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Vitamin B9 (Folate)

Folate is a water-soluble B vitamin that is essential for human health. It is found naturally in a variety of foods, including leafy green vegetables, beans, and citrus fruits, and is also available as a dietary supplement.

Folate has many important health benefits, and research has shown that it can play a role in reducing the risk of several serious conditions.

Natural dietary sources of vitamin B9 (folate)

Here are some natural dietary sources of vitamin B9 (folate):

  • Leafy green vegetables: Leafy green vegetables are rich sources of vitamin B9, with a cup of cooked spinach, for example, providing about 240 micrograms (mcg) of vitamin B9.

  • Legumes: Legumes such as beans, lentils, and chickpeas are good sources of vitamin B9. A cup of cooked kidney beans, for example, provides about 180 mcg of vitamin B9.

  • Citrus fruits: Citrus fruits are good sources of vitamin B9, with a single orange providing about 70 mcg of vitamin B9.

  • Avocado: Avocado is a good source of vitamin B9, with a single fruit providing about 60 mcg of vitamin B9.

  • Asparagus: Asparagus is a good source of vitamin B9, with a cup of cooked asparagus providing about 200 mcg of vitamin B9.

It is worth noting that the amount of folate you can obtain from food varies based on factors such as the soil in which it was grown, the processing methods used, the form in which it is present, and the presence of other substances that may interfere its absorption.

While dietary intake of vitamin folate is important for maintaining adequate levels in the body, it is possible to obtain this nutrient in the bioavailable forms of levomfolic acid (levomefolate calcium/5-MTHF) and folinic acid (calcium folinate) with vitamin supplements. However, the best way to get the essential nutrients your body needs is to eat a variety of whole, unprocessed, fruits, vegetables, nuts, seeds, and other plant-based foods. These types of food ensure that you are getting a wide range of nutrients, which may include folate, and should not be replaced by vitamin and mineral supplements alone.

Folate may help to reduce the risk of heart disease

One of the most well-known health benefits of folate is its ability to support cardiovascular health. Folate helps to lower levels of homocysteine, an amino acid that has been linked to an increased risk of heart disease. High levels of homocysteine are thought to contribute to the development of plaque in the arteries, which can lead to heart attacks and strokes.

Several studies have found that folate supplementation can help to lower homocysteine levels and reduce the risk of heart disease. For example, a study published in the American Journal of Clinical Nutrition found that taking a daily folate supplement was associated with a significantly lower risk of heart disease in women.

Folate may help to reduce the risk of birth defects

Folate is especially important for women who are planning to become pregnant or who are already pregnant. This is because folate plays a key role in fetal development and the prevention of birth defects.

One of the most serious birth defects that can occur is neural tube defects, which are serious abnormalities of the brain and spine. Studies have shown that women who take a daily folate supplement before and during the early stages of pregnancy can significantly reduce their risk of having a baby with neural tube defects.

Folate may help to protect against certain types of cancer

Research has also suggested that folate may have protective effects against certain types of cancer. For example, a study published in the journal Cancer Epidemiology, Biomarkers & Prevention found that higher intakes of folate were associated with a lower risk of breast cancer in postmenopausal women.

Other studies have suggested that folate may also be protective against colon, stomach, and pancreatic cancers. However, more research is needed to confirm these findings and to determine the optimal amount of folate for cancer prevention.

Folate may support brain health

In addition to its other health benefits, folate has also been linked to brain health. Some studies have suggested that folate may have a protective effect against cognitive decline and may help to reduce the risk of conditions like Alzheimer's disease.

For example, a study published in the journal Neurology found that elderly individuals with higher levels of folate in their blood had a lower risk of developing Alzheimer's disease. However, more research is needed to understand the specific mechanisms by which folate may support brain health and to determine the optimal amount of folate for brain health.

What are the symptoms of folate deficiency?

Folate, also known as vitamin B9, is an essential nutrient that plays a role in various bodily functions. Deficiency in folate is relatively uncommon in healthy adults, but it can cause a range of symptoms, including:

Anemia: A deficiency in folate can cause anemia, which is a condition in which the body does not have enough red blood cells to carry oxygen to the body's tissues. Symptoms of anemia include fatigue, pale skin, and shortness of breath.

