The little known difference between folate and folic acid Facebook2.3k Tweet Pin Google+48 If I asked you which of these vitamins was found naturally in food, folate or folic acid, would you know the answer? If not, you’re in good company. Medical professionals, nutrition experts, and health practitioners frequently mix up the two, simply because the terms are often used interchangeably. Many health professionals would even argue that folate and folic acid are essentially the same nutrient. While folic acid is often considered to be a supplemental form of folate, there is an important distinction between these two different compounds. For women past childbearing age, and for men in general, excessive doses of the synthetic form of this nutrient are not necessary, and may even be harmful. What’s the difference between folate and folic acid? Folate is a general term for a group of water soluble b-vitamins, and is also known as B9. Folic acid refers to the oxidized synthetic compound used in dietary supplements and food fortification, whereas folate refers to the various tetrahydrofolate derivatives naturally found in food.

( 1 ) The form of folate that can enter the main folate metabolic cycle is tetrahydrofolate (THF). ( 2 ) Unlike natural folates, which are metabolized to THF in the mucosa of the small intestine, folic acid undergoes initial reduction and methylation in the liver, where conversion to the THF form requires dihydrofolate reductase. The low activity of this enzyme in the human liver, combined with a high intake of folic acid, may result in unnatural levels of unmetabolized folic acid entering the systemic circulation. Several studies have reported the presence of unmetabolized folic acid in the blood following the consumption of folic acid supplements or fortified foods. ( 3 ) Human exposure to folic acid was non-existent until its chemical synthesis in 1943, and was introduced as a mandatory food fortification in 1998. ( 4 ) Food fortification was deemed mandatory due to overwhelming evidence for the protective effect of folic acid supplementation before conception and during early pregnancy on the development of neural tube defects (NTD) in newborns.

Risks associated with excessive folic acid intake While the incidence of NTDs in the United States been significantly reduced since folic acid fortification began, there has been concern about the safety of chronic intake of high levels of folic acid from fortified foods, beverages and dietary supplements. ( 5 ) One of the major risks associated with excessive intake of folic acid is the development of cancer. ( 6 ) In patients with ischemic heart disease in Norway, where there is no folic acid fortification of foods, treatment with folic acid plus vitamin B12 was associated with increased cancer outcomes and all-cause mortality. In the United States, Canada, and Chile, the institution of a folic acid supplementation program was associated with an increased prevalence of colon cancer. ( 7 , 8 ) A randomized control trial found that that daily supplementation with 1 mg of folic acid was associated with an increased risk of prostate cancer. ( 9 ) Researchers have hypothesized that the excessive consumption of folic acid in fortified foods may be directly related to the increase in cancer rates. Excess folic acid may stimulate the growth of established neoplasms, which can eventually lead to cancer.

The presence of unmetabolized folic acid in the blood is associated with decreased natural killer cytotoxicity. ( 10 ) Since natural killer cells play a role in tumor cell destruction, this would suggest another way in which excess folic acid might promote existing premalignant and malignant lesions. A high intake of folic acid might mask detection of vitamin B12 deficiency and lead to a deterioration of central nervous system function in the elderly. In one study, consumption of folic acid in excess of 400 micrograms per day among older adults resulted in significantly faster rate of cognitive decline than supplement nonusers. ( 11 ) Another study found a higher prevalence of both anemia and cognitive impairment in association with high folic acid intake in older adults with a low vitamin B12 status. ( 12 ) As vitamin B12 deficiency is a common problem for many older adults, these studies suggest that high folic acid intake could cause serious cognitive consequences in the elderly. Folate from natural food sources is best Despite the risks associated with high levels of folic acid intake, it is well established that adequate folate intake from the consumption of folate-rich foods is essential for health.

Folate aids the complete development of red blood cells, reduces levels of homocysteine in the blood, and supports nervous system function. It is well known for its role in preventing neural tube defects in newborns, so women of childbearing age must be sure to have an adequate intake prior to and during pregnancy. Excellent sources of dietary folate include vegetables such as romaine lettuce, spinach, asparagus, turnip greens, mustard greens, parsley, collard greens, broccoli, cauliflower, beets, and lentils. ( 13 ) Not surprisingly, some of the best food sources of folate are calf’s liver and chicken liver. You can supplement with folate if your dietary intake is inadequate. Look for products that contain the Metfolin brand, or list “5-methyltetrahydrofolate” or “5-MTHF” on the label. Avoid products that say “folic acid” on the label. Make sure to check your multivitamin, because most multis contain folic acid and not folate. Women planning on becoming pregnant should consume between 800 and 1200 mcg of folate per day for several months before the start of pregnancy.

Unless you’re consuming chicken or calf’s liver and substantial amounts of leafy greens on a regular basis, it’s difficult to obtain this amount from diet alone. If you’re pregnant or trying to get pregnant, I recommend supplementing with 600-800 mcg of folate per day, depending on your dietary intake. Solgar is a good brand, but there are several others that typically use 5-MTHF including Designs for Health, Thorne, Metabolic Maintenance and Pure Encapsulations. All other people, such as men and older women, should be able to get plenty of folate in a diet with adequate vegetable consumption, and do not need to supplement. Like what you’ve read? Sign up for FREE updates delivered to your inbox.

Email* What Folic Acid Is & Where It Comes From - TestCountry Articles Keeping Your Niacin Levels At Normal: Preventing, Testing and Treating Niacin Toxicity and Deficiency » What Folic Acid Is & Where It Comes From Folic acid (C19H19N7O6), also known as pteroyl-L-glutamic acid, Vitamin M, folate, folinic acid, folacin etc., is a water soluble compound which is better known as vitamin B9 to “normal” people who live outside chemistry Labs! It is found mostly in leafy green vegetables like kale and spinach, orange juice, and enriched grains. Several studies have shown that it is necessary for the synthesis of adenine and thymine residues, two of the four monomers that make up our DNA – the inheritable genetic polymer that “defines” us as humans! Our body needs folic acid essentially to make new cells & perform basic life functions of DNA replication & transcription. Moreover, Adenine makes up a very significant molecule for biological systems – the ATP – the Energy Currency of the cell! This emphasizes the importance of folic acid for women who are either planning pregnancy or those who are in their early pregnancy.

