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Are folate and folic acid the same

Folic acid is the synthetic version of the vitamin folate, also known as vitamin B9.

Folate helps the body make healthy red blood cells and is found in certain foods.

Folic acid is used to:

  • treat or prevent folate deficiency anaemia
  • help your baby's brain, skull and spinal cord develop properly in pregnancy, to avoid development problems (called neural tube defects) such as spina bifida
  • help reduce side effects from methotrexate, a medicine used to treat severe arthritis, Crohn's disease or psoriasis

Folic acid is available on prescription. It comes as tablets or as a liquid you swallow.

You can also buy lower dose tablets from pharmacies and supermarkets.

Folic acid can also be combined with:

  • ferrous fumarate and ferrous sulphate, to treat iron deficiency anaemia
  • other vitamins and minerals, as a multivitamin and mineral supplement

Key facts

  • You'll usually take folic acid once a day, but sometimes you'll only need to take it once a week. Your doctor will explain how often to take it.
  • Most adults and children can take folic acid.
  • If you're pregnant or trying to get pregnant, it's recommended you take folic acid until you're 12 weeks pregnant. It helps your baby grow normally.
  • You're unlikely to get side effects with folic acid, but some people feel sick, lose their appetite, get wind or feel bloated. These side effects are usually mild and do not last long.
  • It's best not to drink alcohol while taking folic acid, as it can stop your folic acid from working as well.

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Currently an 800 µg and 5 mg folic acid tablet are the only approved medicines available in New Zealand. These folic acid tablets can be obtained at a lower cost (subsidised) on a prescription or purchased over the counter from a pharmacy. These folic acid-only tablets are what the Ministry of Health recommends for women for at least four weeks prior to conception and for 12 weeks after conception to reduce the risk of NTDs.

In Aotearoa New Zealand, just over half of pregnancies are unplanned, meaning that a significant number of women do not take folic acid supplementation during the critical period (one month before and for the first three months following conception). Fortification of a food is therefore the only other approach that reaches such a large group of women. It is an internationally, well-accepted and safe public health approach.

On 8 July 2021, the Government announced its decision for mandatory folic acid fortification of non-organic wheat flour that is used in making bread. Flour millers will have two years to make the necessary changes.

Until the flour is fortified with folic acid, bread-makers continue to add folic acid to bread on a voluntary basis. Other foods, such as breakfast cereals, fruit and vegetable juices, milk alternatives (eg, soy milk) and certain food drinks (eg, liquid meal supplements) may also contain added folic acid.

For more information on the regulation of folic acid fortification, see the Ministry for Primary Industries website.

Health benefits and risks of folic acid fortification of food

In April 2017, the Ministry of Health commissioned Sir Peter Gluckman, at that time the Prime Minister’s Chief Science Advisor (PMCSA), and the Royal Society Te Apārangi to review the health benefits and risks of folic acid fortification of food.

This involved a literature review and analysis of the available scientific evidence from Aotearoa New Zealand and internationally on the health benefits and risks of folic acid fortification.

An expert panel was appointed to oversee the review which included one lay member as an Observer. This follows the approach taken with previous scientific reviews conducted by the PMCSA and the Royal Society for the Ministry of Health on water fluoridation and exposure to asbestos.

Findings and conclusions

The report finds that there is compelling evidence that mandatory folic acid fortification is associated with lower rates of neural tube defects, and that taking folic acid supplements at the recommended doses in pregnancy has no adverse effects on pregnancy outcome or the child’s health.

No evidence was found to link the use of folic acid supplements or fortification to increased risks of neurological/cognitive decline, diabetes, or cardiovascular disease; nor was there evidence that unmetabolised folic acid is harmful.

Read the full report is available on the Office of the Prime Minister's Chief Science Advisor website.

Should I take folic or folic acid?

Everyone needs folic acid. But for women who can get pregnant, it is really important! If a woman has enough folic acid in her body before she is pregnant, it can help prevent major birth defects of her baby's brain and spine. These birth defects are neural tube defects or NTDs.

How much folate is equivalent to folic acid?

1 mcg DFE = 1 mcg food folate. 1 mcg DFE = 0.6 mcg folic acid from fortified foods or dietary supplements consumed with foods. 1 mcg DFE = 0.5 mcg folic acid from dietary supplements taken on an empty stomach.

Is folate better than folic acid for pregnancy?

According to the Centers for Disease Control and Prevention (CDC) , folic acid is the only form of vitamin B9 that is proven to reduce the risk of neural tube defects in fetuses. For this reason, people who are pregnant or trying to conceive should take 400 micrograms (mcg) of folic acid per day.

What is the best form of folate to take?

But for many people lifestyle factors, popularly used medications or common gene mutations deplete their folate stores. For these individuals AND for the rest of us, methylfolate is the best dietary form of folate. Methylfolate (technically methyltetrahydrofolate) is the body's most active form of folate.

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