The B vitamin folate, also called folic acid, is a water-soluble vitamin. Water-soluble vitamins are stored in the body in very limited amounts and are excreted through the urine. Therefore, it is a good idea to have them in your daily diet. Folate is considered a crucial vitamin before and during pregnancy. Research has shown that folate deficiencies during pregnancy can lead to
birth defects in babies.
Folate's functions include: Helping amino acid metabolism and conversionProducing and maintaining new cellsMaking DNA and RNA, the building blocks of cellsPreventing changes to DNA that may lead to cancer
Making red blood cells, preventing
anemiaAssisting in the creation of neurotransmitters (chemicals that regulate sleep, pain, and mood)
|Age Group (in Years)||Recommended Dietary Allowance|
|1 - 3||150 mcg||150 mcg|
|4 - 8||200 mcg||200 mcg|
|9 - 13||300 mcg||300 mcg|
|14 - 18||400 mcg||400 mcg|
|Pregnancy, 14 - 18||600 mcg||n/a|
|Lactation, 14 - 18||500 mcg||n/a|
|19+||400 mcg||400 mcg|
|Pregnancy, 19+||600 mcg||n/a|
|Lactation, 19+||500 mcg||n/a|
Folate deficiency is a common vitamin deficiency that can occur for a variety of reasons, including: Increased need, as with pregnancy, without increased intakeLow levels of folate containing foods in dietAbnormally high levels of folate passing out of the body
Medication that interferes with the body's ability to use folate such as:
The following populations may be at risk of folate deficiency and may require a supplement: Pregnant women—Folate is critical for the production and maintenance of new cells. This is especially important during pregnancy—a period of rapid cell division.
People who consume excessive amounts of
—Alcohol interferes with the absorption of folate and increases excretion by the kidneys. In addition, many alcoholics tend to have diets low in essential nutrients, like folate.
People on certain medications—Certain medications can interfere with the body's ability to use folate. Check with your doctor about supplementation if you are on medication that may affect your folate levels.
inflammatory bowel diseases
—Malabsorption of folate can occur with inflammatory bowel diseases.
The elderly—Many elderly have low blood levels of folate, which can occur from low intake of the vitamin or problems with absorption.
Folate deficiency may lead to: Megaloblastic anemia (abnormally large red blood cells)Irritability, hostilityWeaknessWeight lossApathy, forgetfulnessAnorexia
, loss of appetite
Sore tongue, glossitis (inflammation of tongue)HeadacheHeart palpitationsParanoid behaviorDiarrhea
In 1991, a landmark study found a relationship between folate and birth defects. Subsequent research has supported the finding that adequate folate intake during the period before and just after conception protects against a number of neural tube defects, including
The crucial period is before and very early after conception—a time when most women do not know they are pregnant. Therefore, the recommendation is that all women of childbearing age make sure they have a folate intake of at least 400 mcg.
There is a variety of foods that contain folate. Some foods, like cereal, rice, and flour, are fortified with folate. Here is a list of major food sources and their folate content.
|Chicken liver, simmered||3.5 ounces||770|
|Fortified breakfast cereal||3/4 cup||
(check Nutrition Facts label)
|Soy flour||1 cup||260|
|Beef liver, braised||3 ounces||215|
|Chickpeas, cooked||1 cup||282|
|Pinto beans, cooked||1 cup||291|
|Spinach, boiled||1 cup||263|
|Lima beans, cooked||1 cup||156|
|Wheat germ, toasted||1/4 cup||100|
|Asparagus, boiled||1 cup||243|
|Orange juice, fresh||8 fluid ounces||74|
|Spinach, raw||1 cup||58|
|Whole wheat flour||1 cup||53|
|Green peas, boiled||1/2 cup||50|
|White rice, long-grain||1/2 cup||45|
|Orange, navel||1 medium||44|
|Peanuts, dry roasted||1 ounce||41|
|Wheat flour, whole grain||1 cup||53|
|Broccoli, boiled||1 spear||40|
|Tomatoes, sun-dried||1 cup||32|
|Tomato juice, canned||1 cup||49|
|Peanut butter, crunchy||2 tablespoons||30|
|Cashews, dry roasted||1 ounce||20|
|Bread, whole wheat||1 slice||14|
To help increase your intake of folate: Spread a little avocado on your sandwich in place of mayonnaise.Drink a glass of orange juice or tomato juice in the morning.Add spinach to your scrambled eggs.Slice a banana on top of your breakfast cereal.Sprinkle some toasted wheat germ on top of pasta or a stir-fry.Throw some chickpeas or kidney beans into a salad.If you take a vitamin supplement, make sure it contains folate.
There can be too much of a good thing. While there is no upper limit for ingesting folate found naturally in foods, but there are recommended intake limits for folate consumed from fortified foods and supplements:
|Age||Micrograms (mcg) per day|
|1-3 years||300 mcg|
|4-8 years||400 mcg|
|9-13 years||600 mcg|
|14-18 years||800 mcg|
|Pregnant or nursing women up to 18 years||800 mcg|
|19 years and older||1,000 mcg|
|Pregnant or nursing women 19 years and older||1,000 mcg|
Large doses of folate can mask symptoms of a different type of vitamin deficiency called
. A B12 deficiency causes some similar symptoms as folate deficiency, but it can also cause damage to the nervous system. Folate supplementation will mask the B12 deficiency by relieving the anemia-associated symptoms but not decreasing damage to the nervous system. This is why it is important that you talk to your doctor before you take a folate supplement. A blood test will help determine if your folate and vitamin B12 levels are appropriate or low. It may be necessary for you to take vitamin B12 supplements along with the folate. Talk to your doctor before starting any vitamin supplement to make sure it is appropriate for you.
Duyff RL. The American Dietetic Association's Complete Food & Nutrition Guide. 3rd ed. Hoboken, NJ: John Wiley and Sons, Inc.; 2006.
Folate. Office of Dietary Supplements, National Institutes of Health website. Available at: http://ods.od.nih.gov/factsheets/Folate-HealthProfessional. Updated December 14, 2012. Accessed March 6, 2014.
Folate, DFE (µg) content of selected foods per common measure, sorted by nutrient content. USDA national nutritional database for standard reference, release 25. US Department of Agriculture website. Available at: https://www.ars.usda.gov/SP2UserFiles/Place/12354500/Data/SR25/nutrlist/sr25w435.pdf. Accessed March 6, 2014.
Folate deficiency. EBSCO DynaMed website. Available at: http://ebscohost.com/dynamed. Updated January 16, 2013. Accessed March 6, 2014.
Folic acid. EBSCO DynaMed website. Available at: http://ebscohost.com/dynamed. Updated October 28, 2013. Accessed March 6, 2014.
Garrison R, Somer E.
The Nutrition Desk Reference. New Canaan, CT: Keats Publishing; 1995.
Last reviewed March 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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