They should have proper amounts of folic acid in their diet for proper development of the infant. Needless to say, the deficiency of folic acid may lead to infant developmental complications galore! Various levels of folic acid have been proposed for a healthy body. According to the guidelines of RDA, the essential amount of dietary folic Acid varies with an individual’s sex & also with his/her age group. Kindly refer to the table below: 1~3 4~8 9~13 14 + Men 150µg 200µg 300µg 400 µg During pregnancy late pregnancy Women 150µg 200µg 300µg 400 µg 600 µg 500 µg So, planning your diet with a nutritionist is highly recommended especially if you are planning to shoulder the responsibility of being a mother! Now, since dietary habits vary at large across the globe, it is sometimes difficult to keep up with the required amounts of folic acid in daily diet.

Due to its crucial role in the metabolic & genetic functions of our bodies & fortification against several diseases, we simply can’t blame our dietary habits & stay ignorant. So, various dietary supplements have come up which tend to “supplement” our faulty eating habits by providing the body what it really needs! Broadly, they may include: Enriched breads Protein supplements (they usually have ample vitamins too!) Convenience Foods Enriched breads: All kinds of breads, rolls, muffins, tortillas, bagels, pizza rust, and waffles etc. Grains: Rice, pasta, bulgur, barley, millet. Fortified Cereals: These are the excellent sources of folic acid and generally provide around 25% of the daily requirements of folic acid.Fruits: Orange juice, canned Pineapple juice, Papaya, Blackberries, Strawberries, Mustard greens, Broccoli, Corn (fresh frozen or canned), Beets, sprouts, Parsnips, Okra.

Vegetables: Spinach, raw, Celery, Swiss chard, cooked, Cauliflower, Tomato juice, Cantaloupe, casaba or honeydew melon, Baked Green or wax beans, Italian green beans, raw Cabbage. Beans: Cranberry beans, Lentils, Pink beans, Adzuki beans, Black beans, Great Northern beans, Navy beans/white beans, Pinto beans, , Kidney beans, Soybeans, Lima beans. Peas: Black-eyed peas or cowpeas, Chickpeas, Pigeon peas, Split peas, Tofu, Peanuts, Peanut butter. Protein Foods: Egg, Liver oil, Yeast extract. Convenience Foods: Instant Breakfast, Bean with bacon soup, Chili with beans, Refried beans, Pork and beans or baked beans, Spaghetti sauce, Lentil soup, Black bean soup, Bean burrito, Frozen waffle. Chemical compounds: these include some compounds that help in the synthesis of folic acids, like sulfonamides. Folic acid tends to be lost or modified during food preparation, cooking, or storage. So, care must be taken while preparing meals.

To retain folic acids: Steam, boil, or simmer vegetables in a minimal amount of water. Serve fruits and vegetables raw whenever possible. Store vegetables in a cool and dry place. Folate vs. Folic Acid: Which is Better? | Wellness Mama You Are Here: Wellness Mama » Blog » Health » Folate vs. Folic Acid Folate vs. Folic Acid Twitter Facebook Google+ Pinterest I’ve gotten several questions lately about folate and folic acid, especially during pregnancy . These two are often used interchangeably and even many doctors will not be able to tell you the difference if you ask. The body needs this important nutrient, especially during pregnancy and folate is the natural form of this nutrient found in foods. You’ll often hear that folic acid is simply the supplemental form, but there are some key differences. Recent research is supporting the fact that folic acid should be avoided and the natural form should be preferred. What’s the Difference Between Folic Acid & Folate? Chris Kresser breaks down the important difference in this article : Folate is a general term for a group of water soluble b-vitamins, and is also known as B9.

Folic acid refers to the oxidized synthetic compound used in dietary supplements and food fortification, whereas folate refers to the various tetrahydrofolate derivatives naturally found in food. ( 1 ) The natural form can enter the main folate metabolic cycle is tetrahydrofolate (THF). ( 2 ) Unlike natural folates, which are metabolized to THF in the mucosa of the small intestine, folic acid undergoes initial reduction and methylation in the liver, where conversion to the THF form requires dihydrofolate reductase. The low activity of this enzyme in the human liver, combined with a high intake of folic acid, may result in unnatural levels of unmetabolized folic acid entering the systemic circulation. Several studies have reported the presence of unmetabolized folic acid in the blood following the consumption of folic acid supplements or fortified foods. ( 3 ) Human exposure to folic acid was non-existent until its chemical synthesis in 1943, and was introduced as a mandatory food fortification in 1998.

( 4 ) Food fortification was deemed mandatory due to overwhelming evidence for the protective effect of folic acid supplementation before conception and during early pregnancy on the development of neural tube defects (NTD) in newborns. I’d recommend reading his full article , but research is supporting the idea that too much synthetic folic acid can increase risk of some types of cancers ( source ) and it may not even be as effective in preventing neural tube defects. Folate (the natural form) has some very important functions in the body : “It is necessary during rapid cell division and growth. In fact, pregnancy is known to actually double the need of dietary folates.

Deficiency has been reported to be the most common vitamin deficiency in the US, and is associated with such conditions as: Anemia Incidence and recurrence of Neural Tube Defects (serious birth defects of the spinal cord and the brain which arise during the early development of the embryo, most common being spina bifida) Increased risk of certain cancers Elevated Homocysteine, a risk factor for cardiovascular disease, stroke and many other health conditions Potential Causes of a Folate Deficiency Inadequate dietary intake Increased requirement, as in pregnancy and lactation Malabsorption Increased elimination of folate” ( source ) How to Get Enough Unfortunately, even high quality prenatal vitamins often contain folic acid instead of the natural folate-forms. In the past, I’ve had to create my own supplement regimen for pregnancy to find the natural forms of all the needed nutrients (though there is now a high quality prenatal that contains the natural methylated form ) Folate is found naturally in foods like liver and spinach. It is also possible to find a natural supplemental form that can be taken in place of folic acid.

