Folate Fact Sheet for Consumers

What is folate and what does it do?

Folate is a B-vitamin that is naturally present in many foods. A form of folate, called
folic acid, is used in dietary supplements and fortified foods.
Our bodies need folate to make DNA and other genetic material. Folate is also
needed for the bodys cells to divide.
How much folate do I need?
The amount of folate you need depends on your age. Average daily recommended
amounts are listed below in micrograms (mcg) of dietary folate equivalents (DFEs).
All women and teen girls who could become pregnant should consume 400 mcg of
folic acid daily from supplements, fortified foods, or both in addition to the folate
they get naturally from foods.
Life Stage

Folic acid is added to many grainbased products. Check the label

to find out whether folic acid has
been added to a food.

Recommended Amount

Birth to 6 months

65 mcg DFE

Infants 712 months

80 mcg DFE

Children 13 years

150 mcg DFE

Children 48 years

200 mcg DFE

Children 913 years

300 mcg DFE

Teens 1418 years

400 mcg DFE

Adults 1950 years

400 mcg DFE

Adults 5170 years

400 mcg DFE

Adults 71 years and older

400 mcg DFE

Pregnant teens and women

600 mcg DFE

Breastfeeding teens and women

500 mcg DFE

What foods provide folate?

Folate is naturally present in many foods and food companies add folic acid to other
foods, including bread, cereal, and pasta. You can get recommended amounts by
eating a variety of foods, including the following:
Vegetables (especially asparagus, Brussels sprouts, and dark green leafy vegetables
such as spinach and mustard greens).
Fruits and fruit juices (especially oranges and orange juice).
Nuts, beans, and peas (such as peanuts, black-eyed peas, and kidney beans).
Grains (including whole grains; fortified cold cereals; enriched flour products such
as bread, bagels, cornmeal, and pasta; and rice).
Folic acid is added to many grain-based products. To find out whether folic acid has
been added to a food, check the product label.
Beef liver is high in folate but is also high in cholesterol, so limit the amount you eat.
Only small amounts of folate are found in other animal foods like meats, poultry,
seafood, eggs, and dairy products.

2 FOLATE FACT SHEET FOR CONSUMERS

What kinds of folic acid dietary supplements

are available?
Folic acid is available in multivitamins and prenatal vitamins.
It is also available in B-complex dietary supplements and
supplements containing only folic acid.

Am I getting enough folate?

Most people in the United States get enough folate. However,
certain groups of people are more likely than others to have
trouble getting enough folate:
Teen girls and women aged 1430 years (especially before
and during pregnancy).
Non-Hispanic black women.
People with disorders that lower nutrient absorption (such as
celiac disease and inflammatory bowel disease).
People with alcoholism.

What happens if I dont get enough folate?

Folate deficiency is rare in the United States, but some people
get barely enough. Getting too little folate can result in
megaloblastic anemia, which causes weakness, fatigue, trouble
concentrating, irritability, headache, heart palpitations, and
shortness of breath. Folate deficiency can also cause open sores
on the tongue and inside the mouth as well as changes in the
color of the skin, hair, or fingernails.
Women who dont get enough folate are at risk of having
babies with neural tube defects, such as spina bifida. Folate
deficiency can also increase the likelihood of having a
premature or low-birth-weight baby.

What are some effects of folate on health?

Scientists are studying folate to understand how it affects health.
Here are several examples of what this research has shown.
Neural tube defects
Taking folic acid regularly before becoming pregnant and
during early pregnancy helps prevent neural tube defects
in babies. But about half of all pregnancies are unplanned.
Therefore, all women and teen girls who could become
pregnant should consume 400 mcg of folic acid daily from
supplements, fortified foods, or both in addition to the folate
they get naturally from foods.
Since 1998, the U.S. Food and Drug Administration has
required food companies to add folic acid to enriched bread,
cereal, flour, cornmeal, pasta, rice, and other grain products
sold in the United States. Because most people in the United
States eat these foods on a regular basis, folic acid intakes have

