Folic acid vs folate: the main differences and why they’re important

Folate and folic acid are two forms of vitamin B₉. They are similar and the terms are often used interchangeably (sometimes even by nutrition experts) but folate and folic acid are still not quite the same. We think that understanding the important differences between the two will help you make informed decisions that are best suited to your needs.

Deeper dive into folate

What is folate? Folate is water-soluble which means the body doesn’t store the nutrient and can extract the superfluous amounts with urine.

Our bodies cannot produce folate and we have to get it from food which is the reason folic acid made it on the World Health Organization’s List of Essential Medicines. ¹

The best sources of folate are leafy green vegetables (very fitting since the term “folate” derives from the Latin word “folium,” which means leaf), are citrus fruits, beans, beef liver and black-eyed peas. If you’re interested in what other folate foods are folate-rich, jump over to this article here.

Healthy adults and children over four years should aim for at least 300 to 400 micrograms (mcg) of folate daily. ^2 3 Not getting enough of the vitamin can lead to a type of anemia in which red blood cells become abnormally large. Typical symptoms include tiredness, shortness of breath and heart palpitations. ⁴ Low levels are thought to cause other health issues as well, possibly even depression. ⁵

Deeper dive into folic acid

Folic acid is the synthetic or oxidized form of vitamin B₉. Folic acid is commonly used in supplements. In some countries, such as the US, Canada and Australia, it’s also added to processed food products like flour and breakfast cereals. In Europe, on the other hand, food fortification with folic acid is not mandatory. Supplements typically contain 400 mcg of folic acid but higher levels are also available.

Health benefits of folate and folic acid

Folate (or folic acid if you use the supplement form) is needed to form DNA. The vitamin helps divide cells and is therefore especially important when tissues are growing rapidly – in infancy, adolescence and pregnancy. ⁶

A growing body of research has shown that folic acid supplements can also help prevent birth defects of the neural tube which are severe birth defects of the brain and spine. ^7 8 Taking a daily prenatal supplement – ideally starting three months before conception – can help build up an effective concentration of the vitamin that safeguards future baby’s health. Keep in mind, however, that the supplements are not a substitute for a folate-rich diet – in pregnancy, you’ll need both.

The differences: folic acid vs folate

Folic acid is more heat-stable than natural folate foods which, is broken down easily by heat and light. ⁹ That is because folate is susceptible to oxidation – it quickly loses effectiveness during food processing and manufacturing. For example, raw spinach loses half of the folate if we cook it in boiled water. ¹⁰

The synthetic form, on the other hand, is more absorbent and better used by the body (a feature that is also known as bioavailability). Studies have shown that only 50 percent of natural folates and 85 percent of folic acid is bioavailable when taken with food, while 100 percent of folic acid is bioavailable taken with an empty stomach. ¹¹

What makes folic acid active?

Folic acid of the second generation and food folate, however, are not biologically active and need to be converted to a form called 5-methyltetrahydrofolate (or 5-MTHF) once inside the body. 5-MTHF is the biologically active form of the B-vitamin.

The MTHFR gene plays a key role in the process – it provides the instructions for making the key enzyme methylenetetrahydrofolate reductase which then facilitates the conversion into an active form. Many people, however, have a so-called genetic polymorphism and with it a reduced ability to convert folate to its active form. ¹² It is estimated that around 55 percent of European live with these genetic variations. ¹³

This is why it is important to reach for a supplement that already contains a (fourth-generation) 5-MTHF active form of folic acid, such as our QUTE PRENATAL. By taking folic acid supplements that are already in reduced and active form you effectively bypass that genetic variation. The body can then immediately use the nutrient without any form of metabolization. ¹⁴

Side effects: folate vs folic acid

Folate from regular diet is not known to cause any side effects and it doesn’t pose health risks. You can’t get too much folate from munching on a big bowl of salad.

Folic acid, too, is generally a safe nutrient if it’s taken in the right dosages. Before and during pregnancies, 400 mcg of supplemented folic acid per day is the recommended intake, in addition to the folate-rich diet. The recommended upper amount of folic acid is at 1,000 mcg per day. ^15161718

In rare cases folic acid can cause stomach problems, skin reactions, insomnia, nosia or diarrhea. ¹⁹

Taking too much folic acid may also mask the symptoms of a vitamin B₁₂ deficiency (such as tiredness) but the neurological damage caused by deficiency will still be made. ²⁰ The condition is more common in older people, who cannot effectively absorb vitamin B₁₂ from their food. ²¹

Conclusion

If you’re on a healthy, balanced diet, you’ll likely receive all the folate you need from food. But in certain cases, an extra boost is needed. Supplemental folic acid is important if you wish to start a family, are already pregnant or lactating. In these cases, you should take 400 mcg of folic acid daily which is recommended extra dosage that helps prevent birth defects of the neural tube. Also note, that folic acid is suggested to anyone of reproductive age as half of the pregnancies are unplanned.  

And finally, when you look for folic acid supplements, keep an eye on the label. The product should contain “5-methyltetrahydrofolate” or “5-MTHF” active form that will also work in people who are not able to convert folic acid itself.

REFERENCES

1. https://apps.who.int/iris/bitstream/handle/10665/325771/WHO-MVP-EMP-IAU-2019.06-eng.pdf
2. https://www.bfr.bund.de/en/frequently_asked_questions_about_folate_and_folic_acid-70348.html
3. https://ods.od.nih.gov/factsheets/Folate-Consumer/
4. https://ods.od.nih.gov/factsheets/folate-HealthProfessional/
5. https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/
6. https://www.mountsinai.org/health-library/supplement/vitamin-b9-folic-acid
7. https://www.fao.org/3/y2809e/y2809e0a.htm
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4486472/
9. http://www.thelancet.com/journals/lancet/article/PII0140-6736(91)90133-A/abstract
10. https://pubmed.ncbi.nlm.nih.gov/12493090/
11. https://www.sciencedirect.com/science/article/pii/S266615432030020X
12. https://ods.od.nih.gov/factsheets/folate-HealthProfessional/#polymorphism
13. Francesco Scaglione & Giscardo Panzavolta (2014) Folate, folic acid and 5-methyltetrahydrofolate are not the same thing, Xenobiotica, 44:5, 480-488, DOI: 10.3109/00498254.2013.845705
14. https://www.degruyter.com/document/doi/10.1515/jpm-2012-0256/html
15. https://www.health.harvard.edu/womens-health/the-ups-and-downs-of-folic-acid-fortification
16. https://www.bfr.bund.de/en/frequently_asked_questions_about_folate_and_folic_acid-70348.html
17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5849489/
18. https://www.nhs.uk/medicines/folic-acid/
19. https://www.mountsinai.org/health-library/supplement/vitamin-b9-folic-acid
20. https://www.who.int/nutrition/publications/micronutrients/FNBvol29N2supjun08.pdf
21. https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/folate-and-vitamin-b12-friendly-or-enemy-nutrients-for-the-elderly/D8C38CD6D49977957C5B098623459519