Mouth sores: A deficiency in folate can cause mouth sores, including cracks at the corners of the mouth and sores on the tongue.

Diarrhea: A deficiency in folate can cause diarrhea.

Poor growth: A deficiency in folate can cause poor growth in children.

Birth defects: A deficiency in folate during pregnancy can increase the risk of birth defects in the developing fetus.

If you think you may have a deficiency in folate, it is important to speak with a health professional for proper diagnosis and treatment. They can recommend appropriate supplements and make dietary recommendations to help you meet your nutritional needs.

What are the potential side effects of taking folate supplements?

Folate, also known as vitamin B9, is generally safe to consume in recommended amounts. However, taking excessive amounts of folate can cause side effects, including:

  • Digestive symptoms: Consuming large amounts of folate can cause digestive symptoms, such as stomach cramps and diarrhea.

  • Skin reactions: Some people may develop skin reactions, such as rash or hives, after taking high doses of folate.

  • Allergic reactions: Some people may be allergic to folate. Symptoms of an allergic reaction may include rash, itching, and difficulty breathing.

  • Masking vitamin B12 deficiency: Excessive intake of folate can mask the symptoms of a deficiency in vitamin B12, which is an essential nutrient that plays a role in various bodily functions. Vitamin B12 deficiency can cause anemia, nerve damage, and other serious health problems.

It is important to note that these side effects are typically associated with taking large amounts of folate, well above the recommended daily intake. It is important to speak with a health professional before taking folate supplements to ensure that you are taking the appropriate amount.

Folate supplements are generally well tolerated and have a low risk of side effects. However, as with any supplement, it is important to speak with a health professional before starting to ensure that they are safe and appropriate for you.

Can folate supplements interact with other medications or supplements?

Yes, folate supplements can interact with certain medications and supplements. Some medications and supplements that may interact with folate include:

  • Methotrexate: This is a medication used to treat cancer and certain autoimmune disorders. Taking folate supplements along with methotrexate can interfere with the effectiveness of the medication.

  • Anticonvulsants: Some anticonvulsant medications, such as phenytoin and carbamazepine, can interfere with the absorption of folate. Taking folate supplements along with these medications may decrease their effectiveness.

  • Cholestyramine: This is a medication used to lower cholesterol levels. Taking folate supplements along with cholestyramine can interfere with the absorption of both the medication and the supplement.

  • Other supplements: Some supplements, such as large doses of vitamin C and zinc, may interfere with the absorption of folate. It is important to speak with a healthcare professional about potential interactions between folate and any other supplements you are taking.

It is important to speak with a health professional before taking folate supplements to ensure that they are safe and appropriate for you. They can help you understand any potential interactions with other medications or supplements you are taking.

Is it safe to take folate supplements if I have a particular health condition?

Folate, also known as vitamin B9, is an essential nutrient that is necessary for various bodily functions. However, it is important to speak with a health professional before taking folate supplements to ensure that they are safe and appropriate for you, particularly if you have a particular health condition. Some conditions that may be affected by folate include:

  • Anemia: Folate is necessary for the production of red blood cells. If you have anemia, taking folate supplements may be beneficial. However, it is important to speak with a healthcare professional about the appropriate amount to take.

  • Pregnancy: It is important to get enough folate during pregnancy to support fetal development. However, taking excessive amounts of folate during pregnancy may not be safe. It is important to speak with a healthcare professional about the appropriate amount of folate to take during pregnancy.

  • Malabsorption disorders: If you have a condition that affects your body's ability to absorb nutrients, such as celiac disease or inflammatory bowel disease, you may be at risk for a deficiency in folate. Taking folate supplements may be beneficial in these cases, but it is important to speak with a healthcare professional about the appropriate amount to take.

  • Kidney disease: If you have kidney disease, your body may have difficulty processing folate. This can lead to an accumulation of the nutrient in the body and potentially cause side effects. It is important to speak with a healthcare professional about the appropriate amount of folate to take if you have kidney disease.

It is always important to speak with a health professional before starting any new supplement to ensure that it is safe and appropriate for you.