increased and the number of babies born with neural tube

defects has decreased since 1998.
Preterm birth, congenital heart defects, and other
birth defects
Taking folic acid might reduce the risk of having a premature
baby and prevent birth defects, such as congenital heart
problems. But more research is needed to understand how
folic acid affects the risk of these conditions.
Cancer
Folate that is found naturally in food may decrease the risk of
several forms of cancer. But folate might have different effects
depending on how much is taken and when. Modest amounts
of folic acid taken before cancer develops might decrease
cancer risk, but high doses taken after cancer (especially
colorectal cancer) begins might speed up its progression. For
this reason, high doses of folic acid supplements (more than
the upper limit of 1,000 mcg) should be taken with caution,
especially by people who have a history of colorectal adenomas
(which sometimes turn into cancer). More research is needed
to understand the roles of dietary folate and folic acid
supplements in cancer risk.
Heart disease and stroke
Some scientists used to think that folic acid and other
B-vitamins might reduce heart disease risk by lowering levels
of homocysteine, an amino acid in the blood. But although
folic acid supplements do lower blood homocysteine levels,
they dont decrease the risk of heart disease. Some studies have
shown that a combination of folic acid with other B-vitamins,
however, helps prevent stroke.
Dementia, cognitive function, and Alzheimers disease
Folic acid supplements with or without other B-vitamins do
not seem to improve cognitive function, but more research on
this topic is needed.
Depression
People with low blood levels of folate might be more likely
to suffer from depression and might not respond as well to
treatment with antidepressants as people with normal folate
levels.
Folic acid supplements might make antidepressant medications
more effective. But it is not clear whether these supplements
help people with both normal folate levels and those with folate
deficiency. More research is needed to learn about the role of
folate in depression and whether folic acid supplements are
helpful when used in combination with standard treatment.

3 FOLATE FACT SHEET FOR CONSUMERS

Can folate be harmful?

Folate that is naturally present in food is not harmful. Folic
acid in supplements and fortified foods, however, should
not be consumed in amounts above the upper limit, unless
recommended by a health care provider.
Taking large amounts of folic acid might hide a vitamin B12
deficiency. Folic acid can correct the anemia but not the nerve
damage caused by vitamin B12 deficiency. This can lead to
permanent damage of the brain, spinal cord, and nerves. High
doses of folic acid might also increase the risk of colorectal
cancer and possibly other cancers in some people.
The upper limits for folic acid are listed below.
Life Stage

Upper Limit

Birth to 6 months

Not established

Infants 712 months

Not established

Children 13 years

300 mcg

Children 48 years

400 mcg

Children 913 years

600 mcg

Teens 1418 years

800 mcg

Adults

1,000 mcg

Are there any interactions with folate

that I should know about?
Folic acid supplements can interact with several medications.
Here are some examples:
Folic acid could interfere with methotrexate (Rheumatrex,
Trexall) when taken to treat cancer.
Taking anti-epileptic medications such as phenytoin
(Dilantin), carbamazepine (Carbatrol, Tegretol, Equetro,
Epitol), and valproate (Depacon) could reduce blood levels
of folate. Also, taking folic acid supplements could reduce
blood levels of these medications.
Taking sulfasalazine (Azulfidine) for ulcerative colitis
could reduce the bodys ability to absorb folate and cause
folate deficiency.
Tell your doctor, pharmacist, and other health care providers
about any dietary supplements and medicines you take. They
can tell you if those dietary supplements might interact or
interfere with your prescription or over-the-counter medicines

or if the medicines might interfere with how your body

absorbs, uses, or breaks down nutrients.

Folate and Healthful Eating

People should get most of their nutrients from food, advises
the federal governments Dietary Guidelines for Americans.
Foods contain vitamins, minerals, dietary fiber and other
substances that benefit health. Dietary supplements might
help in some situations to increase the intake of a specific
vitamin or mineral. For more information on building a
healthy diet, refer to the Dietary Guidelines for Americans and
the U.S. Department of Agricultures food guidance system,
ChooseMyPlate.

Where can I find out more about folate?

For general information on folate:
Office of Dietary Supplements Health Professional Fact
Sheet on Folate
Folic acid and Folic acid in diet, MedlinePlus
For more information on food sources of folate:
U.S. Department of Agricultures (USDA) National Nutrient
Database
Nutrient List for folate (listed by food or by folate
content), USDA
For more advice on buying dietary supplements:
Office of Dietary Supplements Frequently Asked Questions:
Which brand(s) of dietary supplements should I purchase?
For information on the governments food
guidance system:
ChooseMyPlate
Dietary Guidelines for Americans

Disclaimer
This fact sheet by the Office of Dietary Supplements provides
information that should not take the place of medical advice.
We encourage you to talk to your healthcare providers (doctor,
registered dietitian, pharmacist, etc.) about your interest in,
questions about, or use of dietary supplements and what
may be best for your overall health. Any mention in this
publication of a specific brand name is not an endorsement
of the product.

For more information on this and other supplements, please visit our
Web site at: http://ods.od.nih.gov or e-mail us at: ods@nih.gov
Reviewed: April 23, 2013