrees, 50 milligrams of a substance dissolves in 100 milliliters of water, at zero - one unit. Folacin is easily cleaved in caustic alkalis, badly - in dilute hydrochloric, acetic acids, ether, chloroform, alcohol, acetone, benzene, organic solvents. Silver, zinc, lead salts of vitamin B9 are insoluble in water.

Folacin is well adsorbed by Fuller's earth andactivated carbon.

The role of vitamin B9 in the human body

Consider the benefits of folic acid:

  1. Participates in the production of red blood cells, and namely in the export of carbon for protein synthesis in the hemoglobin molecule.
  2. Stimulates the production of hydrochloric acid in the stomach.
  3. Ensures the proper functioning of the nervous system (regulates the transmission of impulses, the processes of inhibition / excitation), the brain and spinal cord. Included in the liquor.
  4. Participates in the synthesis of proteins, DNA and RNA, nucleic acids, as well as in the formation of purines, in particular, cell nuclei.
  5. Stabilizes the emotional background. Folic acid affects the level of production of norepinephrine and serotonin, reduces the negative impact of stress on the body, improves mood, and helps get rid of postpartum depression.
  6. Smoothes climacteric disorders.
  7. Reduces the risk of preterm birth.
  8. Beneficial effect on the digestive system, liver health, white blood cell functionality.
  9. Reduces chromosomal defects in sperm, enhances the activity of male germ cells.
  10. Needed by women and men to improve fertility. The systematic intake of foods with a high content of the vitamin compound helps to avoid deterioration of the reproductive function.
  11. Reduces the risk of developing heart disease, blood vessels, metabolic syndrome in a child. However, in the presence of heart pathologies, uncontrolled intake of vitamin B9 can lead to the onset of myocardial infarction, angina pectoris.
  12. Regulates the concentration of homocysteine, thereby reducing the risk of stroke. Taking 5 milligrams of folacin daily as a dietary supplement has a preventive effect on the body.
  13. Reduces the risk of colorectal cancer. However, as a result of a large-scale screening of the population, scientists have established that the compound cannot be used for the prevention of breast cancer, since folates have a negative effect on the development of mutated breast cells. Vitamin B9 plays an important role for men, regular consumption of a useful compound reduces the risk of developing prostate cancer by 4 times.
  14. Reduces "bad" cholesterol in the blood serum.
  15. Normalizes blood pressure.
  16. Supports the immune system, increases the number of white blood cells.
  17. Improves memory, absorption of B vitamins.
  18. Increases efficiency.
  19. What is especially important for women is that it delays the onset of menopause to a later date.
  20. activity.

In addition, do not forget about the importance of folic acid for conceiving and bearing a healthy child. Regular intake of the nutrient at the planning stages (200 micrograms per day) and during pregnancy (300-400 micrograms per day) reduces the risk of developing congenital pathologies in the embryo by 70%.

Vitamin B9 is a real panacea in cosmetology. It helps with acne, hair loss, serves as a universal remedy for smoothing skin tone, eliminating pigmentation, red spots.

Signs of folate deficiency in the body

In the case of a lack of vitamin B9, the human body experiences a deficiency of a beneficial nutrient in the brain, which leads to vision problems, movements, coordination, convulsions begin . At the same time, in adults, the risk of anemia, glossitis, ulcerative colitis, psoriasis, gingivitis, osteoporosis, neuritis, atherosclerosis, early menopause (in women), stroke, heart attack, and even cancer increases 5 times.

Deficiency of the compound in pregnant women may cause harm to the fetus. In particular, there is a risk of giving birth to a premature baby with a small weight and developmental disorders of the nervous system.

A chronic lack of a compound in children leads to a slowdown in overall development, in adolescents to a delay in puberty.

Typical symptoms of vitamin B9 deficiency in the body:

  • forgetfulness;
  • irritability due to insufficient production of serotonin and norepinephrine;
  • headaches;
  • confusion;
  • diarrhea ;
  • depression ;
  • loss of appetite;
  • apathy ;
  • high blood pressure;
  • fatigue ;
  • insomnia;
  • difficulty breathing;
  • red tongue;
  • the appearance of gray hair;
  • cognitive decline;
  • anxiety;
  • inability to concentrate;
  • memory problems;
  • indigestion due to insufficient production of hydrochloric acid;
  • hair loss;
  • delamination of the nail plate;
  • pallor due to insufficient oxygen transport to peripheral tissues, organs;
  • weakness as a result of decreased hemoglobin;
  • lack of muscle mass - occurs due to poor absorption of proteins due to low stomach acid.

