Folic acid benefits and everything you need to know

What is folic acid?

Folic acid is a water-soluble vitamin. It is a synthetic version of folate, one of the B vitamins.

Since the body cannot make folate (B9), we must get it from our daily diet.

Some foods naturally contain folic acid. Folic acid is added to foods. You can also get folic acid from food supplements.

What is the difference between folate and folic acid?

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

Folic acid has a different structure than folate and has slightly different effects on the body. Folate is a generic term that includes all forms of vitamin B9, including folic acid and 5-MTHF. Folic acid is a specific synthetic form of this vitamin.

Folate is found in such plant and animal foods as:

• Spinach
• Cabbage
• Broccoli
• Avocado
• Citrus fruits
• Eggs
• Beef liver

Folic acid is added to foods such as flour, breakfast cereals and bread.

Folic acid (b9) is also found in dietary supplements such as multivitamins.

What does the body use folate for?

The body uses folate:

• produce and repair DNA
• help cells grow, divide and function properly
• to produce certain proteins
• help red blood cells mature

A folate deficiency can cause many health problems, including:

• anemia
• increased risk of heart disease and certain cancers
• developmental defects in babies if pregnant women do not get enough folate

Many countries, including the United States, require certain grain products to be fortified with folic acid.¹

Folic acid is a synthetic version of the vitamin (B9) folate. Folate (B9) occurs naturally in leafy greens, eggs and citrus fruits. Vitamin B9 is very useful for maintaining important body functions.

Vitamin B9

Vitamin B9 is an essential nutrient whose natural form is folate.

It performs many important functions in the body. For example, it plays a crucial role in cell growth and DNA formation

Benefits of folic acid, folate (B9).

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 have different health effects.²

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

Vitamin B9 deficiency supplementation

Vitamin B9 deficiency can occur for many reasons. Some possible causes of folate deficiency include:

• lack of folic acid in the daily diet
• diseases or surgeries that affect how the body absorbs folate, including celiac disease, short bowel syndrome, and gastric bypass surgery;
• no stomach acid (achlorhydria) or little stomach acid (hypochlorhydria)
• drugs affecting the absorption of vitamin B9
• alcohol consumption
• pregnancy
• hemolytic anemia
• dialysis

Getting too little folate (folic acid) can lead to complications such as anemia, problems with fetal development, mental disorders, impaired immune function, and depression. Taking folic acid or folate supplements can increase vitamin B9 levels and prevent these complications.

Reducing the risk of heart disease

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

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

Folic acid supplements can help lower homocysteine levels and reduce the risk of heart disease.⁸

For example, a review of 30 studies with more than 80,000 total participants found that folic acid supplementation in 4% reduced the overall risk of heart disease and 10% reduced the risk of stroke.⁸

Also, taking folic acid supplements along with antihypertensive medications can reduce high blood pressure significantly more than antihypertensive medications alone. Folic acid supplements may also improve blood vessel function in people with heart disease.

Brain maintenance

Low levels of folate in the blood are associated with poor mental function and an increased risk of dementia. Even folate levels that are technically normal but close to the low limit can increase the risk of psychiatric disorders in older adults.

Adequate folate intake may also help prevent Alzheimer's disease.⁵

in 2019 in a study of 180 adults with mild cognitive impairment, taking 400 micrograms of folic acid supplements daily for 2 years improved brain function and reduced blood levels of proteins associated with Alzheimer's disease.

Treatment of mental health disorders

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

For example, people with depression may have lower blood levels of vitamin B9 than people without depression.

in 2022 A review of research shows that folic acid and folate supplements can help reduce symptoms of mental health conditions such as postpartum depression, schizophrenia and bipolar disorder.

Taking folic acid supplements along with antidepressants may reduce symptoms of depression more than antidepressants alone.⁶

A review of seven studies found that treatment with folic acid supplements and antipsychotics can improve symptoms in people with schizophrenia more than antipsychotics alone.⁷

Prevention of birth defects and pregnancy complications

Folic acid supplements may help prevent neural tube defects. Getting enough vitamin B9 during pregnancy can reduce the chance of your baby being born with this condition.³

Folic acid supplements not only help prevent fetal development problems, but also help reduce the risk of pregnancy complications such as preeclampsia.⁴

Diabetes and folic acid

Folic acid supplements can help improve blood sugar regulation and reduce insulin resistance in people with diabetes. Some medications can reduce folic acid levels, so you may need to supplement with vitamin B9.

