B9, folate, folic acid - whatever name you hear this nutrient referred to as - is something you’ll want to make sure you’re getting.

Especially as a woman of reproductive age.

It’s an essential vitamin that cannot be synthesized in the body and therefore must be obtained through supplementation of food.

And just like the other B vitamins found in a women's multivitamin, it’s water soluble, meaning it’s not stored in the body and must be consumed daily.

But don’t be confused between the two names you’ll commonly hear. One is better to choose than the other.

Here are the two key differences between "Folate" and "Folic Acid":  

  • Folate is the natural form of vitamin B9 produced within the body.
  • Whereas folic acid is the synthetic form found in lower quality supplements and fortified foods like cereal, rice, orange juice, and pasta.

To begin this article, let's go through why you need to be getting adequate folate...

*If you're interested, see our "Benefits of Vitamin D for Women" article.

1. Folate plays a beneficial role in the formation of RNA and DNA in women

If you’ve never heard of it before, DNA methylation is the epigenetic modification of DNA that is critical to regulating development of a normal genome - and it’s dependent on folate [1].

That’s because folate is a key source of a carbon group used in this methylation process.

The regulatory mechanisms that require folate are responsible for modulating the structure of chromatin structure.

The above contains DNA and protein, and contributes to regulating molecular processes in the nucleus including transcription, replication, repair, and processing of RNA [2].

So, without folate and without these processes, DNA cannot develop and it results in chromosomal abnormalities and damage.

2. Folate assists in amino acid conversion in women

Aside from pregnancy, one of the most important roles of folate is to serve as a co-factor in the conversion of homocysteine to methionine.

Elevated levels of homocysteine have been shown to induce programmed cell death in human vascular tissue cells by interfering with protein synthesis.

Due to its similarity to methionine, homocysteine can enter protein synthesis pathways, which can result in the production of abnormal proteins that are toxic to cells [3].

Doesn’t sound like it’s such a good thing, right?

However, there are two metabolic pathways by which homocysteine levels are kept in check:

  1. One regenerates homocysteine back into methionine using folate and vitamin B12 as co-factors
  2. The other converts homocysteine into cysteine using B6.

Both of these pathways are dependent on adequate folate, B12, and B6.

Therefore, a lack of Folate, B12 & B6 vitamins interrupts the conversion and results in elevated homocysteine levels.

And a disruption to homocysteine and folate metabolism is implicated for a number of conditions, including [4]

  • Congenital birth defects
  • Late pregnancy complications
  • Neurodegenerative and psychiatric diseases
  • Osteoporosis
  • Cancer.

3. Folate boosts Women's red blood cell production

Iron is generally the common link when it comes to anemia, but did you know a folate deficiency can cause anemia, too?

Erythroblasts—immature blood cells—require two specific nutrients during their proliferation phase:

  • Folate.
  • B12.

Both are needed for the formation of heme; the pigmented, iron-containing portion of hemoglobin in red blood cells. 

A deficiency in either of these vitamins inhibits maturation of erythroblasts and can lead to erythroblast apoptosis (death).

And what happens then? The risk of anemia increases due to insufficient synthesis of red blood cells [5].

As such, you may start to experience symptoms of Folate & B12 deficiency: 

  • Fatigue
  • Low energy,
  • Paraesthesia (pins and needles)
  • Mouth ulcers
  • Muscle weakness
  • Cognitive impairment.

Keep in mind, though, that anemia isn’t always brought on by a lack of intake.

Folate deficiency anemia can also result in inadequate intestinal absorption.  Usually due to damage of the intestinal lining, which can happen in conditions like Celiac disease, for example.

4. Looking to conceive now or anytime in the future? You'll want Folate

Women reading about the benefits of folate

We all know how important eating healthy, staying hydrated, exercising, and avoiding toxins like cigarettes and alcohol is for conception.

But getting enough folate in your diet is also essential.

And of all the important roles of folate, its involvement in pregnancy is probably the most notable.

It’s also important to remember that folate isn’t just critical once you discover you’re pregnant - it’s also critical pre-conception.

From the moment conception happens, usually before you even get a positive pregnancy test, your baby is already producing important neurological cells that are vital for the development of the brain and spin.

Folate is required for all the above.

One of the most prominent functions of folate in pregnancy is the prevention of neural tube defects (NTDs). These arise from failure of embryonic neural tube closure between 21-27 days after conception, which is also a time when most women may not even realize they’re pregnant [6].

NTDs include various malformations, such as those in the brain (anencephaly) or lesions of the spin (spina bifida), both of which are life-threatening.

Hence, ensuring you are getting adequate folate before trying to conceive is incredibly important.

According to a 2015 study, 22.8% of women aged 12-49 had suboptimal levels of RBC folate concentration [7]. Meaning that if they were to get pregnant, their risk of fetal NTDs is increased.

Adequate folate during pregnancy also decreases the risk of: 

  • congenital abnormalities like orofacial clefts
  • low birth weight and pre-term births
  • miscarriage
  • and other pregnancy complications, such as pre-eclampsia and placental abruption [8, 9].

Where Women Can Find Folate

Bunch of Asparagus used to explain the sources and benefits of Folate for Women

So, you’re probably thinking supplementation is the best route to guarantee adequate intake, but there are also many food sources that contain good amounts.

But while food is of course the most ideal way to get folate, there’s no promise that you’ll absorb enough. 

As a result, supplementation via high quality multivitamins (such as Performance Lab NutriGenesis Multi for Women) may be something to consider in addition to eating folate-rich foods.

If you go down that route, ensure you’re buying a supplement containing the already methylated form, methylfolate.

This specific form is what’s need for the conversion of homocysteine back to methionine, and also means it doesn’t need to be converted from folic acid to methylfolate in order to be utilized.

Folate, however, is naturally found in many foods. And if you’re a vegan or vegetarian, you need not worry!

Here are your best sources of Folate for women:

  • Beef liver - one of the most concentrated sources available
  • Legumes (kidney beans, peas, lentils)
  • Asparagus
  • Eggs
  • Leafy greens (kale, arugula, spinach)
  • Beets
  • Citrus (orange, grapefruit, lemon, lime)
  • Brussel sprouts
  • Broccoli
  • Nuts and seeds (walnuts, flax)
  • Avocado