Folic Acid Delivers Health Benefits Beyond Pregnancy—Here’s How To Tell if You Need a Supplement

If you’re taking a vitamin B complicated on daily basis, you are probably properly conscious of the numerous advantages B nutritional vitamins have in your total well being. One in all these important nutritional vitamins is folate (or B9), which helps your physique construct DNA, RNA, and purple blood cells—making it essential throughout being pregnant to your child’s growth.

Whereas most individuals get sufficient folate from meals like darkish, leafy greens, beans, and nuts, it is also added to sure meals merchandise and made right into a complement referred to as folic acid—a type of folate that is extra simply absorbed by your physique, and is usually advisable in case your folate ranges are low.

Irrespective of the way you get this vitamin, it’s essential you get sufficient of it so your physique can really feel its finest. Right here, specialists share all of the optimistic results folic acid has in your well being, who ought to take a folic acid complement, and who ought to keep on with getting folate from solely meals.

First, how a lot folic acid do you want per day?

The common grownup ought to get 400 micrograms DFE (dietary folate equal) or 240 micrograms of folic acid from dietary supplements and fortified meals per day, in line with the Nationwide Institutes of Well being (NIH).

Tip: DFE displays the upper absorption of folic acid over folate naturally current in meals. For reference,1 microgram of folate from meals is equal to 0.6 micrograms of folic acid from dietary supplements and fortified meals.

5 well being advantages of folic acid

1. It could actually stop beginning defects in being pregnant

While you’re pregnant, folic acid helps your child’s neural tube—what ultimately turns into their mind and backbone—develop.

“Folic acid helps the manufacturing of nucleotides,” that are the essential constructing blocks of RNA and DNA, says William Li, MD, creator of ‌Eat to Beat Your Weight-reduction plan: Burn Fats, Heal Your Metabolism, and Dwell Longer‌‌. Nucleotides assist kind the central nervous system in a creating embryo, he provides.‌

Which means, getting sufficient “folic acid is important for stopping main beginning defects of your child’s mind and backbone, generally known as neural tube defects, or NTDs,” says Stephanie Hack, MD, FACOG, a board-certified OB/GYN and founding father of Woman Elements Physician. Neural tube beginning defects could cause severe medical issues in infants together with:

• Cleft palate (a gap or break up within the roof of the mouth that occurs when tissue would not be a part of collectively utterly)
• Spina bifida (a situation that impacts the backbone and should trigger bodily and/or mental disabilities)
• Mind injury

So how a lot folic acid must you take if you happen to’re pregnant or planning to grow to be pregnant? “The CDC recommends taking about 400 micrograms of folic acid (or 600 micrograms DFE) on daily basis to assist stop beginning defects,” says Dr. Hack.

Consuming naturally folate-rich meals (extra on this later) also can enable you to get the quantity you want throughout being pregnant. Many breads, pastas, and cereals are fortified with folic acid, so consuming these also can enable you to meet your day by day goal.

That stated, it’s fairly onerous to get 400 micrograms of folate by way of eating regimen alone. That’s the place prenatal nutritional vitamins turn out to be useful. They’re formulated with simply the correct amount of folic acid for pregnant folks. And if you happen to’re planning to grow to be pregnant, begin taking a folic acid complement 12 weeks earlier than conceiving, says Dr. Hack. That is useful as a result of neural tube defects typically occur early in being pregnant, generally earlier than you even know you are anticipating, she provides.

“The CDC recommends taking about 400 micrograms of folic acid (or 600 DFE) on daily basis to stop beginning defects.”—Stephanie Hack, MD, OB/GYN

2. It could actually deal with a folate deficiency

Whereas most individuals get sufficient folate (particularly in nations just like the U.S. the place meals like cereals and pastas are fortified with folic acid), sure teams are nonetheless prone to folate deficiency.

Individuals with alcohol use dysfunction, inflammatory bowel illness (IBD), and celiac illness can all have decrease ranges of folic acid, per Mount Sinai. These situations can mess along with your physique’s skill to soak up sure nutritional vitamins and vitamins.

Individuals with an MTHFR gene variant may be extra liable to a folate deficiency. The MTHFR gene is important for making the MTHFR protein—a kind of protein that helps your physique soak up folate, in line with the Nationwide Library of Medication. So in case you have a mutation in an MTHFR gene, your physique could not have the ability to course of folate very properly.

