Folic acid is a synthetic form of folate, or vitamin B-9. You need B vitamins for a healthy metabolism, brain, nervous system, skin, hair, eyes and liver. Your body does not store vitamin B-9, so you must get it each day from diet, folic acid supplements or fortified food. Because it helps the body produce DNA and RNA and is critical to cell and tissue growth, folic acid is especially important during pregnancy.
Vitamin B-9 and Health
No matter who you are, you need vitamin B-9 for health, but if you are pregnant or of childbearing age and could become pregnant, folate is especially important. Folate deficiency can cause serious spinal cord and brain birth defects. These include spina bifida, a condition in which the fetus's spinal column does not close around the spinal cord and anencephaly, a condition in which all or most of the brain does not develop.
In addition to birth defects, a folate deficiency can result in anemia, heart palpitations, sore mouth, behavioral disorders, weakness, diarrhea, headaches and high blood levels of homocysteine, a risk factor for heart disease. Because vitamin B-9 is so important to cell and tissue growth, children who are deficient may experience a slow growth rate.
Recommendations
The Daily Reference Intake (DRI) for folate is 65 mcg for infants up to age six months and 80 mcg for infants ages 7 to 12 months. The DRI for children is 150 mcg for ages 1 to 3, 200 mcg for ages 4 to 8 and 300 mcg for ages 9 to 13. Boys 14 years and older and men need 400 mcg each day, as do women over 50. However, girls 14 years and older and women up to age 50 need 400 mcg of folate plus an additional 400 mcg from folic acid supplements or fortified foods.
Dietary Sources of Folate and Folic Acid
Folate is present in leafy greens, such as spinach, dried legumes and citrus fruits. Since 1996, many foods in the United States have been fortified with folic acid. These foods include grain products, such as bread, cereal, flour, pasta, corn meal and rice. Breakfast cereal is one of the most heavily fortified, with a 3/4-cup serving containing 400 mcg of folic acid.
Precautions
Folate from food is safe and, at recommended doses, folic acid is generally safe. Very high doses of folic acid may cause sleep and stomach problems, skin reactions and possibly seizures. Taking more than 800 mcg of folic acid can mask a vitamin B-12 deficiency, which can result in permanent neurological damage. For this reason, it is safer to supplement with a B-complex vitamin rather than taking individual vitamin B supplements so that a balance among the B vitamins can be maintained.
Interactions
Drugs that can lower folate levels include antacids, H2 blockers, proton pump inhibitors, bile acid sequestrants, carbamazepine, sulfasalzine, triamterene, birth control pills, methotrexate and nonsteroidal anti-inflammatory drugs, such as ibuprofen. When taking tetracycline and folic acid, the two should not be taken at the same time, because folic acid reduces the effectiveness of the antibiotic.
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