Gestational Diabetes Causes: High Folate Levels?

Written by Dr. Steve Chaney on . Posted in Diabetes, Gestational Diabetes?

What Should You Look For In A Prenatal Supplement?

Author: Dr. Stephen Chaney

 

gestational diabetes causesAccording to the CDC, almost 10% of the women in this country will develop diabetes during pregnancy, something referred to as gestational diabetes. After delivery, their blood sugar levels will usually return to normal.

However, gestational diabetes is not a benign condition. It increases your risk of serious complications during both pregnancy and delivery. It also increases the risk that your baby will suffer complications during birth, and it increases their risk of developing obesity and diabetes later in life.

Obesity and a family history of diabetes both increase the likelihood that you will develop gestational diabetes during pregnancy. Beyond that, what could be gestational diabetes causes are not well known.

There have been numerous suggestions in the literature that high folate levels may increase your risk of gestational diabetes. If that is true, it is concerning.  After all you are being told you should probably be taking a folic acid supplement before and during pregnancy to prevent birth defects. Could the very supplement you are taking to prevent birth defects be harming both you and your unborn child?

Before you throw out your folic acid supplements, I should hasten to add that the science is not definitive. Some studies have reported an association between high folate levels and gestational diabetes. Other studies have seen no association. It has been very confusing. No one has been able to figure out why the study results have been so inconsistent.

In this issue of “Health Tips From The Professor,” I share a study that may clear up the confusion.

How Was The Study Done?

pregnancy diabetesThis study (Lai et al, Clinical Nutrition, doi: 10.1016/j.clnu.2017.03.22 ) was part of a larger study,  “Growing Up in Singapore Towards Healthy Outcomes” (GUSTO). The larger study was designed to assess multiple factors related to the health of pregnant mothers and their offspring. This particular study was designed to assess whether there was an association between high blood folate levels and gestational diabetes in Asian women.

The investigators recruited 923 women of Chinese, Malay, and Indian descent when they were less than 14 weeks pregnant. The women returned to the clinic at 26-28 weeks of pregnancy. Fasting blood samples were obtained for analysis of plasma folate, B12, and B6 levels. Gestational diabetes was diagnosed during the same clinic visit based on a fasting blood glucose level followed by a second blood glucose test 2 hours after ingestion of 75 grams of glucose. The women also completed a diet recall during this office visit.

 

Do High Folate Levels Cause Gestational Diabetes?

 

When the data were analyzed:

  • A high blood level of folate was associated with a 30% increase in gestational diabetes.
  • A high blood level of B12 was associated with a 20% decrease in gestational diabetes.
  • A high blood level of B6 showed no association with gestational diabetes.

vitamin b12When the investigators looked at the association between folate status and gestational diabetes in each of the ethnic groups individually, they discovered that the association between high blood folate levels and gestational diabetes occurred almost entirely in the Indian women.

This offered an important clue. A high proportion of the Indian women were following a vegetarian diet, which could predispose to B12 deficiency. When the investigators looked at both folate and B12 status, they found:

  • A high blood level of folate combined with B12 insufficiency was associated with a 97% increase in gestational diabetes.
  • A blood level of folate in women with normal B12 status showed no association with gestational diabetes.

What Does This Study Tell Us?

This is a single study, and it is based on associations which do not prove cause & effect. Additional studies are clearly needed to prove this hypothesis. However, if these data are confirmed, this study has several interesting ramifications.

#1: It offers a possible explanation for the inconsistencies of previous studies looking at the associations of high folate status with gestational diabetes. Most previous studies simply measured folate status without looking at B12 levels. This study suggests it is important to assess both folate and B12 status. Elevated blood folate levels may only predispose to gestational diabetes in populations that are also B12 deficient.

