A vitamin. A cartel. A cover-up.
Folic acid fortification prevented thousands of birth defects. It also involved the largest criminal fines in history.
It worked. Really well.
The 1991 British Medical Research Council study showed a 71% reduction in neural tube defects with folic acid supplementation.
By 1998, the US mandated adding folic acid to enriched grain products. The result? An estimated 1,300 fewer birth defects annually.
The vitamin cartel scandal.
While public health celebrated, major folic acid manufacturers were running an international price-fixing conspiracy.
Hoffmann-La Roche fine
BASF fine
EU fines across 8 companies
The largest criminal fines in history at that time.
They hid what we were eating.
FDA initially proposed separate labels for natural "folate" versus synthetic "folic acid."
After industry comments? Both labeled simply as "folate."
The revolving door:
- -27% of FDA reviewers later worked for companies they regulated
- -57% of hematology-oncology reviewers joined pharma after leaving
Not everyone can process it.
of people carry MTHFR variants that reduce folic acid metabolism
of people have unmetabolized folic acid in their blood
Unmetabolized folic acid may reduce immune function and potentially promote cancer. Yet 69 nations now have mandatory fortification.
The timeline tells the story.
First industrial synthesis of folic acid at Lederle Laboratories
British study shows 71% reduction in neural tube defects
Vitamin cartel operates - price-fixing across the industry
US mandatory fortification begins
Partial labeling reform - folic acid amounts must be listed
The debate continues.
MTHFR polymorphisms affect the majority of the population
Potential cancer risks from excess synthetic folic acid
Associations with autism in research studies
5-MTHF alternatives bypass MTHFR limitations and don't mask B12 deficiency
The pattern repeats.
- 1.Criminal price-fixing cartel demonstrates willingness to manipulate markets
- 2.Same companies remain dominant in the $1+ billion global market
- 3.FDA retreats from distinct labeling after industry comments
- 4.Revolving door between regulator and regulated continues
Public health success. Corporate capture.
Folic acid fortification prevented thousands of birth defects. That's real.
But the question remains: do current policies serve everyone, or primarily protect established commercial interests?
MTHFR for Beginners
Understanding methylation, genetic variants, and why MTHFR isn't the problem you think it is.