Depletes Folic Acid. This medication is commonly used for High Cholesterol
Bile acid sequestrants work by binding to cholesterol and bile acids in the intestine, unfortunately, they can also bind to folic acid, hindering its uptake into the bloodstream. For individuals taking bile acid sequestrants, supplementing with folic acid may be advisable to prevent or address potential deficiencies.
Threlkeld DS, ed. Cardiovascular Drugs, Antihyperlipidemic Agents, Bile Acid Sequestrants. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1999, 171L. Cerner Multum, Inc. "UK Summary of Product Characteristics." Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 224.
5-Methyl Folate — 200 mcg
Low folate status contributes to elevated homocysteine, a metabolite that has been associated with endothelial dysfunction, arterial stiffness, and a higher risk of stroke and coronary heart disease. Large observational studies consistently show that individuals with higher homocysteine levels have greater rates of cardiovascular events, and folate intake is one of the key nutritional determinants of homocysteine. Clinically, folic acid supplementation (often combined with vitamins B6 and B12) can lower homocysteine and appears to modestly reduce stroke risk in some populations, making the identification and correction of folate deficiency an important part of broader cardiovascular risk reduction.
Folate deficiency in the periconceptional period significantly increases the risk of neural tube defects (NTDs) such as spina bifida and anencephaly, because adequate folate is required for proper closure of the embryonic neural tube in the first month of pregnancy. Large observational datasets and randomized trials have shown that appropriate folic acid supplementation before conception and in early pregnancy can reduce NTD risk by roughly 50–70% in the general population, with even greater risk reduction in women with a prior NTD‑affected pregnancy. The practical implication is that all women of childbearing potential, not just those actively planning pregnancy, are typically advised to maintain adequate daily folic acid intake so that red‑cell folate stores are sufficient well before conception occurs.