Folate and folic acid are both forms of vitamin B9, an essential nutrient involved in DNA synthesis, red blood cell production, and neurological function. However, despite their similarities, these two forms of vitamin B9 are not identical.
Did you know that folate and folic acid are processed differently by the body?
In this article we will explore the difference between folate and folic acid, their dietary sources, and their roles in supporting overall wellbeing.
What is Folate?
Folate is the naturally occurring form of vitamin B9 found in whole foods like beans, leafy green vegetables, asparagus, broccoli and citrus foods.
Folate is absorbed in the small intestine, where it is taken up by cells and converted into its active form 5-methyltetrahydrofolate (5-MTHF) which is directly used in the methylation processes to control key functions such as:
DNA Synthesis and Cell Division: Essential for rapidly dividing cells, including red and white blood cells (1).
Neurotransmitter Function: Supports the production of serotonin, dopamine, and norepinephrine (2).
Cardiovascular Health: Folate, along with other B vitamins, helps break down homocysteine, an amino acid that can damage the inner walls of arteries when present in high levels (3).
Foetal Development: Crucial for neural tube formation in early pregnancy, reducing the risk of neural tube defects (NTDs) such as spina bifida (4).
Natural Dietary Sources of Folate
- Leafy greens (spinach, kale, romaine lettuce)
- Broccoli, Brussel Sprouts and cauliflower
- Green peas
- Legumes (lentils, chickpeas, black beans and kidney beans)
- Asparagus
- Eggs
- Liver and other organ meats
- Citrus fruits (oranges, lemons)
- Avocados
- Beetroot
- Salmon and shrimp
- Nuts and seeds (pumpkin seeds)
What is Folic Acid?
Folic acid is the synthetic form of vitamin B9, commonly used in fortified and enriched foods like:
- Breakfast cereals
- Bread
- Flour
- Pasta
- Some prenatal supplements
Unlike folate, folic acid is not biologically active and must undergo a series of enzymatic conversions in the liver and intestines to become 5-MTHF, the bioavailable form used by the body.
Folic acid fortification was introduced as a public health measure in many countries to reduce the incidence of neural tube defects in pregnancy.
Understanding Supplement Labels: Folic Acid vs. Methylfolate
In the UK and EU, supplement labels follow strict regulations.
The nutrient breakdown (supplement facts) must list folate under the general term “Folic Acid”, even if the product contains a natural form like Calcium L-Methylfolate.
The ingredients list must specify the exact form used for example, Calcium L-Methylfolate or 5-MTHF.
Why This Matters
Consumers may assume “Folic Acid” means synthetic, but some supplements contain bioavailable methylfolate, so checking the ingredients list helps identify whether the supplement contains synthetic folic acid or natural methylated folate.
At Revive Active we have carefully curated our supplement range to contain the active form of folate called Calcium L-Methylfolate alongside the cofactors necessary for optimal absorption and assimilation.
Absorption and Metabolism of Folate
As Folate is primarily absorbed in the small intestine some people may experience reduced folate absorption.
Gastrointestinal Conditions: Inflammatory Bowl Diseases such as Coeliac disease, Colitis and Crohn’s disease can impair folate absorption. For instance, people with Crohn's disease, especially those who have had their ileum removed or have inflammation in that area, may have difficulties absorbing vitamin B12 and folate from food (5).
Alcohol Consumption: Chronic alcohol exposure significantly impairs folate absorption by inhibiting the expression of the reduced folate carrier, decreasing hepatic uptake, reducing renal conservation, and increasing urinary excretion, leading to overall folate depletion (6).
Medications: Drugs like aminopterin, methotrexate, pyrimethamine, trimethoprim, and triamterene inhibit the enzyme dihydrofolate reductase, which may lead to folate deficiency (7).
Genetic Variations: Some evidence shows that variations in the MTHFR gene, can reduce the activity of the enzyme crucial for converting folate into its active form. A study published by ACR Open Rheumatology found that around 84.7% of patients with hypermobile Ehlers-Danlos syndrome (hEDS) or hypermobility spectrum disorder (HSD) carried one or both of these genetic variations (8).
