7 Ways Folate and Folic Acid Are Different

Folate and folic acid are forms of vitamin B9 that support healthy cell growth and development, especially in pregnancy. A folate deficiency can lead to serious complications, including birth defects and anemia.

Folate occurs naturally in foods, and refers to all types of vitamin B9, including folic acid. Folic acid is a synthetic (man-made) form of B9 found in supplements and added to (fortified) foods.

“It can be difficult to maintain adequate levels of B9 over time because it’s not stored by your body,” says dietitian Julia Zumpano, RD. “Folate and folic acid give you two options to increase your vitamin B9 intake, and protect your health and the health of the fetus, if you’re pregnant.”

For people of all ages, it can be hard to maintain adequate B9 levels and meet the recommended daily amount without taking supplements. People who are pregnant or those planning to conceive need folic acid to reduce the risk of birth defects of the brain and spine (neural tube defects).

What’s the difference between folate and folic acid?

The terms “folate” and “folic acid” are often used as if they’re identical, but they’re not. Both are forms of vitamin B9. Vitamin B9 is one of eight B (B-complex) vitamins that help make DNA and red blood cells, which carry oxygen throughout your body. This essential nutrient supports healthy cell growth and function and boosts your immune system. It can also prevent health problems like anemia.

“Folate and folic acid are both B9 vitamins that benefit your health in similar ways,” Zumpano says. “But they have important differences you need to be aware of, especially if you’re pregnant or have been diagnosed with a folate deficiency.”

Here are seven key differences:

• Digestion: Folate is processed in your small intestine. Folic acid is metabolized by your liver and other tissues.
• Speed of action: Your body can use folate from foods immediately. But folic acid needs to be changed (converted) to another form of folate first. This means folic acid can be slower to act in your body, and unused folic acid may build up in your blood.
• Stability: Folate found in foods easily breaks down when exposed to heat or light. Folic acid in supplements and fortified foods is more stable. This means your body can usually get more vitamin B9 from these sources compared to the amount you get from foods naturally containing folate.
• Uses: Folic acid is most often used to treat or prevent B9 deficiency. Most multivitamin-mineral supplements contain folic acid, especially prenatal vitamins for people who are pregnant or planning to conceive. It’s also used to reduce the toxicity (harmfulness) of certain medications.
• Side effects: Eating too much folate generally won’t hurt you. But taking too much folic acid may cause side effects. Rarely, you may experience bloating, loss of appetite or nausea.
• Drug interactions: High doses of folic acid can block the effects of certain drugs used to treat seizures, psoriasis, parasites and anesthesia. They can also hide serious neurological symptoms due to vitamin B12 deficiency.
• Nutrition label placement: On labels, folate is shown as mcg (micrograms) of dietary folate equivalents (DFE), with folic acid (also in mcg) in parentheses below it.

Which type of B9 is best for you?

The type of vitamin B9 and amount that’s best for you depends on several factors, including your age. Most people can safely increase their intake of folate that occurs in foods, but it’s wise to be cautious with supplements.

The recommended daily amount of folate is:

*Adequate intake
Source: 2020-2025 Dietary Guidelines for Americans

You may need additional folic acid if you’re on certain medications or have:

• Abnormal change (mutation) in your MTHFR gene, which provides instructions for a protein that helps your body process folate.
• Alcohol use disorder.
• Conditions such as spina bifida, celiac disease or inflammatory bowel disease (IBD).
• Kidney disease, and are on dialysis.
• No stomach acid (achlorhydria), or low stomach acid (hypochlorhydria).
• Undergone a procedure such as gastric bypass surgery.

“Talk to your healthcare provider if you think you need more folate or folic acid,” advises Zumpano. “A blood test can confirm a B9 deficiency, and you can make a plan to maintain your good health.”