Health benefits folic acid

Benefits, Foods, Deficiency, and More

Folic acid is a water-soluble vitamin. It’s a synthetic version of folate, one of the B vitamins (1).

Because your body can’t make folate, you need to get it from your diet.

Some foods naturally contain folate. Folic acid is added to other foods. You can also get folic acid from dietary supplements (2).

What’s the difference between folate and folic acid?

Although the terms “folate” and “folic acid” are often used interchangeably, they are actually different forms of the same vitamin: vitamin B9.

Folic acid has a different structure than folate and has slightly different effects in your body. “Folate” is the generic name that encompasses all forms of vitamin B9, including folic acid and 5-MTHF. Folic acid is a specific synthetic form of this vitamin (1, 2, 3).

You can find folate in plant and animal foods like these (1):

spinach
kale
broccoli
avocado
citrus fruits
eggs
beef liver

Folic acid is added to foods such as flour, ready-to-eat breakfast cereals, and breads (4, 5).

It’s also in dietary supplements, such as multivitamins (1, 4).

What does the body use folate for?

Your body uses folate to (1):

make and repair DNA
help cells grow, divide, and work properly
produce certain proteins
help red blood cells mature

Folate deficiency can lead to many health problems, including (1, 2, 6, 7):

anemia
an increased risk of heart disease and certain cancers
developmental irregularities in infants if pregnant people don’t get enough folate

Many countries, including the United States, require certain grain products to be fortified with folic acid. Folic acid fortification helps prevent neural tube irregularities in infants (7, 8).

Summary
Folic acid is a synthetic version of the B vitamin folate, which naturally occurs in leafy greens, eggs, and citrus fruits, among other foods. It’s essential to important functions in the body.

The Recommended Dietary Allowance (RDA) for folate is listed in Dietary Folate Equivalents (DFEs). This unit of measure accounts for the differences in how your body absorbs folate from foods and folic acid from fortified foods and supplements.

Your body absorbs natural folate about half as well as folic acid from supplements (1).

Adults need about 400 mcg DFE of folate each day. During pregnancy and breastfeeding, folate needs can increase. The RDA during pregnancy is 600 mcg DFE (1, 6, 7, 9).

Your body stores 15–30 mg of folate. Most of that folate is in your liver, and the rest is in your blood and tissues (1).

The RDA for folate for infants, children, and teens is (1):

Birth to 6 months: 65 mcg DFE
Ages 7–12 months: 80 mcg DFE
Ages 1–3: 150 mcg DFE
Ages 4–8: 200 mcg DFE
Ages 9–13: 300 mcg DFE
Ages 14–18: 400 mcg DFE

Summary
Adults need about 400 mcg DFE of folate each day.

Both folic acid and folate are used in supplements. Although these two nutrients treat the same conditions, they are metabolized differently in the body and can affect health in different ways (1).

Here are some common uses and benefits of folic acid supplements.

Treating folate deficiency

Folate deficiency can happen for many reasons. Some possible causes of folate deficiency are (1, 2):

a lack of folate in your diet
diseases or surgeries that affect how your body absorbs folate, including celiac disease, short bowel syndrome, and gastric bypass surgery
no stomach acid (achlorhydria) or low stomach acid (hypochlorhydria)
drugs that affect folate absorption, including methotrexate and sulfasalazine (Azulfadine)
alcohol use disorder
pregnancy
hemolytic anemia
dialysis

Consuming too little folate can cause complications such as anemia, fetal development issues, mental impairment, impaired immune function, and depression. Taking folic acid or folate supplements can bring up your levels and prevent these complications (6, 7, 9, 10).

Preventing birth defects and pregnancy complications

Folic acid supplements can help to prevent neural tube irregularities, including spina bifida and anencephaly. Getting enough folic acid during pregnancy can reduce the chance that your baby will be born with one of these conditions (7, 9).

Folic acid supplements not only help prevent fetal development issues but also help lower the risk of pregnancy complications such as preeclampsia (10).

Maintaining brain health

Low blood folate levels are linked to poor mental function and an increased risk of dementia. Even folate levels that are technically normal but on the low side might increase the risk of mental impairment in older adults.

Adequate folate intake may also help protect against Alzheimer’s disease (11, 12).

In a 2019 study in 180 adults with mild cognitive impairment, taking 400 mcg of folic acid supplements daily for 2 years improved measures of brain function and reduced blood levels of proteins that are involved in Alzheimer’s disease (13).

Another study looked at 121 people with newly diagnosed Alzheimer’s disease who were being treated with the medication donepezil (Aricept).

Those who also took 1,250 mcg of folic acid per day for 6 months had improved thinking ability and less inflammation than those who took Aricept alone (14).

Treating mental health conditions

Folate is involved in the production of brain chemicals called neurotransmitters. Consuming too little folate has been linked to depression, schizophrenia, and other mental health conditions.

For example, people with depression may have lower blood levels of folate than people without depression (15).

A 2022 review of studies suggests that folic acid and folate supplements may help reduce symptoms of mental health conditions such as postpartum depression, schizophrenia, and bipolar disorder (16).

