Dr Clare Craig@ClareCraigPath
Aug 14
27 tweets
Still not at 50,000 by the end of this week.
Yesterday someone called this topic "niche".
Here is why they are wrong and what you need to know about folic acid.
Folic acid is not vitamin B9.
It is a lab made synthetic, oxidised chemical.
Human enzymes are VERY slow (0.08% as efficient as rat equivalent) but can convert it into useable folate.
In the meantime unmetabolised folic acid (UMFA) circulates in the body.
There is a huge medical literature on unmetabolised folic acid because it has a range of negative effects.
It acts as a drug.
Because it is a drug.
Here is the manufacturer's info on who needs to avoid or take great care with this drug.
Here is the NHS advice on the people who could be harmed by it.
Here is NHS advice on what medications interact with this drug.
So why is this drug being mandated in our flour by law including organic and imported flour?
It all comes down to a 30 yr old public health belief that they could save babies which has not kept up with the evidence.
In 1991, a randomised controlled trial showed that giving huge doses of folic acid to women who had previously had a baby with a neural tube defect (spina bifida or, in a rare worst case, failed brain developement) reduced the risk.
Smaller trials showed similar.
Public health authorities got very excited.
They had found something to save babies!
Their careers could be meaningful!
What a legacy!
It turns out that the mechanism that did produce this effect, was very much a drug effect.
The enzymes are overwhelmed and the unmetabolised drug alters cells signalling in the developing brain.
x.com/shamrockFen/st
Liam Weavers@shamrockFen
Aug 12
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I’ve been looking at how folic acid prevents neural tube defects.
A recent paper shows this is not simple “vitamin replacement.” Folic acid appears to act through local DHFR conversion, one-carbon chemistry, ALDH1L1, and retinoic-acid signalling during early development.
I asked one of the authors about the delivery route. Their reply clarified the concern. In their experiments, folic acid is added directly to embryos/cells and must be converted locally into THF-linked chemistry.
But in humans, folic acid is swallowed. If it is converted in the gut/liver, it is no longer delivered locally as folic acid. The only way folic acid can reach tissues as folic acid is by circulating unmetabolised (UMFA).
That matters.
UMFA is not be a passive marker of intake. It is the circulating substrate route by which synthetic folic acid becomes locally developmentally active.
A pathway that rescues a failed developmental state may also affect embryos where no rescue is needed.
That is why I think UMFA needs proper developmental safety assessment.
pnas.org/doi/10.1073/pn
@Dr Clare Craig
There was only ever one trial in ordinary women and at a lower dose (800 micrograms).
It is imperfect. The folic acid group were also given vitamins. The control group were given trace elements including manganese - a known neurotoxin.
But it is all we have.
In 1992, they announced their results.
6 neural tube defects in the control group.
0 in the vitamin folic acid group.
Now the public health officials were ecstatic.
They immediately advised that all women should take a supplement in pregnancy.
By 1994, Judith Hall said in The Lancet that it would be "unethical" to do further trials - banning future research on "abortus material".
What was she referring to "abortus material for"?
She was referencing how the researchers who ran the ONLY relevant trial for ordinary women had expressed concerns about pregnancy losses.
For every neural tube defect "prevented" they recorded 9 excess pregnancy losses.
They coined the phrase "terathanasia" to describe the problem - the death of deformed babies.
No woman is told that she has a nine times greater risk of losing her pregnancy than preventing a neural tube defect.
And why would a nutrient cause pregnancy loss anyway?
The UK government have adopted the line that these baby deaths were a good thing.
They claim that folic acid sustains early pregnancies that would have failed for longer - increasing detectable miscarriages.
But...
there was an excess of pregnancy losses in earliest weeks too.
These were not sustained pregnancies.
They were just pregnancy losses.
hartgroup.org/government-rei
CDC claim that it worked was also partly based on dead babies.
They tracked "live births" at a time when diagnostics was improving leading to earlier terminations.
European data including terminations shows similar drop in live births with no change in pregnancies affected.
Too late!
The committees on nutrition, food and public health all wanted to add it to flour.
For decades, nothing happened because folic acid promotes cell growth.
It is a cancer risk.
At fortification doses it increases risk by 20%.
hartgroup.org/dosage-is-key-
Then, the WHO made adding folic acid to food part of their sustainable development goals.
So there is a top down push to mass medicate the population.
And a bottom up driver of people thinking they are saving babies.
Then the Labour government, took on the Tory's work and put the mandate through using a "statutory instrument".
There was never a debate in the House of Commons!
That debate could have asked:
1. What about the risks?
2. How can you justify exposing 69 million people when (in a best case) only 600,000 have any possibility of a benefit?
3. Isn't mass medication of the population is an ethical red line that should never be crossed?
They could also have pointed out that adding it to ALL non-wholemeal flour would mean there was no way to opt out - even for those who must avoid it.
No restriction on food type & a signif higher dose than USA, Canada or Aus.
Start here and scoll up: x.com/ClareCraigPath
Dr Clare Craig@ClareCraigPath
Aug 13
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Baby food x.com/ClareCraigPath
That is why this is not "niche".
That is why everyone must sign this petition for a full House of Commons debate:
petition.parliament.uk/petitions/7695
@Thread Reader App unroll
Sorry - Judith Hall letter was 1997 not 1994.
Dr Clare Craig
@ClareCraigPath
Co-Chair HART: https://t.co/8NvaTOTiF5
Diagnostic pathologist, lover of data, digital pathology and AI, sceptical but optimistic. Views my own not the RCPath's.
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