Folic acid hypovitaminosis is often seen in people with bowel disease who have difficulty absorbing nutrients.substances. In addition, during pregnancy and lactation, the need for a substance increases by 1.5 - 2 times.

Vitamin B9 deficiency is exacerbated by alcohol intake, which interferes with folate metabolism by preventing the compound from being transported to its destination (to the tissues).

The level of folic acid in the human body is diagnosed by analysis. 3 micrograms of folate per liter of blood serum indicates a lack of a vitamin and the need to replenish the reserves of a useful compound.

Often, the signs of deficiency of vitamins B9 and B12 in the body are identical. To distinguish the lack of one compound from another, the level of methylmalonic acid (MMA) should be measured. An increased value indicates a lack of B12 in the body, a normal (within normal range) indicates a lack of folic acid.

How much vitamin B9 should I take to make up for the lack of a compound?

The therapeutic daily dose of folic acid depends on the severity of symptoms and the presence of other diseases caused by deficiency of the substance. To correctly establish the norm, you should undergo an examination and seek help from a doctor.

Generally, therapeutic intake of vitamin B9 ranges from 400 to 1000 micrograms per day.

In megaloblastic anemia, treatment should also begin with checking the levels of B9 and B12 in the body. This is due to the fact that in cyanocobalamin deficiency, the addition of folic acid may not only not alleviate the symptoms of the disease, but also worsen existing neurological problems.

In 80% of cases, a lack of a beneficial compound is experienced by people with an active lifestyle, sunbathers, patients with celiac disease and obesity, with a body mass index over 50. In addition, B9 deficiency can lead to a lack of folate, which increases the level of homocysteine, creating fertile ground for the development of cardiovascular diseases.

Folate deficiency contributes to changes in the bone marrow and peripheral blood.

Let us consider the process of development of these pathologies in detail.

Changes in the peripheral blood and bone marrow

A characteristic sign of the appearance of megaloblastic anemia at an early stage is the formation of hypersegmented multinucleated leukocytes in the blood: basophils, eosinophils, neutrophils.

As a result of the experiment, when a person was transferred to a folate-deficient diet after 7 weeks, the subject developed Pelger-Huet anomaly. Namely, an increase in the number of strands (threads) connecting the segments of the nucleus. Normally, this indicator is equal to one, in neutrophils with megaloblastic anemia - two or three.

Apart fromIn addition, folate deficiency anemia is accompanied by a sharp decrease in the number of red blood cells in the blood, and macrocytosis appears in the later stages of the disease.

There are cases when iron deficiency is combined with a lack of folate in the body, in this situation there may not be abnormally large red blood cells in the peripheral blood. The only characteristic indicators of combined anemia (iron deficiency and folate) are metamyelocytes in the bone marrow, hypersegmentation of neutrophils. Severe stages of folate deficiency can lead to thrombocytopenia and leukopenia.

Typical forms of megaloblastic changes in the bone marrow are manifested in 3 sprouts: megakaryocytic, myeloid, erythrocyte. Often in patients, deviations affect all three growths of maturation. At the same time, the main change in the nuclear forms of the erythrocyte series is a clearer detection of chromatin.

Folic acid overdose

Vitamin B9 has a low risk of toxicity, excess of the compound is excreted in the urine. However, the systematic intake of high doses of the substance (1000 or more micrograms per day) can lead to hypervitaminosis, which, like any disease, is best detected in the early stages of formation.

Consider the side effects of hypervitaminosis in adults:

  1. Hyperplasia of kidney epithelial cells.
  2. Increased excitability of the CNS.
  3. Decrease in the concentration of cyanocobalamin in the blood (in case of long-term use of large doses of pteroylglutamic acid).
  4. Dyspepsia.
  5. Sleep disorder.
  6. Anorexia.
  7. Digestive disorders (intestinal disorders).

An overdose of vitamin B9 in pregnant women can lead to asthma in the newborn.

Long-term use of folic acid in excess of 500 micrograms per day reduces blood B12 concentrations, so an excess of one compound causes a deficiency of another.

Indications for use and contraindications

Consider why you should take vitamin B9:

  1. hypo- and avitaminosis B9.
  2. During pregnancy. Often among women the question arises: how long to drink folic acid. Doctors recommend using it throughout the entire period of pregnancy in order to prevent the development of neural tube defects in the fetus.
  3. During lactation.

