The Case Against Mass Medication by Stealth In The UK
Folic acid fortification was mandated in the US on January 1st, 1998. The US Food and Drug Administration issued the ruling in 1996 requiring all enriched cereal-grain products (including flour, breads, pasta, and rice) to be fortified with folic acid. The aim was to help prevent neural tube defects in newborns (Ref 1)
Neural tube defects (NTDs) are serious, congenital birth defects of the brain and spine.
They occur during the first month of pregnancy when the neural tube (the structure that eventually develops into the baby’s brain and spinal cord) fails to close completely.
Spina Bifida is the most common NTD. It happens when the spine and backbone do not close all the way, which can lead to spinal cord damage.
In the UK it will become compulsory to add folic acid to non-wholemeal flour from the end of 2026 (Ref 2).
Again the stated aim is to prevent neural tube defects. Pregnant women and women trying to become pregnant are already advised to take a folic acid supplement.
The purpose of putting folic acid in everyday foods is to get folic acid into pregnant women who don’t take folic acid. i.e., the legislation will impact 69 million people in the UK because the government is determined to get folic acid into pregnant women who don’t take it.
Research in the early 1990s found that giving pregnant women folic acid reduced the incidence of NTDs. The trials were short (the gestation period) and thus longer term effects were unknown. The first large trial was conducted on women at risk of having a baby with a NTD.
The first large (Hungarian) trial in healthy women found that folic acid reduced NTDs. However, the Hungarian team followed the women beyond birth for many years and found serious issues with miscarriages and stillbirths.
Dr Clare Craig has started a petition “End the mandatory fortification of white flour with folic acid immediately” (Ref 3). In our discussion, Clare explains why she is calling for the mandate to be stopped. I summarise the issues below her bio, for those who want to read the headlines.
The main issues with the folic acid mandate
In no particular order…
1) The body wants folate, not folic acid.
Folic acid is a synthetic drug with a long shelf life (18-36 months). It’s sold as vitamin B9. The natural form of vitamin B9 is folate. There are many concerns about the pathways through which folic acid elevates folate levels vs how folate in food naturally elevates levels (Ref 4).
Folate is easy to obtain if people eat real food; especially offal and/or leafy greens. Clare explains in the podcast how the US RDA (Recommended Daily Allowance) was set and how the real daily requirement is likely to be 100 mcg, not 400 mcg (Ref 5). Below is a table showing the folate content in mcg per 100g of a selection of foods.
It has been estimated that approximately 85 percent of folic acid from fortified foods or supplements is absorbed, while only 50 percent of natural folate from foods is used by your body (Ref 6). This impacts the over consumption of folic acid, which brings us to…
2) Folic acid is likely to be over-consumed.
It would become far easier for the typical person to over-consume folic acid. If pregnant women continued to follow advice to take folic acid, they especially could over-consume folic acid. Clare has presented some numbers on X (Ref 7).
Too much folic acid can lead to serious issues (Ref 8). It can mask a B12 deficiency, which can lead to irreversible nerve damage. It may accelerate age-related mental decline. It may slow brain development in children. It may increase the likelihood of cancer recurrence.
3) Folic acid is a drug. This mandate would mass medicate the population.
Folic acid is a drug. It has a patient information leaflet (Ref 9). Mandating folic acid in foods is an act of mass medication of the population. A number of people (I am one) are concerned at general government overreach – in the field of public health especially.
The idea that the government can force medication into food (or the water supply) is chilling to us.
This mandate would force every member of the population who consumes anything containing flour to consume synthetic folic acid. Even Duchy organic sausages contain flour (Duchy organic was a brand created by Prince Charles, now King Charles).
This product is already fortified with folic acid (Ref 10). Thank you Clare for spotting that one.
There are approximately 600-650,000 births in the UK each year. Over 99 percent of the population would have something mandated for claimed benefit for a fraction of one percent of the population.
4) Folic acid should not be consumed by many people.
There are a number of people who “cannot take folic acid” (Ref 11). I’ve shared a screen shot from the UK National Health Service website below. People with cancer is not a small group. Add those with a stent and those with vitamin B12 deficiency and the issue is bigger.
This page used to include people having kidney dialysis (Ref 12), but that line has recently been removed. Clare submitted a Freedom of Information request to ask why, which she documented in a Substack post (Ref 13).
The reply was dishonest, as that Substack article showed.
The caution for people with a coronary stent was also removed from this page, but has since been put back. Many of the approximately 1.4 million people who have survived a heart attack and a large portion of the 2.3 million with coronary heart disease will have a stent (Ref 14).
These people should not consume folic acid.
5) Folic acid can harm.
As just one example, a randomised controlled trial with a follow-up of 10.8 years found that the men given folic acid (as opposed to the placebo) had nearly three times the incidence of prostate cancer diagnosis (Ref 15).
A small study reviewing men undergoing surgery for prostate cancer found an increase in prostate cancer incidence observed with folate supplementation (Ref 16).
6) Folic acid may reduce neural tube defects but increase fetal deaths.
Under this point, I’m going to reference the academic papers that Clare cited during our discussion. Starting with the first positive evidence for folic acid supplementation and neural tube defects.
