Folate vs. folic acid – what you need to know


There’s been a lot of hype around folic acid for health. We’ve heard for a long time that it’s essential in order to prevent birth defects– specifically neural tube defects like spina bifida and anencephaly. Since these conditions come with devastating consequences, the CDC makes the recommendation that ALL women of childbearing age supplement 400mcg of folic acid, daily and 800mcg for pregnant women.

What is difficult (and really unfortunate!), is there has been some confusion over folic acid, a synthetic, man-made “nutrient” and folate, which is naturally occurring in food cultivated from the seed of live foods.

folic acid vs folate

While they’re often used interchangeably, they are different and can have long-term impacts on your health, for the positive and the detriment. One is health promoting and healing, while the other has been linked to serious health issues and can interact with several pharmaceuticals. Can you guess which one is what?

Folate is the naturally occurring version, crucial to the healthy functioning of our bodies.

Folic Acid is man-made and is used to fortify foods that have either LOST the folate due to processing (wheat —> bread is a good example of a process by which a food losses its innate nutritional value; the producer then replaces just a few –usually 7-9 of the dozens of the lost nutrients– in synthetic form back into the food). Or, it’s ABSENT because of soil depletion and environmental pollution and influence.

Fortification in the USA began in 1998 at the say-so of the FDA. Since then, we’ve fortified a lot.

We also fortify foods, like boxed, bagged and other highly processed foods, that don’t naturally  have significant levels of a nutrient, with that nutrient because of a current cultural push to get it into our bodies because we’re not consuming enough of whole foods that would naturally provide us with the nutrition on their own.

L-methylfolate is given when someone can’t break folic acid down, as there is a four step break down process, with L-methylfolate being the “end result” of the process.

Folic Acid > Dihydrofolate > Tetrahydrofolate > 5, 10, Methylene THF > L-methylfolate

Folate, on the other hand, is naturally occurring.

And what the body needs is FOLATE.

Folate is the highly bioavailable b-vitamin “B9.” B vitamins function and absorb BEST with their fellow b-vitamins, and are found together in nature, in live foods– especially GREEN veggies.

foods high in folate

A few of the most concentrated sources include:

  • Spinach
  • broccoli
  • Brussel sprouts
  • lettuce
  • liver
  • eggs
  • citrus
  • asparagus
  • avocado
  • sunflower seeds
  • almonds
  • peanuts
  • cauliflower
  • mushrooms
  • beets
  • celery
  • carrots
  • winter and summer squashes

Apart from being a protective against certain birth defects, folate is required for synthesizing and repairing DNA, proper cell division, healthy production of red blood cells (to prevent anemia and related conditions).

Folate naturally metabolizes directly in the small intestine, and requires less effort and burden on the body than its synthetic “imposter” folic acid.

Folic acid, on contrast, has a high enzyme burden and takes much longer to be metabolized and utilized by the body.

Proper enzyme function is essential to the utilization of folate. With folic acid there is a more complex, 4 step process that must take place within the liver, where as, as stated before, folate is metabolized directly in the SI. Supplementing with folic acid, and consuming more than your enzymes can handle at a time, leads to health complications.

Concerns with the synthetic version include that it will mask a B-12 deficiency, particularly in the elderly. Because the deficiency is not noticed, this then leads  to greater problems down the road. Folic acid has also been linked to cancer, specifically of the lungs and prostate.

At 800 mcg, or .8mg, of folic acid, serious heath risks have been documented: heart attack, anemia, and seizures. Long term use risks/side effects: abdominal cramps, diarrhea, rashes, sleep disorders, irritability, confusion, nausea, stomach upset, behavior changes, skin reactions, seizures, gas, excitability, etc.

In addition, there are MANY drug interaction possibilities, even with other supplements, where as consuming FOLATE from foods and herbs contain it inherently, there are no side effects or health risks.

Healing Strategies

1. Increase your intake of the folate-heavy foods listed above.

2. As with any sort of supplement, be sure that it is FOOD BASED and know the reputation and  the harvesting and processing practices of the company producing your chosen supplement.  How do you know if the supplement is food-based vs. synthetic based? A good way to know is by taking a look at the ingredient list. Does it list foods and herbs in the ingredients? Or the names of the nutrients? For instance: “spinach” vs. “folic acid.”

3.  If it is determined that you are not utilizing or absorbing folate, seek out a practitioner that will help you ask and answer “why.” When you know what is hindering or preventing you from absorbing and utilizing folate (or any other nutrient), you can take steps to correcting this.


Folate containing prenatals/supplements:

As always – be sure to check with your health care provider before changing supplements and get their thoughts on the one you want to begin taking.


Liquid Supermom 2 Bee prenatal with 800mcgs of folate sourced from organic lemon peel.

“In addition to concentrated whole food nutrition, Supermom 2 Bee was also carefully crafted to include the most bioavailable forms of key vitamins and minerals with an emphasis on making it as easy on the body as possible to utilize. Supermom 2 Bee™ includes Folate, Vitamin D3, the methylated form of B12, and a whole food form of iron.”

And if you already have a whole foods vitamin you love and simply want extra folate, they also offer a liquid folate separately.

Seeking Health

Contains folate in their Optimal Prenatal [50% as Quatrefolic® ((6S)-5-methyltetrahydrofolate, glucosamine salt) and 50% as folinic acid (calcium folinate)] as well as B12 in the form of methylcobalmin and adenosylcobalamin, both of which are helpful if you carry the MTHFR gene. This prenatal does not contain iron (as some women have problems with supplemental iron) so you’d need to find another source for that if it’s needed.

Thorne Research

(available on Amazon) Contains Folate 1 mg (500 mcg as Calcium Folinate and 500 mcg as L-5-Methyltetrahydrofolate from L-5-Methyltetrahydrofolic Acid, Glucosamine Salt) and Vitamin B12 200 mcg. (100 mcg as Adenosylcobalamin and 100 mcg as Methylcobalamin)

Innate Response

(available on Amazon) Contains 800mcgs of folate.

Douglas Laboratories

(available on Amazon) Contains  1,000 mcg of Metafolin®, a patented form of (6S) 5-methyltetrahydrofolate (5-MTHF). This is a folate only supplement so you’d need to add a multi vitamin if you wish.


More information:

The little known difference between folate and folic acid by Chris Kresser

Folate vs. folic acid by Kate from Wellness Mama

Folate and you, perfect together by Kelly Brogan MD

Folate vs folic acid – how to avoid a dangerous pregnancy by Stefanie Ruper

Asher Thayer
Asher lives in Grand Rapids, MI where she serves her community as Naturopath. She is passionate about helping her clients find health and wholeness naturally, and believes that in order to be truly well we must learn to honor all of ourselves; mind, body, emotions. Lover of good food, trees and people, when she isn't working you'll find her cooking, mentoring kiddos, and spending time in the woods. Learn more about her practice by visiting her website, facebook, or by tossing her an email!
Asher Thayer
Asher Thayer
Asher Thayer
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  1. Lori

    After googling everything under the sun and every herbal and added ingredient in about 10 all natural prenatal supplements I went the Innate Response route. Great reviews and also packed with everything you need. Good process. No herbal supplements that are “likely safe” or “possibly unsafe”I am in my first trimester so I am NOT taking any chances with my little nugget. Thought I would share in case any one else is going through the 3 days worth of googling ingredients that I just did. <3

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