From the Guidelines
Folate and folic acid are not exactly the same thing, though they are closely related, with folate being the generic term for one of the B-complex vitamins and folic acid being the oxidized and most active form used in vitamin preparations and food fortification. According to the study published in Genetics in Medicine 1, folate is the natural form of vitamin B9 found in certain foods, while folic acid is the synthetic form used in supplements and fortified foods. The key difference is that folic acid must be converted by the body into the active form, 5-methyltetrahydrofolate, which is the primary circulating form of folate, before it can be used. Some of the key points to consider include:
- Folic acid is almost twice as bioavailable as folate
- Folate and folic acid play a crucial role in preventing neural tube defects during pregnancy
- The recommended daily intake for adults is not specified in the study, but it is known that pregnant women need a higher intake to prevent birth defects
- Some individuals with certain genetic variations may have difficulty converting folic acid efficiently and might benefit more from folate or methylfolate supplements. The study highlights the importance of folate and folic acid in preventing neural tube defects, with a 72% reduction in recurrence risk in those who consumed folic acid before conception, as demonstrated by the British Medical Research Council trial.
From the FDA Drug Label
Folic acid is a precursor of tetrahydrofolic acid, which is involved as a cofactor for transformylation reactions in the biosynthesis of purines and thymidylates of nucleic acids Naturally occurring conjugated folates are reduced enzymatically to folic acid in the gastrointestinal tract prior to absorption.
Folate and folic acid are related but not exactly the same thing. Folic acid is a precursor to tetrahydrofolic acid, which is a form of folate. The body converts folic acid into folate, which is then used for various biological processes. In the context of the drug label, folate refers to the active form of the vitamin, while folic acid is the supplemental form 2.
From the Research
Definition and Difference
- Folate and folic acid are often used interchangeably, but they are not exactly the same thing 3, 4.
- Folate, also known as vitamin B9, is a naturally occurring nutrient found in foods, while folic acid is a synthetic form of folate used in supplements and fortified foods 3, 4.
- Folic acid must be converted into its active form, 5-methyltetrahydrofolate (5-MTHF), in the body to be effective 3, 4.
Health Implications
- Folate deficiency has been linked to various health problems, including neural tube defects, cardiovascular disease, cancer, and cognitive dysfunction 4, 5, 6.
- Folic acid supplementation has been shown to reduce the risk of childhood leukemia and other health problems, but it may also pose health risks in certain conditions, such as megaloblastic anemia and reduced hepatic transformation 3, 5.
- 5-MTHF supplementation may be a better option than folic acid in certain cases, as it does not require activation and is immediately available to the body 3, 4.
Supplementation and Metabolism
- Folic acid, folinic acid, and 5-MTHF are different forms of folate supplementation, each with its own advantages and disadvantages 4, 7.
- The metabolism of folate is complex and involves various enzymes and pathways, including the one-carbon cycle and the methylation cycle 6, 7.
- Genetic polymorphisms, such as those in the MTHFR and MTRR genes, can affect folate metabolism and increase the risk of certain health problems 5, 7.