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Why Do You Need Folic Acid?

By Rosanna Sutherby, PharmD

January 29, 2021

Ask A Pharmacist

Folic acid is an essential nutrient that is instrumental in everything from preventing birth abnormalities to reducing your risk of cancer and heart disease. It plays a significant role in producing red blood cells and regulating the process by which your DNA makes copies of itself.

What Is Folic Acid?

Folic acid is the synthetic (manufactured) form of folate. Folate, also known as vitamin B9, is an essential vitamin that your body uses to make red blood cells and for proper DNA metabolism. Your body cannot make folate on its own, so you must obtain it from your diet or supplements.

What Are Good Sources of Folate and Folic Acid?

Folate is found naturally in a variety of foods. Examples of foods that are rich in folate include:

Broccoli
Brussels sprouts
Citrus fruit, such as oranges and lemons
Egg yolks
Leafy green vegetables
Legumes, such as chickpeas, black beans, and kidney beans
Liver
Melons
Nuts
Peas
Strawberries

You can also get folic acid from prescription products, vitamin supplements, and fortified foods, including:

Bread
Cereal
Pasta
Rice

Your body does not differentiate between folate and folic acid. Both forms must be converted to L-methylfolate before your body can use them.

What Are the Uses for Folic Acid?

In addition to folate obtained from your diet, healthcare providers may recommend folic acid supplements or prescription products to treat or prevent certain conditions. Uses for folic acid include:

Preventing some types of birth abnormalities
Preventing heart disease
Preventing or treating anemia
Reducing the risk of some cancers
Reducing the side effects of methotrexate, a medication used to treat cancer and autoimmune disorders
Treating depression

Folic Acid During Pregnancy

The recommended daily allowance (RDA) of folate or folic acid for adults is 400 mcg. However, the need for folate increases during pregnancy. Your body uses folate for the growth and proper development of the baby.

Taking folic acid before and during your pregnancy can prevent some types of birth abnormalities, such as neural tube defects (NTDs). NTDs are birth abnormalities of the brain or spine. Spina bifida is a type of NTD in which the baby’s spinal column does not close completely. NTDs typically happen during the first month of pregnancy, often before you are aware that you are pregnant.

To prevent NTDs, the CDC recommends that all women of reproductive age take 400 mcg of folic acid daily in addition to folate consumed in your diet. The RDA of folate or folic acid for pregnant women is 600 mcg. Because NTDs happen early in pregnancy, it is vital to begin folic acid supplementation months before becoming pregnant.

Your provider may prescribe 600 mcg to 1 mg of folic acid daily during your pregnancy and for about six weeks after you have your baby. If you are nursing, you should continue taking 500 mcg of folic acid daily.

Folic Acid for Folate-Deficiency Anemia

Folate plays a large role in producing red blood cells that carry oxygen to all parts of your body. Low levels of folate can cause a condition called megaloblastic anemia. In megaloblastic anemia, your body makes fewer and larger than normal red blood cells. These cells are misshaped and die quicker than normal red blood cells. They are not able to properly carry oxygen throughout your body.

Your doctor may prescribe 1 mg to 5 mg of folic acid daily to treat your anemia. You may also need to take vitamin B12 to treat this type of anemia.

Folic Acid for Depression

Some studies have found that patients with major depression have low folate levels. Additionally, people with low folate levels may not respond as well to antidepressants. Researchers suggest that supplementing with 800 mcg of folic acid or 7.5 mg to 15 mg of L-methylfolate may help treat depression.

A 2013 study concluded that patients who took 7.5 mg or 15 mg of L-methylfolate showed improvements in their functioning and symptoms of depression and were more satisfied with their medication treatment.

Do You Need a Prescription to Buy Folic Acid?

You can buy folic acid over-the-counter (OTC) or with a prescription from your healthcare provider. Most OTC formulations contain 400 mcg to 800 mcg of folic acid per pill. Prescription folic acid is available in 1 mg tablets.

L-methylfolate is available by prescription as 7.5 mg, 15 mg, and 30 mg pills under several names, including:

Be aware that taking too much folic acid can make it difficult to tell if your vitamin B12 levels are low. You should not take more than 1 mg (1,000 mcg) of folic acid per day without consulting with your provider.

If you are taking prescription folic acid or L-methylfolate, be sure to use a free Rx savings card to compare prescription prices and get the lowest prescription price at a pharmacy near you.

Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients’ concurrent conditions and potential drug interactions.

References:

https://www.wellrx.com/FOLIC%20ACID/drug-information/

https://www.wellrx.com/health-conditions/about/health-condition/birth-defects-prevention/~default/

https://www.mayoclinic.org/drugs-supplements-folate/art-20364625

https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3218540/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3799525/

https://medlineplus.gov/neuraltubedefects.html

https://www.cdc.gov/ncbddd/folicacid/about.html#:~:text=Why%20folic%20acid%20is%20important,and%20spine%20(spina%20bifida)

https://www.ncbi.nlm.nih.gov/books/NBK537254/

https://pubmed.ncbi.nlm.nih.gov/15671130/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3869616/