Taking folate supplements in addition to antidepressant medication may reduce depression symptoms more than taking antidepressant medication alone (17).

A review of seven studies found that treatment with folate supplements plus antipsychotic medication may improve symptoms in people with schizophrenia more than antipsychotic medication alone (18).

However, larger, more robust studies are needed to further support these findings.

Reducing heart disease risk factors

Folate-based supplements, including folic acid, may help improve heart health and reduce the risk of heart disease.

High levels of the amino acid homocysteine are thought to increase heart disease risk. Because folate helps break down homocysteine, low folate can lead to high homocysteine levels, also known as hyperhomocysteinemia.

Folic acid supplements can help bring down homocysteine levels and may lower heart disease risk (19).

For example, a review that included 30 studies with more than 80,000 total participants showed that supplementing with folic acid led to a 4% reduction in overall heart disease risk and a 10% reduction in stroke risk (19).

What’s more, using folic acid supplements along with antihypertensive medications may reduce high blood pressure significantly more than antihypertensive medications alone. Folic acid supplements may also improve blood vessel function in people with heart disease (20, 21).

Other possible benefits

Folic acid supplements may also help with these other health conditions:

Diabetes. Folate supplements may help improve blood sugar regulation and reduce insulin resistance in people with diabetes. Because the diabetes drug metformin can lower folate levels, you may need a supplement if your levels are low (22, 23, 24).
Fertility issues. Folate can improve egg quality and help eggs grow and implant in the uterus. Taking folate may increase the chance of getting pregnant and carrying a baby to term. People who use assisted reproductive technology to conceive may be more likely to have a baby if they have a higher intake of supplemental folate (25, 26).
Inflammation. Inflammation plays a role in many diseases. Folic acid and folate supplements have been shown to reduce markers of inflammation such as C-reactive protein (27).
Kidney disease. The kidneys usually filter waste out of the blood, but when the kidneys are damaged, homocysteine can build up. About 85% of people with chronic kidney disease have too much homocysteine in their blood. Folic acid supplements may help reduce homocysteine levels and heart disease risk in people with kidney disease (28).

Larger studies are still needed to confirm the benefits of folate supplementation.

This list doesn’t include every possible benefit of folic acid. There are many other reasons people may use folate-based supplements.

Consult a healthcare professional

Before starting folic acid supplements, it’s important to talk with a healthcare professional. They can make sure the supplements will not interact negatively with other medications you may be taking.

Summary
Folic acid supplements are commonly used to prevent fetal development issues in pregnant people. Low levels of folate can be associated with health risks, and a deficiency of this essential nutrient may be caused by a medical condition.

Folate plays essential roles in a baby’s development.

It’s involved in cell division and tissue growth. It also helps the baby’s brain and spine, called the neural tube, develop. Taking folic acid both before and during pregnancy can help prevent neural tube irregularities such as anencephaly and spina bifida (1, 7, 8).

The U.S. Preventive Services Task Force, an independent panel of national disease-prevention experts, recommends that anyone who is trying to become pregnant start taking a daily folic acid supplement containing 400–800 mcg at least 1 month before becoming pregnant and through the first 2–3 months of pregnancy (9).

However, the common recommendation in practice encourages people capable of getting pregnant — of childbearing age and engaging in sexual activity that could result in pregnancy — to take a folic acid supplement, because many pregnancies can be unplanned (6, 7, 9).

Since the 1990s, flour and other foods have been fortified with folic acid. Consuming both fortified foods and folic acid supplements before and during pregnancy can help reduce the risk of neural tube irregularities (5, 7, 8).

Beyond preventing fetal development issues, taking folic acid supplements during pregnancy may improve a child’s mental function and reduce the chance of the child developing autism spectrum disorder (ASD).

However, taking too much folic acid may have a negative effect on a child’s brain development and increase their chances of developing autism, which will be discussed in the next section (29).

Folate is also important for the health of the pregnant person. Supplementing with folic acid has been shown to reduce the risk of pregnancy-related complications, including preeclampsia. Higher folate levels in a pregnant person may lower the risk of preterm birth (10, 30).

Folate is important for the health of both pregnant people and their babies, and it’s not always easy to get enough of this nutrient through your diet alone (6, 7, 9).

Summary
Folic acid supplements help support pregnancy, reduce pregnancy-related complications, and reduce the chance of fetal development issues.

When you take folic acid, your liver has to convert it into the active form, 5-methyltetrahydrofolate (5-MTHF).

If your liver doesn’t convert it quickly enough, folic acid can build up in your blood. Eating foods containing 5-MTHF instead of folic acid can prevent this from happening (1).

Foods that contain 5-MTHF include (1):

leafy greens
beans and lentils
asparagus
avocado

Certain gene changes affect how your body uses folate. Methylenetetrahydrofolate reductase (MTHFR) is an enzyme that breaks down homocysteine. Changes called mutations in the code for MTHFR can affect your health by changing folate levels in your body (2).

One of the most common mutations to MTHFR is C677T. People with this variant have less activity of an enzyme that breaks down homocysteine. They may have high levels of homocysteine, which could increase their heart disease risk.

