Healthy Habits: Folic acid vs. folate

Folic acid and folate are often mixed up, yet they are distinct forms of vitamin B9 that the body handles differently. Folate occurs naturally in foods like leafy greens, beans and eggs. Folic acid is the synthetic version manufacturers use because it’s cheaper and more shelf-stable. It is used in many supplements, including prenatal vitamins, and in fortified foods like enriched flour and breakfast cereals.

The body absorbs and uses food-based folate readily. Folic acid, however, requires extra conversion in the liver — a step that some people, especially those with common genetic variations, manage less efficiently. Nutrition specialists therefore recommend getting most vitamin B9 from whole foods, which offer the nutrient in a familiar form along with fiber, antioxidants and other beneficial compounds.

I personally recommend getting as much nutrition as possible from whole foods first. Then supplement only with high-quality options such as organic whole-food vitamins, freeze-dried acerola cherry powder for extra vitamin C, chlorella, blue spirulina and other superfoods you can mix into shakes, smoothies or slushies.

Here are some folate-rich foods, listed from highest amount to lowest: beef liver, lentils, spinach, asparagus, black-eyed peas, avocados, beets, broccoli, Brussels sprouts and oranges. Building meals around these foods gives you assimilable folate plus other nutrients that no pill can fully replace.

This small-batch zesty green dip combines folate-rich spinach, broccoli and black-eyed peas with fresh lemon juice and cilantro. It makes a tasty spread or appetizer for four to six people. The ingredients can easily be doubled for larger groups. Always choose organic ingredients when possible. For the tahini in this recipe, a great brand is unhulled stone-ground Pepperwood Organics Whole Sesame Tahini Paste.

To make it, steam 1 cup broccoli florets and 2 cups fresh spinach leaves until just tender, about 3 minutes. Drain very well, getting all excess moisture out. In a food processor combine ¾ cup drained cooked or canned black-eyed peas, the steamed vegetables, ¼ cup fresh cilantro leaves, the zest and juice of 1 large lemon, 1½ tablespoons tahini, 1 garlic clove, 1½ tablespoons extra-virgin olive oil, ¼ teaspoon ground cumin, a pinch of red pepper flakes or smoked paprika, Celtic sea salt and black pepper to taste. Add ¼ teaspoon cayenne pepper powder for heat.

Process until creamy, adding a splash of filtered water if needed. Chill at least 20 minutes to meld flavors. Serve with sliced vegetables, sourdough crackers, tortilla chips or pita. The dip keeps up to three days in the refrigerator.

When you rely on supplements with folic acid instead of whole foods, the body still has to convert it into its active form called 5-methyltetrahydrofolate (5-MTHF) before cells can actually use it. That conversion depends on an enzyme made by the MTHFR gene.

Variations in this gene are common. In people who carry them, especially from both parents, the conversion can be slower. This may raise homocysteine levels and reduce usable folate.

Higher homocysteine has been linked to greater risks of blood clots, heart disease and stroke. Some research also connects MTHFR variants and low folate status to challenges such as high blood pressure, pregnancy complications, birth defects and mood disorders. That is why some clinicians prefer active forms like methylfolate or folinic acid over synthetic folic acid for those with known variants.

Stacking synthetic folic acid from fortified foods, multivitamins and prenatals can leave some people with unmetabolized folic acid in the blood, which studies have associated with potential concerns including masked B12 deficiency and other effects. Our bodies need folate, but the form and amount matter.

If you are reviewing your supplements, look for labels listing methylfolate (5-MTHF), folinic acid or food-source folate instead of plain folic acid. Pregnant women or those trying to conceive should talk with their clinician before any changes, as standard folic acid guidelines still aim to prevent neural tube defects.

For people who avoid folic acid but still want a safety net, there are supplements that use either active folate forms or concentrates of folate-rich plants, such as Mary Ruth’s organic liquid vitamins. Some products combine powdered collard greens, turnip greens and microalgae to provide folate and vitamin B12 sourced from foods instead of synthetic folic acid.

If you have been struggling with fatigue, brain fog, mood changes, high blood pressure or a history of blood clots, it doesn’t automatically mean an MTHFR variant is to blame or that folic acid is the sole culprit. It does make sense to examine your B-vitamin sources, consider testing with a doctor when appropriate and lean more on real foods that supply folate your body already recognizes.

Be well and God bless you.