Is Folic Acid the Same as Folate?

Folate is a B-complex vitamin found naturally in fruits and vegetables. The word folate is derived from the Latin word "folium," which means leaf, so, as you would expect from the name, folate is found in leafy vegetables like spinach. Dry beans, asparagus, avocado, strawberries, papaya, corn, broccoli, and citrus fruits are also good sources.
Folic acid is a synthetic form of folate made from bacteria. It's found in dietary supplements, and it's used to enrich or fortify some processed foods such as bread, cereal, and some brands of orange juice. Folate and folic acid are similar in structure, but your body absorbs folic acid better than folate.

Why Your Body Needs Folate or Folic Acid

Your body can use either folic acid or folate to make deoxyribonucleic acid (DNA) and ribonucleic acid (RNA), which contain the genetic blueprints of all your cells. So, either folate or folic acid is necessary for cell division and growth.

Women who don't get enough folate or folic acid during the first trimester of pregnancy are at risk of giving birth to babies who have neural tube defects, including spina bifida and anencephaly, so the United States Food and Drug Administration requires grain and cereal products to be enriched with folic acid. Because of this enrichment, the rate of neural tube defects has dropped significantly. 

Folate, Folic Acid, and Your Health

Folate and folic acid intake were associated with health benefits in research studies when scientists looked at large populations. People who ate folate-rich foods also had lower risks of certain cancers and cardiovascular disease. These findings led to increased use of folic acid supplements because consumers hoped they might reduce their chances of getting sick with those conditions.

The concept of folic acid being protective made some sense because folate is important to cell division and damage to DNA can lead to cancer. Folic acid lowers blood levels of a protein called homocysteine, and elevated levels of homocysteine are associated with higher risk of cardiovascular disease. Consuming folate-rich foods, especially from fruits and vegetables, has another layer of benefits from other nutrients and antioxidants.

However, when it comes to nutrition, dietary supplements, and health risk, population studies typically find correlations but usually not direct causes. Follow-up studies haven't found that taking folic acid reduces any risk of cancer or cardiovascular disease.

Using Folic Acid Supplements Safely

Alcoholics, people with liver disease, and individuals who take certain medications or undergo kidney dialysis are more likely to be deficient in folate and may benefit from folic acid fortified foods or supplements.

The Institute of Medicine sets the tolerable upper limit (highest level known to be safe) of folic acid as 1,000 micrograms per day, but there is no upper limit set or natural folate intake from foods—you can eat as much as you'd like.

Although folic acid supplements are safe, taking them in large amounts can mask a vitamin B-12 deficiency, which can result in neurological damage if the B-12 deficiency is not corrected. This is especially important for the elderly population who are at greater risk for vitamin B-12 deficiency. So speak with your healthcare provider or a registered dietitian before taking folic acid supplements beyond what is found in fortified foods.