Though the recommendation for pregnancy is 400-600mcg of folate/folic acid, this is the minimal amount needed to prevent birth defects. When using folate instead of folic acid (thus removing the added risks to mom with the synthetic form), it is often advisable to take more than the minimum. As always, check with a doctor or midwife before taking or changing anything, especially during pregnancy, but do your research on this one! What I do: Before and during pregnancy, I take 800-1200 mcg of folate. I have used Pure Encapsulations Folate (slightly higher quality) and Solgar Folate (less expensive) with good results. The one downside is that it isn’t as easily absorbed, so it is often necessary to take more and to get it from real food sources. I also eat liver at least once a week during pregnancy. UPDATE: I now take this prenatal instead which contains adequate levels .

Additional Reading: Folate Gold (also known as Folic Acid) 1,000 mcg per vegan capsule 180 vegan capsules per bottle Folate Gold is a whole-food source of vitamin B9 as folate, concentrated from certified organic citrus lemon peel and is one of few products on the market today that does not contain any added synthetic, isolated Folic Acid. Folate Gold is manufactured to quality standards that far exceed current GMPs and is verified by independent third-party labs to meet identity, purity, and potency label claims. 1,000 mcg of Organic Folate from Lemon Peel Extract Folate Gold is a whole-food, full-spectrum concentrate of vitamin B9 as folate from certified organic citrus lemon peel and is one of few folate products on the market today that does not contain any added synthetic, isolated folic acid. Product Details - Go Ahead, Take a Closer Look When it comes to product features, the devil, as the saying goes, is in the details. Take a closer look at the Supplement Facts panel to see for yourself why Folate Gold is the TRUE Gold Standard among competing Folate products.

Non-GMO Project Verified for GMO Avoidance Whole-Food Folate Gold is Non-GMO Project Verified , which is assurance that the product has been manufactured in accordance with best practices for GMO avoidance. The Non-GMO Project is North America's premier independent verification program. Certified Organic Ingredient = NO Pesticides Residues Folate Gold is made from citrus lemon that is harvested without the use of any harmful pesticides and standardized to folate using a solvent-free process that ensures exceptional purity while protecting the integrity of the bioactive compounds. Certified Compliant with Kosher and Vegan Standards Folate Gold is Kosher and Vegan certified by independent organizations; this provides assurance that the product has been manufactured in compliance with stringent kosher laws and vegan standards. Verified FREE of Gluten and Other Common Allergens Every lot of Folate Gold is tested and verified free of corn, egg, gluten, milk, peanut, shellfish, and soy allergens by an independent, third-party lab that specializes in allergen testing for complete peace of mind.

Every Lot Third-Party Tested for 140+ Quality Markers Every lot of Folate Gold is subject to over 140 purity and potency assays by independent, third-party labs to ensure that the product meets potency claims and exceeds industry-defined purity standards. FREE of Magnesium Stearate and Other Harmful Additives Consistent with NutriGold's guiding principle to 'do no harm,' Folate Gold is manufactured without the use of harmful additives like stearic acid, Magnesium Stearate , silicon dioxide, artificial ingredients, and preservatives. Related Products Sign up for our newsletter Name Vitamin B9 (Folic acid) Vitamin B9 (Folic acid) In 1941, a substance extracted from spinach leaves and named folic acid from the Latin word "folium" for leaf was found to be effective in the treatment of anemia. Folic acid is the parent compound of a large group of naturally occurring, structurally related compounds collectively known as the folates. Folic acid is a water-soluble vitamin. This vitamin is absorbed from the small intestine, carried by the bloodstream and stored in the body, but not in significant amounts.

7 mg are stored in the liver and other tissues but they can supply the deficiency only for a few months. The body uses what it needs and excretes what is in extra through urine. Roles Folic acid participates in several important metabolic processes in the body. It is essential for the normal growth and maintenance of all cells because it acts as a coenzyme for normal DNA and RNA synthesis. Folate is vital for the reproduction of the cells within the fetus. A deficiency affects normal cell division and protein synthesis, especially impairing growth. Vitamin B9, with the collaboration of vitamin B12 converts homocysteine in methionine therefore reducing blood levels of homocysteine and lowering risks of heart disease. It also maintains nervous system's integrity and intestinal tract functions. It is involved in the production of neurotransmitters such as serotonin, which regulate mood, sleep and appetite. Intake Vitamin B9 (Folic acid) | University of Maryland Medical Center Vitamin B9 (Folic acid) Vitamin B9 (Folic acid) Overview Vitamin B9, also called folate or folic acid, is one of 8 B vitamins.

All B vitamins help the body convert food (carbohydrates) into fuel (glucose), which is used to produce energy. These B vitamins, often referred to as B-complex vitamins, also help the body use fats and protein. B-complex vitamins are needed for a healthy liver, and healthy skin, hair, and eyes. They also help the nervous system function properly. Folic acid is the synthetic form of B9, found in supplements and fortified foods, while folate occurs naturally in foods. All the B vitamins are water-soluble, meaning the body does not store them. Folic acid is crucial for proper brain function and plays an important role in mental and emotional health. It aids in the production of DNA and RNA, the body's genetic material, and is especially important when cells and tissues are growing rapidly, such as in infancy, adolescence, and pregnancy. Folic acid also works closely with vitamin B12 to help make red blood cells and help iron work properly in the body. Vitamin B9 works with vitamins B6 and B12 and other nutrients to control blood levels of the amino acid homocysteine.

High levels of homocysteine are associated with heart disease, however researchers are not sure whether homocysteine is a cause of heart disease or just a marker that indicates someone may have heart disease. It is fairly common to have low levels of folic acid. Alcoholism, inflammatory bowel disease (IBD), and celiac disease can cause folic acid deficiency. Also, certain medications may lower levels of folic acid in the body. Folic acid deficiency can cause: Poor growth Forgetfulness Mental sluggishness Pregnant women need more folic acid to lower the risk of neural tube birth defects, including cleft palate, spina bifida, and brain damage. Neural tube defects are birth defects caused by abnormal development of the neural tube, a structure that eventually gives rise to the brain and spinal cord. Since folic acid has been added to many grain foods in the U.S., such as bread and cereal, neural tube defects have decreased dramatically. Birth defects As mentioned, pregnant women who do not get enough folic acid are more likely to have children with birth defects. Pregnant women should get 600 mcg of folic acid per day.

