The topic of folate and folic acid often arises in discussions about PCOS and its management. But are folate and folic acid the same thing? Ths short answer is no! Although both of these supplements are two different forms of the essential vitamin B9, there IS actually a difference between folate and folic acid. In this blog post, we will delve into the similarities and differences between folate and folic acid, exploring why knowing these distinctions is crucial for understanding which one is best for you.

Understanding the difference between Folate and Folic:

Folate, also known as vitamin B9, is a naturally-occurring form of the vitamin found in various food sources such as leafy greens, beans, peas, and broccoli. Conversely, folic acid is a synthetic form of vitamin B9 that is added to fortified foods and dietary supplements. Although folate and folic acid share similar roles and chemical structures, several significant differences set them apart.

Metabolism and Absorption:

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 utilized. Initially, folic acid is converted into dihydrofolate (DHF) and then subsequently into 5-MTHF, the active form of folate. However, this conversion process may be less efficient, especially for individuals with certain genetic variations.

Implications for Health:

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 unmetabolized folic acid in the bloodstream may be associated with an increased risk of certain health conditions, including prostate cancer and cognitive decline.

The Role of Folate and Folic Acid in Pregnancy:

Both folate and folic acid play an integral role in preventing neural tube defects, such as spina bifida, during fetal development. Folate is essential for DNA synthesis and cell division, particularly in early pregnancy. The U.S. Centers for Disease Control and Prevention (CDC) recommends that all women of childbearing age, including those with PCOS, consume at least 400 micrograms (mcg) of folate daily, either through supplements or fortified foods, to reduce the risk of neural tube defects. While folic acid has also been shown to reduce the risk of such defects, it may be less effective than folate due to its conversion process.

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. Women with PCOS should discuss their individual needs and concerns regarding supplementation with a healthcare professional or a registered dietitian.

Conclusion:

While folate and folic acid share similarities as forms of vitamin B9, understanding their differences is important for managing our PCOS effectively. Folate, the natural form found in foods, is readily metabolized and utilized 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:

• Choi SW, Mason JB. Folate status: effects on pathways of colorectal carcinogenesis. J Nutr. 2002 Mar;132(3 Suppl):2413S-2418S.
• Crider KS, Bailey LB, Berry RJ. Folic Acid Food Fortification—Its History, Effect, Concerns, and Future Directions. Nutrients. 2011;3(3):370-384.
• Greenberg JA, Bell SJ, Guan Y, Yu YH. Folic acid supplementation and pregnancy: more than just neural tube defect prevention. Rev Obstet Gynecol. 2011;4(2):52–59.
• Scholl TO, Johnson WG. Folic acid: influence on the outcome of pregnancy. Am J Clin Nutr. 2000 May;71(5 Suppl):1295S-1303S.