The Difference Between Folic Acid and Folate: Why Folic Acid Should Be Avoided According to New Studies and Naturopathic Consensus

Folic acid and folate are often used interchangeably, but despite their similar names, they are quite different. These compounds are both forms of vitamin B9, a crucial nutrient for the body, but they are absorbed, metabolized, and used in distinct ways. As we explore the difference between folic acid and folate, it becomes clear why many health experts, particularly those in the field of naturopathy, recommend avoiding folic acid entirely and opting for folate in its natural form.

This article will dive deep into the science behind folic acid and folate, their roles in the body, and why new research and the growing consensus in the naturopathic community suggest that folic acid should never be used.

Understanding Folic Acid and Folate: What’s the Difference?

Both folic acid and folate are forms of vitamin B9. Folate occurs naturally in food, while folic acid is the synthetic form used in supplements and fortified foods. At first glance, they may seem interchangeable, but the way the body processes them differs significantly.

1. Folate (Naturally Occurring Vitamin B9)

Folate is the natural form of vitamin B9 found in foods like leafy green vegetables, beans, lentils, peas, citrus fruits, and avocados. When you consume folate-rich foods, the body absorbs the vitamin directly in its active form. It doesn’t require much processing to be utilized effectively, and your body can readily convert it into the active form called tetrahydrofolate (THF), which is essential for cell division, DNA synthesis, and red blood cell formation. You can also buy natural methylated folate in a supplement. 

2. Folic Acid (Synthetic Vitamin B9)

Folic acid, on the other hand, is the synthetic version of vitamin B9. It is commonly added to fortified foods and is widely used in supplements to prevent folate deficiency, especially in pregnant women. When you consume folic acid, your body must first convert it into the active form (THF) through a two-step process in the liver and other tissues. However, the conversion is not always efficient, especially in certain populations, leading to potentially harmful outcomes.

The Problem with Folic Acid: Why It Should Be Avoided

While folic acid was introduced in the 1990s to combat neural tube defects in newborns and has undoubtedly contributed to public health improvements, the growing body of research suggests that it may cause more harm than good. Here are some of the key reasons why folic acid should never be used:

1. Inefficient Conversion Process

The primary concern with folic acid is that the body does not always convert it efficiently into the active form of folate (THF). In fact, approximately 30-40% of the population has a genetic mutation called MTHFR (methylenetetrahydrofolate reductase), which reduces the ability to convert folic acid into its active form. As a result, people with this mutation may struggle to process folic acid properly, leading to high levels of unmetabolized folic acid in the bloodstream.

This excess unmetabolized folic acid can accumulate and potentially cause harm, including interfering with the immune system, cognitive function, and DNA synthesis. Furthermore, unmetabolized folic acid has been linked to increased risk of cancer, particularly in individuals with a history of cancer or those already genetically predisposed.

2. Masking Vitamin B12 Deficiency

Folic acid can mask the symptoms of vitamin B12 deficiency, especially in people with low vitamin B12 levels. This is a serious concern, as vitamin B12 deficiency can lead to nerve damage, neurological problems, and even irreversible cognitive decline. When folic acid is consumed in excess, it can “correct” the symptoms of anemia (which is often a result of vitamin B12 deficiency), but it does not address the underlying cause of the problem. Consequently, people may remain unaware of their vitamin B12 deficiency until it has caused significant damage.

3. Link to Cancer Risk

Research indicates a potential link between excess folic acid intake and certain types of cancer. Some studies have shown that high levels of unmetabolized folic acid in the blood may promote the growth of existing cancer cells. For example, colorectal cancer risk may be heightened in people who consume excess folic acid, especially in those who are already predisposed to developing cancer due to genetic mutations or environmental factors.

While folate is essential for DNA repair and cellular function, excessive folic acid may promote the growth of abnormal cells, leading to increased cancer risk. This makes it even more critical to limit folic acid intake and prioritize the natural form of folate found in whole foods.

4. Potential for Cognitive Decline

Folic acid supplementation has also been implicated in cognitive decline, particularly in older adults. Studies have suggested that high doses of folic acid may accelerate cognitive decline, especially when paired with low vitamin B12 levels. This combination can disrupt the homocysteine metabolism pathway, which is critical for maintaining healthy brain function.

In contrast, natural folate found in food sources does not carry the same risks and has been shown to support brain health by reducing homocysteine levels and supporting proper cognitive function.

5. The Risk of Overuse

Folic acid is found in many processed foods, including cereals, pasta, and bread. As a result, many individuals may unknowingly consume too much folic acid. While this may not initially seem harmful, the chronic overconsumption of folic acid can exacerbate the problems mentioned earlier, including cancer risk, immune dysfunction, and neurological damage.

The Naturopathic Perspective: Why Folate is Preferred

The field of naturopathy places a strong emphasis on the use of natural, whole-food sources of nutrients to promote overall health. According to many naturopathic practitioners, folic acid should never be used due to its synthetic nature and the risks associated with its consumption. Instead, they advocate for the use of folate, the bioactive form of vitamin B9, which the body can easily process and use without the need for additional conversion steps.

Here are a few reasons why naturopaths prefer folate:

1. Bioavailability and Absorption

Unlike folic acid, natural folate is already in its active form, making it readily available for the body to use without requiring complex conversion processes. This makes folate from whole foods or supplements (like methylfolate) a much safer and more effective option.

2. Reduced Risk of Toxicity

Because folate is naturally occurring and requires minimal processing, the risk of toxicity from consuming too much folate is minimal. The body simply uses what it needs and excretes the excess, without the harmful side effects associated with unmetabolized folic acid.

3. Support for MTHFR Mutations

For individuals with MTHFR mutations, using methylfolate (a form of folate) ensures that the nutrient can be efficiently processed and utilized by the body. This can significantly improve folate metabolism and prevent the buildup of unmetabolized folic acid, which can otherwise contribute to a range of health issues.

4. Holistic Wellness

Naturopaths take a holistic approach to wellness, meaning that they prioritize natural, food-based nutrients over synthetic supplements. By opting for folate-rich foods like leafy greens, beans, and liver, individuals can optimize their overall nutrient intake while minimizing the risk of any adverse effects.

Conclusion: The Need for Caution with Folic Acid

While folic acid has played an important role in preventing neural tube defects in pregnancies, recent studies and the growing consensus within the naturopathic community suggest that folic acid should be avoided in most cases due to its potential risks. From inefficient conversion and unmetabolized folic acid to its links with cancer and cognitive decline, the drawbacks of folic acid far outweigh its benefits.

Instead, it’s best to prioritize natural folate from whole foods or supplements containing methylfolate, which is safer, more bioavailable, and better absorbed by the body. By making these informed choices, you can ensure that you’re getting the vitamin B9 your body needs without the risks associated with folic acid.

If you’re concerned about your folate intake, speak with a healthcare professional or a naturopathic practitioner who can guide you toward the best options for your health and wellness.

Dr. Clark Store Methyl-Folate