Contraindications to the use of pteroylglutamic acid:

  • malignant neoplasms;
  • cyanocobalamin deficiency;
  • hemosiderosis, hemochromatosis;
  • hypersensitivity (allergy) to the drug.

How much vitamin B9 should I consume per day?

If folic acid is to be included in the diet of children under 3 years of age, the compound should be administered carefully in small doses. According to the conclusion of the FAO / WHO expert group, the daily norm for a child from birth to 6 months is 40 micrograms, 7 to 12 months - 50 units, from 1 to 3 years - 70, from 4 to 12 years - 100. From 13 years old, the dose for adolescent and adult equals 200 micrograms per day.

However, it should be borne in mind that the daily requirement of folic acid is purely individual. The minimum dose for an adult is 200 milligrams, the maximum is 500. During pregnancy, this figure increases to 400 units, while breastfeeding - up to 300.

Distribution of vitamin B9 in nature

Folic acid can be included in a complex of multivitamin preparations or produced separately. Synthetic forms of vitamin B9 are 2 times more active than natural ones.

What is the difference between "medicated" and "natural" food folates?

Tablets containing 600 micrograms of folic acid are equivalent to foods containing 1,000 units of the beneficial substance.

Interestingly, plants and most microorganisms are capable of synthesizing folates, while birds and mammals do not. An insignificant part of pteroylmonoglutamic acid is found in plant and animal cells. The main amount of folate in them is part of the conjugates (di-, tri-, polyglutamates), which have additional glutamic acid molecules. They, in turn, are united by a strong amide bond, like a peptide.

In bacteria, the predominant form of folate is pteroyltriglutamic acid containing 3 molecules of glutamate, in yeast it is a complex with 6 particles called heptaglutamate.

Often, the “bound” folacin found in food products is represented by polyglutamates, while the “free” group (casei mono-, di- and triglutamates) is no more than 30%.

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What foods contain folic acid
Product name Vitamin B9 content in micrograms (per 100 grams)
Mung bean 625
Cranberry beans 604
Dried agar 580
Chickpeas 557
Yeast 550
Dried spearmint 530
Lentils 479
Pink beans 463
Dried soybeans 375
Dried basil 310
Wheat germ 281
Pea 274
Dried coriander (cilantro) 274
Dried marjoram 274
Thyme (thyme) dried 274
Ground sage 274
Dried tarragon (tarragon) 274
) Green asparagus 262
Beef liver 253
Ara chis 240
Chicken liver 240
Dried oregano (oregano) 237
) Sunflower seeds 227
Pork liver 225
Soy protein 200
Spinach 194
Turnip leaves 194
Mustard leaves 187
Bay leaf 180
Dried parsley 180
Laminaria (seaweed) 180
Wheat bread with bran 161
Rye toast 148
Chicken yolk 146
Frozen artichoke 126
Oat bran bread 120
Parsley (fresh) 117
Hazelnut / Hazelnut 113
Cod liver 110
Beets (raw) 109
Sesame 105
Walnut 98
Wild rice (zest) 95
Dried spirulina 94
Flax seeds 87
Cow kidneys 83
Avocado 81
Beet (boiled) 80
Rice bran 63
Cocoa powder 45
Boiled chicken egg 44
Oyster mushroom ) 38
Garnet 38
Cheese 35
Watermelon 35
Feta cheese 32
Powdered milk 30
Orange 30
Buckwheat 28
Salmon 27
Mushrooms 25
Blackberry 25
Pomegranate juice 25
Kiwi 25
Strawberry 25
Barley 24
Corn 24
Cauliflower 23
Raspberry 21
Banana 20
Jerusalem artichoke 18.5
Eggplant 18.5
Pineapple 18
Honey 15
Tomatoes 11
Lemon 9
Onion 9
Potato 8
Milk 5
​​

The list of foods that contain vitamin B9 is useful for compiling a balanced daily diet that provides the body with the necessary amount of nutrients.

Important nuances should be taken into account in the process of compiling the menu:

  • when cooking vegetables and meat, 80-90% of folates are destroyed;
  • when grinding grains - 60 - 80%;
  • when roasting offal and meat - 95%;
  • when freezingfruits and vegetables - 20 - 70%;
  • when boiling eggs - 50%;
  • when canning vegetables - 60 - 85%;
  • during pasteurization and boiling of fresh milk - 100%.

Thus, cooking foods high in folic acid results in partial or complete loss of the beneficial compound. To enrich the diet with vitamin B9, greens, vegetables and fruits should be eaten raw. In addition, in the winter season, it is recommended to feed the body with food supplements, vitamin complexes, which include a daily dose of folates.

