Folate vs. folic acid: What to know

Folate and folic acid have very similar effects. Both help the body create new cells, such as red blood cells.

Folate goes through the digestive system and enters the bloodstream through the gut. From there, folate passes into the liver for processing. Any excess passes to the kidneys, and from the kidneys, it leaves the body in urine.

Taking too much of a fat-soluble vitamin can cause health problems. The body stores vitamins A and D in fat reserves, so they can build up over time.

However, it is very hard to have too much folate, as it dissolves in water. This means that the body can get rid of excesses easily. Although the blood may carry some excess folate, this does not cause any known health risks.

The following table compares folic acid with folate:

Manufacturers fortify foods with folic acid rather than folate. This is because folate is lost during cooking or baking, as heat and light can break it down. Folic acid is more stable.

The sections below list some sources of folic acid and folate.

Folic acid

Folic acid is present in a range of fortified foods, as well as in supplement form. Sources of folic acid include:

• fortified pasta, rice, and corn masa flour
• fortified breakfast cereals
• fortified bread
• vitamin supplements

Supplements usually contain 400–1,000 micrograms (mcg) of folic acid. On average, an adult in the United States will get 140 mcg of folic acid per day from fortified foods.

Folate

The recommended dietary allowance of folate is 400 mcg per day for an adult and 600 mcg for a pregnant woman.

Folate occurs naturally in many foods. Some foods contain more folate than others. According to the National Institutes of Health (NIH), the five foods with the highest folate levels are:

Dark green, leafy vegetables, fruits, nuts, seafood, eggs, dairy products, poultry, orange juice, and grains all contain folate. Eating a varied diet with different sources of folate will help a person maintain a good balance of nutrients.

Meat and dairy products are good sources of folate, but they may also be high in unhealthful fats. Choose lean meat and lower fat dairy, or get protein and folate from nuts and beans instead.

Both folic acid and folate are important for women before becoming pregnant and during early pregnancy. Having a high enough level of folate in the blood can help prevent birth irregularities.

Specifically, low blood folate levels may increase the risk of neural tube irregularities. These congenital changes affect the spinal cord and brain. Two common examples are:

• spina bifida, a condition in which the spine does not form properly and which can damage the nerves
• anencephaly, which prevents parts of the brain and skull from forming normally

The Centers for Disease Control and Prevention (CDC) recommend that women begin to take a folic acid supplement at least 1 month before conception.

The recommendation is 400 mcg of folic acid per day, plus a varied diet with foods rich in folate.

Because many everyday foods contain folic acid, deficiency is uncommon.

Having low levels of folate in the blood can cause folate deficiency anemia. When this develops, the body makes larger red blood cells that do not work properly. Common symptoms include:

• tiredness
• low energy levels
• a tingling feeling in the arms, hands, legs, or feet
• mouth ulcers
• problems with sight
• memory loss

Folic acid works with other B vitamins to control levels of an amino acid called homocysteine. Having high levels of homocysteine in the body can increase the risk of heart disease and stroke. Including enough folate in the diet or taking supplements can help reduce the risk of stroke.

Also, digestive conditions such as celiac disease can prevent the body from absorbing nutrients properly. This could increase the chance of a folate deficiency. Alcohol dependence may also increase this risk.

The body needs folate to function normally. Most children and adults get enough folate through their diet. Choose a wide variety of foods to get the best range of nutrients.

Women who are planning to become pregnant or who are in the early stages of pregnancy should take a folic acid supplement. This can help prevent birth irregularities.

Folic acid is always included in prenatal vitamins, and individual folic acid supplements are available for purchase in health stores, pharmacies, and online.