Individuals taking sure drugs may have low ranges of folic acid. Examples of medicines that may intrude along with your physique’s absorption of folate embody the next, per Mount Sinai:

• Antacids, used to deal with heartburn
• H2 blockers, used to scale back abdomen acid, together with cimetidine (Tagamet), famotidine (Pepcid), and ranitidine (Zantac)
• Proton pump inhibitors, used to scale back abdomen acid, together with esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), and rabeprazole (Aciphex)
• Bile acid sequestrants, used to decrease ldl cholesterol, together with colestipol (Colestid), cholestyramine (Questran), and colesevelam (Welchol)
• Anti-seizure drugs, together with phenobarbital, primidone (Mysoline), and carbamazepine (Tegretol)
• Nonsteroidal anti-inflammatory medication (NSAIDs), together with ibuprofen (Advil, Motrin) and naproxen (Aleve)
• Sulfasalazine (Azulfidine), used to deal with inflammatory bowel illness (IBD) and rheumatoid arthritis (RA)
• Triamterene (Dyrenium), a diuretic (water tablet)
• Cycloserine, an antibiotic
• Pyrimethamine (Daraprim), used to stop and deal with malaria and to deal with toxoplasmosis
• Trimethoprim, an antibiotic used to deal with urinary tract and different infections

What are the signs of a folic acid deficiency?

In case your folic acid ranges are missing, it will possibly present up in your well being. One of many first signs is usually fatigue, in line with the Cleveland Clinic. A folic acid deficiency also can result in the next, per Mount Sinai:

• Poor development (in infants and kids)
• Tongue irritation
• Gingivitis
• Lack of urge for food
• Shortness of breath
• Diarrhea
• Irritability
• Forgetfulness
• Psychological sluggishness

3. It helps your coronary heart well being

Folic acid can be essential to your coronary heart well being. “It helps your physique break down an amino acid referred to as homocysteine,” says Dr. Li. When homocysteine ranges get too excessive, it will possibly injury your endothelium—or the liner of your blood vessels. Over time, this will trigger blockages that result in severe coronary heart issues like stroke, provides Dr. Li.

Whereas there isn’t any concrete proof that top quantities of homocysteine trigger coronary heart illness, there are some research to recommend that folks with elevated homocysteine ranges are greater than twice as prone to have a stroke than these with wholesome ranges, and are at the next danger of coronary heart illness total, per Mount Sinai.

Value noting: Folate is essential to your purple blood cells to correctly perform. When there is a deficiency on this vitamin, it will possibly result in folate deficiency anemia, which may trigger an array of problems, together with heart problems, per the Cleveland Clinic. 

All in all, getting sufficient folic acid is a protected guess relating to decreasing dangerous ranges of homocysteine and defending your coronary heart. Attempt to fill your eating regimen with folic-acid wealthy meals. And in case you have a historical past of coronary heart issues, ask your physician whether or not you may gain advantage from taking a vitamin B complement.

4. It might assist decrease your most cancers danger

A eating regimen wealthy in folic acid could be protecting in opposition to some types of most cancers, together with abdomen, breast, cervical, pancreatic, and colorectal most cancers, in line with Mount Sinai.

The reverse could also be true, too: “Low folate ranges within the physique are related to an elevated danger of most cancers,” says Dr. Li, citing an August 2018 evaluation in Present Diet Stories.

Whereas scientists are nonetheless uncertain why folic acid has this anti-cancer impact, some suppose it’d relate “to folate’s involvement with the right synthesis of DNA,” Dr. Li says. DNA is principally the “genetic code” or blueprint for the right growth and functioning of your physique. So if one thing goes incorrect when making DNA, mutations can occur, which may generally result in most cancers.

Nonetheless, there’s no concrete information that taking folic acid dietary supplements prevents most cancers, per Mount Sinai. The easiest way to scale back your most cancers danger and keep wholesome total is by consuming a balanced eating regimen with folic acid-rich meals, and by seeing your physician commonly for any advisable most cancers screenings primarily based in your age, household historical past, and present well being.

5. It might assist with melancholy

In accordance with the NIH, folks with low blood ranges of folate usually tend to have melancholy. A December 2017 meta-analysis within the Journal of Psychiatric Analysis additionally discovered that folks with melancholy could have decrease ranges of folate of their blood than these with out melancholy. This will have an effect on your therapy, too, as folks with low folate ranges could not reply as properly to antidepressants in comparison with folks with wholesome folate ranges, per the NIH.

This implies getting sufficient folate could assist assist your psychological well being and probably scale back the signs of melancholy, together with suicidality. The truth is, a large-scale September 2022 examine in JAMA Psychiatry discovered that taking 1 milligram of folic acid per day (which is taken into account the higher tolerable restrict for adults) was related to decrease charges of suicide and self-harm makes an attempt in additional than 850,000 examine contributors.

Whereas these are promising findings, the connection between folic acid and melancholy continues to be not totally understood. For instance, it is unclear whether or not a decreased urge for food (a doable symptom of melancholy) results in folate deficiency or whether or not folate deficiency contributes to melancholy, says Dr. Hack.

Researchers do have some preliminary theories about this connection, although. One is that “folic acid is required by the mind to supply neurotransmitters reminiscent of serotonin and dopamine,” says Dr. Li. As a result of serotonin and dopamine each play an essential function in temper, growing them could scale back the signs of melancholy, he notes.

That stated, different research have discovered that taking folic acid isn’t any higher than a placebo relating to relieving melancholy, in line with Mount Sinai.