In 1991, a study was published in The Lancet by the MRC Vitamin Study Research Group. It was called “Prevention of neural tube defects” (Ref 17). The trial was conducted with 1,817 women at high risk of having a pregnancy with a neural tube defect, because of a previous affected pregnancy.
They were randomly allocated to one of four groups – folic acid, other vitamins, both, or neither.
Of the 1,817 women, 1,195 had a completed pregnancy in which the neural tube defect or otherwise status of the foetus or infant was known. Of these, 27 of these had a known neural tube defect, 6 in the folic acid groups and 21 in the two other groups.
The other vitamins showed no significant protective effect. The MRC researchers declared that there was no demonstrable harm from the folic acid supplementation (they admitted that the ability of the study to detect rare or slight adverse effects was limited.)
They concluded that:
“Folic acid supplementation starting before pregnancy can now be firmly recommended for all women who have had an affected pregnancy, and public health measures should be taken to ensure that the diet of all women who may bear children contains an adequate amount of folic acid.”
The limitations of the trial were – it only studied women at risk of having babies with neural tube defects. We don’t know what would have happened had women not at risk been studied. The trial was too short to be able to conclude that there was no demonstrable harm.
The trial was stopped early, which is always a red flag. While Table IV in the paper showed that there were six neural tube defects among women taking folic acid and 21 among those who weren’t, Table VI showed that there were 19 abnormal outcomes other than NTDs among the folic acid women and 13 in those not taking folic acid.
These abnormalities included Down’s syndrome, Adams-Oliver syndrome, dislocatable hips, and cardiac malformation.
The next trial raised by Clare was the Hungarian one in women with no identified risk for having a pregnancy with a NTD (Czeizel et al) (Ref 18). As Clare noted in our discussion, the intervention was a multivitamin tablet (with 12 vitamins, 4 minerals and folic acid) – not just a folic acid supplement.
The placebo wasn’t a placebo. It was a supplement containing copper, manganese, zinc and a very low dose of vitamin C (Clare described Manganese as a known neurotoxin). Among 4,753 pregnancies evaluated, there were six cases of neural tube defects in the placebo group and none in the folic acid/multi vitamin group.
Cited nearly 4,500 times at the time of writing this note, that 1992 paper became the justification for telling women to take a folic acid supplement to prevent NTDs.
Clare then shared far less cited research – the follow-up work conducted by the Hungarian research team. Czeizel et al published a final report in 1994 – after two more years of follow-up had given further insights into the two arms of the trial.
Table 2 of that 1994 paper revealed that there were 70 more deaths in the multivitamin/folic acid group than in the ‘placebo’ group. The deaths were reported as chemical pregnancies (early positive tests without clinical pregnancy – usually within five weeks of conception), miscarriages, ectopic pregnancies, and stillbirths.
The clearest analysis of the differences was presented by Clare in this Substack for HART in March 2026 (Ref 19). Being as fair as possible – excluding chemical pregnancies and counting only clinically recognised losses – Clare found that “there were nine dead babies for every NTD prevented.”
Dr Andrew Czeizel referred to this in a letter to The Lancet in 1998. He confirmed that the final database of the Hungarian trial showed an increasing trend in the rate of fetal death including chemical pregnancies, miscarriages, and stillbirths.
He put this down to higher fertility among the women taking folic acid and the significant increase (about 40 percent) in the rate of multiple pregnancies, which carry higher risk. As Clare said, those are still babies that have been lost and that is still a traumatic loss for the parents and family.
It’s not ethical to dismiss that higher death rate as ‘oh well – there were higher fetal deaths but the women had more chance of getting pregnant so win some, lose some…’
Clare’s March 2026 Substack explains why the public health recommendation to take folic acid, after the 1992 paper, was not reversed despite the authors of that paper providing further, deeply troubling, information.
Once public health authorities have a direction to travel, it is very difficult to get them to change course (which would mean admitting they were wrong) – see dietary guidelines.
Clare presents a compelling case that the folic acid mandate has many risks and harms for many people. It risks a dangerous mass medication precedent in the UK. It is likely already harming many people in the US.
Perhaps most importantly, the rationale for the entire project may actually be harming many more babies than it claims to help. Nine pregnancy and stillbirth losses for every neural tube defect avoided.
Having reviewed the recent work of Clare and HART on this issue, I think that if this mandate does get prevented – and it should – it will be almost single-handedly down to Clare’s research, campaigning and explanation of the issue.
It is gathering momentum on X and in the podcast world, with many people reposting Clare’s work and interviewing her on this topic.
Clare’s summarised the issue at the end of our discussion as follows:
“I can’t quite get over how black and white this is, how extreme this is, and how nobody knows about it and nothing’s being done about it. You know, it’s such an unusual situation.
Normally there’s a bit more grey, or normally there’s some people really advocating for it. We don’t even have that. People are just ignorant. It’s not that they’re passionately pro, they just don’t know what it’s really about.”
Spread the word folks. Even though we don’t eat bread, flour products or even Duchy sausages, millions of people do including friends and family whom we love.
Even if you don’t care about that, you should care about governments mass medicating populations.
If we lose the freedom to say what we consume, we lose everything.
See more here substack.com
Please Donate Below To Support Our Ongoing Work To Defend The Scientific Method
Trackback from your site.