Women who plan to become pregnant should make sure to get the recommended 400 mcg per day since many neural tube defects can happen shortly after conception and before a woman even knows she is pregnant. Prenatal vitamins contain the needed amount of folic acid for pregnant women. Studies show that women who take folic acid supplements before conception and during the first trimester may reduce their risk of having children with neural tube defects by 72 to 100%. Other studies suggest that in the setting of folic acid fortification of grains, folic acid supplementation does not appear to offer further benefit for preventing spina bifida. Folic acid may also help prevent miscarriage, although the evidence is not clear. Child development studies show that taking prenatal folic acid supplements at the time of conception is associated with a lower risk of autism. Other studies show that taking folic acid supplements in early pregnancy was associated with a reduced risk of severe language delay in children at age 3 years. And some research suggests that low folate levels during pregnancy is associated with a higher risk of emotional problems in the offspring. Heart disease Folate may help protect the heart through several methods.

First, there is some evidence that getting enough folic acid in your diet can reduce your risk of heart disease, although this evidence is based on population studies and not more definitive clinical trials. There is not yet any evidence that taking folic acid supplements would help. Also, many studies suggest that people with high levels of the amino acid homocysteine are roughly 1.7 times more likely to develop coronary artery disease, and 2.5 times more likely to have a stroke than those with normal levels. B complex vitamins, especially vitamins B9, B6, and B12, help lower homocysteine levels. However, there is no evidence that high homocysteine levels actually cause heart disease. Most people who are concerned about heart disease should focus on getting enough B vitamins from healthy foods. In some cases, however, your doctor may recommend taking B vitamins to lower homocysteine levels. If you are worried about heart disease, ask your doctor whether taking a B vitamin supplement is right for you. Age-related hearing loss One study suggests that folic acid supplements help slow the progression of age-related hearing loss in elderly people with high homocysteine levels and low folate in their diet.

It is not known whether healthy seniors would benefit. Age-related macular degeneration (AMD) One large study found that women who took 2,500 mcg of folic acid along with 500 mg of vitamin B6 and 1,000 mcg of cyanocobalamin (vitamin B12) daily reduced their risk of developing AMD, an eye disease that can cause vision loss. Depression The evidence about whether folic acid can help relieve depression is mixed. Some studies show that 15 to 38% of people with depression have low folate levels in their bodies, and those with very low levels tend to be the most depressed. One study found that people who did not get better when taking antidepressants had low levels of folic acid. A double-blind, placebo-controlled study found that taking 500 mcg of folic acid daily helped the antidepressant Prozac work better in women, but possibly not men. Another study found that taking folic acid and vitamin B12 was no better than placebo in relieving depression in older people.

Cancer Folic acid in the diet seems to protect against the development of some forms of cancer, including: Colon cancer Pancreatic cancer Stomach cancer However, this evidence is based on population studies that show people who get enough folate in their diet have lower rates of these cancers. Researchers do not know exactly how folate might help prevent cancer. Some think that folic acid keeps DNA healthy and prevents mutations that can lead to cancer. There is no evidence that taking folic acid supplements helps prevent cancer. The best course of action is to make sure you eat a balanced diet with enough folate, which will help protect you against a number of diseases. Low dietary intake of folate may increase the risk of developing breast cancer, particularly for women who drink alcohol. Regular use of alcohol, more than 1½ to 2 glasses per day, is associated with higher risk of breast cancer. One large study, involving more than 50,000 women followed over time, suggests that adequate intake of folate may reduce the risk of breast cancer associated with alcohol. Dietary Sources Rich sources of folate include: Spinach In addition, all grain and cereal products in the U.S. are fortified with folic acid.

Available Forms Vitamin B9 is found in multivitamins, including children's chewable and liquid drops, and B complex vitamins. It is also sold separately. It is a good idea to take folic acid as part of, or along with, a multivitamin because other B vitamins are needed for it to work. It is available in a variety of forms, including tablets, soft gels, and lozenges. How to Take It Most people (except pregnant women) should be able to get enough folic acid from their diets. Check with a knowledgeable health care provider before taking folic acid supplements or giving them to children.

Daily recommendations for dietary folic acid are: Pediatric Infants, 0 to 6 months: 65 mcg (adequate intake) Infants, 7 to 12 months: 80 mcg (adequate intake) Children, 1 to 3 years: 150 mcg (RDA) Children, 4 to 8 years: 200 mcg (RDA) Children, 9 to 13 years: 300 mcg (RDA) Teens, 14 to 18 years: 400 mcg (RDA) Adult Men and women, 19 years and older: 400 mcg (RDA) Pregnant women: 600 mcg (RDA) Breastfeeding women: 500 mcg (RDA) Amounts used in studies for heart disease range from 400 to 1,200 mcg. However, high levels of folate can hide a vitamin B12 deficiency, and should be taken only under a doctor's supervision. If you are considering taking a folic acid supplement, ask your doctor to help you determine the right dose for you.

Precautions Because of the potential for side effects and interactions with medications, you should take dietary supplements only under the supervision of a knowledgeable health care provider. At the recommended daily allowance, side effects from folic acid are rare. Very high doses can cause: Stomach problems Nausea Seizures Talk to your doctor before taking more than 800 mcg of folic acid. Folic acid can hide the symptoms of an underlying vitamin B12 deficiency, which can cause permanent damage to the nervous system. Taking any one of the B vitamins for a long period of time can result in an imbalance of other important B vitamins. For this reason, you may want to take a B-complex vitamin, which includes all the B vitamins. People who are being treated for seizures or cancer should not take folic acid without talking to their doctors. Possible Interactions If you are currently being treated with any of the following medications, you should not use folic acid supplements without first talking to your doctor. Antibiotics, tetracycline: Folic acid should not be taken at the same time as the antibiotic tetracycline because it interferes with the absorption and effectiveness of this medication.

Folic acid, either alone or in combination with other B vitamins, should be taken at different times from tetracycline. All vitamin B-complex supplements act in this way and should be taken at different times from tetracycline. Phenytoin (Dilantin): Phenytoin, an anti-seizure medication, may lower levels of folate in the body. However, folic acid may interfere with the way phenytoin works, raising the risk of seizures. Ask your doctor before taking folic acid supplements. Pyrimethamine (Daraprim): Pyrimethamine is a medication used to prevent and treat malaria and to treat toxoplasmosis. Folic acid may make this medication less effective. Chemotherapy medications: Folic acid may raise the amounts of 5-fluorouracil and capecitabine (Xeloda) to dangerous levels in the body. If you are undergoing chemotherapy, ask your oncologist before taking any supplements or herbs. Medications that lower levels of folic acid: The following medications may interfere with the body's absorption of folate, meaning you may need to take a folic acid supplement while taking them. Talk to your doctor first.

