Welcome to our comprehensive guide on Folate and Folic Acid, two essential nutrients that play a key role in cell growth, red blood cell formation, and neural tube development. If you've ever wondered about the difference between folate and folic acid, or why they're so crucial to our health, especially if you have PCOS, you're in the right place. In this guide, we'll delve into the intricacies of these nutrients, from their chemical structure and metabolism to their sources and bioavailability.

We'll also explore their health implications, including their role in preventing neural tube defects and other health benefits. Whether you're an expecting mother, someone dealing with a folate deficiency, or suffering from PCOS, this guide is designed to provide you with the knowledge you need.

Folate and Folic Acid: An Overview

In our quest to understand the essential nutrients our bodies need, we often come across the terms 'folate' and 'folic acid'. While they might sound similar and are often used interchangeably, they are not identical. This section will provide an overview of these two forms of vitamin B9, highlighting their similarities and differences.

Folate and folic acid are both crucial for our health, playing significant roles in various bodily functions. However, their sources and the way our bodies process them differ. Let's delve deeper into understanding these essential nutrients.

What is Folate?

Folate, also known as vitamin B9, is a crucial nutrient that our bodies need to function optimally. It's a water-soluble vitamin, meaning it dissolves in water and is not stored in the body.

This essential nutrient plays a vital role in the synthesis and repair of DNA, aiding rapid cell division and growth. It's particularly important during periods of rapid growth such as pregnancy and infancy.

Folate is naturally found in a variety of foods, including leafy green vegetables, beans, peas, and broccoli and in also fruits, nuts, and seafood. It's also present in dietary supplements often in the form of 5-MTHF and is one of the bedrocks of our Myoplus & Preconception formulas.

Discover how our award winning PCOS Supplements with Myo-inositol & Folate can help you.

What is Folic Acid?

Folic acid, also known as monopteroylglutamic acid or pteroylmonoglutamic acid, is a synthetic form of vitamin B9. It's a common ingredient in dietary supplements and is often added to processed foods such as flour and breakfast cereals. Unlike its natural counterpart, folate, not all folic acid consumed is converted into the active form of vitamin B9, 5-MTHF, in the digestive system.

Instead, some of it is converted in the liver. However, this process can be slow and inefficient in some people, leading to a buildup of unmetabolised folic acid in the bloodstream. This can occur even with small daily doses of around 400 mcg.

While there is evidence that high levels of unmetabolised folic acid may be associated with some health risks, more studies are needed to confirm this. It's worth noting that taking folic acid along with other B vitamins, particularly vitamin B6, can make the conversion process more efficient.

Despite potential drawbacks, folic acid plays a crucial role in our diet, aiding in the production of DNA and other genetic material. It's particularly important during pregnancy, as it can help protect against birth defects and miscarriage.

Folate vs Folic Acid: Key Differences

Understanding the differences between folate and folic acid is crucial for making informed dietary choices. These two forms of vitamin B9, while similar in many ways, have key distinctions that affect their absorption, metabolism, and potential health implications. In this section, we will delve into the key differences between folate and folic acid, exploring their unique chemical structures, sources, and potential health impacts. This knowledge can help you decide whether to seek an alternative to folic acid or better understand how these two nutrients function in your body.

Chemical Structure and Metabolism

While both folate and folic acid are essential for DNA synthesis and repair, red blood cell formation and are often used interchangeably, they have distinct differences in their chemical structure and metabolism.

One primary difference between folate and folic acid lies in their metabolism and absorption in the body. Folate is readily converted into its active form, 5-methyltetrahydrofolate (5-MTHF), in the small intestine through the action of an enzyme called dihydrofolate reductase (DHFR).

On the other hand, folic acid needs to undergo two conversion steps before it can be utilised. Initially, folic acid is converted into dihydrofolate (DHF) and then subsequently into 5-MTHF, the active form of folate. However, this conversion process, which takes place in the liver, is less efficient and therefore folic acid is metabolised slower than folate, especially in individuals with certain genetic variations.

