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Folate and folic acid are different forms of vitamin B9. While there’s a distinct difference between the two, their names are often used interchangeably.

There’s even a lot of confusion among professionals about folic acid and folate. This article explains the difference between folic acid and folate.

Vitamin B9 is an essential nutrient that naturally occurs as folate.

It serves many important functions in your body. For example, it plays a crucial role in cell growth and DNA formation (1).

Low levels of vitamin B9 are associated with an increased risk of several health conditions, including:

  • Elevated homocysteine. High homocysteine levels have been associated with an increased risk of heart disease and stroke (2).
  • Birth defects. Low folate levels in pregnant women have been linked to birth abnormalities, such as neural tube defects (3).
  • Cancer risk. Poor levels of folate are also linked to increased cancer risk, though higher levels of folate have also been linked with a higher risk of prostate cancer. More research is needed in this area (4, 5).

For these reasons, supplementing with vitamin B9 is common. Fortifying food with this nutrient is mandatory in many countries, including the United States and Canada.

Summary

Vitamin B9 is an essential nutrient that’s mainly present as folate and folic acid. It’s commonly taken in supplement form and even added to processed food in North America.

Folate is the naturally occurring form of vitamin B9.

Its name is derived from the Latin word “folium,” which means leaf. In fact, leafy vegetables are among the best dietary sources of folate.

Folate is a generic name for a group of related compounds with similar nutritional properties.

The active form of vitamin B9 is a type of folate known as levomefolic acid or 5-methyltetrahydrofolate (5-MTHF).

In your digestive system, most dietary folate is converted into 5-MTHF before entering your bloodstream (6).

Summary

Folate is the naturally occurring form of vitamin B9. Before entering your bloodstream, your digestive system converts it to the biologically active form of vitamin B9 ⁠— 5-MTHF.

Folic acid is a synthetic form of vitamin B9 that’s also known as pteroylmonoglutamic acid.

It’s used in supplements and added to processed food products, such as flour and breakfast cereals.

Unlike folate, not all of the folic acid you consume is converted into the active form of vitamin B9 — 5-MTHF — in your digestive system. Instead, it needs to be converted in your liver or other tissues (6).

Yet, this process is slow and inefficient in some people. After taking a folic acid supplement, it takes time for your body to convert all of it to 5-MTHF (7).

Even a small dose, such as 200 to 400 mcg per day, may not be completely metabolized until the next dose is taken. This problem may become worse when fortified foods are consumed in addition to taking folic acid supplements (8, 9).

As a result, unmetabolized folic acid is commonly detected in people’s bloodstreams, even in the fasted state (10, 11, 12).

This is a cause for concern, as high levels of unmetabolized folic acid have been associated with several health problems.

However, one study suggests that taking folic acid along with other B vitamins, particularly vitamin B6, makes the conversion more efficient (11).

Summary

Folic acid is a synthetic form of vitamin B9. Your body does not convert it into active vitamin B9 very well, so unmetabolized folic acid may build up in your bloodstream.

Several studies indicate that chronically elevated levels of unmetabolized folic acid may have adverse health effects, including increased cancer risk.

High levels of unmetabolized folic acid have been associated with increased cancer risk, though some studies disagree. No conclusive evidence proves that unmetabolized folic acid plays a direct role (13, 14, 15).

Even a small, daily dose of 400 mcg may cause unmetabolized folic acid to build up in your bloodstream (9, 16).

Although high folic acid intake is a concern, the health implications are unclear, and further studies are needed.

Summary

Researchers are concerned that high levels of unmetabolized folic acid may negatively affect health, but more studies are needed before any strong conclusions can be reached.

It’s best to get vitamin B9 from whole foods.

High-folate foods include:

  • asparagus
  • avocados
  • Brussels sprouts
  • leafy greens like spinach and lettuce

However, for some people, such as those who are pregnant, supplements are an easy way to ensure adequate vitamin B9 intake.

Folic acid is the most common supplemental form of vitamin B9. It can be purchased at many drug stores, as well as online.

Other supplements contain 5-MTHF, which is considered an adequate alternative to folic acid (17).

Supplemental 5-MTHF is available in the form of levomefolate calcium or levomefolate magnesium. It’s sold under the brand names Metafolin, Deplin, and Enlyte, and it’s available online.

Summary

The healthiest dietary sources of vitamin B9 are whole foods, such as leafy green vegetables. If you need to take supplements, methyl folate is a good alternative to folic acid.

Folate is the natural form of vitamin B9 in food, while folic acid is a synthetic form.

High intake of folic acid may lead to increased blood levels of unmetabolized folic acid. Some researchers speculate that this may have adverse health effects over time, but further studies are needed before solid conclusions can be reached.

Alternatives to folic acid supplements include 5-MTHF (levomefolate) or whole foods, such as leafy greens.