Antacids. H2 blockers: Used to reduce stomach acid, including cimetidine (Tagamet), famotidine (Pepcid), and ranitidine (Zantac). Proton pump inhibitors: Used to reduce stomach acid, including someprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), and rabeprazole (Aciphex). Bile acid sequestrants: Used to lower cholesterol, including colestipol (Colestid), cholestyramine (Questran), and colsevelam (Welchol). Anti-seizure medications: Including phenobarbital, primidone (Mysoline), and carbamazepine (Tegretol). Nonsteroidal anti-inflammatory drugs (NSAIDs): Including ibuprofen (Advil, Motrin) and naproxen (Aleve). Sulfasalazine (Azulfidine): Used to treat inflammatory bowel disease (IBD) and rheumatoid arthritis (RA). Triamterene (Dyrenium): A diuretic (water pill). Cycloserine: An antibiotic.

Pyrimethamine (Daraprim): Used to prevent and treat malaria and to treat toxoplasmosis. Trimethoprim: An antibiotic used to treat urinary tract infections. When taken for long periods of time, these medications, as well as other anti-inflammatory medicines, can increase the body's need for folic acid. Methotrexate: Methotrexate, a medication used to treat cancer, rheumatoid arthritis (RA), and psoriasis, reduces the amount of folic acid in the body. If you take methotrexate for RA or psoriasis, your doctor may prescribe a higher dose of folic acid, which helps reduce the side effects of methotrexate. People taking methotrexate for cancer, however, should not take folic acid supplements unless their doctor tells them to. Folic acid may interfere with methotrexate's effects on cancer. Supporting Research Abularrage CJ, Sidawy AN, White PW, Aidinian G, Dezee KJ, Weiswasser JM, Arora S. Effect of folic Acid and vitamins B6 and B12 on microcirculatory vasoreactivity in patients with hyperhomocysteinemia.

Vasc Endovascular Surg. 2007 Aug-Sep;41(4):339-345. Ahrens K, Yazdy M, Mitchell A, Werler M. Folic acid intake and spina bifida in the era of dietary folic acid fortification. Epidemiology. 2011; 22(5):731-737. Albert CM, Cook NR, Gaziano JM, Zaharris E, MacFadyen J, Danielson E, Buring JE, Manson JE. Effect of folic acid and B vitamins on risk of cardiovascular events and total mortality among women at high risk for cardiovascular disease: a randomized trial. JAMA. 2008;299(17):2027-2036. Alpert JE, Mischoulon D, Nierenberg AA, Fava M. Nutrition and depression: focus on folate. Nutrition. 2000;16:544-581. Auerhahn C. Daily folic acid supplementation for 3 years reduced age related hearing loss. Evid Based Nurs.

2007 Jul;10(3):88. Bleie O, Semb AG, Grundt H, Nordrehaug JE, Vollset SE, Ueland PM, et al. Homocysteine-lowering therapy does not affect inflammatory markers of atherosclerosis in patients with stable coronary artery disease. J Intern Med. 2007 Aug;262(2):244-253. Booth GL, Wang EE. Preventive health care, 2000 update: screening and management of hyperhomocysteinemia for the prevention of coronary artery disease events. The Canadian Task Force on Preventive Health Care. CMAJ. 2000;163(1):21-29. Celik T, Iyisoy A, Yuksel UC, Isik E. Homocysteine-lowering vitamins and cardiovascular mortality: Are they really effective? Int J Cardiol. 2007 Aug 7; [Epub ahead of print]. Choi S-W, Mason JB. Folate and carcinogenesis: an integrated scheme. J Nutr.

2000:130:129-132. Chowers Y, Sela B, Holland R, Fidder H, Simoni FB, Bar-Meir S. Increased levels of homocysteine in patients with Crohn's disease are related to folate levels. Am J Gastroenterol. 2000;95(12):3498-3502. Christen WG, Glynn RJ, Chew EY, et al. Folic acid, pyridoxine, and cyanocobalamin combination treatment and age-related macular degeneration in women. Arch Intern Med. 2009;169:335-341. de Bree A, van Mierlo LA, Draijer R. Folic acid improves vascular reactivity in humans: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2007;86(3):610-617. Durga J, Verhoef P, Anteunis LJ, et al. Effects of folic acid supplementation on hearing in older adults: a randomized, controlled trial. Ann Intern Med.

2007;146:1-9. Goodman MT, McDuffie K, Hernandez B, Wilkens LR, Selhub J. Case-control study of plasma folate, homocysteine, vitamin B12, and cysteine as markers of cervical dysplasia. Cancer. 2000;89(2):376-382. Guilland JC, Aimone-Gastin I. Vitamin B9. Rev Prat. 2013; 63(8):1079,1081-4. Honein MA, Paulozzi LJ, Mathews TJ, Erickson JD, Wong LYC. Impact of folic acid fortification of the US food supply on the occurrence of neural tube defects. JAMA. 2001;285(23):2981-2236. Jänne PA, Mayer RJ. Chemoprevention of colorectal cancer. N Engl J Med. 2000;342(26):1960-1968. Kliegman. Nelson Textbook of Pediatrics.

19th ed. Philadelphia, PA: Saunders, An Imprint of Elsevier. 2011. Krauss RM, Eckel RH, Howard B, Appel LJ, Daniels SR, Deckelbaum RJ, et al. AHA Scientific Statement: AHA Dietary guidelines Revision 2000: A statement for healthcare professionals from the nutrition committee of the American Heart Association. Circulation. 2000;102(18):2284-2299. Mayne ST, Risch HA, Dubrow R, et al. Nutrient intake and risk of subtypes of esophageal and gastric cancer. Cancer Epidemiol Biomarkers Prev. 2001;10:1055-1062. Nilsen RM, Vollset SE, Rasmussen SA, Ueland PM, Daltveit AK. Folic acid and multivitamin supplement use and risk of placental abruption: a population-based registry study. Am J Epidemiol. 2008;167(7):867-874.

