Medications for epilepsy can lead to folate depletion. And these medications are often used for other medical conditions, so if you take them for sleep, neuropathy, pain or other issues, read on!
If you’ve been following my writings awhile, you know I love raising awareness about drug muggers, pharmaceutical drugs that have the unfortunate side effect of depleting your body’s levels of vitamins and minerals. Here’s another important depletion you should hear about because it has to do with a very popular medication called carbamazepine, and an anti-cancer nutrient called folate.
I first mentioned this many years ago, but what I’m about to tell you has been known for decades.
Way back in 2002 it was discussed in Epilepsy Currents, an open-access commentary and literature review journal published by the American Epilepsy Society. So what I’m about to share has been known, although I doubt you know about it because few people focus on drug nutrient depletions. It’s a focus for me.
Carbamazepine and Epilepsy
Carbamazepine is a popular anti-epilepsy drug that works by suppressing nerve impulses that trigger seizures or the chronic condition of epilepsy. It’s quite effective for certain types of epilepsy disorders, and can make the difference between life and death for many. No question about the drug itself, which is sold by the brand name Tegretol®.
In addition to epilepsy, this medication is also used to treat diabetic neuropathy, bipolar disorder, atypical facial pain and trigeminal neuralgia. You may be interested in my other article regarding this topic, Trigeminal Neuralgia – Coping With Those Cranial Lightning Bolts.
According to a 2016 study published in the journal Clinical Laboratory, the drug has been shown to significantly reduce levels of both vitamin B12 (methylcobalamin) as well as natural folate, also called Vitamin B9. Folate depletion is my focus today, but if you’re interested in learning more about B12 depletion, you can see my graphic here, listing all the medication categories that suppress it.
Drugs Implicated in the Depletion of Vitamin B12
Vitamin B12 is critical to your health, and responsible for many metabolic processes so take a minute to read this blog that I wrote for you, Your Guide To B Vitamins: 6 Critical Reasons To Consider Mito B Complex.
The 2016 study was conducted in 58 children shortly after starting carbamezpine, but the drug mugging effect happens in adults too. It can happen to people whether or not they have epilepsy. This particular depletion is problematic for many reasons.
First of all, folate is needed for red blood cells and to make iron in the body. It’s considered an anti-cancer nutrient in the sense that it guards and protects DNA strands. If you like the graphic above, you may be interested in a resource I have which provides more of these depletions, as well as the drugs that deplete it, working down metabolic pathways. Check out my Keyring SNPS resource – usually favored by doctors.
1) Folate plays a huge role in cell and tissue growth.
You have trillions of cells and the crystalline DNA strands in each cell are highly susceptible to harm. Folate encourages DNA synthesis and repair of “injured” strands, and is involved in the production of healthy red blood cells which are necessary to transport oxygen throughout your body. These are vital mechanisms that you really don’t want impaired! This is why folate is important to protect against neural tube defects and why it’s found in prenatal vitamin formulas.
So if you take a drug mugger of folate like carbamazepine (or 150+ other medications) then you need to be aware of this depletion. I’m not saying to supplement with folate though… give me just a minute to explain why. Right now I want to make the case for what happens to you when you take a drug mugger of natural folate (B9).
Folate is one of two essential nutrients a woman must have prior to her pregnancy. Read my article specifically about PREGNANCY and find out what the other nutrient is!
If you’d like to find out more about epilepsy, visit this detail page: American Association of Neurological Surgeons.
Relationship of Homocysteine with Folate
2) When folate levels decline, homocysteine rises.
This is because folate helps convert homocysteine into methionine, an essential amino acid. Without enough folate, homocysteine levels rise to toxic levels.
High levels of homocysteine are a known risk factor for heart attacks. It can also be a neurotoxin and impair the methylation (and cleanup) process within your cells. Remember you have trillions of cells. In short, rising homocysteine levels is an undesirable side effect of taking medications that deplete natural folate.
Your body also requires folate to convert compounds in your brain into happy neurotransmitters and sleep hormones. In particular, folate is required to make more of your happy hormones like serotonin and dopamine. Folate deficiencies definitely play a role in depression and tearfulness, premenstrual moodiness and suicidal ideation. There’s even a drug version of folate called Deplin® on the market, which is a stronger version of the same natural folate you can eat or supplement with.
If you or your child are on carbamazepine, or any of the other medications that deplete folate (refer to my Drug Muggers book, there’s an entire chapter on this), please consider supplementing with folate. By the way, I feel that natural folate is superior to “folic acid” considered a synthetic form.
Folate Goes By Other Names
The names of the natural forms of folate include:
Levomefolic acid
5-MTHF
L-methylfolate sometimes abbreviated as LMF
5-methyltetrahydrofolate
(6S)-5-methyltetrahydrofolate abbreviated as (6S)-5-MTHF
Before you embark on any supplement regimen, I suggest you ask a holistic-minded practitioner what is right for you with consideration to any allergies you may have, as well as your liver, kidney function and even genetic mutations.
You want to be very careful because supplementing with B vitamins can counter the effect of epilepsy medicine. The mechanism of action of anti-seizure drugs requires suppression of folate (in some cases), so be very careful if you wish to supplement and make sure your physician approves of the plan, and closely supervises you.
Ask your doctor first and if permitted, use very low doses and separate from the medication. In some cases, you will not want to supplement at all with a dietary supplement, however, it might be okay to eat leafy greens which are very high in natural folate. Again, talk to your physician because each epilepsy medication is different, and each depletes different nutrients.
Medications and Conditions that Deplete Folate (partial list) :
- Antacids like calcium carbonate, Maalox, etc.
- H2 blockers like famotidine, cimetidine, etc.
- Proton pump inhibitors like omeprazole, esomeprazole, etc.
- Bile acid sequestrants cholestyramine, colestipol
- Carbamazepine
- Nonsteroidal anti-inflammatory drugs (NSAIDs like ibuprofen, naproxen)
- Sulfasalazine
- Triamterene
- Celiac disease and Crohn’s
And if you are interested in natural ways to guard against the harmful effects of epilepsy, read my article, Protect Your Brain From Seizures Naturally.
Study: https://www.ncbi.nlm.nih.gov/pubmed/28164642
Suzy Cohen, has been a licensed pharmacist for over 30 years and believes the best approach to chronic illness is a combination of natural medicine and conventional. She founded her own dietary supplement company specializing in custom-formulas, some of which have patents. With a special focus on functional medicine, thyroid health and drug nutrient depletion, Suzy is the author of several related books including Thyroid Healthy, Drug Muggers, Diabetes Without Drugs, and a nationally syndicated column.
