Folate of Folic Acid: What's in a Name?

Folic acid: A yellowish-orange compound, a member of the vitamin-B complex, occurring in green plants, fresh fruit, liver and yeast and used medicinally to treat pernicious anemias.

Folate:  Folic acid.

Another name is vitamin B9. There are several other names of various forms of this important vitamin. None but folate is the natural form. My dictionary doesn’t discriminate between the two.

As a nutritional therapist I know the importance of this vitamin. We need it, along with B6, B12 and a few minerals, for the crucial methylation process, something our bodies do thousands of times every second. We must have it to synthesize and repair DNA. Rapid cell division and growth require folate, especially during pregnancy. Without it we cannot manufacture red blood cells.

Indeed, the government has even mandated the addition of folic acid to breads and cereals, in an effort to prevent neural tube defects in babies. You’ll find it in almost all prenatal and other multivitamins.

So, you may ask, what’s the big deal? We’re all used to calling it folic acid. Why even use the term folate? Indeed, even my computer’s grammar checker knows the term folic acid, but frowns, with a squiggly red underline at the term folate.  Is there a difference? If so, does it really matter?

Yes, it matters. Folate and folic acid are not the same thing. The body uses them differently. Indeed, a number of studies show that the manufactured form, folic acid, causes havoc in the body, while natural folate is protective.

Folic Acid vs. Folate and Cancer

In an article in the American Journal of Clinical Nutrition, researchers discovered that women who took multivitamins containing folic acid for ten years were more likely to be diagnosed with breast cancer than those who didn’t.

Another study shows that people taking folic acid for more than three years increased their risk of having a colorectal adenoma, a cancer precursor, by 35%.

A six-year Norwegian study found that people who took folic acid along with other vitamins were 43% more likely to die from cancer than those who did not supplement with this artificial form of the vitamin. In short, research shows that the manufactured folic acid feeds cancer.

On the other hand, people not taking folic acid, but getting folate from food, have less cancer, dependent on the level of folate they consume.

Folic Acid and the Immune System

In light of mandated folic acid supplementation of flour and cereals, a frightening fact has emerged: Manufactured folic acid supplementation increases the risk of childhood asthma by 26%. With asthmatic children on the rise, this is important to be aware of.

On the other hand, a study done at Johns Hopkins included 8,000 people and found that those with the highest levels of natural folate had fewer allergies and less asthma, as shown by lower IgE antibodies. Those with the lowest levels of folate had a 40% greater risk of wheezing than those with the highest levels.

Folate Shortage and Heart Disease

When folate is deficient, people often accumulate homocystiene, contributing to heart disease. Adding lots of leafy vegetables, yeast, liver and fruits to the diet can help replenish body supplies. Supplements should contain folate in its natural form rather than manufactured folic acid. When folic acid is supplemented instead, it can lead to cancer.

Folate and Pregnancy

Obviously, sufficient folate is crucial to a successful pregnancy and a healthy infant. Since most prenatal vitamins include manufactured folic acid, most people, unaware of the research, feel their needs for this crucial vitamin are covered. It’s important to encourage pregnant women to get lots of natural folate from veggies, beans and other food sources. Not only will this help protect their embryo from neural tube defects and future asthma, it will help protect women from future cancers. These natural foods also carry lots of other nutrients, all of which contribute to healthy infants and mothers. Childhood cancers are on the upswing, and many of them could also be avoided with better prenatal nutrition.

What’s going on?

We really don’t know. One big unknown is what happens to excess folic acid when it reaches the bloodstream. There are limits to how much folic acid the intestines can change into the useable form of folate. Any excess goes into the circulation in a form that is alien to the body. Scientists haven’t figured this one out yet.

One thing we do know is that the body stores up to four months’ worth of folate, so a dietary shortage won’t manifest immediately when it isn’t consumed regularly. That assumes, of course, that the body stores are sufficient. However, when these body stores have been used up, the results can be devastating, including neural tube defects in developing embryos, resulting in spina bifida. Symptoms can include various anemias, including pernicious and macrocytic; diarrhea; weakness and shortness of breath; mental confusion and memory difficulties; peripheral neuropathy, with numbness and pain, especially in the feet and hands; depression; mouth or peptic ulcers; or swollen tongue; headaches; behavioral problems, and heart palpitations.

Elderly people who exhibit confusion and other signs suggesting dementia should be tested for folate and B12 deficiencies, since the two vitamins work together. Often they are missing intrinsic factor, which is normally produced by the stomach, and may need injections of B12 in order to absorb folate. Supplementing with methylated forms of both B12 and folate may be another solution.

Now that you know the difference in folate and folic acid, you understand the risks and benefits of eating the right foods and supplementing only with natural folate. Please spread the word by passing this blog link along to anybody you think may be interested or may benefit from what you've just learned.

This article was recently published in the Nutritional Therapist, the publication of the Nutritional Therapy Association. For more information, check Wikipedia.com and DrFuhrman.com.