The underside line? There is no assure folic acid dietary supplements alone will deal with your melancholy signs. Discuss to your physician earlier than making an attempt them, and if they offer the OK, add it to your therapy plan alongside clinically confirmed strategies like remedy and drugs.

Dietary sources of folic acid

For many adults (except for people who find themselves pregnant or these making an attempt to grow to be pregnant), it’s finest to get all of the folate you want from complete meals. The excellent news? A number of meals are naturally wealthy in folate, or are fortified with folic acid, so it’s probably you may get sufficient when consuming a balanced eating regimen.

Some meals naturally excessive in folate embody the next, per the Nationwide Institutes of Well being (NIH):

• Beef liver
• Greens (particularly asparagus, brussels sprouts, and darkish inexperienced leafy greens like spinach and mustard greens)
• Fruits and fruit juices (particularly oranges and orange juice)
• Nuts, beans, and peas (like peanuts, black-eyed peas, and kidney beans)

Folic acid can be added to the next meals, per the NIH:

• Enriched bread, flour, cornmeal, pasta, and rice
• Fortified breakfast cereals
• Fortified corn masa flour (used to make corn tortillas and tamales, for instance)

Who ought to take folic acid dietary supplements? 

Whereas most individuals ought to have the ability to get sufficient folic acid from their diets, some teams, like the next, could profit from taking a complement.

• People who find themselves pregnant or plan to conceive: Begin taking prenatals with folic acid three months earlier than you propose to get pregnant, and goal for 400 micrograms per day, says Dr. Hack. In case you’re at the next danger of getting a child with neural tube defects (as a result of you’ve got a seizure dysfunction or had different infants with neural tube defects), 4,000 micrograms per day is advisable, she provides. However all the time discuss to your physician first about correct dosage.
• Individuals with excessive blood ranges of homocysteine: In case your blood work reveals you’ve got excessive ranges of homocysteine, taking a folic acid complement could scale back your danger of coronary heart issues and decrease the amino acid to more healthy ranges in your blood, says Dr. Li. The advisable dose on this case is 400 micrograms, he provides.
• Individuals prone to folate deficiency: This consists of folks with alcohol use dysfunction, extreme malnutrition, inflammatory bowel illness (IBD), celiac illness, or the MTHFR gene variant, says Dr. Hack.
• Individuals with melancholy: In case your physician agrees, taking a folic acid complement alongside different remedies, like antidepressants and life-style adjustments, may assist scale back your signs. However bear in mind researchers are nonetheless unclear about how a lot folic acid to take to alleviate melancholy, says Dr. Li.

It doesn’t matter what your scenario, all the time verify along with your physician earlier than beginning a brand new complement as a result of some could negatively work together with different drugs or trigger unwanted side effects. Your physician also can assist resolve the fitting dosage for you.

Who mustn’t take folic acid dietary supplements?

For some folks, taking a folic acid complement may do extra hurt than good. Use warning if you happen to belong to one of many following teams, and all the time discuss to your physician earlier than beginning any new complement:

• Individuals allergic to folic acid: It is uncommon, however doable, to have a folic acid allergy. Indicators of an allergic response embody pores and skin rash, itching, redness, and in extreme instances, issue respiratory, per the Mayo Clinic. You probably have any of those signs after taking a complement, cease taking it and see your physician as quickly as doable.
• Individuals who take sure drugs: Typically folic acid can intrude with sure drugs and make them much less efficient. For instance, “folks taking the seizure remedy Dilantin (phenytoin) ought to discuss to their physician earlier than taking folic acid, as a result of it may decrease the drug focus in your blood, making it much less efficient,” says Dr. Li. The identical goes for different anticonvulsant medicines like fosphenytoin (Cerebyx) and primidone (Mysoline), per the Mayo Clinic. Folic acid also can intrude with some drugs used to deal with most cancers, per Mount Sinai, and reduce the effectiveness of barbiturates and the anti-malaria drug pyrimethamine (Daraprim), per the Mayo Clinic.

Is it doable to take an excessive amount of folic acid?

While you take the day by day advisable dosage, folic acid is mostly protected. However if you happen to take an excessive amount of (greater than 1,000 micrograms, or the day by day higher restrict), you’ll be able to have unfavourable unwanted side effects. Although uncommon, excessive doses of folic acid could cause the next signs, per Mount Sinai:

• Abdomen issues
• Sleep issues
• Pores and skin reactions
• Confusion
• Lack of urge for food
• Nausea
• In extreme instances, seizures

“Excessive doses of folic acid also can masks signs of a vitamin B12 deficiency,” says Dr. Hack. An extended-term vitamin B12 deficiency might be harmful, as it will possibly result in everlasting injury of the mind, spinal twine, and nerves, in line with the NIH.

You may normally keep away from this downside by taking a complement with 100% of the day by day worth of each folic acid and vitamin B12, per the Mayo Clinic.

To be protected, all the time discuss to your physician earlier than taking greater than 800 micrograms of folic acid.

—reviewed by Jennifer Logan, MD, MPH