Why Folate Matters to Women's Health

“Folate” and “folic acid” are often used interchangeably. Folate is the naturally occurring form of vitamin B9 found in many foods, while folic acid (pteroylmonoglutamic acid) is a synthetic form of folate commonly used as a fortifying agent in processed foods, cereals, rice, and in place of folate in many supplements.

What foods are high in folate?

Our bodies need folate for many key processes— including cell division and building DNA—and yet, our bodies don’t provide us with any. This requires us to find ways of obtaining sufficient amounts of folate from external sources, such as diet and supplementation. Folate can be found in a variety of foods, such as veggies (asparagus, peas, and Brussels sprouts), fruits (citrus, bananas, and melons), legumes, and dark leafy greens.

As women’s bodies rapidly grow and change during pregnancy, the demand for more nutrients increases beyond our natural ability to manage through diet alone

While adding more of these foods to your diet is important to maintaining healthy folate levels, there are times when supplementation may be necessary. Most of us are aware of the need for increased folate when pregnant, or planning to become pregnant, but there are lesser-known benefits as well!

Folate deficiency and pregnancy

Take a prenatal vitamin containing 1 mg of 5-MTHF both during preconception and throughout the first trimester. If you are unable to tolerate a prenatal vitamin due to nausea, try taking a 5-MTHF supplement alone.  

As women’s bodies rapidly grow and change during pregnancy, the demand for more nutrients increases beyond our natural ability to manage through diet alone. A prenatal vitamin helps meet those nutritional needs, and along with iron and B12, folate plays an essential role in supporting both mother and baby. Folic acid deficiency can mean issues like anemia for the mother, and congenital abnormalities and neural tube defects (NTDs) for the babe.

Folate isn't only for pregnancy! Sufficient levels of folate are also critical for optimal brain health and mood balancing. In fact, there’s evidence that one of the most common symptoms of folate deficiency is depression. Studies of depressed patients found that approximately one-third were deficient in folate, and there are indications that this percentage may be even higher among the elderly.¹ Research suggests that between 35 and 90 percent of senior patients admitted to a psychiatric ward are deficient, and that supplementation significantly improves clinical recovery.² Folate plays such an important role in brain health because it functions as a “methyl donor,” carrying and donating methyl molecules to important brain compounds including the neurotransmitters serotonin, norepinephrine, and dopamine.

Folate vs folic acid

When the body absorbs folate, it goes through a series of biochemical processes, bioactivating into 5-methyltetrahydrofolate (5-MTHF), a form the body can use. Recent research, however, has shown that some people are unable to effectively metabolize supplemental folic acid and convert it into the active 5-MTHF form. So unless you’ve had extensive testing done to gather more information about your genetics and methylation capabilities, taking a supplement that contains the 5-MTHF form of folate (rather than folic acid) will ensure that you’re getting the most bioavailable folate for both you and your growing baby!

Benefits of folate for women

Folate has also been shown to play a positive role in the prevention of osteoporosis, thanks to its ability to reduce homocysteine levels. High homocysteine levels may interfere with collagen’s cross-linking process, leading to a defective bone matrix. This is especially important for postmenopausal women, and may also increase risk factors for vascular disease.

Recently research about the link between folate deficiency and cervical dysplasia has shown that treating cervical dysplasia with higher doses of folate have resulted in improvement of cytological (Pap) smears. There is also evidence of improved regression-to-normal rates in those patients with cervical dysplasia that were treated with folate when compared to those who were untreated.³

Caution: Folate supplementation should be accompanied by vitamin B12 supplementation to prevent the folate from masking a B12 deficiency because folate prevents the tell-tale anemia that typically accompanies a lack of B12. It is generally recommended that folate supplements be taken a few hours before or after other medication. As always, talk to your healthcare provider first about the best dosage for your specific concerns.

You may also enjoy: 5 Prenatal Nutrients for Pregnancy Prep, The Naturopathic Doula's Advice for Pregnancy Supplements, and Trying to Conceive: Fertility Tips You Need to Know.