In a pregnant person, this variant can also increase the chance of neural tube irregularities in a developing fetus (2, 31).

There are genetic tests for MTHFR variants, but few people need them.

Having an MTHFR mutation alone doesn’t mean you’re at risk of health problems or that you need treatment. But if your homocysteine levels are high, a healthcare professional may recommend that you take a supplement (31).

Summary
Certain genetic mutations may affect the folate levels in your body.

Eating folate-rich foods and taking natural forms of folate such as 5-MTHF are generally considered safe. But taking high doses of folic acid through supplements could potentially lead to a buildup of unmetabolized folic acid in your blood.

“Unmetabolized” means your body hasn’t broken down the folic acid or converted it into other forms of folate. No confirmed health risks due to unmetabolized folic acid have yet been found, but undiscovered risks may still exist (1, 32, 33, 34, 35).

It’s important to note that most children and adults in the United States get enough folate from food and don’t need to take a folic acid supplement (1).

Autism

Taking folic acid during pregnancy helps prevent neural tube irregularities. But having high levels of unmetabolized folic acid in your blood may increase the chance that your child will have ASD.

People who take less than 400 mcg of folic acid daily are unlikely to have high levels of unmetabolized folic acid in their blood (29, 36).

High levels of unmetabolized folic acid during pregnancy may affect children’s mental development.

In a study of 1,682 mother-child pairs, children whose mothers supplemented with more than 1,000 mcg of folic acid per day during pregnancy scored lower on a test of mental abilities than children whose mothers took 400–999 mcg per day (37).

Although these studies suggest there may be risks to taking high doses of folic acid during pregnancy, more research is needed to confirm these findings.

Other possible risks of high folic acid intake

Taking high doses of folic acid may be associated with other health conditions, including the following.

Cancer

Folic acid might lower the risk of cancers affecting the head and neck, pancreas, esophagus, and bladder. But it may increase the risk of prostate cancer.

So far, research on the topic has not delivered conclusive results, and more studies are needed.

But research suggests that folate may suppress some types of cancer during its early stages, while high doses of folic acid taken after precancerous cells have developed may cause cancer to grow and progress (1, 38, 39).

Impaired immune function

High dose folic acid supplements may suppress the immune system by reducing the activity of protective immune cells such as natural killer (NK) cells. Whether these immune changes could put people at increased risk of infection is still unknown (40).

Summary
Research has suggested that high folic acid intake may be associated with certain health conditions, including cancer, autism, and immune system suppression.

Folate and folic acid can be found in many forms. They are added to multinutrient supplements, including multivitamins and B-complex vitamins. Most adult supplements contain 680–1,360 mcg DFE (400–800 mcg of folic acid) (1).

The Tolerable Upper Intake Level (UL) is the highest daily folic acid dose you can take without experiencing harmful side effects.

The UL includes only folate from fortified foods and dietary supplements. High intake of naturally occurring folate from food has not been shown to cause any adverse effects (1).

The UL for folate in supplements and fortified foods is (1, 32):

Age range	UL
adults	1,000 mcg
children ages 14–18	800 mcg
children ages 9–13	600 mcg
children ages 4–8	400 mcg
children ages 1–3	300 mcg

Most children in the United States get enough folate from food, and 30–66% of children ages 1–13 who take folic acid supplements exceed the UL for their age group. Ask a pediatrician before giving your child a folic acid supplement to make sure it’s safe (1).

You can take all forms of folic acid with or without food.

Before taking folic acid

A healthcare professional might recommend a folic acid supplement if you have a deficiency or you are pregnant or thinking about getting pregnant.

Let a healthcare professional know what other prescription and over-the-counter medications you take. Folic acid may interact with some medicines (1).

Storage and handling

Store folic acid supplements in a cool, dry place. Keep supplements away from humid areas, such as the bathroom.

Overdose

There’s no set upper limit for folate in foods. Because folate is water-soluble, your body removes any extra you consume. Still, it may be possible to develop side effects if you take folic acid supplements in amounts greater than the UL (1, 2).

A healthcare professional may recommend higher doses if you have a folate deficiency. Avoid taking more than the UL unless a healthcare professional directs you to do so.

Summary
The maximum amount of folic acid and folate adults can consume from supplements and fortified foods without experiencing harmful side effects is 1,000 mcg. Children typically get enough folate from food alone.

Folic acid supplements may interact with some commonly prescribed medications, including (1):

methotrexate, which is used to treat some cancers and autoimmune diseases
epilepsy medications such as phenytoin (Dilantin), carbamazepine (Carbatrol, Tegretol, others), and valproate (Depacon)
sulfasalazine (Azulfadine), which is used to treat ulcerative colitis

If you’re taking one of these medications, ask your doctor before taking folic acid supplements.

Summary
Folic acid supplements may interact with some medications.

Folate supplements are especially important for people who (1, 2):

are pregnant or of childbearing age
have a condition that affect folate absorption, such as celiac disease or inflammatory bowel disease
have gene changes that affect how their bodies break down and use folate
are older and live in care facilities
are at higher risk of folate deficiency because of their diet
have alcohol use disorder

Avoid giving folate supplements to infants under 1 year old unless a healthcare professional recommends it. Breastmilk, formula, and food should be the only sources of folate in an infant’s diet (1).