Pogribna M, Melnyk S, Pogribny I, Chango A, Yi P, James SJ. Homocysteine metabolism in children with Down syndrome: in vitro modulation. Am J Genet. 2001;69(1):88-95. Rock CL, Michael CW, Reynolds RK, Ruffin MT. Prevention of cervix cancer. Crit Rev Oncol Hematol. 2000;33(3):169-185. Rohan TE, Jain MG, Howe GR, Miller AB. Dietary folate consumption and breast cancer risk [communication]. J Natl Cancer Inst. 2000;92(3):266-269. Roth C, Magnus P, Schjolberg S, et al. Folic acid supplements in pregnancy and severe language delay in children. JAMA. 2011; 306(14):1566-1573. Schnyder G. Decreased rate of coronary restinosis after lowering of plasma homocysteine levels. N Engl J Med.

2001;345(22):1593-1600. Sellers TA, Kushi LH, Cerhan JR, et al. Dietary folate intake, alcohol, and risk of breast cancer in a prospective study of postmenopausal women. Epidemiology. 2001;12(4):420-428. Smith AD, Kim YI, Refsum H. Is folic acid good for everyone? Am J Clin Nutr. 2008;87(3):517-533. Snowdon DA. Serum folate and the severity of atrophy of the neocortex in Alzheimer disease: findings from the Nun study. Am J Clin Nutr. 2000;71:993-998. Steenweg-de Graaff J, Roza SJ, Steegers EA, et al. Maternal folate status in early pregnancy and child emotional and behavioral problems: the Generation R Study. Am J Clin Nutr. 2012; 95(6):1413-1421. Su LJ, Arab L.

Nutritional status of folate and colon cancer risk: evidence from NHANES I epidemiologic follow-up study. Ann Epidemiol. 2001;11(1):65-72. Suren P, Roth C, Bresnahan M, et al. Association between maternal use of folic acid supplements and risk of autism spectrum disorders in children. JAMA. 2013; 309(6):570-577. Temple ME, Luzier AB, Kazierad DJ. Homocysteine as a risk factor for atherosclerosis. Ann Pharmacother. 2000;34(1):57-65. Thompson JR, Gerald PF, Willoughby ML, Armstrong BK. Maternal folate supplementation in pregnancy and protection against acute lymphoblastic leukemia in childhood: a case-controlled study. Lancet. 2001;358(9297):1935-1940. Thomson SW, Heimburger DC, Cornwell PE, et al. Correlates of total plasma homocysteine: folic acid, copper, and cervical dysplasia.

Nutrition. 2000;16(6):411-416. Title LM, Cummings PM, Giddens K, Genest JJ, Jr., Nassar BA. Effect of folic acid and antioxidant vitamins on endothelial dysfunction in patients with coronary artery disease. J Am Coll Cardiol. 2000;36(3):758-765. Torkos S. Drug-nutrient interactions: a focus on cholesterol-lowering agents. Int J Integrative Med. 2000;2(3):9-13. Wald DS. Randomized trial of folic acid supplementation and serum homocysteine levels. Arch Intern Med. 2001;161:695-700. Wang HX. Vitamin B12 and folate in relation to the development of Alzheimer's disease. Neurology. 2001;56:1188-1194. Windham GC, Shaw GM, Todoroff K, Swan SH. Miscarriage and use of multi-vitamins or folic acid. Am J Med Genet.

2000;90(3):261-262. Wong WY, Thomas CM, Merkus JM, Zielhuis GA, Steegers-Theunissen RP. Male factor subfertility: possible causes and the impact of nutritional factors. Fertil Steril. 2000;73(3):435-442. Alternative Names Folic Acid vs Folate — What's the Difference? | 36,692 views Folate and folic acid are different forms of vitamin B9. Even though there is a distinct difference between the two, their names are often used interchangeably. In fact, there is a lot of confusion regarding folic acid and folate, even among professionals. Being aware of their differences is important, because they do not have the same effects on your health. This article explains the difference between folic acid and folate. Vitamin B9 Vitamin B9 is an essential nutrient that naturally occurs as folate. Folate serves many important functions in the body. For example, it plays a crucial role in cell growth and the formation of DNA. Having low levels of folate is associated with an increased risk of several health conditions.

These include: Elevated homocysteine: High homocysteine levels have been associated with an increased risk of heart disease and stroke ( 1 , 2 ). Birth defects: Low folate levels in pregnant women have been linked to birth abnormalities, such as neural tube defects ( 3 ). Cancer risk: Poor levels of folate are also linked to increased cancer risk ( 4 , 5 ). For these reasons, supplementation with vitamin B9 is common. Fortifying food with this nutrient is actually mandatory in countries such as the US, Canada and Chile. However, the problem is that supplements and fortified foods usually contain folic acid, not folate. Advertisement Bottom Line: Vitamin B9 is an essential nutrient, mainly present as folate and folic acid. It is commonly taken in supplements, and is even added to processed food in North America. What is Folate? Folate is the naturally-occurring form of vitamin B9. Its name is derived from the Latin word “folium,” which means leaf. In fact, leafy vegetables are among the best dietary sources of folate. Folate is actually a generic name for a group of related compounds with similar nutritional properties.

The active form of vitamin B9 is a folate known as levomefolic acid or 5-methyltetrahydrofolate (5-MTHF). In the digestive system, the majority of dietary folate is converted into 5-MTHF before entering the bloodstream ( 6 ). Bottom Line: Folate is the naturally-occurring form of vitamin B9. Before entering the bloodstream, the digestive system converts it into the biologically active form of vitamin B9, 5-MTHF. What is Folic Acid? Folic acid is a synthetic form of vitamin B9, also known as pteroylmonoglutamic acid. It is used in supplements and added to processed food products, such as flour and breakfast cereals. For many years, folic acid was thought to be much better absorbed than naturally-occurring folate. However, a diet containing a variety of folate-rich, whole foods has been shown to be almost as effective ( 7 ). Unlike most folate, the majority of folic acid is not converted to the active form of vitamin B9, 5-MTHF, in the digestive system.