In order for the intestinal flora to synthesize B9 better, it is recommended to consume yogurt, biokefir, preparations with bifidobacteria daily.

Folic acid absorption

Let us consider in detail the pathway of folate absorption.

In human observations and experiments on animals, it has been established that vitamin B9 taken per os (orally) is almost completely absorbed in the body as quickly as possible. With the introduction of 40 micrograms of labeled pteroylglutamic acid per kilogram of body weight, the level of absorption of the substance in 5 hours reaches 98.5% of the administered dose. 50% of the absorbed amount is excreted in the urine one day after the drug is received.

Folic acid is absorbed in the proximal small intestine and duodenum.

Of particular interest is the process of absorption of dietary folates, which are predominantly found in the form of polyglutamates produced by them (methyl, formyl).

Monoglutamates are easily absorbed in the body. In this case, polyglutamates are assimilated by enzymes produced in the intestine (conjugas, gammaglutamylcarboxypeptidase) only after the elimination of excess glutamic acid.

In the intestine, B9 is first reduced to tetrahydrofolic acid (THFA) by dihydrofolate reductase, then methylated. In some diseases of the gastrointestinal tract (malabsorption syndrome, childhood non-infectious diarrhea, sprue, idiopathic steatorrhea), folate absorption is impaired. This leads to a violation of the absorption of the substance, the development of folate deficiency, which subsequently can lead to a decrease in enzyme-forming, juice-secreting functions, destruction of the intestinal epithelium.

In the process of studying the absorption of tetrahydrofolic acid derivatives (formyl and methyl), the following was established: N-methyl-THPA is absorbed by simple diffusion without change in the absorption process. When N-formyl-THPA (folic) acid enters the human body, during absorption, it is almost completely converted into methyltetrahydrofolate in the intestine.

After suction,folates enter the liver, where they gradually accumulate, transform into active forms. In the human body is about 7 - 12 milligrams of this compound. At the same time, 5-7 milligrams of them are concentrated directly in the liver. Some of the folates are polyglutamates, of which more than 50% of folic acid derivatives are in the form of methyltetrahydrofolic acid. Scientists call it a spare form B9.

Studies have shown that when pteroylglutamic acid is added to the diet of animals, the amount of folate in the liver increases significantly. Liver folacin, unlike derivatives of other tissues, is very labile. The accumulated reserves of liver folates are able to compensate for the lack of a useful compound in the body for 4 months, preventing the development of anemia. In addition, the human body (in the intestinal mucosa, kidneys) contains a certain reserve of vitamin B9.

The amount of folate in the liver is 4 times greater than in the urinary organs. However, its ability to accumulate and consume a useful compound directly depends on providing the body with vitamins, amino acids, and proteins. For example, as a result of an experiment conducted on rats, scientists found that a deficiency of cyanocobalamin (B12), methionine, biotin in the diet leads to a decrease in folates, especially polyglutamates, as well as the ability to convert them into THFA.

Do not underestimate the importance of the liver in the metabolism of folic acid derivatives. The functional state of the organ affects the level of folate absorption, the course of reactions involving vitamin B9 coenzymes. Fatty infiltration, cirrhosis of the liver impair its ability to accumulate, consume the compound. Often, as a result of such lesions, a serious disease develops - megaloblastic anemia.

Recycled folic acid residues are excreted from the human body in urine and feces. At the same time, the amount of folate in the urine, in most cases, does not correspond to their intake with food. In other words, more output than input.

Therapeutic doses of vitamin B9

The best way to prevent folate deficiency is to eat a diet that includes fresh vegetables and fruits in the daily menu. With a lack of folate in the diet, it is recommended to additionally consume 150 - 200 micrograms of the vitamin daily.

If pteroylglutamic acid deficiency is due to vitamin malabsorption due to gastrointestinal disease, the compound should be increased to 500 to 1000 units per day. Often, this dose guarantees the absorption of the required level of the drug. An example of this kind of shortage is a severe disease of the sprue (non-tropical, tropical), in which theabsorption of nutrients, atrophy of the mucous membrane of the small intestine develops. The introduction of folic acid into the patient's diet has a positive therapeutic effect, which helps to improve the clinical picture, alleviate the human condition.

