B9 (Folic Acid)

Folate, folic acid and methylfolate: what's the difference?

• Folate is the natural form found in food, such as spinach and other leafy greens, lentils (dal), chickpeas, beans, liver and oranges.
• Folic acid is the stable, synthetic form used in most supplements and fortified foods. It is very well absorbed.
• Methylfolate (L-5-MTHF) is an active form that some people choose, although folic acid works well for most.

Folic acid for pregnancy

Taking at least 400 mcg of folic acid a day, starting at least one month before conception and continuing through the first 12 weeks, greatly reduces the risk of neural tube defects such as spina bifida. Because many pregnancies are unplanned, this is recommended for all women who could become pregnant. Women with diabetes, epilepsy, obesity or a previous affected pregnancy may be prescribed a much higher dose, often 5 mg, by their doctor.

How much folic acid is safe?

For most adults, the upper limit for folic acid from supplements and fortified foods is 1,000 mcg (1 mg) a day unless a doctor prescribes more. High doses can hide the signs of vitamin B12 deficiency while nerve damage continues, so older adults and vegetarians taking folic acid should make sure their B12 is checked too. Some anti-seizure and methotrexate treatments interact with folate, so ask your doctor if you take them.

Choosing folic acid tablets

Check whether the label lists the amount as mcg of folic acid or as mcg DFE (dietary folate equivalents): 400 mcg of folic acid equals about 680 mcg DFE. Most women planning a pregnancy are better served by a prenatal vitamin that includes folic acid, iron and iodine, unless their doctor recommends folic acid alone. Plain folic acid tablets are inexpensive and widely sold in Bangladeshi pharmacies.

Men and older adults rarely need folic acid supplements unless a doctor finds a deficiency or anaemia.