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

If you are taking a vitamin B advanced daily, you are doubtless nicely conscious of the numerous advantages B nutritional vitamins have in your general 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 on your child’s improvement.

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 beneficial in case your folate ranges are low.

Regardless 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, consultants share all of the constructive results folic acid has in your well being, who ought to take a folic acid complement, and who ought to follow 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, based on 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 might forestall delivery defects in being pregnant

Once 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 loss plan: Burn Fats, Heal Your Metabolism, and Stay Longer‌‌. Nucleotides assist kind the central nervous system in a creating embryo, he provides.‌

Meaning, getting sufficient “folic acid is crucial for stopping main delivery 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 Girl Components Physician. Neural tube delivery defects could cause severe medical issues in infants together with:

• Cleft palate (a gap or cut up within the roof of the mouth that occurs when tissue does not be a part of collectively fully)
• Spina bifida (a situation that impacts the backbone and will trigger bodily and/or mental disabilities)
• Mind harm

So how a lot folic acid must you take when you’re pregnant or planning to turn out to be pregnant? “The CDC recommends taking about 400 micrograms of folic acid (or 600 micrograms DFE) daily to assist forestall delivery defects,” says Dr. Hack.

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

That mentioned, it’s fairly onerous to get 400 micrograms of folate by food plan alone. That’s the place prenatal nutritional vitamins turn out to be useful. They’re formulated with simply the correct quantity of folic acid for pregnant folks. And when you’re planning to turn out 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 usually 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) daily to stop delivery defects.”—Stephanie Hack, MD, OB/GYN

2. It might 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 vulnerable 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 circumstances can mess together with your physique’s capability to soak up sure nutritional vitamins and vitamins.

Individuals with an MTHFR gene variant may additionally be extra vulnerable to a folate deficiency. The MTHFR gene is crucial for making the MTHFR protein—a kind of protein that helps your physique take in folate, based on 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 nicely.

Individuals taking sure medicines may additionally have low ranges of folic acid. Examples of medicines that may intervene together with your physique’s absorption of folate embrace 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 medicines, together with phenobarbital, primidone (Mysoline), and carbamazepine (Tegretol)
• Nonsteroidal anti-inflammatory medicine (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 capsule)
• 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 could present up in your well being. One of many first signs is usually fatigue, based on the Cleveland Clinic. A folic acid deficiency may result in the next, per Mount Sinai:

• Poor development (in infants and youngsters)
• 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 also be essential on 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 could harm your endothelium—or the liner of your blood vessels. Over time, this could 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 individuals with elevated homocysteine ranges are greater than twice as more likely to have a stroke than these with wholesome ranges, and are at the next danger of coronary heart illness general, per Mount Sinai.

Price noting: Folate is essential on your purple blood cells to correctly operate. When there is a deficiency on this vitamin, it could 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 reducing dangerous ranges of homocysteine and defending your coronary heart. Attempt to fill your food plan 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 could assist decrease your most cancers danger

A food plan wealthy in folic acid is perhaps protecting towards some types of most cancers, together with abdomen, breast, cervical, pancreatic, and colorectal most cancers, based on 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 overview in Present Diet Stories.

Whereas scientists are nonetheless uncertain why folic acid has this anti-cancer impact, some assume it would 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 improvement 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 knowledge 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 general is by consuming a balanced food plan with folic acid-rich meals, and by seeing your physician frequently for any beneficial most cancers screenings based mostly in your age, household historical past, and present well being.

5. It could assist with despair

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

This implies getting sufficient folate could assist help your psychological well being and presumably cut back the signs of despair, together with suicidality. In reality, 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 members.

Whereas these are promising findings, the connection between folic acid and despair remains to be not absolutely understood. For instance, it is unclear whether or not a decreased urge for food (a potential symptom of despair) results in folate deficiency or whether or not folate deficiency contributes to despair, 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 akin to serotonin and dopamine,” says Dr. Li. As a result of serotonin and dopamine each play an essential position in temper, rising them could cut back the signs of despair, he notes.

That mentioned, different research have discovered that taking folic acid isn’t any higher than a placebo relating to relieving despair, based on Mount Sinai.

The underside line? There is not any assure folic acid dietary supplements alone will deal with your despair signs. Discuss to your physician earlier than attempting them, and if they offer the OK, add it to your therapy plan alongside clinically confirmed strategies like remedy and medicine.

Dietary sources of folic acid

For many adults (except people who find themselves pregnant or these attempting to turn out to be pregnant), it’s finest to get all of the folate you want from entire meals. The excellent news? Plenty of meals are naturally wealthy in folate, or are fortified with folic acid, so it’s doubtless you may get sufficient when consuming a balanced food plan.

Some meals naturally excessive in folate embrace 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 also 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 intend to get pregnant, and purpose for 400 micrograms per day, says Dr. Hack. When you’re at the next danger of getting a child with neural tube defects (as a result of you might have a seizure dysfunction or had different infants with neural tube defects), 4,000 micrograms per day is beneficial, she provides. However all the time speak to your physician first about correct dosage.
• Individuals with excessive blood ranges of homocysteine: In case your blood work exhibits you might have excessive ranges of homocysteine, taking a folic acid complement could cut back your danger of coronary heart issues and decrease the amino acid to more healthy ranges in your blood, says Dr. Li. The beneficial dose on this case is 400 micrograms, he provides.
• Individuals liable to folate deficiency: This contains folks with alcohol use dysfunction, extreme malnutrition, inflammatory bowel illness (IBD), celiac illness, or the MTHFR gene variant, says Dr. Hack.
• Individuals with despair: In case your physician agrees, taking a folic acid complement alongside different remedies, like antidepressants and way of life modifications, might assist cut back your signs. However consider researchers are nonetheless unclear about how a lot folic acid to take to alleviate despair, says Dr. Li.

It doesn’t matter what your state of affairs, all the time test together with your physician earlier than beginning a brand new complement as a result of some could negatively work together with different medicines or trigger uncomfortable side effects. Your physician may assist determine the correct dosage for you.

Who shouldn’t take folic acid dietary supplements?

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

• Individuals allergic to folic acid: It is uncommon, however potential, to have a folic acid allergy. Indicators of an allergic response embrace pores and skin rash, itching, redness, and in extreme instances, issue respiration, per the Mayo Clinic. When you’ve got any of those signs after taking a complement, cease taking it and see your physician as quickly as potential.
• Individuals who take sure medicines: Generally folic acid can intervene with sure medicines and make them much less efficient. For instance, “folks taking the seizure medicine Dilantin (phenytoin) ought to speak to their physician earlier than taking folic acid, as a result of it might 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 may intervene with some medicines 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 potential to take an excessive amount of folic acid?

Once you take the day by day beneficial dosage, folic acid is mostly protected. However when you take an excessive amount of (greater than 1,000 micrograms, or the day by day higher restrict), you may have adverse uncomfortable 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 may masks signs of a vitamin B12 deficiency,” says Dr. Hack. A protracted-term vitamin B12 deficiency might be harmful, as it could result in everlasting harm of the mind, spinal wire, and nerves, based on the NIH.

You may normally keep away from this drawback 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 speak to your physician earlier than taking greater than 800 micrograms of folic acid.

—reviewed by Jennifer Logan, MD, MPH