Folate vs. Folic Acid

Most of the times we hear the terms folate and folic acid used interchangeably, so we assume that they are pretty similar things. The reality couldn’t be further from the truth. For a start, folate is a natural substance found in green, leafy vegetables. Folic acid on the other hand is a synthetic substance, quite similar to folate, but it’s not the same. We have been taking folic acid systematically since 1998, when it was introduced as mandatory food fortification. Being synthetic, it can be easily and cheaply produced in a lab, which has made it the standard choice of vitamin producers. But this doesn’t mean that this is the best choice for us.

The difference between folate and folic acid

Biological Fact: folate is used a lot faster and much more efficiently in the body than folic acid

Folic acid is processed SO slowly in the body that tends to accumulate in the blood and this is not healthy

The molecules of folate and folic acid may be very similar but this does not necessarily mean that they are metabolized in the same way in the body. Biologists and biochemists know that even the slightest change in the structure of a molecule can have dramatic effects in its ability to fulfill its biological role. This is how things work on the molecular level.

Folate and folic acid are an excellent example of this biological truth. Folate is readily converted in the small intestine to a similar form called tetrahydrofolate (THF) and enters its main metabolic cycle [4]. In other words, folate is used up by the body fast and easy.

Folic acid on the other hand cannot be processed in the gut like folate, but is instead transferred to the liver, where a very different conversion path is followed in order to produce THF. This is important because the additional conversion steps require a specialized enzyme [called dihydrofolate reductase].

Here is the catch: this enzyme is not particularly active in the human liver and therefore cannot process large amounts of folic acid, for many people not even the official recommended daily allowance (aprox.  400mcg). In other words, folic acid is used up by the body slowly and inefficiently and lots of it will not be able to even enter the first stage of metabolism.

It is also reported that about 40% – 60% of the population carry genetic modifications that prevent adequate conversion of folic acid [1], which leaves us with a reasonable amount of this nutrient unable to fulfill its biological role. Folic acid that cannot be converted to THF in the liver enters the blood circulation unchanged and results in unnaturally high levels of unmetabolized circulating folic acid.

Since the food fortification program started, a significant increase in the incidence of colorectal and prostate cancer have been officially reported in several countries, such as Canada, US and Chile [2.3]. Of course there are many more factors that fuel colorectal cancer, but unprocessed folic acid could very well be one of them.

People taking folic acid supplements showed consistently higher rates of colorectal cancer and obligatory food fortification is a major part of the picture. This problem is believed to be related to the high levels of unprocessed folic acid in the blood [1].  Even the natural folate has been shown in the lab to fuel the progression of pre-existing cancers. In other words, it there is anything cancerous developing in the body, unprocessed folate or folic acid will enhance and speed up cancer progression. Since there is an inherent difficulty to process folic acid in the liver, the danger coming from folic acid supplements or foods fortified with it is pretty obvious. Natural folate is not a problem because it is converted to THF much faster and efficiently in the gut and enters its metabolic path right away.

The Solution

You now know why folate is better than folic acid – it just works better in our bodies. Wherever possible, you should aim to include folate-rich foods in your diet. This is the most natural way to take in folate.

But in pregnancy or while trying to conceive, this is not enough. In this case, a supplement with folate is ideal. Many supplements contain folate from natural food sources, which is always preferable from synthetic folate. Another form of folate that is very, very easily assimilated in the body (even easier than natural folate) is methyl-folate. Taking a supplement with methyl-folate is also an excellent option. If you have an MTHFR mutation (do check this article about more info about MTHFR and fertility), you MUST opt for methyl-folate supplement and avoid supplements or food fortified with folic acid or folate.