Folic acid is particularly important during pregnancy, but folate deficiencies can occur in anyone—they’re far more common than most people realize. While women particularly need folic acid, this B vitamin offers a number of health benefits for children, adults and developing fetuses.
Unlike many vitamins, there are upper levels of folic acid intake you must be wary of—if not, serious side effects may occur. It’s especially important to talk to your doctor about whether you have a folic acid deficiency, and what kind of dosage is appropriate for you.
So what is folic acid, exactly?
Folates and folic acid are often used interchangeably, but they’re actually quite different. Folic acid is the synthetic version of folate, a B vitamin that’s linked to skin, hair and nail health. Folic acid is used in supplements and fortified foods, like bread, cereal and pasta and rice. It’s better than using natural folates, which can break down from heat and light. Cooking pasta, rice and cereal would break down natural folates, while synthetic folic acid can survive.
Folic acid is especially important during pregnancy, because it helps prevent birth defects of the brain and spine, anencephaly and spina bifida. The CDC recommends that women of reproductive age get at least 400 mcg of folic acid per day, since many pregnancies are unplanned, and the majority of birth defects occur in the first three to four weeks after conception. However, everyone can use folic acid to help create new cells.
Know your upper limit
The amount of folic acid you need varies on age and sex, but adult women should aim to get at least 400 mcg per day, with an upper limit of 1,000 mcg. Teenagers 14-18 have an upper limit of 800 mcg, children nine to 13 600 mcg, ages four through eight 400 mcg and children under four should consume no more than 300 mcg per day. Do not give supplements to children under one.
Why is that important? When you get more folates than your body can handle, your body can’t metabolize it fast enough. Folic acid can build up in your bloodstream. While researchers haven’t determined whether folic acid buildup has any specific side effects, they consider it worrisome enough to set those upper limits. Some research points to increased instances of autism, impaired immune function and even cancer—but again, results are inconclusive. It’s still best to follow the upper limit for your age group.
Many people get enough folic acid from fortified foods, but if you don’t eat fortified bread, pasta, rice or cereal, you should consider supplementing. Talk to your doctor before starting a folic acid supplement, which can be found on their own or in multivitamins—especially those designed for women. Naturally occurring folates do not seem to build up in the bloodstream in the same way.
Folic acid may interact with certain medications, including methotrexate, phenytoin, carbamazepine, valproate and sulfasalazine. If you are currently medicated for cancer, an autoimmune disorder, epilepsy or ulcerative colitis, it is especially important to clear folic acid supplements with your doctor.
Benefits of folic acid
You already know that folic acid is important in preventing birth defects and improving your chances of conception, but what if you’re past childbearing age or simply don’t want children? It’s still a good idea to get folic acid in your diet or supplements.
Folic acid can help improve blood sugar regulation, which makes it helpful for people with diabetes. It also reduces inflammation, which has been linked to diseases like cancer, heart disease, lung disease and neurodegenerative disorders. It can also help people with kidney disease: when homocysteine builds up in the kidneys, which usually flushes it out, folic acid can aid the process.
Folic acid is especially important if you’re predisposed to certain conditions, including alcoholism, celiac disease, inflammatory bowel disease, genetic changes that affect folate breakdown or may not get enough folate in your diet. Older adults, especially those in nursing homes, should make sure they meet the recommended daily limit.
The bottom line
Getting enough folic acid is crucial—but on the other hand, you should be careful not to exceed the upper limit with supplements. (Folate in your diet is fine, since it’s water soluble and excess will be flushed out.) Talk to your doctor about how much folic acid you’re getting, and whether you need to add more supplements.