#2: This study suggests a previously unknown interaction between folate and B12. This is not simply a case of high folate levels masking the symptoms of B12 deficiency. The prevalence of gestational diabetes was much greater when blood folate levels were elevated than it was with B12 deficiency alone. In other words, folate made the symptoms worse. The authors offered a potential mechanism for this interaction, but it was speculative. In short, we simply do not understand the mechanism of this interaction at present.

What Does This Study Mean For You?

folic acid pregnancyIf this study is confirmed, it has several important implications for any woman who is pregnant or is considering becoming pregnant.

#1: Methyl folate offers no advantage over folic acid: These data are based on blood folate levels, not on folic acid intake. Methyl folate and folic acid are equally likely to increase blood folate levels.

#2: B12 supplementation is important if you are vegetarian or are restricting meat intake: This is just a reminder of what you have probably heard before. There are many potential causes of B12 deficiency. However, in the younger age range, vegetarianism is the most common cause of B12 deficiency.

#3: A holistic approach to supplementation is better than taking individual vitamins. In this case, it is clearly preferable to take a supplement containing both folic acid and B12 than one just containing folic acid or methyl folate. That is an important message. You are constantly being reminded that optimal folate status is important for a healthy pregnancy. It is easy to find supplements containing just folic acid or methyl folate. Avoid those supplements! Look for ones that contain both folic acid and B12 (preferably with B6 and the other B vitamins as well). The same holds true for prenatal supplements. Make sure they contain all the B vitamins in balance, not just folic acid.

So, could high folate levels be one of the gestational diabetes causes?  We simply don’t know yet.

 

The Bottom Line

 

  • Recent headlines have suggested that high blood folate status is associated with an increased risk of developing gestational diabetes during pregnancy. This raises the question as to whether the supplementation you have been told was essential to prevent birth defects could also put you at risk for another health problem.
  • The study actually showed that high blood folate status only increases the risk of gestational diabetes in women who are also B12 deficient.
  • If you are pregnant or thinking of becoming pregnant, this study has several important implications for you.
    • Methyl folate offers no advantage over folic acid. These data are based on blood folate levels, not on folic acid intake. Methyl folate and folic acid are equally likely to increase blood folate levels.
    • B12 supplementation is important if you are vegetarian or are restricting meat intake. This is just a reminder of what you have probably heard before.
    • A holistic approach to supplementation is better than taking individual vitamins. In this case, it is clearly preferable to take a supplement containing both folic acid and B12 than one just containing folic acid or methyl folate. That is an important message. You are constantly being reminded that optimal folate status is important for a healthy pregnancy. It is easy to find supplements containing just folic acid or methyl folate. Avoid those supplements! Look for ones that contain both folic acid and B12 (preferably with B6 and the other B vitamins as well). The same holds true for prenatal supplements. Make sure they contain all the B vitamins in balance, not just folic acid.
  • For details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Latest Article

Groin Pain Relief

Posted April 16, 2019 by Dr. Steve Chaney

What Is The Pectineus Muscle And Why Is It Important?

Author: Julie Donnelly, LMT –The Pain Relief Expert

Editor: Dr. Steve Chaney

 

Spring Is In The Air

spring floridaI remember as a child we sang “Though April showers may come your way…they bring the flowers that bloom in May…”

Of course, here in Florida we are blessed with flowers all year, but there’s still a lovely feeling that happens in Spring.  It’s still cool enough most days to go out running, and the humidity is still low.  Traffic will soon be easing up as our friends from the north start their trek back home, and daylight savings time is giving us more time to get to the beach for sunset.  Lovely!

Fun Facts About Spring….

  • The earliest known use of the term “spring cleaning” was in 1857
  • The word “spring” has been used for the season since the 16th century
  • The first day of spring is called the vernal equinox
  • On the first day of spring, the sunrise and sunset are about 12 hours apart everywhere on earth
  • Spring fever isn’t just a saying. Experts say the body changes due to the temperature and can cause an upset in your health.
  • The actual start of spring varies from March 19th to the 21st, but it is commonly celebrated on the 21st.

