Folate vs Folic Acid: What’s The Difference?

December 06, 2022


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. The terms are often used interchangeably.

Are They The Same Thing?

Many health professionals would even argue that folate and folic acid are essentially the same nutrients. Folic acid is often considered to be a supplemental form of folate. However, 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 Are The Differences Between Folate and Folic Acid?

Folate is a general term for a group of B vitamins and is also known as B9. It refers to the various derivatives naturally found in food. On the other hand, folic acid refers to the oxidized synthetic compound used in dietary supplements and food fortification,

The form of folate that can enter the main metabolic cycle is “tetrahydrofolate” (THF).  Unlike natural folates (which are metabolized to THF in the mucosa of the small intestine), folic acid undergoes initial chemical processes in the liver.

Several studies have reported the presence of unmetabolized folic acid in the blood following the ingestion of folic acid supplements or fortified foods. Human exposure to folic acid was non-existent until its chemical synthesis in 1943. It was introduced as a mandatory food fortification in 1998.

Food fortification was deemed mandatory due to evidence for the protective effect of neural tube defects (NTD) in newborns.

Risks Associated with Excessive Folic Acid Intake

folic acid

The incidence of neural tube defects in the United States has been significantly reduced since folic acid fortification began. However, there has been concern about the safety of chronic intake of high levels of folic acid from fortified foods, beverages, and dietary supplements.

One of the major risks associated with excessive intake of folic acid is the development of cancer. 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.  A randomized control trial found that daily supplementation with 1 mg of folic acid was associated with an increased risk of prostate cancer.

A high intake of folic acid might lead to a deterioration of central nervous system function in the elderly. In one study involving older adults, consumption of folic acid resulted in a significantly faster rate of cognitive decline than nonusers.

Folate from Natural Food Sources Is Best

Despite the risks associated with high levels of folic acid intake, adequate intake of folate from the consumption of folate-rich foods is essential for health.

Folate aids the complete development of red blood cells. It reduces levels of homocysteine in the blood. And folate supports nervous system function.

Sources of Folate

Food sources of folate

Excellent sources of dietary folate include vegetables such as romaine lettuce, spinach, asparagus, turnip greens, mustard greens, parsley, collard greens, broccoli, cauliflower, beets, lentils, calf’s liver, and chicken liver.

You can supplement with folate if your dietary intake is inadequate. Look for products that 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.

If you have any questions about folate, call our office at 412-595-7332.