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From Mayo Clinic to your inboxSign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. ErrorEmail field is required ErrorInclude a valid email address Learn more about Mayo Clinic’s use of data.To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. They help us to know which pages are the most and least popular and see how visitors move around the site. All information these cookies collect is aggregated and therefore anonymous. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Your tissues, your cells, your DNA — to function well, they all need folate. In fact, this natural form of vitamin B9 is crucial. But not everyone gets enough of it. We spoke to Lisette Breto, PharmD, a clinical pharmacist with Banner Health, about folate and folic acid. She explained how folate deficiency may be connected to other medical conditions, which groups should boost their folate intake, and the important differences between folate and folic acid. What is folate?Folate helps in the making of DNA and other genetic material. Folate shows up in lots of different foods, including:
Folic acid, meanwhile, is the synthetic version of folate. Dr. Breto explained that in 1998, the U.S. Food and Drug Administration (FDA) approved fortifying certain foods with folic acid, such as cereal, flour, and bread, to decrease risk of neural tube defects (NTD). Because certain foods are now fortified with folic acid, Dr. Breto said it’s now uncommon in the U.S. for someone to have low folate. Instead, it can show up with or be the result of other medical conditions. When your folate levels are low, you might have symptoms like those of anemia: feeling fatigued, lethargic, out of breath or lightheaded. Who gets folate deficiency?The National Institutes of Health (NIH), outlines the following groups typically at risk for folate deficiency:
With some of these groups, low folate usually comes from poor folate absorption. Dr. Breto also mentioned that for some people it can be due to poor nutrition or a restricted diet. Researchers have also studied low folate’s possible role in conditions like Alzheimer’s disease, hypertension, and autism spectrum disorder, but results have so far been inconclusive. Can I get too much folate/folic acid?Yes! But it really only happens with folic acid — not folate — since folic acid doesn’t always fully metabolize. For some folks, that metabolizing process is slow. And when too much folic acid builds up in your bloodstream, it can cause an undetectable vitamin B12 deficiency. It can also mask or hide a vitamin B12 induced megaloblastic anemia, a condition where your bone marrow produces unusually large and abnormal red blood cells. This masking can be dangerous because B12 deficiency doesn’t just cause anemia; it can also lead to serious nerve damage. The active form of vitamin B9, known as 5-MTHF, can be purchased as a supplement. Dr. Breto explained that these supplements can interact with other medications, so it’s important to involve your health care provider first. It’s easy to mistakenly think folate and folic acid are interchangeable terms, Dr. Breto said. But some folks may benefit more from one than the other. She mentioned that the following groups are more likely to be prescribed folic acid supplements.
When should I involve my doctor?The answer is simple: always. Your health care provider can help determine how much folate or folic acid is best for you. Reviewing your medical history is an important part of dialing in the right amount. And because low folate levels may relate to other medical conditions, getting medical guidance for these other conditions will help your folate levels. Eager to learn more? You may also want to read these related articles, written with help from other Banner Health experts: Is it better to take folate or folic acid?In terms of providing the body with available nutrient, dietary folate—the form found in whole foods—is preferable to the synthetic folic acid found in supplements and processed foods. It is both more readily available to the body, and it does not pose the same potential risks of build up.
Is folate or folic acid more bioavailable?The bioavailability of food folate is generally lower than that of folic acid, but the extent of the difference is unclear (11, 12). Recommended daily allowances for food folate take into account its lower bioavailability.
Why is folic acid used instead of folate?People often use the two interchangeably as they are both forms of vitamin B9 but in fact there is an important difference. Folic acid is the synthesized version that is commonly used in processed foods and supplements. Folate can be found in whole foods such as leafy vegetables, eggs, and citrus fruits.
What is the best form of folate to take?But for many people lifestyle factors, popularly used medications or common gene mutations deplete their folate stores. For these individuals AND for the rest of us, methylfolate is the best dietary form of folate. Methylfolate (technically methyltetrahydrofolate) is the body's most active form of folate.
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Is folate or folic acid better absorbed
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