Summary
People who are pregnant or of childbearing age or who have folate deficiencies often use folic acid supplements.

There are many versions of folate. Folinic acid, folic acid, and 5-methyltetrahydrofolate are the ones most widely used in dietary supplements (1).

Folinic acid is a natural form of folate found in foods. Healthcare professionals call it leucovorin. It’s used to prevent toxic side effects from the drug methotrexate, which is a treatment for some types of cancer (41).

Folinic acid is more effective than folic acid at raising blood folate levels (41).

Some studies have shown that 5-MTHF absorbs better than other forms of synthetic folate. Plus, it’s less likely to interact with medications. This suggests it may be better to take 5-MTHF supplements than folic acid. However, other studies have found no significant differences (42).

Summary
Folinic acid, folic acid, and 5-methyltetrahydrofolate (5-MTHF) are the types of folate most commonly used in dietary supplements.

Just one thing

If you’re considering getting pregnant, it’s recommended that you take a folic acid supplement and eat a diet high in folate. If you think you have a folate deficiency, a healthcare professional can diagnose it and help you get the folate you need.

Benefits, Foods, Deficiency, and More

Folic acid is a water-soluble vitamin. It’s a synthetic version of folate, one of the B vitamins (1).

Because your body can’t make folate, you need to get it from your diet.

Some foods naturally contain folate. Folic acid is added to other foods. You can also get folic acid from dietary supplements (2).

What’s the difference between folate and folic acid?

Although the terms “folate” and “folic acid” are often used interchangeably, they are actually different forms of the same vitamin: vitamin B9.

You can find folate in plant and animal foods like these (1):

spinach
kale
broccoli
avocado
citrus fruits
eggs
beef liver

Folic acid is added to foods such as flour, ready-to-eat breakfast cereals, and breads (4, 5).

It’s also in dietary supplements, such as multivitamins (1, 4).

What does the body use folate for?

Your body uses folate to (1):

make and repair DNA
help cells grow, divide, and work properly
produce certain proteins
help red blood cells mature

Folate deficiency can lead to many health problems, including (1, 2, 6, 7):

anemia
an increased risk of heart disease and certain cancers
developmental irregularities in infants if pregnant people don’t get enough folate

Many countries, including the United States, require certain grain products to be fortified with folic acid. Folic acid fortification helps prevent neural tube irregularities in infants (7, 8).

Summary
Folic acid is a synthetic version of the B vitamin folate, which naturally occurs in leafy greens, eggs, and citrus fruits, among other foods. It’s essential to important functions in the body.

Your body absorbs natural folate about half as well as folic acid from supplements (1).

Adults need about 400 mcg DFE of folate each day. During pregnancy and breastfeeding, folate needs can increase. The RDA during pregnancy is 600 mcg DFE (1, 6, 7, 9).

Your body stores 15–30 mg of folate. Most of that folate is in your liver, and the rest is in your blood and tissues (1).

The RDA for folate for infants, children, and teens is (1):

Birth to 6 months: 65 mcg DFE
Ages 7–12 months: 80 mcg DFE
Ages 1–3: 150 mcg DFE
Ages 4–8: 200 mcg DFE
Ages 9–13: 300 mcg DFE
Ages 14–18: 400 mcg DFE

Summary
Adults need about 400 mcg DFE of folate each day.

Both folic acid and folate are used in supplements. Although these two nutrients treat the same conditions, they are metabolized differently in the body and can affect health in different ways (1).

Here are some common uses and benefits of folic acid supplements.

Treating folate deficiency

Folate deficiency can happen for many reasons. Some possible causes of folate deficiency are (1, 2):

a lack of folate in your diet
diseases or surgeries that affect how your body absorbs folate, including celiac disease, short bowel syndrome, and gastric bypass surgery
no stomach acid (achlorhydria) or low stomach acid (hypochlorhydria)
drugs that affect folate absorption, including methotrexate and sulfasalazine (Azulfadine)
alcohol use disorder
pregnancy
hemolytic anemia
dialysis

Preventing birth defects and pregnancy complications

Folic acid supplements not only help prevent fetal development issues but also help lower the risk of pregnancy complications such as preeclampsia (10).

Maintaining brain health

Adequate folate intake may also help protect against Alzheimer’s disease (11, 12).

Another study looked at 121 people with newly diagnosed Alzheimer’s disease who were being treated with the medication donepezil (Aricept).

Those who also took 1,250 mcg of folic acid per day for 6 months had improved thinking ability and less inflammation than those who took Aricept alone (14).

Treating mental health conditions

Folate is involved in the production of brain chemicals called neurotransmitters. Consuming too little folate has been linked to depression, schizophrenia, and other mental health conditions.

For example, people with depression may have lower blood levels of folate than people without depression (15).

A 2022 review of studies suggests that folic acid and folate supplements may help reduce symptoms of mental health conditions such as postpartum depression, schizophrenia, and bipolar disorder (16).