Inflammation

Inflammation plays an important role in many diseases. Folate and folic acid supplements have been shown to reduce markers of inflammation such as C-reactive protein.⁹

Vitamins recommended by specialists can be found in the category: Vitamins

Folic acid supplements are commonly used to prevent fetal development problems in pregnant women. Low levels of folic acid can be associated with health risks, and a lack of this essential nutrient can lead to disease.

Gene changes affecting folic acid levels

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

If the liver does not convert fast enough, folic acid can build up in the blood. Eating foods that contain 5-MTHF can help prevent this.

Foods that contain 5-MTHF:

• leafy greens
• beans and lentils
• asparagus
• avocado

Certain gene changes affect how the body uses folate. Methylenetetrahydrofolate reductase (MTHFR) is an enzyme that breaks down homocysteine. Changes called mutations in the MTHFR code can affect health by changing the amount of folic acid in the body.

One of the most common MTHFR mutations is C677T. People with this variant have less of the enzyme that breaks down homocysteine. People can have high levels of homocysteine, which can increase the risk of heart disease.

An MTHFR mutation alone does not mean that health problems are at risk or that treatment is needed. But if homocysteine levels are high, a health care professional may recommend taking a supplement.

Certain genetic mutations can affect the amount of folic acid in the body.

Side effects and precautions

It is generally safe to eat foods rich in folate and take natural forms of folate such as 5-MTHF. However, taking supplements and taking high doses of folic acid can lead to a buildup of unmetabolized folic acid in the blood.

"Unmetabolized" means that the body has not broken down folic acid and converted it into other forms of folic acid. No confirmed health risks have yet been found from unmetabolized folic acid, but unanticipated risks may still exist.

Impaired immune function

High doses of folic acid supplements can suppress the immune system by reducing the activity of protective immune cells. Whether these immune changes may increase the risk of infection in humans is still unknown.¹⁰

Studies have shown that high intakes of folic acid may be linked to certain health conditions, including cancer, autism, and immune system suppression.

How to take folic acid

Folate and folic acid can be found in different forms. Often added to multivitamin supplements, including multivitamins and B complex vitamins. Most adult supplements contain 400-800 micrograms of folic acid.

The Tolerable Upper Intake Limit is the highest daily dose of folic acid you can take without experiencing harmful side effects.

The upper limit only covers folic acid from fortified foods and supplements. High intakes of naturally occurring folic acid from foods have not been shown to cause any adverse effects.

All forms of folate can be taken with food or on their own.

Before taking folic acid

A healthcare professional may recommend folic acid supplements if you have a folate deficiency or are pregnant.

Folic acid storage

Store folic acid supplements in a cool, dry place. Additionally, keep away from damp areas such as the bathroom.

Overdose

There is no upper limit for folic acid in food products. Since folate is water soluble, your body eliminates any excess that you consume. However, side effects may occur if you take folic acid supplements above the recommended upper limit.

The maximum amount of folate and folic acid that adults can take is 1,000 micrograms. There should be no harmful side effects from getting this amount from supplements and fortified foods. Children usually get enough folic acid from food alone.

Who uses folic acid most often?

Folic acid supplements are especially important for people who:

• expecting a child
• have a condition that affects the absorption of folic acid, such as celiac disease or inflammatory bowel disease
• have gene changes that affect how the body breaks down and uses folate
• are older
• have a higher risk of folate deficiency due to their diet
• have alcohol use disorders

Folic acid supplements should be avoided in infants under 1 year of age unless recommended by a health professional. Breastfeeding, formula and food should be the only sources of folic acid in a baby's diet.

Alternatives

There are many versions of folate. The most widely used in supplements are: folinic acid, folic acid and 5-methyltetrahydrofolate.

Folic acid is more effective than folic acid in increasing blood folate levels.¹²

Some studies have shown that 5-MTHF is better absorbed than other forms of synthetic folic acid. It is also less likely to interact with medications. This suggests that 5-MTHF supplementation may be better than folic acid. However, other studies have found no significant differences.¹³

Folic acid is the natural form of folic acid found in foods. Healthcare professionals call this leucovorin.

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

It is important to rememberthat everyone's health is individual and there is no common recipe for everyone!

So, if you want to know if your body might be lacking nutrients right now, health professionals recommend a guide –  "Your Day".

• In time, pay attention to the signals sent by your well-being
• Replenish the body with natural minerals, vitamins and nutrients necessary for health.
• Enjoy energy and good mood everyday!