Folic acid supplementation enhances arsenic methylation: results from a folic acid and creatine supplementation randomized controlled trial in Bangladesh.

Study answer

What this study found

Folic acid supplementation improved arsenic methylation, lowering urinary inorganic arsenic and monomethylarsonic acid and increasing dimethylarsinic acid, with the 800 μg/day dose generally producing a larger effect than 400 μg/day. At weeks 6 and 12, folic acid groups had significantly lower %InAs and %MMAs and higher %DMAs versus placebo; the 800 μg group showed a larger reduction in %MMAs than the 400 μg group at weeks 6 and 12 (P = 0.034). Creatine had a smaller effect, mainly lowering %MMAs without changing %InAs or %DMAs. After folic acid was stopped, metabolite proportions tended to…

Study & population

Randomized controlled trial in arsenic-exposed Bangladeshi adults from Araihazar, recruited from the HEALS cohort.

Intervention

Adults were assigned to oral daily supplements for 12 weeks: folic acid 400 μg/day, folic acid 800 μg/day, creatine 3 g/day, or creatine 3 g/day plus folic acid 400 μg/day, all given as pills.

Key limitation

The trial was relatively short and relied on biomarker outcomes rather than clinical endpoints.

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Original abstract