I’ve gotten several questions lately about folic acid vs. folate, especially during pregnancy. Folic acid and folate are often used interchangeably and even many doctors will not be able to tell you the difference if you ask.

The body needs folate, especially during pregnancy and folate is the form found in foods. You’ll often hear that folic acid is simply the supplemental form of folate, but there are some key differences. Recent research is supporting the fact that folate should be used in place of folic acid.

What’s the difference?

Chris Kresser breaks down the important difference between folate and folic acid 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 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.”

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:

“What is the role of folate?  Folate is necessary during rapid cell division and growth. In fact, pregnancy is known to actually double the need of dietary folates.

Folate 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 Altered hepatic (liver) metabolism Increased elimination of folate” (source)