Medically reviewed by Thomas Dean Chiampas, PharmD, BCPS, AAHIVP — Written by Claire Sissons on December 11, 2019
- Differences
- Sources
- Pregnancy
- Deficiency
- Summary
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Although they are very similar, there are some key differences between folic acid and folate. Both relate to vitamin B-9, which plays a key role in preventing birth irregularities and aiding the production of healthy red blood cells.
Folate refers to the many forms of vitamin B-9. These include folic acid, dihydrofolate (DHF), tetrahydrofolate (THF), and more. The body uses B vitamins to create new cells.
Folic acid is a synthetic form of folate. Food manufacturers add it to many products because it does not occur naturally. Bread, pasta, rice, and breakfast cereals tend to contain added folic acid.
Share on Pinterest Folate and folic acid are available in a range of foods.
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:
| Folic acid | Folate | |
| Benefits |
|
|
| Risks |
|
|
| Side effects | Side effects are highly uncommon but may include:
| Folate from natural sources is unlikely to cause side effects. |
| Types | Folic acid is synthetic. It is available in some foods and in supplement form, as either a pill or a liquid. | Folate covers the following forms of vitamin B-9:
Folate occurs naturally in a range of foods. |
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:
- beef liver
- spinach
- black-eyed peas
- fortified breakfast cereal
- asparagus
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.
Last medically reviewed on December 11, 2019
Folate is a B group vitamin needed for healthy growth and development. It is known as ‘folate’ when it is found naturally in food, such as leafy green vegetables, fruits and legumes. ‘Folic acid’ is the synthetic form of folate and is added to food, such as bread and breakfast cereals, or used in dietary supplements.
Why is folate important for pregnancy?
Folate and folic acid are important for pregnancy because they can help prevent birth defects known as neural tube defect, such as spina bifida.
Spina bifida is one of the most common birth defects. It occurs in the first weeks of pregnancy, when the brain and spinal cord are forming.
Most cases of neural tube defects can be prevented if you have enough folate before and during early pregnancy.
You can get enough folate by eating folate-rich foods and taking a supplement.
Which foods contain folate?
Many foods are naturally rich in folate, but folate dissolves in water and is easily destroyed by cooking. It is best to lightly cook vegetables or eat them raw. Microwave or steam cooking is best.
The following are good sources of natural folate:
- vegetables (broccoli, brussels sprouts, cabbage, cauliflower, English spinach, green beans, lettuce, mushrooms, parsnip, sweet corn, zucchini)
- fruit (avocado, grapefruit, oranges, berries, bananas)
- legumes (chickpeas, soya beans, lima beans, red kidney beans, lentils, haricot beans)
- eggs
- nuts
- juices (many apple and orange juices)
- Vegemite
In Australia, all flour used for making bread (except organic bread), rolls, bagels, English muffins and flat breads made with yeast must contain folic acid. It can also be found in some breakfast cereals.
Three slices of bread (100g) contains an average of 120 micrograms of folic acid.
You can check the food label of any bread product made in Australia to check if it contains folic acid (sometimes listed as folate) in the ingredients.
When should I start taking folic acid supplements?
Folic acid supplements are available in Australia over the counter from pharmacies and supermarkets, and through your doctor at varying doses. Some women need more folate than others. Talk to your doctor about what dose of folic acid is right for you.
Generally, when trying to get pregnant or in the early months of pregnancy, you will need to look for supplements that contain at least 400 micrograms of folic acid. These will generally be supplements that contain only folic acid or special pregnancy supplements. Although many multivitamins targeted at pregnant women may contain folic acid, it’s important to check you are getting the recommended dose.
The best way to guarantee you get enough folic acid is to take a daily folic acid supplement at least 1 month before and until 3 months after conception. You don’t need to take folic acid supplements after that.
How will I know if I need a high dose of folic acid?
Some women have an increased risk of having a pregnancy affected by a neural tube defect and are advised to take a higher dose (5mg) of folic acid each day until they are 12 weeks pregnant. Women have an increased risk if:
- they or their partner have a neural tube defect
- they or their partner have a family history of neural tube defects
- they have had a previous pregnancy affected by a neural tube defect
- they have diabetes
- they have a body mass index (BMI) greater than 30
- they have a risk of not absorbing nutrients well
In addition, women who are taking anti-epileptic medication should consult their doctor for advice because they may also need to take a higher dose of folic acid.
If any of the above apply to you, talk to your doctor since they can prescribe a higher dose of folic acid. Your doctor or midwife may also recommend additional screening tests during your pregnancy.
Speak to your doctor if you are planning a pregnancy or if you think you might be pregnant.