Vitamin B9 - Folic Acid & Folate

April 19, 2022

By Barret Procyshyn, Pharmacist at Dauphin Clinic Pharmacy

Folic Acid or folate in the natural form, like riboflavin is another type of B vitamin. A water-soluble vitamin, like all the other B vitamins, it must be obtained frequently from a well-balanced diet. Folate is the naturally occurring form of Vitamin B9. Folic Acid is how it is supplemented either as an additive to foods or as a product in the pharmacy. Folic Acid is available on its own, in multivitamins, in prenatal vitamins and in vitamin B complex products. While its usually recommended to obtain your vitamins from good food, folic acid as a supplement or additive is 30 to 40% better absorbed than the natural version.

You should still attempt to obtain as much natural folate as possible. Dark leafy green vegetables are a great source. Sesame seeds, beans, walnuts, liver, seafood, and eggs are other options. Please note that boiling these products often causes a significant amount of vitamin B loss. Commonly fortified foods include breads, cereals, pasta, and rice. This has helped the North American diet increase folic acid intake. Just be cautious as often these products are also heavily refined, contain harmful additives and too much sugar.

Simply, folate is extremely important. It helps to form our DNA and RNA and helps break down proteins for use. It also helps break down and clear out homocysteine, an amino acid that can harm the body if it reaches toxic levels. It is needed to help form red blood cells and as you have likely heard pregnant women should supplement with folic acid. This is because it is crucial for growth and fetal development.

For other vitamins and supplements, we often state more evidence is required to know their impact on a specific disease or condition. This is not the case for folic acid and fetal development. A lack of B9 is directly linked to defects of the spine and brain. It occurs early in development and has a significant impact on the child's quality of life. Randomized control trials have shown supplementation of folic acid almost eliminates the risk of these birth defects. However, timing is critical. It needs to be taken the first few weeks from conception, which is often before the mother realizes she is pregnant. Since we have started fortifying foods neural tube defects have dropped by about 25%. Since we now know how effective folic acid is to take during pregnancy it has dropped rates in North America even further. If you are planning to get pregnant ensure you are taking folic acid or at the least a prenatal vitamin.

Folic Acid has been linked to reducing the risk of stroke and perhaps slowing dementia. Knowing how our body uses folic acid to help metabolize nutrients, make red blood cells, and upkeep the nerves and brain, these theories seem possible. However clinical tries have not found direct links and the benefits of supplementing it is much less clear than in fetal development.

As mentioned, folic acid is available in multiple doses and found in a variety of health products. Determining how much you need plays a role in selecting the product which is right for you. The dose unlikely to cause any adverse effects in the general population is about 1000mcg (1mg), which does not consider what you obtain as natural dietary folate. Be cautious of obtaining all your folic acid from a multivitamin as you may not absorb all the supplemented dose.

Supplementing with folic acid is also crucial when taking immune suppressing therapy such as methotrexate, a medication used to treat rheumatoid arthritis. Folic acid is supplemented on the days the methotrexate is not used. Methotrexate unfortunately blocks the actions of folic acid. By replenishing folate, folic acid supplementation can significantly help prevent common methotrexate side effects like nausea, vomiting, and mouth sores. This shows its power as a vitamin.

If you have questions about what to take for vitamins, minerals, and supplements, talk to your pharmacist.

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist, or other health care professional.

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