Taking folate supplements in addition to antidepressant medication may reduce depression symptoms more than taking antidepressant medication alone (17).

A review of seven studies found that treatment with folate supplements plus antipsychotic medication may improve symptoms in people with schizophrenia more than antipsychotic medication alone (18).

However, larger, more robust studies are needed to further support these findings.

Reducing heart disease risk factors

Folate-based supplements, including folic acid, may help improve heart health and reduce the risk of heart disease.

Folic acid supplements can help bring down homocysteine levels and may lower heart disease risk (19).

Other possible benefits

Folic acid supplements may also help with these other health conditions:

Diabetes. Folate supplements may help improve blood sugar regulation and reduce insulin resistance in people with diabetes. Because the diabetes drug metformin can lower folate levels, you may need a supplement if your levels are low (22, 23, 24).
Fertility issues. Folate can improve egg quality and help eggs grow and implant in the uterus. Taking folate may increase the chance of getting pregnant and carrying a baby to term. People who use assisted reproductive technology to conceive may be more likely to have a baby if they have a higher intake of supplemental folate (25, 26).
Inflammation. Inflammation plays a role in many diseases. Folic acid and folate supplements have been shown to reduce markers of inflammation such as C-reactive protein (27).
Kidney disease. The kidneys usually filter waste out of the blood, but when the kidneys are damaged, homocysteine can build up. About 85% of people with chronic kidney disease have too much homocysteine in their blood. Folic acid supplements may help reduce homocysteine levels and heart disease risk in people with kidney disease (28).

Larger studies are still needed to confirm the benefits of folate supplementation.

This list doesn’t include every possible benefit of folic acid. There are many other reasons people may use folate-based supplements.

Consult a healthcare professional

Summary
Folic acid supplements are commonly used to prevent fetal development issues in pregnant people. Low levels of folate can be associated with health risks, and a deficiency of this essential nutrient may be caused by a medical condition.

Folate plays essential roles in a baby’s development.

However, taking too much folic acid may have a negative effect on a child’s brain development and increase their chances of developing autism, which will be discussed in the next section (29).

Folate is important for the health of both pregnant people and their babies, and it’s not always easy to get enough of this nutrient through your diet alone (6, 7, 9).

Summary
Folic acid supplements help support pregnancy, reduce pregnancy-related complications, and reduce the chance of fetal development issues.

When you take folic acid, your liver has to convert it into the active form, 5-methyltetrahydrofolate (5-MTHF).

If your liver doesn’t convert it quickly enough, folic acid can build up in your blood. Eating foods containing 5-MTHF instead of folic acid can prevent this from happening (1).

Foods that contain 5-MTHF include (1):

leafy greens
beans and lentils
asparagus
avocado

In a pregnant person, this variant can also increase the chance of neural tube irregularities in a developing fetus (2, 31).

There are genetic tests for MTHFR variants, but few people need them.

Summary
Certain genetic mutations may affect the folate levels in your body.

It’s important to note that most children and adults in the United States get enough folate from food and don’t need to take a folic acid supplement (1).

Autism

Taking folic acid during pregnancy helps prevent neural tube irregularities. But having high levels of unmetabolized folic acid in your blood may increase the chance that your child will have ASD.

People who take less than 400 mcg of folic acid daily are unlikely to have high levels of unmetabolized folic acid in their blood (29, 36).

High levels of unmetabolized folic acid during pregnancy may affect children’s mental development.

Although these studies suggest there may be risks to taking high doses of folic acid during pregnancy, more research is needed to confirm these findings.

Other possible risks of high folic acid intake

Taking high doses of folic acid may be associated with other health conditions, including the following.

Cancer

Folic acid might lower the risk of cancers affecting the head and neck, pancreas, esophagus, and bladder. But it may increase the risk of prostate cancer.

So far, research on the topic has not delivered conclusive results, and more studies are needed.

Impaired immune function

Summary
Research has suggested that high folic acid intake may be associated with certain health conditions, including cancer, autism, and immune system suppression.

The Tolerable Upper Intake Level (UL) is the highest daily folic acid dose you can take without experiencing harmful side effects.

The UL includes only folate from fortified foods and dietary supplements. High intake of naturally occurring folate from food has not been shown to cause any adverse effects (1).

The UL for folate in supplements and fortified foods is (1, 32):

Age range	UL
adults	1,000 mcg
children ages 14–18	800 mcg
children ages 9–13	600 mcg
children ages 4–8	400 mcg
children ages 1–3	300 mcg

You can take all forms of folic acid with or without food.

Before taking folic acid

A healthcare professional might recommend a folic acid supplement if you have a deficiency or you are pregnant or thinking about getting pregnant.

Let a healthcare professional know what other prescription and over-the-counter medications you take. Folic acid may interact with some medicines (1).

Storage and handling

Store folic acid supplements in a cool, dry place. Keep supplements away from humid areas, such as the bathroom.

Overdose

A healthcare professional may recommend higher doses if you have a folate deficiency. Avoid taking more than the UL unless a healthcare professional directs you to do so.