Folic acid, on the other hand, is absorbed via the small intestine but requires conversion in the liver to become active. The enzyme dihydrofolate reductase (DHFR) is responsible for this conversion, but its activity can be impaired in some people, meaning that excess folic acid may remain unmetabolised in the bloodstream (9).
Folate and B Vitamins: A Team Effort
Folate (B9) works closely with other B vitamins, especially B12, to help convert food into energy, support the nervous system, and contribute to normal hormone function. Since B vitamins are water-soluble and not stored efficiently in the body, a consistent dietary intake is essential. Folate also relies on B3, B6, and zinc to be properly converted into its active form, 5-MTHF.
Final Thoughts on Folate and Folic Acid
Understanding the differences between folate and folic acid is essential for making informed dietary and supplement choices. While folate from whole foods is readily absorbed and utilised, folic acid requires conversion and may not be as efficient in individuals with genetic variations or underlying absorption issues. Prioritising natural folate sources, supporting gut health, and considering personal genetics can help optimise vitamin B9 intake for overall health and wellbeing.
References
- 1. Crider, K. S., Yang, T. P., Berry, R. J., & Bailey, L. B. (2012). Folate and DNA Methylation: A Review of Molecular Mechanisms and the Evidence for Folate’s Role. Advances in Nutrition, 3(1), 21–38. https://doi.org/10.3945/an.111.000992
- 2. Stahl, S. M. (2008). L-Methylfolate: A Vitamin for Your Monoamines. The Journal of Clinical Psychiatry, 69(9), 1352–1353. https://doi.org/10.4088/jcp.v69n0901
- 3. Corliss, J. (2015, March 18). Folic acid, a B vitamin, lowers stroke risk in people with high blood pressure. Harvard Health Blog. https://www.health.harvard.edu/blog/folic-acid-a-b-vitamin-lowers-stroke-risk-in-people-with-high-blood-pressure-201503187810
- 4. Viswanathan, M., Urrutia, R. P., Hudson, K. N., Middleton, J. C., & Kahwati, L. C. (2023, August 1). Introduction. Www.ncbi.nlm.nih.gov; Agency for Healthcare Research and Quality (US). https://www.ncbi.nlm.nih.gov/books/NBK593617/
- 5. Tests and investigations. (2022, September). Crohnsandcolitis.org.uk. https://crohnsandcolitis.org.uk/info-support/information-about-crohns-and-colitis/all-information-about-crohns-and-colitis/healthcare/tests-and-investigations
- 6. Halsted, C. H., Villanueva, J. A., Devlin, A. M., & Chandler, C. J. (2002). Metabolic Interactions of Alcohol and Folate. The Journal of Nutrition, 132(8), 2367S2372S. https://doi.org/10.1093/jn/132.8.2367s
- 7. Lambie, D. G., & Johnson, R. H. (1985). Drugs and Folate Metabolism. Drugs, 30(2), 145–155. https://doi.org/10.2165/00003495-198530020-00003
- 8. Courseault, J., Umar, M., Bordnick, P., Simons, J., Milla Volic, Stock, A., & Bix, G. (2024). Prevalence of MTHFR Polymorphisms in Patients With Hypermobile Ehlers‐Danlos Syndrome and Hypermobile Spectrum Disorders in a US Hypermobility Clinic. ACR Open Rheumatology. https://doi.org/10.1002/acr2.11667
- 9. McEntee, G., Minguzzi, S., O’Brien, K., Ben Larbi, N., Loscher, C., Ó’Fágáin, C., & Parle-McDermott, A. (2011). The former annotated human pseudogene dihydrofolate reductase-like 1 ( DHFRL1 ) is expressed and functional. Proceedings of the National Academy of Sciences, 108(37), 15157–15162. https://doi.org/10.1073/pnas.1103605108
*The advice in this article is for information only and should not replace medical care. As with any nutritional supplement please consult your qualified healthcare professional before use, especially if pregnant, breastfeeding, if you have a known medical condition or are taking medication. Food supplements must not be used as a substitute for a varied and balanced diet and a healthy lifestyle.
Genna Nelson
Nutritional Therapist and GN Wellness