Instead, it needs to be converted in the liver or other tissues ( 6 , 8 ). Yet this process is slow and inefficient. After taking a folic acid supplement, it takes time for the body to convert all of it to 5-MTHF ( 8 ). Even a small dose, such as 200–400 mcg per day, may not be completely metabolized until the next dose is taken. This problem is even worse when fortified foods are eaten along with folic acid supplements ( 9 , 10 ). As a result, un-metabolized folic acid is commonly detected in people’s bloodstreams, even in the fasted state ( 11 , 12 , 13 ). This is a cause for concern, since high levels of un-metabolized folic acid have been associated with several health problems. However, one study suggests that taking folic acid along with other B-vitamins, particularly vitamin B6, makes the conversion more efficient ( 11 ). Bottom Line: Folic acid is a synthetic form of vitamin B9.

The body does not convert it into active vitamin B9 very well, so un-metabolized folic acid may build up in the bloodstream. Is Un-Metabolized Folic Acid Harmful? Several studies indicate that chronically elevated levels of un-metabolized folic acid may have adverse health effects. These include: Increased cancer risk: High levels of un-metabolized folic acid have been associated with increased cancer risk. They may also speed up the growth of precancerous lesions ( 14 , 15 , 16 ). Undetected B12 deficiency: Among elderly people, high folic acid levels may hide vitamin B12 deficiency. Untreated vitamin B12 deficiency may increase the risk of dementia and impair nerve function ( 17 , 18 ). Even a small, daily dose of 400 mcg may cause un-metabolized folic acid to build up in the bloodstream ( 9 , 10 ). Although high folic acid intake is a concern, the health implications are unclear and further studies are needed. Advertisement Bottom Line: High levels of un-metabolized folic acid may negatively affect health by increasing cancer risk or hiding vitamin B12 deficiency.

This build up happens very easily, and the full impact on health is not yet known. What is the Healthiest Source of Vitamin B9? It is best to get vitamin B9 from whole foods. High-folate foods include asparagus, avocados , Brussels sprouts, and leafy greens such as spinach and lettuce. However, for some people — such as pregnant women — supplements may be an easy way to make sure you’re getting enough vitamin B9. In those cases, it is best to choose supplements that do not contain folic acid. Some supplements contain 5-methyltetrahydrofolate (5-MTHF), which is considered a healthier alternative to folic acid. Studies have shown that 5-MTHF is equal to or even better than folic acid ( 19 , 20 , 21 , 22 , 23 ). Supplemental 5-MTHF is bound to calcium, and is usually known as methyl folate or levomefolate calcium. It is also sold under the brand names Metafolin and Deplin. Bottom Line: The healthiest dietary sources of vitamin B9 are whole foods, such as leafy green vegetables.

If you need to take supplements, methyl folate is a healthier alternative to folic acid. Take Home Message There are several distinct differences between folate and folic acid. While folate occurs naturally in foods, folic acid is synthetic. The human body doesn’t seem to handle folic acid very well, and has trouble converting it into the active form of vitamin B9. This can cause un-metabolized folic acid to build up, which may have negative health effects. Luckily, there are many alternatives to folic acid. These include methyl folate supplements and a huge variety of healthy, whole foods. What Is Folate? - The Benefits of Vitamin B9 for Your Heart, Brain and DNA 0 What Is Folate? – The Benefits of Vitamin B9 for Your Heart, Brain and DNA Folate, also known as vitamin B9, is an essential nutrient in your diet. While synthetic folic acid is added to some processed foods, natural folate from the foods you eat is both safer and superior. Ahead are some of the many health benefits of folate, the best food sources and why it’s better to get your vitamin B9 from dietary sources rather than supplements or ‘enriched’ supermarket products.

What is Folate Good For? Vitamin B9 plays an important role in cellular growth and maintenance throughout your body in the way it influences DNA synthesis and repair. Folate can be considered an ‘activator’ of vital cardiovascular, neurological and developmental processes within human DNA and folate deficiency can have some serious health consequences. Folate for Cardiovascular Health Homocysteine is an amino acid that is found circulating in your blood. While it’s normal to have a small amount of homocysteine, elevated levels of this compound have been consistently associated with atherosclerosis and coronary heart disease. Folate is needed to metabolize homocysteine into the essential amino acid methionine for muscular growth and repair. When vitamin B9 is low in your body, homocysteine levels have been shown to increase. Elevated homocysteine or hyperhomocysteinemia also increase the risk of blood vessel damage and internal blood clotting leading to a stroke. Low folate intake has even been linked to high LDL cholesterol levels, another predictor of heart disease. For a healthy heart and well functioning cardiovascular system, folate is an important nutritional element for normalizing homocysteine levels and good health in general.

Brain Health Korean researchers have found a link between low folate levels and dementia and other markers of declining neurological health. Once again, elevated homocysteine levels are believed to be responsible with more folate found to be the remedy. Vitamin B9, along with other B vitamins, is involved in the creation and proper function of neurotransmitters within your brain and many people report folate to be beneficial for reducing brain fog. Folate deficiency has also been linked to feelings of irritability, depression and insomnia . Of course they can be many other potential causes of these conditions but the high folate foods listed ahead may help if you are experiencing health issues like these. Male Infertility Folate is necessary for both sperm creation and proper functioning. Men with a low intake of folate have been shown to often have sperm with a defective chromosomal structure. Increasing dietary folate may help improve sperm quality and assist men with infertility problems trying to achieve a successful pregnancy with their partner. Folate Before and During Pregnancy Vitamin B9 plays a vital role in fetal development during pregnancy.

A deficiency in folate, both before and in the early stages of being pregnant can lead to neural tube defects, a serious problem that can result in the baby being born with spina bifida or the pregnancy terminated. Researchers found increasing folate intake for one month prior to conception and up to three months after can greatly reduce the risk of neural tube defects. Folate is so important for pregnant women that doctors will usually advise taking a folic acid supplement (the synthetic version of folate) for expectant mothers. This is likely good advice in such situations, but given increased folate levels are beneficial for a full month before conception, a far better option is to be already including high folate foods in your diet if you are trying to get pregnant. The Difference between Folate and Folic Acid Soon after the importance of folate in preventing birth defects was discovered, the synthetic version of vitamin B9, folic acid, began being added into commonly eaten foods and drinks like bread and milk. While this decision has likely been important for preventing birth defects in mothers with diets lacking in natural sources of B9, there is some concern that supplemental synthetic folic acid may not be so beneficial for men and women not intending to get pregnant.