Summary
The maximum amount of folic acid and folate adults can consume from supplements and fortified foods without experiencing harmful side effects is 1,000 mcg. Children typically get enough folate from food alone.

Folic acid supplements may interact with some commonly prescribed medications, including (1):

methotrexate, which is used to treat some cancers and autoimmune diseases
epilepsy medications such as phenytoin (Dilantin), carbamazepine (Carbatrol, Tegretol, others), and valproate (Depacon)
sulfasalazine (Azulfadine), which is used to treat ulcerative colitis

If you’re taking one of these medications, ask your doctor before taking folic acid supplements.

Summary
Folic acid supplements may interact with some medications.

Folate supplements are especially important for people who (1, 2):

are pregnant or of childbearing age
have a condition that affect folate absorption, such as celiac disease or inflammatory bowel disease
have gene changes that affect how their bodies break down and use folate
are older and live in care facilities
are at higher risk of folate deficiency because of their diet
have alcohol use disorder

Summary
People who are pregnant or of childbearing age or who have folate deficiencies often use folic acid supplements.

There are many versions of folate. Folinic acid, folic acid, and 5-methyltetrahydrofolate are the ones most widely used in dietary supplements (1).

Folinic acid is more effective than folic acid at raising blood folate levels (41).

Summary
Folinic acid, folic acid, and 5-methyltetrahydrofolate (5-MTHF) are the types of folate most commonly used in dietary supplements.

Just one thing

Folic acid: benefits, harms, advice from a nutritionist

In the middle of the 20th century, American biochemists struggled with the secret of a substance that helps pregnant women with megaloblastic anemia. In 1941, they managed to obtain folic acid from spinach leaves, and by 1945 they were able to synthesize it chemically.

What is
What is
Dosage
Benefits
Restrictions and side effects
Expectant mothers: advice from a gynecologist
Expert commentary

The material was commented by Maria Volchenkova, nutritionist at Best Doctor, clinical psychologist, member of the Russian Union of Nutritionists, Nutritionists and Food Industry Specialists, an expert in working with DNA tests.

Advertising on RBC www.adv.rbc.ru

What is folic acid

Folic acid is a scientifically developed water-soluble analogue of vitamin B9essential for the proper development of the circulatory and immune systems. In 1931, the existence of an unknown substance that helps pregnant women overcome megaloblastic anemia was reported by doctor and researcher Lucy Wills. She noticed that her patients recovered after taking the yeast extract.

Only ten years later, scientists were able to establish that this substance was folate, and remove it from spinach leaves. And for the first time it took 4 tons of plants. The drug was called folic acid - from the Latin word folium (leaf). K 19In 1945, they learned how to synthesize it chemically [1].

Folic acid and all its derivatives are classified as folates. However, there are some differences between the artificial vitamin and B9 found in foods in how they are absorbed and act on the body.

Folate is found in beans, broccoli, leafy vegetables, eggs, beef liver, etc. Remember: the more processed the products are, the less useful substances remain in them. Folic acid supplements are not necessary if a person leads a healthy lifestyle and eats a balanced diet.

Why folic acid is needed

We store most of our folate in the liver, and the rest in the blood and tissues. This substance is critical for a wide range of functions in the body [2], [3], [4], [5]:

production and maintenance of new cell health;
DNA replication process;
cell division;
metabolism of nucleic and amino acids;
maturation of erythrocytes.

Folate deficiency is associated with an increased risk of megaloblastic anemia, heart disease. Vitamin B9 deficiencyin pregnant women can lead to various developmental disorders of the child [6].

Nearly half of vitamin B9 is lost during cooking

Folic acid dosage

Synthetic folic acid is almost completely absorbed by the body, while folate, which a person receives from food, is absorbed by about 50%.

Recommended intake for folate:

Birth to 6 months: 65 mcg/day
Up to 1 year: 80 mcg/day
1-3 years: 150 mcg/day
4-8 years: 200 mcg/day
9-13: 300 mcg/day
From 14 years old: 400 mcg/day
Pregnant (with an uncomplicated obstetric history): 400–600 mcg/day
Nursing mothers: 500 mcg/day.

Although folic acid overdose is extremely rare, excess folic acid can lead to a number of negative health effects. The daily intake of folate should not exceed 1000 mcg/day [7].

The Benefits of Folic Acid

Since its discovery, folic acid has been considered primarily a "women's vitamin". It plays an important role in the maturation of eggs, the normalization of the menstrual cycle, and the development of the fetus. However, further medical research has shown that this substance has many beneficial properties for all.

May prevent pregnancy complications

Sufficient folate in the expectant mother's body is essential for egg quality, implantation and fetal maturation [8]. Often, folic acid supplements are prescribed to pregnant women to prevent birth defects in the development of the child, as well as complications associated with pregnancy, in particular preeclampsia [9]. In addition, high levels of vitamin B9 in the body are associated with a lower risk of preterm birth [10], [11].

Helps control blood sugar levels

Folic acid can reduce the chance of blood sugar spikes and increase the sensitivity of body cells to insulin. A folate-rich diet may reduce the risk of diabetic complications, including neuropathy [12], [13], [14].