Do you like to garden?  Now is the perfect time to get your gardens planted so you’ll have home grown veggies for the entire summer.  For me, it’s also a great time to do some spring cleaning and get the house in order before the summer closes all the windows and the air conditioning becomes our indoor relief.

But these activities can also cause a strain on muscles, so don’t forget to take care of yourself. If you put too much strain on muscles you haven’t used all winter, you can develop problems and need groin pain relief.

 

A Tiny Muscle Can Cause Groin Pain

groin pain relief pectineusLately I’ve had several clients come in because of groin pain that has their medical practitioners stumped.  Their symptoms are varied, but most complain that it feels like they hit their pubic bone with a rubber mallet.  Ouch!

One client loves to ride her horse, but the pain had prevented that for several weeks. Another was considering selling the motorcycle that she and her husband love because she just can’t sit on it anymore.

Several years ago, I had a male client tell me that he had this same pain and he was told it could be his prostrate causing the issue.  Fortunately, that wasn’t he problem at all.

The muscle that caused all these problems, and a lot more, is the Pectineus.

The Pectineus muscle originates on your pubic bone and inserts into the very top of your inner thigh bone (femur).

You can see the Pectineus and surrounding muscles more clearly by going to https://en.wikipedia.org/wiki/Pectineus_muscle

Most muscles have more than one function, and this is true for the Pectineus.  The function we’ll look at today is called adduction.  It brings your leg in toward midline.  If you think of a soccer player kicking the ball with the inside of his ankle, it was the Pectineus that helped draw his leg in so he could do the shot.

Each of my clients had pain while trying to bring their leg out so they could sit on their horse, or on their motorcycle.  The tight muscle was pulling on their pubic bone and causing a severe strain.

This muscle is easier to have someone else treat it for you because of its location but give it a try and see if you can locate & treat it yourself.

 

Groin Pain Relief

groin pain relief treatmentThe picture to the left is showing an athlete self-treating her adductors.  These muscles, and the Pectineus muscle, all originate at the same point on the pubic bone.  The picture is showing her massaging the middle of the adductors.

To reach the Pectineus, move the ball all the way up to the crease in your leg.  You can do the treatment with a ball, but because of the size of the muscle and its location, it’s easier to do it with your fingertips.

Sit as this athlete is sitting, and even bring your opposite leg up so your foot is flat on the floor.  For example, in this picture, the athlete would bring her right leg up so her right foot is on the floor, and then lean a bit further onto her left hip.  That opens up the area so she can reach a bit easier into the muscle while using her fingertips.

Press into the muscle, being careful to feel for a pulse, and moving if you feel one.  If the Pectineus is in spasm, you’ll know it immediately when you press on it.  If it’s not in spasm, you won’t be able to find it at all.

Remember to stay within your pain tolerance level, this isn’t a “no pain, no gain” situation.  Never go deeper than what feels tender, but not so much that you want to faint. Hold the pressure for 15 seconds. Then let up on the pressure, but keep your fingers in the same place.

Repeat this movement several times. Each time it will hurt less, and eventually it won’t hurt at all.  That’s when the muscle has completely released, and you will have relief from the pain.

It’s as simple as that!

Why stay in pain when it’s so easy to find the muscular source of the problem and eliminate it?

calf cramps remedy bookTreat Yourself to Pain-Free Living (https://julstromethod.com/product/treat-yourself-to-pain-free-living-hardcopy/). It is filled with over 100 pictures and descriptions proven to show you how to find and self-treat muscle spasms from head to foot!

Join the 1000’s of people worldwide who have discovered that tight muscles were the true source of pains they thought were from arthritis, fibromyalgia, and other serious conditions.  You have nothing to lose, and everything to gain by releasing tight muscles.

Treat Yourself to Pain-Free Living is your step-by-step guide to pain relief!

 

Wishing you well,

 

Julie Donnelly

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

julie donnellyAbout The Author

Julie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

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