Are folate and folic acid the same thing?

What is folate?

Most of us will be aware of folate and folic acid due to their importance during pregnancy.

This is because when a woman is pregnant, both she and the growing foetus need plenty of vitamin B9, thereby increasing the amount needed overall.

Vitamin B9 is important for normal growth and development of the foetus. Deficiency can result in problems for the mother such as anemia and the risk of congenital abnormalities for the baby.(6)

A lack of sufficient folate is particularly linked with a higher risk of neural tube defects in the developing foetus.(3)

This occurs when the baby’s spinal column does not develop properly and it can lead to very serious health problems. These include spina bifida, which can cause partial paralysis, and anencephaly, which results in stillbirth or death shortly after birth.(7)

However, research has revealed that supplemental folic acid can drastically reduce the risk of neural tube defects.

One study found that the risk of neural tube defects was reduced by 70% when the mother had a previous history of pregnancy with the same issue.

Meanwhile a Hungarian study showed a 100% decrease in risk in first time pregnancies.(3)

How much folic acid do pregnant women need to take?

In the USA, the Centers for Disease Control and Prevention (CDC) recommends that all women of reproductive age take 400mcg of folic acid every day. This is in addition to folate from natural food sources.(2)

Meanwhile, in the UK, the NHS recommends that women who are pregnant, trying to conceive or could get pregnant take a 400mcg supplement every day. They can stop taking the supplement once they are 12 weeks pregnant.(8)

Some women who are at a higher risk of pregnancy affected by neural tube defects may need to take a higher dose. Your doctor can advise you on the right amount for you.

Consider folic acid supplements early

If you’re trying to get pregnant, it’s very important to start thinking about folic acid supplementation early on.

This is because neural tube development occurs very early in pregnancy (within the first 3-4 weeks). Many women won’t even realise that they are pregnant during this time, so waiting for a positive pregnancy test may be leaving things too late.

Rather, you should consider taking folic acid as a matter of course if you are trying to become pregnant. This way, if you do fall pregnant during this time you will be covered.

What are the other health effects of folic acid?

Folic acid or folate may also be helpful in other areas of our health.(8)

One area of interest is our cardiovascular health. Remember the special amino acid, homocysteine, which we mentioned right at the top of this article? Folate or folic acid plays a role in breaking it down.

If too much homocysteine is circulating in your system, there appears to be a higher risk of cardiovascular disease.

Hence, if folic acid helps to reduce homocysteine levels, it seems reasonable that there may be cardiovascular health benefits. However, at this stage the research is not conclusive.

There is also some evidence that folate or folic acid plays a role in other diseases, including depression, Alzheimer’s disease and some types of cancer. Again, the research is very limited at this point and we need to know more before drawing firm conclusions.

What happens if you become deficient in vitamin B9?

As well as potentially putting you at a higher risk of cardiovascular disease, a lack of vitamin B9 can disrupt other processes in your body.

As we know, it’s essential for making DNA and RNA.

Severe deficiency in vitamin B9 can cause a condition called megoblastic anemia. Because your ability to make DNA is impaired, your body changes the way it produces red blood cells. Instead of making lots of very tiny cells, you end up making a smaller number of larger cells.

This also affects the way you make white blood cells and platelets.

Unfortunately your larger red blood cells are less efficient at carrying oxygen. As a result, you might experience symptoms such as fatigue, weakness, headaches and shortness of breath.(8)

If you suspect you might have a folate deficiency, speak to your doctor to get a professional diagnosis.

Can you take too much folic acid?

It is extremely difficult to consume too much folate from food sources. However, it is possible to take too much folic acid in the form of supplements.

If you take too much folic acid this way, there are some negative health effects to be aware off.

Firstly, it can mask vitamin B12 deficiency.

There is also a debate in the scientific community about whether high doses of folic acid can contribute to your risk of cancer.

The results of research into the link between high doses of folic acid and cancer have been mixed, with some studies showing an increased risk and others a decreased risk.(9)

There is also uncertainty around potential links between folic acid supplementation and respiratory health in young children. Higher folate concentrations in a mother’s bloodstream might be linked to atopic dermatitis in their children.(9)

Do I need to take a folic acid supplement?

Many people can get enough folate from their diet by eating foods such as leafy vegetables, fruit juice and whole grains.

However, if you are pregnant, the amount of folate or folic acid you need increases. As such, many health bodies around the world recommend taking a supplement.

There is a lot of evidence to support the protective benefits of getting enough folate or folic acid against the risk of your baby developing neural tube defects. These are extremely serious health issues which can result in severe illness or death.

If you choose to take a supplement, be mindful that it is possible to take too much. Speak to your doctor to find the right dose for you, and don’t take more than you are advised.

Related reading

• Vegan foods with vitamin B12
• Which whole foods for which vitamins?