The varying metabolism and absorption of folate and folic acid have important implications for our overall health. Research suggests that around 40% of people may have a genetic variant that reduces the efficient conversion of folic acid into its active form. As a result, inadequate conversion may lead to folate deficiency. Moreover, high levels of unmetabolised folic acid in the bloodstream may be associated with an increased risk of certain health conditions, including prostate cancer and cognitive decline, although as we discussed, more studies are needed to confirm this.

Sources and Bioavailability

When it comes to sources and bioavailability, folate and folic acid have distinct differences. Folate is naturally occurring and can be found in a variety of foods such as leafy green vegetables, fruits, and legumes. It's bioavailable, meaning it's easily absorbed by the body and used efficiently.

On the other hand, folic acid is a synthetic form of the vitamin, often used in supplements and fortified foods. While it's a more stable form, its bioavailability can vary. It requires conversion by the liver and other tissues into a form the body can use, a process which may not always be efficient, especially in high doses.

Therefore, while both folate and folic acid are important for health, they differ in their sources and how effectively they can be used by the body. This is a key consideration for those seeking an alternative to folic acid or trying to understand the difference between folate and folic acid.

Health Implications

The health implications of folate and folic acid are a topic of ongoing research. However, some studies^1 suggest that high levels of unmetabolised folic acid might be linked to an increased risk of cancer. This is a contentious issue, as not all studies agree and there's no conclusive evidence that unmetabolised folic acid plays a direct role.

On the other hand, folate, being a natural form of vitamin B9, has been associated with numerous health benefits. It's crucial for DNA synthesis and repair, red blood cell formation, and proper brain function. Folate deficiency can lead to anemia, poor immune function, and, in pregnant women, neural tube defects^2 in their babies.

It's important to note that while folic acid supplements can be a convenient alternative to folic acid-rich foods, they should not replace a balanced diet. Always consult with a healthcare professional before starting any new supplement regimen.

The Importance of Folic Acid & Folate

Folic acid, a type of B vitamin, is an essential nutrient that plays a significant role in our overall health. Its importance cannot be overstated, as it is involved in numerous critical functions in your body. From aiding in cell growth and development to preventing neural tube defects, folic acid is a key player in maintaining our health. In the following sections, we will delve deeper into why is folic acid important and its various roles in our body.

Role in Cell Growth and Development

Both Folic acid & Folate play a key role in the body, particularly in cell growth and development^3. This is why they're often referred to as a building block of cells. It's involved in the creation and repair of DNA, the genetic material that makes up our cells.

This function in your body is crucial for tissues that rapidly divide and grow, such as those in a fetus, making folic acid especially important during pregnancy.

Moreover, they aid in the production of red blood cells, which carry oxygen throughout the body. Without sufficient folic acid or folate, the body can't produce enough healthy red blood cells, leading to a type of anemia.

Prevention of Neural Tube Defects

Folic acid & Folate play a pivotal role in the prevention of neural tube defects, a type of birth defect that affects the brain and spine. These defects occur when the tissues that eventually form the spinal cord or brain don't develop correctly. The importance of folic acid and folate in this context is underscored by the fact that low levels of these vitamins have been linked to an increased risk of these defects.

Research has shown that adequate intake of folic acid can significantly reduce the incidence of neural tube defects. This is why health experts recommend women of childbearing age to take folic acid or folate supplements, especially during the early stages of pregnancy.

The timing of folic acid intake is crucial. It must be taken in the first few weeks after conception, often before a woman even knows she's pregnant. This is because the neural tube, which becomes the brain and the spine, develops during this period.

Other Health Benefits

Folic acid and folate, play a key role in more than just cell growth and neural tube defect prevention. They have a myriad of other health benefits that are often overlooked.

One of the important functions of folic acid/folate is they're role in heart health. Research^4 has shown they help reduce the levels of homocysteine, an amino acid linked to heart disease, in your blood. By doing so, it lowers the risk of heart disease and stroke.

Additionally, folic acid and folate have been found to have a positive impact on mental health^5. They aid in the production of serotonin, a neurotransmitter that regulates mood, sleep, and appetite. This is why a deficiency in folic acid can lead to depression and other mental health disorders.

Sources of Folate and Folic Acid

This section will guide you through the various natural foods and fortified products that can help you maintain a healthy level of these essential nutrients. Whether you're planning a meal or shopping for supplements, knowing where to find folate and folic acid can help you make informed decisions for a balanced diet. Let's explore these sources and how they contribute to our health.

