By Kathy Hubbard
Just so we’re clear, folate, aka vitamin B-9, occurs naturally in some foods. Folic acid is the synthetic form in fortified foods and vitamin supplements. Got it? Whatever you call it, it’s important for a range of functions in your body.
“It helps the body make healthy new red blood cells, for example,” Medical News Today said. “Red blood cells carry oxygen throughout the body. If the body does not make enough of these, a person can develop anemia, leading to fatigue, weakness, and a pale complexion.”
Beyond the pale, folate is essential for preventing birth defects. Mayo Clinic advises women to start taking folic acid supplements at least three months before becoming pregnant. MNT says that folate deficiency during pregnancy can lead to neural tube irregularities. The two most common irregularities are spina bifida (a spinal cord defect) and anencephaly (a brain defect).
Folate is also essential for synthesizing and repairing DNA and other genetic material. It is necessary for cells to divide. Mayo says that folic acid works with vitamins B-6 and B-12 to control high homocysteine levels in the blood. “Elevated homocysteine levels might increase your risk of diseases of the heart and blood vessels (cardiovascular disease).”
Some research suggests that folate may reduce the risk of some cancers and help treat depression.
A good source of folate is found in dark green leafy vegetables, beans, peas, nuts, fresh fruits, fruit juices, liver, seafood, and eggs. In addition, cereals, breads, and pastas are fortified with folic acid.
“Because of its importance for health, the Food and Drug Administration requires manufacturers to add folic acid to grain products in the United States. Since they introduced this, the number of babies born with neural tube irregularities has decreased,” MNT says.
So, how do you know you are getting enough folate or folic acid? Mayo Clinic says we can get enough folate from the foods we eat. Harvard Health says that the additives and supplements are actually better absorbed than getting folate from food.
They explain that the Recommended Dietary Allowance for folate is listed as micrograms (mcg) of dietary folate equivalents (DFE). “Men and women ages 19 years and older should aim for 400 mcg DFE. Pregnant and lactating women require 600 mcg DFE and 500 mcg DFE, respectively. People who regularly drink alcohol should aim for at least 600 mcg DFE of folate daily since alcohol can impair its absorption.”
On the other end of the spectrum, in order not to have an adverse reaction, one shouldn’t exceed 1,000 mcg each day. Although excess folic acid is excreted in the urine, taking too high a quantity can mask a vitamin B-12 deficiency which can cause mental health issues, incontinence, loss of taste and smell, and more.
“This can typically be remedied by taking a supplement containing 100 percent of the daily value of both folic acid and vitamin B-12,” Mayo says.
I found a list of values for some foods, and I can see why supplements are often recommended. For instance, a cup of cooked spinach will have 263 mcg, but it has only 58 mcg when eaten raw. Enriched rice can range from 195 to 222 mcg, while a cup of cooked lentils or Blackeye peas cooked from dried top the chart at 358. Being math-challenged, I’d have a hard time keeping track.
“When used orally at appropriate doses, folic acid is likely safe,” Mayo says. “Oral use of folic acid can cause a bad taste in your mouth, nausea, loss of appetite, confusion, irritability, and sleep pattern disturbance. In addition, people with allergies might react to folic acid supplements. Warning signs of an allergic reaction include skin rash, itching, redness, and/or difficulty breathing.”
Before taking supplements of any sort, you should talk to your primary care provider, particularly if you have epilepsy, type 2 diabetes, rheumatoid arthritis, lupus, inflammatory bowel disease, or celiac disease. You should also know that folic acid can interact with certain medications, so that’s just one more good reason to consult with a medical professional.
Kathy Hubbard is a member of the Bonner General Health Foundation Advisory Council. She can be reached at firstname.lastname@example.org.