Everything You Need to Know About Folic Acid

Folic acid is an essential B vitamin humans need for multiple reasons. It’s actually a synthetic form of B9, also known as pteroylmonoglutamic acid. The natural form of vitamin B9 is called folate. It comes from the Latin word folium, meaning “leaf.” Folate is also known as levomefolic acid or 5-methyltetrahydrofolate, or 5-MTHF. So, besides the very long names, what are the differences between folate vs folic acid

What Does Folic Acid Do in the Body?

When folic acid is ingested, the liver and other tissues convert it into folate, or 5-MTHF, before it enters the bloodstream. Folic acid is necessary for the body to make new cells and red blood cell formation. Your skin, hair, and nails are constantly developing new cells. It is also vital during pregnancy, as it aids in fetal development. 

What Foods Contain Folate?

In the question of folate vs. folic acid, people can get them in multiple ways. In food, folate is most commonly found in leafy vegetables like spinach, lettuce, and okra. It also occurs in asparagus, avocados, brussels sprouts, fruits, peans, dried beans, nuts, mushrooms, yeast, liver, kidney, eggs, seafood, and tomato and orange juice. Folic acid is sold as a supplement and is usually found anywhere vitamins are sold. 

Who Needs Folic Acid?

While everyone needs folic acid, it is most important to people going through pregnancy. The CDC recommends all women of reproductive age who could get pregnant should consume at least 400 micrograms of folic acid daily. 

Folic acid prevents birth defects during pregnancies by helping in development of the child’s brain and spinal cord. Without the right amount of folic acid, the risk of anencephaly and spina bifida increases.

Why is Folic Acid Added to Food?

In 1998, the U.S. Food and Drug Administration instituted rules that require food manufacturers to add folic acid to certain foods, mostly grain products like breads, cereals, flour, rice, and pasta. It is a process called fortification. The labels of these foods are marked “enriched,” so customers know they are fortified. The process has been beneficial, leading to a rise in folic acid intake in the U.S. Currently, 92 countries around the world fortify at least one type of cereal grain. 

What Are the Problems Between Folate Vs. Folic Acid?

When people take folic acid, it gets converted into folate before the body can use it. But some people have a genetic variant that does not let them process folic acid efficiently into its active form of folate. When this occurs, it can lead to unmetabolized folic acid in the bloodstream. This inability to convert vitamin B9 into folate vs. folic acid is suspected to lead to health risks, including cancer, but further studies need to be done to confirm this.

What Happens if You Don’t Get Enough Folic Acid?

Some symptoms of a lack of folic acid include weakness, fatigue, irregular heartbeat, shortness of breath, problems with concentration, loss of hair, sores in the mouth, and pale skin. It is also the cause of megaloblastic anemia, which occurs when the body doesn’t produce enough red blood cells and the ones it does produce are larger than normal. 

Folic acid also breaks down homocysteine in the body, an amino acid. When there is a lack of folate or the body can’t convert folic acid into folate, it can lead to high levels of homocysteine. This can cause a higher risk of heart disease or stroke. 

Who Is At the Highest Risk of Deficiency of Folic Acid?

There are few groups of people who are more susceptible to health issues because of lower levels of folic acid. One that has already been mentioned is people who are pregnant, because folic acid is such a necessary factor in the production of blood cells and development of the brain and spine. 

Another high-risk group is alcoholics, who aren’t able to process the folic acid into folate as efficiently as necessary. Alcoholics also tend to have an unhealthy diet that lacks foods that contain folate. 

People with digestive disorders like inflammatory bowel disease or celiac disease are also unable to metabolize folic acid, which can lead to problems. Others who have had intestinal surgeries involving the digestive organs are sometimes left with a lower level of stomach acid, which makes absorbing folate more difficult.

Making Sure You Are Getting Enough Folic Acid

Folic acid, and its natural form, folate, is important for everyone, but especially those who are pregnant or are thinking of becoming pregnant. Folate is present in many foods and folic acid is a widely available supplement. Whichever form you choose in folate vs. folic acid, it’s a necessary part of a daily diet, so take notice of what you’re eating and determine if you need to supplement your intake.