Helps prevent cancer

In the late 1980s, evidence emerged that a diet based on green leafy foods rich in folate, fiber, calcium, magnesium and other nutrients could prevent colon cancer. In those years, the concept of “folic anti-cancer diet” became popular [15].

A diet rich in foods rich in vitamins B9, B6 and B12 reduces the risk of breast cancer. Also, with the help of folate, it is possible to slow down the process of tumor growth if it has already appeared [16].

Preventive daily folic acid intake for pregnant women is 400-800 mcg/day

Promotes brain health

Low blood folate levels are associated with impaired brain function and an increased risk of dementia. Older people even have low levels of B9within the normal range are associated with an increased risk of mental disorders [17], [18].

Folic acid supplements may improve brain function in people with psychiatric and cognitive impairments. The substance helps to slow the progression and help in the treatment of Alzheimer's disease [19], [20].

Combats mental disorders

Studies have shown that people with depression have low levels of folic acid in their blood [21]. Vitamin B9 supplementation in combination with antidepressants is more effective in managing depressive symptoms than antidepressant treatment alone [22]. In addition, folic acid supplementation in combination with antipsychotics has been shown to improve symptoms in patients with schizophrenia [23].

Reduces the risk of heart disease

Folate plays an important role in the metabolism of homocysteine. An excess of this amino acid increases the likelihood of developing cardiovascular diseases [24].

Research has shown that folic acid supplementation can reduce the overall risk of heart disease by 4% and stroke by 10% [25].

Vitamin B9 supplementation has been associated with improved blood flow and reduced high blood pressure [26], [27]. Both factors have a positive effect on the health of the cardiovascular system.

Limitations and side effects

Intake of high doses of synthetic folic acid may mask B12 deficiency. The fact is that with a lack of both vitamins, megaloblastic anemia develops, and folate effectively copes with this condition. However, it does not correct the neurological problems that occur with B12 deficiency, and the deficiency of an important substance may go unnoticed until irreversible consequences appear [28].

Also, high doses of B9 can reduce the activity of protective immune cells, including natural killer (NK) cells [29], [thirty]. It is not recommended to combine folic acid with certain prescription drugs, in particular drugs for epilepsy, ulcerative colitis, and some types of cancer and autoimmune diseases [31].

Gynecologist's advice

Elena Lyubimkina, obstetrician-gynecologist at GMS Clinic, ultrasound doctor, integrative medicine doctor

In pregnant women, folic acid and folate deficiency increases the risk of miscarriage, partial or complete placental abruption, spontaneous abortion. If mothers experienced a lack of folate during pregnancy, the risk of mental retardation in their children increases later.

Patients often have latent folate and folic acid deficiencies before pregnancy and in the first trimester. It is during this period that it is especially dangerous, since the formation of the neural tube in the fetus begins from the first days of conception and ends at the 28th week of pregnancy. At this stage, a woman may not yet know about the deficiency of her much-needed vitamin and the possible consequences.

That's why it's ideal to take folic acid 9 months before conception. This is how much an egg is formed in a woman's body.

Even if pregnancy is known at a later date, it is never a good idea to start taking folic acid. The expectant mother will have enough folate reserves for about 4 months, so do not panic. As soon as you find out you're pregnant, start taking folic acid.

During pregnancy, the consumption of this vitamin increases greatly. However, with adequate pharmacological support, the level of folate in the body remains at the proper level during all three trimesters and during breastfeeding.

With folate deficiency, weakness, headache, fainting, pale skin, red tongue, diarrhea are noted. If the balance is not replenished on time, a disease such as folate deficiency anemia may develop.

The main source of folate for humans is food. The degree of absorption and utilization of folates depends on the nature of the products, the method of their preparation and the state of the gastrointestinal tract. For example, accelerated technologies for growing leafy vegetables do not allow plants to accumulate vitamin B9 in the proper amount.. At the same time, in pregnant women, the need for folate almost doubles. It is impossible to hope that the expectant mother will be able to make up for this shortage only with food, without synthetic additives.

Laboratory diagnostics (clinical blood count with formula calculation, total serum folates, plasma homocysteine, segmented macrocytes) is very important for the prevention of the development of clinical manifestations of folate deficiency. Ideally, the genetics of folate cycle metabolism. Depending on the results of the studies, the doctor selects an individual dosage and form of the drug.

General advice for pregnant and lactating women: Take 400-800 micrograms/day of folic acid. This dose should not be exceeded without indications and a doctor's appointment. In case of an overdose, the risks of impaired carbohydrate metabolism in the fetus and neurotoxicity increase.

In women with congenital defects in the genes for folate metabolism and homocysteine metabolism, if they eat a lot of methionine-rich foods (meat, eggs, coffee, cottage cheese), homocysteine detoxification slows down, especially in the brain. They may develop a condition such as chronic hyperhomocysteinemia, which is dangerous primarily for the fetal brain. Women with mutations in the folate cycle genes are recommended to take vitamin B9in the form of methylfolate (5-methyltetrahydrofolate, metafolin) at a dose of 400-800 mcg / day.