Conclusion

In conclusion, folate is an essential nutrient that has many important health benefits. It can help to reduce the risk of heart disease, birth defects, and certain types of cancer, and may also support brain health. While folate can be found in a variety of foods, supplements may be necessary for individuals who do not get enough from their diet. 

It is worth noting that folate, folinic acid and levomefolic acid supplements may interact with certain medications or supplements, and they may have side effects in some people. If you are currently taking any medications or supplements, or if you have any underlying medical conditions, you should speak to your health professional before taking these or any other nutritional supplement. Your health professional can help you determine which supplements are safe and appropriate for you, based on your individual circumstances and medical history.

References

  • American Journal of Clinical Nutrition, "Folic acid supplement use and the risk of cardiovascular disease," https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874181/

  • Cancer Epidemiology, Biomarkers & Prevention, "Folate intake and risk of breast cancer: the Women's Health Initiative observational study," https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3444193/

  • Oulhaj A, Jernerén F, Refsum H, Smith AD, de Jager CA. Omega-3 Fatty Acid Status Enhances the Prevention of Cognitive Decline by B Vitamins in Mild Cognitive Impairment. J Alzheimers Dis. 2016;50(2):547-57. doi: 10.3233/JAD-150777. PMID: 26757190; PMCID: PMC4927899.
  • Christen WG, Glynn RJ, Chew EY, Albert CM, Manson JE. Folic acid, pyridoxine, and cyanocobalamin combination treatment and age-related macular degeneration in women: the Women's Antioxidant and Folic Acid Cardiovascular Study. Arch Intern Med. 2009 Feb 23;169(4):335-41. doi: 10.1001/archinternmed.2008.574. PMID: 19237716; PMCID: PMC2648137.
  • Hankey GJ. B vitamins for stroke prevention. Stroke Vasc Neurol. 2018 Jun 6;3(2):51-58. doi: 10.1136/svn-2018-000156. PMID: 30022794; PMCID: PMC6047336.
  • Molloy AM, Kirke PN, Troendle JF, Burke H, Sutton M, Brody LC, Scott JM, Mills JL. Maternal vitamin B12 status and risk of neural tube defects in a population with high neural tube defect prevalence and no folic Acid fortification. Pediatrics. 2009 Mar;123(3):917-23. doi: 10.1542/peds.2008-1173. PMID: 19255021; PMCID: PMC4161975.
  • Bozkurt N, Erdem M, Yilmaz E, Erdem A, Biri A, Kubatova A, Bozkurt M. The relationship of homocyteine, B12 and folic acid with the bone mineral density of the femur and lumbar spine in Turkish postmenopausal women. Arch Gynecol Obstet. 2009 Sep;280(3):381-7. doi: 10.1007/s00404-009-0936-0. Epub 2009 Jan 17. PMID: 19151987.
  • Xiao Q, Freedman ND, Ren J, Hollenbeck AR, Abnet CC, Park Y. Intakes of folate, methionine, vitamin B6, and vitamin B12 with risk of esophageal and gastric cancer in a large cohort study. Br J Cancer. 2014 Mar 4;110(5):1328-33. doi: 10.1038/bjc.2014.17. Epub 2014 Jan 30. PMID: 24481406; PMCID: PMC3950867.
  • Molloy AM, Kirke PN, Brody LC, Scott JM, Mills JL. Effects of folate and vitamin B12 deficiencies during pregnancy on fetal, infant, and child development. Food Nutr Bull. 2008 Jun;29(2 Suppl):S101-11; discussion S112-5. doi: 10.1177/15648265080292S114. PMID: 18709885.
  • Jayedi A, Zargar MS. Intake of vitamin B6, folate, and vitamin B12 and risk of coronary heart disease: a systematic review and dose-response meta-analysis of prospective cohort studies. Crit Rev Food Sci Nutr. 2019;59(16):2697-2707. doi: 10.1080/10408398.2018.1511967. Epub 2018 Nov 15. PMID: 30431328.

  • Neurology, "Folate and vitamin B12 intake and the incidence of Alzheimer disease," https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2696999/

  • Journal of the American Medical Association, "Folic acid for the prevention of neural tube defects: results of the Medical Research Council Vitamin Study," https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2507174/

 

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