With total gastrectomy and atrophy of the gastric mucosa, megaloblastic anemia is observed due to cyanocobalamin rather than folate deficiency. Daily intake of 200 - 500 micrograms of B9, in combination with a single intramuscular injection of 300 - 500 micrograms of B12, has a beneficial therapeutic effect. To eliminate megaloblastic anemia that has arisen against the background of alcohol intoxication, pregnancy, infection, the patient is prescribed an increased dose of folic acid - from 500 to 1000 micrograms per day.

Folate malabsorption has been observed during treatment of leukemias with vitamin B9 antagonists. These substances block the conversion of a useful compound into an active tetrahydroform. As a result, prolonged use of drugs causes severe complications, poses a potential threat to human life. For the treatment of patients, active forms of folate are used: injections of N5-formyl-THFA (300 micrograms per day). In case of violation of the formation of the enzyme dihydrofolate reductase, it is recommended to use folic acid.

Consider how to drink folic acid for specific diseases (indications for use):

  1. Aphthous stomatitis. Deficiency in the body of micronutrients, vitamins (iron, B9, B12), involved in hematopoiesis, leads to the formation of cracks on the lips and ulcers on the oral mucosa (aphthae). To eliminate the disease, it is recommended to take 500 micrograms of folic acid and 100 milligrams of iron glycinate 3 times a day. The duration of treatment depends on the severity of the disease and varies from 120 to 180 days. During this period, once a month, the patient should be injected with 100 micrograms of cyanocobalamin. During treatment, it is important to monitor the level of vitamin B12 in the blood.
  2. Gingivitis and periodontitis. To relieve gum inflammation, folic acid should be consumed orally at 100 micrograms per day. At the same time, it is necessary to supplement the treatment with daily rinsing of the oral cavity with a 1% solution of the vitamin in the morning and evening. The course of therapy is 2 months.

Remember, regardless of the type of disease, the therapeutic dose of vitamin B9 depends on the patient's condition and is selected individually by the attending physician.

Vitamin B9 and men's health

Folic acid is needed not only for children under one year old, women to become pregnant and bear a child, but also for men. Chronic nutrient deficiency in the body of the stronger sex increases the risk of developing megaloblastic anemia, as well aspathologies from the reproductive system, up to infertility. Daily intake of vitamin B9 in a therapeutic dose completely eliminates these complications.

The main indicator of men's health is the state of spermatozoa. So, for the synthesis of germ cells, nucleic acids and protein are needed. Lack of folate leads to a violation of the production, deterioration, a decrease in the concentration and motility of spermatozoa. In addition, a deficiency of a vitamin compound can cause the formation of an incorrect number of chromosomes in germ cells, which can lead to the appearance of hereditary diseases in a child (for example, Down syndrome).

Why is folic acid needed in the male body?

Vitamin B9 contributes to the proper development of spermatozoa. Folates play a particularly important role in the pubertal period, when an intensive process of development of sexual characteristics begins (appearance of hair on the face, body, coarsening of the voice, intensive growth).

Folic acid drug interactions

Consider the compatibility of vitamin B9 with other nutrients, drugs:

  1. Corticosteroids hormones flush folate from the body. It is not recommended to take these drugs at the same time.
  2. Vitamin C, B12 increase the effect of folic acid.
  3. Nitrofuran drugs interfere with the metabolism of the pteroylglutamine compound.
  4. High doses of aspirin reduce folate levels in the body.
  5. Antibiotics, sulfonamides, alcohol-containing drugs, antihyperlipidemic agents impair the absorption of vitamin B9.
  6. Estrogen replacement therapy, taking anti-tuberculosis, anti-epileptic drugs (hydantoin derivatives, barbiturates) causes severe folate deficiency.

Thus, folic acid is a vital nutrient that acts as a starter, controller of the synthesis of amino acids of DNA, RNA and proteins, and participates in the construction of cells. The human body does not produce enough vitamin B9. Therefore, in order to satisfy the need for a connection, he obtains it from food.

Due to the fact that folates are rapidly metabolized, they are practically not accumulated in the body, but are immediately excreted in the feces and urine.

The normal plasma concentration of pteroylglutamic acid is 7.0 to 39.7 nanomoles per liter. For normal intrauterine development of the fetus, the minimum level of the substance in the mother's body must be at least 10 nanomoles per liter.

To meet the daily requirement of the body for the vitamin, you need to saturate the diet with foods rich in B9 or take additional folic acid supplementswith a prophylactic dose of the compound. These include: Folacin, Folio, Vitrum Prenatal, Materna, Elevit, Pregnavit, Multi-tabs perinatal. In the absence of folate deficiency in the body, additional intake of the compound is not required.