Folate or folic acid? The good, the bad, and everything else you should know
Folate (vitamin B9) is one of the most respectednutrients for good health. Folate is needed to form DNA and RNA, the molecules that carry your genetic information. It’s also involved with breaking down proteins and amino acids, including the potentially harmful homocysteine, as well as producing healthy red blood cells and assisting with fetal development during pregnancy.
Folate is the natural form of folic acid and found in many foods such as leafy green vegetables, legumes, eggs, wholegrains, and organ meats. However, many people are deficient in this vital nutrient.
Let’s dive into the benefits of folic acid (folate) and why you need it.
Facts about folic acid and folate
Folate is critical for a process called methylation, which supports numerous physiological functions in the body. It’s also required to make DNA and other genetic material, and for proper cell division.
Additional folate is required at certain stages of life, particularly during pregnancy and preconception. Elderly people and those with a MTHFR mutation may also need to increase their folate intake to fill in any gaps in their diet.
Folate/folic acid for pregnancy
Women who are pregnant or planning pregnancy need to increase their folate intake to support the developing fetus. Demands for folate increase significantly during pregnancy and preconception due to the major role that folate plays in the rapid tissue growth and cell division during fetal development. Insufficient folate during this time can lead to neural tube defects and congenital abnormalities in the fetus. 
Folic acid benefits for women who are not pregnant include supporting red blood cell anemia and supporting energy metabolism, cognitive function, and homocysteine metabolism.
Read more about folate supplement benefits for women.
Folate for arthritis
Patients taking the anti-rheumatic drug Methotrexate (MTX) are advised to supplement with folic acid or folate because MTX blocks folic acid. Taking folate supplements can help to reduce the risk of deficiency and also reduce side effects of MTX such as nausea, abdominal pain, and mouth sores. 
Folate for healthy mood
One of the many benefits of folate supplementation is natural mood support.  Folate plays a major role in the synthesis of neurotransmitters required for healthy mood, including serotonin, norepinephrine, and dopamine. People with major depression or certain psychiatric disorders are often found to be low in these brain chemicals, which has led researchers to link folate deficiency with depression.
Folate and autism spectrum disorder
A major review found that taking folic acid during pregnancy may reduce the risk of children being born with autism spectrum disorder.  Folic acid supplementation in children diagnosed with autism has also been shown to improve neurologic and behavioral symptoms. However, the review noted that several other studies have found an enhanced risk of ASD following folic acid supplementation.
A case study published in Psychiatric Genetics found that L-methylfolate supplementation improved behavioral symptoms and aggression in a child with autism who also had MTHFR.
Folate/folic acid deficiency symptoms
As a critical cofactor in one-carbon metabolism, folate deficiency can have severe health implications. It has been linked with an increased risk of neural tube defects, cardiovascular disease, cancer and cognitive dysfunction. 
However, folate deficiency may not be noticed until the symptoms of anemia develop. Anemia is the result of low red blood cell production, and causes fatigue, paleness, irritability, shortness of breath, and dizziness.
Severe folate deficiency may also result in a red and sore tongue, diarrhea, a reduced sense of taste, weight loss, and depression.  Neurological symptoms may include memory loss, difficulty concentrating, and general confusion.
How much folate per day should I take?
Standard recommendations for daily folate intake are 400 mcg for adults aged 19 and over. Women who are pregnant are advised to take 600 mcg, and women who are breastfeeding should take 500 mcg. However, this may not reflect how much folate per day each person requires to support their individual requirements.
Consider that Deplin® (a medical food form of methylfolate) is prescribed in dosages of 7.5 mg and 15 mg, and studies have noted the greatest benefits are observed when patients with treatment-resistant depression take 15 mg methylfolate/day. 
In addition, multiple studies have shown that women who take more than the RDA of 400 mg folate per day have a reduced incidence of depression.  Megaloblastic anemia is treated with a similar dosage range.
It’s important to note that the Institute of Medicine has established an upper level folic acid dosage of 1,000 μg/day. It is unlikely to obtain too much folate from foods, and there are no adverse effects associated with folate from food. 
Can you take too much folic acid?
While high intake of methylfolate is unlikely to be a health risk, excess folic acid usage may have some disadvantages. High intake of folic acid may mask a B12 deficiency, which can allow neurological damage to progress before a diagnosis is made. This means that if a patient is taking too much folic acid, symptoms of B12 deficiency may still be present but the deficiency will not be detected in blood tests.
Those at risk of chronic diseases such as cancer or cardiovascular disease should be aware of the symptoms of too much folic acid.
Supplementing with folate: methylfolate vs folic acid
Research has shown that taking methylfolate instead of folic acid reduces the risk of masking symptoms of vitamin B12 deficiency. Methylfolate also is less likely to interact with certain drugs. Most importantly, methylfolate is able to bypass the MTHFR mutation that prevents proper breakdown of folic acid in the body. 
To support your body’s folate needs, look for a supplement made with methylfolate. Some of the best multivitamins with methylfolate include Methyl-life’s® Methylated Multi, which contains a patented and highly stable methylfolate alongside other bioactive nutrients to support healthy methylation and cognitive function.
Folate is required at every age and stage of life to support healthy methylation, cardiovascular function, cognitive health, red blood cell formation, and much more. Although folic acid is the most commonly prescribed form of folate, methylfolate is superior in terms of absorption and utilization in the body. Folic acid intake is also associated with various disadvantages, including UnMetabolized Folic Acid (UMFA), particularly in the case of the MTHFR mutation, whereas methylfolate is able to bypass this mutation.