Do You Need Folate Supplements?

Folate (also known as vit­a­min B9) plays an essen­tial role in many chem­i­cal reac­tions in your body, includ­ing DNA syn­the­sis and amino acid metabolism.

One impor­tant folate-dependent chem­i­cal reac­tion is clear­ing the body of homo­cys­teine by con­vert­ing it to methio­n­ine.  If it doesn’t get bro­ken down prop­erly, homo­cys­teine can build up in your artery walls and con­tribute to atherosclerosis.

Spinach is a power-packed source of folate, with other dark green leafy veg­eta­bles not far behind (yeah kale!)  Folate is also found in a wide vari­ety of other foods, includ­ing fruits, beans, meats, and more.

Despite its broad avail­abil­ity in the Amer­i­can diet, pub­lic health author­i­ties have deter­mined that many peo­ple are at risk of folate defi­ciency, and have required that for­ti­fied grains include extra folate.

But nat­ural sources of folate, even with for­ti­fied grains added in, may not be enough.

One rea­son you might ben­e­fit from sup­ple­men­ta­tion is that you can’t make direct use of the folate found in food.  First, your body has to con­vert it to usable form – 5 methyl-tetrahydrate folate.  (We can call it by its nick­name:  5-MTHF.  Catchy, isn’t it?)

If you have a defi­ciency of the enzymes needed to make the con­ver­sion into 5-MTHF, you can con­sume boun­ti­ful amounts of folate from food but still be defi­cient where it counts – the amount of folate cir­cu­lat­ing in your blood stream.

That’s why you should select a sup­ple­ment that pro­vides folate that’s already in the form of 5-MTHF.  That way you’re sure to have plenty of the active form avail­able to cat­alyze your inter­nal chem­i­cal reac­tions and clear your body of excess homocysteine.

Preg­nant women, and even women who could poten­tially become preg­nant, are urged to take extra folate because it helps pre­vent birth defects.

In addi­tion to its proven role in sup­port­ing your over­all health, folate may have the poten­tial to improve the out­comes of sev­eral spe­cific med­ical con­di­tions.  That’s why every­one should con­sider using folate – par­tic­u­larly in its most bioac­tive form — as a supplement.

Car­dio­vas­cu­lar dis­ease and stroke

Folate sup­ple­ments have shown some promise in help­ing to pre­vent stroke.  And in the­ory extra 5-MTHF should help with other car­dio­vas­cu­lar prob­lems, like coro­nary heart dis­ease. (Although research to prove this ben­e­fit is pretty sketchy.)


Some sci­en­tists have spec­u­lated that folate sup­ple­men­ta­tion might be use­ful in the pre­ven­tion of cer­tain can­cers, par­tic­u­larly colon can­cer.  Though there is some research to sup­port this hypoth­e­sis, the results are unclear.  And in some sit­u­a­tions, it seems that adding folate sup­ple­ments to your diet could actu­ally raise your risk of cer­tain cancers.


Using folate sup­ple­men­ta­tion in the treat­ment of depres­sion has also been stud­ied.  Here is some of what we know:

There’s a sub­group of peo­ple with depres­sion who are folate-deficient.  For that sub­group, sup­ple­men­ta­tion with extra folate boosts the response to stan­dard SSRI anti-depressant drugs.  At the same time, if you have nor­mal lev­els of folate in your blood to begin with, you won’t get an extra boost from supplementation.

Unfor­tu­nately, since most of this research has been per­formed by phar­ma­ceu­ti­cal com­pa­nies, we don’t know what would hap­pen if patients took folate sup­ple­ments by them­selves, leav­ing out the SSRI’s altogether.

How much folate should I take and what kind?

If you choose to use a folate sup­ple­ment, I rec­om­mend a prod­uct that comes in the 5-MHTF form that’s most usable by your body.  Begin with a dose of about 800 micro­grams per day.


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