Expert comment

Maria Volchenkova, nutritionist at Best Doctor, clinical psychologist, member of the Russian Union of Nutritionists, Nutritionists and Food Industry Specialists, expert in working with DNA tests

folic acid". These are different forms of vitamin B9 and their names are often mistakenly used as synonyms.

Folates are the natural form of vitamin B9 found most in leafy greens. In addition, folate is found in avocados, Brussels sprouts, broccoli and some other foods.

Vitamin B9 deficiency increases the risk of cardiovascular disease, pregnancy disorders and fetal developmental disorders. To prevent these risks, a person should receive vitamin B9 in an absorbable form.

The absorption of vitamin B9 depends on the so-called folate cycle genes. With mutations in these genes, there are difficulties with the absorption of folic acid, a synthetic form of vitamin B9.. The active (that is, well absorbed) form of vitamin B9 is called 5-methylenetetrahydrofolate. Interestingly, most dietary folates are converted into the active form, which is easier for the body to absorb.

Excess intake of the synthetic form of vitamin B9 can result in folic acid constantly circulating in the blood, which is not converted to its active form. This happens, for example, with the constant unreasonable intake of multivitamins with too high dosages of vitamin B9.. That is, the body is not able to use it for its own needs.

Since vitamin B9 is involved in the process of cell division, theoretically, an excess of unabsorbed folic acid increases the risk of cancer. If you do not have direct indications (pregnancy and its planning), then for the prevention of vitamin B9 deficiency, it is best to use food sources of folate. Feel free to add leafy greens to your daily salad serving. Avocados will provide you, in addition to folate, potassium, which is also important for the cardiovascular system. Broccoli provides the body with a powerful antioxidant - sulforaphane. Cause an excess of vitamin B9only due to food sources is very difficult. A person simply cannot eat such a quantity of food.

Read also

Hangover relief and weight normalization: what succinic acid can do
What is nicotinic acid and how can it be used

Tags: vitamins

Folic acid - everything you need to know

Folic acid is a synthetic form of folate, a water-soluble vitamin also known as vitamin B9. This acid does not occur naturally in foods, but is often added to refined grains such as breads and cereals and is also found in vitamin and mineral dietary supplements. Since folic acid is different from natural folate, it must be converted to the active form of vitamin B9 before the body can use it.(5-MTHF). This process takes place in four stages, each of which requires several enzymes. One such enzyme is the MTHFR (methylenetetrahydrofolate reductase) enzyme. Some people have genetic mutations that reduce the effectiveness of MTHFR, which can lead to a buildup of folic acid in the blood. The accumulation of folic acid in the blood has been linked to negative health effects, including impaired immune function, decreased brain function, and accelerated cancer cell growth. Thus, the rate of conversion of folic acid into an active form is genetically determined and individual for each.

Folic acid is one of the most widely discussed topics in modern nutritional research.

The natural form of vitamin B9 is folate. Foods rich in folate include legumes, asparagus, artichokes, eggs, green leafy vegetables (spinach, arugula, kale), beets, citrus fruits, Brussels sprouts, broccoli, nuts and seeds, beef liver, wheat germ, papayas, bananas, avocados .

However, studies show that most people do not get enough dietary folate to meet their needs, which is why many countries, including the US and Canada, are fortifying refined grains such as white flour, bread with folic acid and cereals. Food fortification, for example in the US, has increased folic acid intake by 28% and reduced the rate of folate deficiency in the population (measured by the amount of folate in red blood cells) from 39% to less than 4%.

The specified physiological requirement for vitamin B9 for adults is 400 mcg per day (pregnant women need 600 mcg per day), for children - 50-400 mcg per day. The upper tolerable intake level is 1000 micrograms per day.

Adequate levels of vitamin B9 are associated primarily with the prevention of neural tube defects. Low levels of folic acid in the first weeks of pregnancy lead to malformations of the brain, spinal cord and/or spine. Since up to 90% of women do not get enough vitamin B9, all women of reproductive age are advised to take at least 400 micrograms of additional folate per day. Many dietary supplements intended for pregnant women contain folic acid, but it is better to use special dietary supplements containing methylfolate (5-MTHF), since this active form of vitamin B9 can be used by the body without additional transformations.

A high intake of folic acid is known to protect against certain types of cancer, including breast, colon, lung, and pancreatic cancer. This is most likely due to the role of folate in gene expression. Some researchers believe that low folate levels may increase the risk of abnormal cell growth.
Low levels of folate also contribute to the formation of unstable and easily degradable DNA, which can increase the risk of cancer.
However, for people who already have cancer, there is some evidence that a high intake of folic acid (from dietary supplements, not from foods) may promote the growth of certain types of tumors.

Adequate folate levels help reduce homocysteine, which has been linked to cardiovascular disease.
Folate helps convert homocysteine to methionine. With a lack of folate, homocysteine levels rise. Studies have shown that daily intake of folic acid can reduce homocysteine levels by 25%.

Severe vitamin B9 deficiency is uncommon, especially in countries where folate fortification has been established.

Welcome

Find us on iTunes!

Popular Posts