Folate V Folic Acid: what’s the difference and why does it matter?

Folate and Folic acid are two terms that are often used interchangeably, yet they refer to different forms of Vitamin B9 – an essential nutrient with several important functions in the body. Understanding these differences can help you make informed choices about your diet and supplements, particularly if you are planning a pregnancy.

Vitamin B9 contributes to maternal tissue growth during pregnancy, normal blood formation, normal homocysteine metabolism, normal psychological function, normal immune function, the reduction of tiredness and fatigue and plays a role in the process of cell division. These all apply to both folate and folic acid when consumed in adequate amounts.

If you are a mum to be, or a woman trying to get pregnant, you will almost certainly have been advised to take folic acid, a crucial nutrient which contributes to normal homocysteine metabolism, and normal blood formation Few would argue that it is a vital prenatal nutrient given that a substantial body of research exists showing that getting enough of it, both before and during early pregnancy, is crucial for the healthy development of a baby’s brain, skull and spine.

Whilst folic acid is a nutrient that is increasingly studied and recognised for its role in supporting normal psychological function and healthy cell division, it remains best known for supporting pregnancy. During this time, folate contributes to maternal tissue growth, and women who are pregnant or planning a pregnancy have higher requirements than those who are not pregnant.¹ It is concerning then that figures from the National Diet and Nutrition Survey show that folate deficiency is common in the UK among women of childbearing age.² To help address this problem, new legislation is being developed which proposes to fortify non-wholemeal wheat flour with folic acid by the end of 2026.³

So, what exactly is this vital nutrient, how much do you need, where do you find it and what are the most reliable and easily absorbable sources for optimum intake?

The folic acid/folate distinction

Women who are pregnant or trying to conceive need folic acid are largely undisputed but what is less clear is what it is and where you find it. This is not helped by the fact that the terms ‘folic acid’ and ‘folate’ are often used interchangeably and are commonly taken to mean the same thing. Yet they are not. Yes, they are both forms of vitamin B9 but folate (derived from the Latin word ‘folium’ meaning leaf) is the natural form found in foods such as leafy greens like kale, spinach and broccoli. Folate is also used as a generic term for all types of vitamin B9. Folic acid, on the other hand, is a synthetic manmade version of folate which is used in supplements and fortified foods such as some breakfast cereals. Both forms are essential but there are other key differences between the two.

What is folate?

Folate is Vitamin B9, a water-soluble vitamin which means it is not stored in the body for long and must be obtained from your food on a regular, ideally daily, basis. When you eat folate-rich foods these are processed in your digestive system, and your body can use the folate it gets from that food immediately. The downside is that there may be limited amounts of natural folate found in food sources, however, as folate in foods is known to break down quickly when exposed to heat or light (meaning cooking can reduce the amount retained).

What is folic acid?

This is the most common form of supplemental vitamin B9, is the synthetic form of Vitamin B9 used in most supplements and many fortified foods. Folic acid, however, needs to go through a process of conversion in the body to become an active form of folate. However, synthetic folic acid is often seen as a more ‘stable’ and reliable form of vitamin B9 than folate-rich foods alone.

Both forms ultimately contribute to the body’s pool of active Vitamin B9.

Folate metabolism issues

All forms of folates, whether natural or synthetic, must be converted into the biologically active form of vitamin B9 known as 5-methyltetrahydrofolate (5-MTHF) they can be used by the body. This conversion process can vary from person to person and may be influenced by certain inherited differences in folate metabolism.

Some individuals with identified MTHFR gene variants may have a reduced ability to convert folate into its active form. This can lead to higher levels of homocysteine (an amino acid which is harmful to cells) in the body.

Some people have inherited differences in folate metabolism, such as certain variations in the MTHFR gene, which can affect how efficiently folate is processed in the body.

Similarly, factors that affect nutrient absorption can influence folate status. Ensuring adequate folate intake through a balanced diet and following UK guidance on folic acid supplementation can help maintain sufficient levels. Anyone concerned about their folate intake or absorption is advised to speak with a healthcare professional.

Taking folic acid with medicines

Folic acid supplements are generally safe and provide a convenient way to support adequate folate intake. Certain medicines may affect how folic acid is processed in the body, and folic acid may also interact with some medicines. Other medications and supplements, including some commonly used for various conditions, can also influence folate levels.

If you are taking any medicines or have recently stopped taking certain medications and are considering folic acid supplementation, it is recommended to discuss this with a GP or healthcare professional to ensure the best approach for your situation.

Folate v folic acid: which one do YOU need?

Most people who eat a relatively healthy diet will usually get all the folate they need from food but for a woman planning to become pregnant, who could become pregnant or is in the early stages of pregnancy taking folic acid in supplement form is recommended and advisable.⁴ This is because even with the best will in the world and an exemplary diet it is hard for a pregnant woman, or one planning to have a baby, to get the optimum recommended amount of folate from food alone. The synthetic version – that is, folic acid found in supplements and fortified foods – is seen to be a more dependable form of folate but folate-rich foods are essential as part of a balanced wholesome diet. For this reason, a combination of taking folic acid supplements and eating foods rich in folate is advised for women trying to conceive or who are in early pregnancy.

At a glance: folate-rich foods

Leafy greens such as broccoli, cabbage, spinach, lettuce and kale. Other good vegetable sources include asparagus, Brussel sprouts and beetroot. Legumes such as dried beans and peas like kidney beans, chickpeas and lentils.
Fruits including melon, papaya, citrus fruits (oranges, grapefruits and limes) and most berries.
Eggs (need to ensure these are fully cooked)
Nuts, especially peanuts
Seeds
Bovril and Marmite

How much folic acid do you actually need? The official guidelines

Both the NHS and the National Institute for Health and Care Excellence (NICE) recommend that women trying for a baby, or who are pregnant, should take 400 µg of folic acid daily. This is ideally started a couple of months before trying to conceive and continued during the first 12 weeks of pregnancy.^5,6

In some cases, people may be advised to take a higher dose due to certain health factors or medications that increase their need for folic acid. If you are unsure then please speak to your GP or healthcare professional who can provide personalised guidance on the most appropriate dose, how long to take it or whether you can have it. ^7,8

When, and how, to take your folic acid supplements

Your supplement can be in the form of a multivitamin which contains the recommended 400 µg of folic acid; a singular supplement that contains only folic acid or a preconception or prenatal vitamin which is specially formulated to contain both the recommended 400 µg of folic acid and a range of other vitamins and minerals to support your pregnancy.

Whatever type of folic acid supplement you choose, aim to take it at roughly the same time every day (say, with breakfast or your evening meal) so that it becomes a part of your preconception and early pregnancy routine.

Be mindful of the fact, however, that if you are already taking a multivitamin and mineral this may already contain the recommended amount of folic acid you need so you didn’t need to take another separate single folic acid supplement, or you could exceed the recommended daily amount. Taking too much folic acid can potentially hide signs that you have a deficiency of vitamin B12.⁹