Folate is actually better termed folates as vitamin B9 is in reality a series of water-soluble B vitamins. Tetrahydrofolate is the usable form and folates are metabolized into it within your small intestine. Folic acid on the other hand is a similar but synthetic compound which has to be processed by your liver into tetrahydrofolate. This processing requires the enzyme dihydrofolate reductase, but low levels of this enzyme combined with a high intake of folic acid from fortified foods and supplements may lead to unmetabolized folic acid circulating in the body with unknown consequences. Chris Kresser has a detailed article on this process and the potential dangers of excessive folic acid intake. The important takeaway is that ‘enriched’ processed foods and supplemental folic acid can’t compare with the benefits of natural folate from good food sources. Let’s have a look at eight of the best now. 8 High Folate Foods 1. Asparagus Nutrient dense asparagus is around 65% the recommended daily intake of folate and is rich in other vitamins like vitamin K , vitamin A and vitamin C . 2.

Leafy Greens Most dark leafy greens are a great source of folate with spinach, collard greens, mustard greens, bok choy and romaine lettuce amongst the best. 3. Citrus Fruits Oranges and other citrus are great source of folate when eaten or freshly squeezed but avoid high sugar packaged orange juice. The fact that this product is sometimes ‘fortified’ with folic acid, even though the source fruit was initially high in folate, goes to show just how much nutrition is processed out of most supermarket foods. 4. Beans and Pulses Lentils, pinto beans, black beans, navy beans and split peas are all high sources of folate (assuming you can tolerate them without too much gas). 5. Broccoli Nutritional superstar broccoli has many health benefits. Amongst them is around a quarter of the RDI of folate in a cup of the steamed vegetable. 6. Seeds and Nuts 7. Liver Chicken and beef liver is a very high source of folate and many other nutrients, but these aren’t that commonly eaten by most people. 8. Avocado Delicious avocados turn up again and again as one of the healthiest foods.

Along with all of their other nutrients, avocados are beneficial source of folate , with nutritional data listing 22% of the recommended daily intake of folate. Getting Your Folate Getting a good supply of folate into your diet to protect your brain and cardiovascular system shouldn’t be difficult if you eat a wide variety of natural foods like these. Women who intend to get pregnant would do well to increase these kind of foods in their diet, both before and after conception for the health of the baby. Did you know the difference between folate and folic acid and, aside from women wanting to get pregnant, do you think it’s right that folic acid is added to processed foods or should we rely on naturally high folate foods like those listed above? Jim Dillan Jim Dillan is health and wellness researcher, writing about natural nutrition, improving your physical and mental well-being and moving to a healthier lifestyle. His website Superfood Profiles has detailed articles on superfood health benefits, hair and skin treatments and healthy recipes. Follow Us On Social! Hi I'm Helen! Hi there, I'm Helen Sanders, chief editor at Health Ambition. We believe in empowering people with knowledge to make smarter, healthier choices in their lives.

I and a panel of specialists have made it our mission to make our followers feel better and live longer without restrictive diets or lifestyle changes. Welcome aboard! Earnings Disclaimer: When you buy certain products from some of the sites which we link to, Health Ambition receives a commission. 5 Symptoms of Vitamin B9 Deficiency / Nutrition / Vitamins and Minerals Vitamins and Minerals Vitamin B9, also known as folic acid or folate, is a key participant in almost every biochemical process in your body. You need this vitamin to break down food and convert macronutrients, like carbohydrate, fat and protein into energy. You also need it to synthesize normal red blood cells, regulate hormones and ensure faithful replication and synthesis of DNA and RNA. For most people, a balanced diet consisting of all food categories is enough to meet the daily 400 micrograms requirement of folate. Foods like dark green vegetables, beans and legumes, animal liver, sunflower seeds, citrus fruits and juices and fortified cereals are excellent dietary sources of this vitamin and can deliver your total daily requirement in just one serving. There are special instances when extra folate may be required.

Pregnancy or lactating mothers need additional folate to support the fast growth rate of their infants. People who are taking anti-folate medications or cannot efficiently extract and absorb dietary folate may also need extra folate supplementation to prevent the risk of deficiency. The following are the five health consequence of folate deficiency. 1. Megatoblastic Anemia Megatoblastic anemia is the number one adversity caused by folic acid deficiency. Inadequate supply of folate impedes the production of normal red blood cells (RBC), causing structural and functions defects. Folate deficiency causes your RBC to become abnormally large and weak. Their lifespan is also much shorter than normal RBC. If you exhibit symptoms like chronic fatigue, ashen facial color, dizziness and fainting, you may be suffering from megatoblastic anemia due to insufficient folate. 2. Preterm Labor Women who do not take extra folate supplementation during pregnancy are at high risk of preterm labor. Folate helps to remove homocysteines in your blood. Without enough folate, your blood homocysteine concentration increases, causing serious pregnancy complications, which may induce spontaneous abortion. 3.

Prenatal and Neonatal Birth Defects Your baby will suffer irreversible damages if you do not take enough folate during pregnancy and lactation. Folate is a controlling factor in the neurological development of the growing fetus. Babies born to folate deficient mothers are extremely likely to develop severe neural defects like spina bifida and anencephaly. They are also at high risks of congenital heart and limb disorders and mental retardation. Breast-feeding mothers also need extra folate supplementation. Folate deficiency in newborns can stunt the baby's growth rate and impair his or her brain development. 4. Stress Related Disorders The blood concentration of homocysteines also affects your body's response to stress. High levels of homocysteines inhibits the production and release of your anti-stress hormones and increases your risks of stress related disorders like depression, anxiety and insomnia. This is why it is especially important for postmenopausal women to eat plenty of folate-rich food or take an extra daily supplement to prevent PMS syndromes. 5. Cancer Folate acid deficiency can also raise the error rate in gene transcription and replication.

Cell mutation and tumor growth is more likely to occur when you cannot accurately copy and make new DNA and RNA. Infantile folate deficiency is a strong contributing factor of childhood leukemia. Deficiency in adults can lead to higher occurrence of gastric, colorectal, breast and prostate cancers.

Question: What compound is also known as vitamin B9 or folacin?
Answer: Folic acid