Natural Sources of Folate

Leafy green vegetables like spinach and kale are rich in folate.

Legumes such as lentils, chickpeas, and black beans are also excellent sources.

Fruits, particularly citrus fruits like oranges and grapefruits, contain significant amounts of this nutrient.

Whole grains and fortified cereals can also contribute to a healthy diet rich in folate.

Sources of Folic Acid

Fortified pasta, rice, and corn masa flour

Fortified breakfast cereals

Fortified bread

Vitamin supplements

These are some of the common sources of folic acid, a synthetic form of vitamin B9. The fortification of these foods has significantly increased the average intake of folic acid, making it an essential part of a healthy diet. Supplements usually contain between 400–1,000 micrograms of folic acid, contributing to an average daily intake of 140 mcg from fortified foods in the United States. Always remember to consult your healthcare provider before starting any supplement regimen.

Signs of Folate and Folic Acid Deficiency

Recognising the signs of folate and folic acid deficiency is crucial for maintaining optimal health. This deficiency can manifest in various ways, often subtly, making it difficult to identify without a thorough understanding of its symptoms and causes. It's important to remember that folate plays a vital role in our body's functions, from red blood cell formation to DNA synthesis.

A deficiency in this essential vitamin can lead to various health complications, including anemia and increased risk of heart disease. Therefore, understanding the signs of deficiency and the factors that contribute to it is key to prevention and early intervention.

Common Symptoms

Feeling of constant fatigue and low energy levels

A tingling sensation in the arms, hands, legs, or feet

Development of mouth ulcers

Problems with vision

Memory loss

Risk Factors and Causes

Folate deficiency is not a condition to be taken lightly. It can be caused by several factors, some of which are controllable, while others are not. The NHS has identified certain groups that are typically at a higher risk for this deficiency. This includes people with alcohol use disorder, women of childbearing age, pregnant women, and individuals with malabsorptive disorders or MTHFR polymorphism.

In many of these cases, the deficiency arises from poor absorption of folate in the body. This could be due to the body's inability to properly process the nutrient or a restricted diet that lacks sufficient folate sources.

Research is ongoing to understand the role of low folate levels in conditions like Alzheimer’s disease, hypertension, and autism spectrum disorder. However, the results so far have been inconclusive. It's crucial to understand these risk factors and causes to prevent or manage folate deficiency effectively. Regular blood tests can help monitor folate levels in the blood and mitigate the risk of deficiency.

Recommended Intakes of Folate and Folic Acid

Understanding the recommended intakes of folate and folic acid is crucial for maintaining optimal health. These nutrients play a vital role in various bodily functions, including cell growth and DNA synthesis. The daily requirements differ based on age, gender, and specific health conditions. Let's delve into the specifics of these requirements and considerations for different population groups.

Remember, while folate is naturally present in many foods, folic acid is a form of this vitamin that's used in dietary supplements and fortified foods. Therefore, it's important to consider both when evaluating your daily intake.

Daily Requirements

The daily requirements for folate and folic acid vary depending on age and gender. For adults, the recommended dietary allowance (RDA) is 400 micrograms of dietary folate equivalents (mcg DFE) per day. This is equivalent to 400 mcg of food folate or 200 mcg of folic acid from a supplement taken on an empty stomach.

Pregnant women have a higher requirement, with an RDA of 600 mcg DFE to support the rapid growth of the placenta and fetus. Breastfeeding women also need more, with an RDA of 500 mcg DFE to ensure adequate milk production.

The best way to meet your daily requirements is to consume a balanced diet rich in folate-containing foods.

Potential Risks and Considerations

In our journey to understand folate and folic acid, it's crucial to consider potential risks and considerations. While these nutrients play a vital role in our health, there's a fine line between beneficial and excessive intakes.

This section will delve into the possible consequences of overconsumption and the interactions they may have with certain medications. It's always important to strike a balance and consult with your doctor or a healthcare professional to ensure optimal health.

Overconsumption and Side Effects

While folate is essential for our health, overconsumption can lead to complications. High intakes of folate from food are generally not a concern, but an excess from supplements may have adverse health effects.

One such side effect is that it may mask the symptoms of vitamin B12 deficiency, which can lead to nerve damage if not treated. This is especially concerning for older adults who are more likely to have a B12 deficiency.

Long term use of high-dose folic acid supplements can also increase the risk of certain types of cancer. It's crucial to balance the benefits and risks, and not exceed the recommended daily intake.

Interactions with Medications

Folic acid, while beneficial in many ways, can interact with certain medications, potentially leading to adverse effects. For instance, it may interfere with methotrexate, a cancer treatment drug, and decrease blood levels of anti-seizure medications such as phenytoin, carbamazepine, and valproate.

Moreover, if you're taking sulfasalazine for ulcerative colitis, your body might struggle to absorb folic acid effectively, leading to a deficiency. It's crucial to consult your healthcare provider or pharmacist if you're on any medication or dietary supplements to avoid harmful interactions.

Folic acid can also mask a vitamin B12 deficiency, leading to a condition known as megaloblastic anemia. This can result in the production of unusually large and abnormal red blood cells. It's not just anemia; a B12 deficiency can cause serious nerve damage as well.

Considerations for PCOS Management:

For women with PCOS, it is crucial to ensure adequate intake of vitamin B9 in our diets. This can be achieved by consuming foods rich in folate, such as dark leafy greens, legumes, and certain fruits and vegetables. Additionally, incorporating fortified foods and dietary supplements can help meet the recommended daily intake. However, it is vital to be aware of the differences between folate and folic acid, particularly during pregnancy or if planning to become pregnant. While both forms can help prevent neural tube defects, folate may be more effective than folic acid due to its direct availability as an active form. This is why folate is ones of the hero ingredients of our award winning Preconception supplement. Women with PCOS should discuss their individual needs and concerns regarding supplementation with a healthcare professional or a registered dietitian.

Wrapping Up: Folate vs Folic Acid

In conclusion, understanding the differences between folate and folic acid is crucial for maintaining optimal health. While folate and folic acid share similarities as forms of vitamin B9, both playing key roles in cell growth and development, and preventing neural tube defects, understanding their differences is important for managing our PCOS effectively. Folate, the natural form found in foods, is readily metabolised, and utilised by the body, while folic acid, the synthetic form added to fortified foods and supplements, requires additional conversions to become active. Paying attention to our intake of vitamin B9 is crucial, especially during pregnancy. By consuming a balanced diet, incorporating folate-rich foods, and considering the specific needs of our bodies, we can empower ourselves to take control of our health and live our best lives with PCOS.

References:

1. Thabet RH, Alessa REM, Al-Smadi ZKK, et al. Folic acid: friend or foe in cancer therapy. Journal of International Medical Research. 2024;52(1). doi:10.1177/03000605231223064
2. Denny KJ, Jeanes A, Fathe K, Finnell RH, Taylor SM, Woodruff TM. Neural tube defects, folate, and immune modulation. Birth Defects Res A Clin Mol Teratol. 2013 Sep;97(9):602-609. doi: 10.1002/bdra.23177. PMID: 24078477; PMCID: PMC4053177.
3. Shulpekova Y, Nechaev V, Kardasheva S, Sedova A, Kurbatova A, Bueverova E, Kopylov A, Malsagova K, Dlamini JC, Ivashkin V. The Concept of Folic Acid in Health and Disease. Molecules. 2021 Jun 18;26(12):3731. doi: 10.3390/molecules26123731. PMID: 34207319; PMCID: PMC8235569.
4. Marcus J, Sarnak MJ, Menon V. Homocysteine lowering and cardiovascular disease risk: lost in translation. Can J Cardiol. 2007 Jul;23(9):707-10. doi: 10.1016/s0828-282x(07)70814-0. PMID: 17622392; PMCID: PMC2651913.
5. Williams E, Stewart-Knox B, Bradbury I, Rowland I, Pentieva K, Helander A, McNulty H. Effect of folic acid supplementation on mood and serotonin response in healthy males. Br J Nutr. 2005 Oct;94(4):602-8. doi: 10.1079/bjn20051501. PMID: 16197587.