The use of folates, and specifically folic acid (vitamin B9) supplementation is currently one of the most controversial topics on nutrition blogs and websites.
Much of the controversy revolves around the adverse effects folic acid could have on the body and its potential to raise the risk of cancer (Ebbing, 2009).
Folic acid is essential for proper DNA replication, especially when this is happening at hyperspeed. For this reason, prenatal vitamins and various fortified foods often contain folic acid; they lower the incidences of neural tube defects (NTDs) during pregnancy. Folic acid is additionally often paired with biotin for hair growth and skin care.
While effective in preventing neural tube defects and perhaps in promoting hair growth, folic acid is now being targeted as a potentially harmful supplement. This is especially true for individuals and companies who wish to sell replacement supplements, such as methylfolate. To help clear the fog on this topic let’s answer a few key questions: What does folic acid do? Why is folic acid potentially harmful? And is methylfolate really better?
What Does Folic Acid Do?
Folic acid belongs to the family known as folates. Folates such as folinic acid, tetrahydrofolate, and methylfolate form when folic acid is chemically reduced and fixated. The body reduces folic acid twice, yielding tetrahydrofolate (commonly known as folate). Tetrahydrofolate is the biologically active version of this supplement. Folates take on different chemical structures within the cell. These then carry out a variety of other processes like DNA synthesis and amino acid formation (Chaney, 2015).
Is Folic Acid Potentially Harmful?
There are many articles, blogs, and videos that mention the potential adverse effects that stem from excess folic acid in circulation. For example, the excess folic acid can lower the numbers of natural killer cells (NKC’s) which help prevent cancer formation (Moss, 2009). Many other sites state that while much of this research is true, there is more evidence to support folic acid supplementation than not. For those untrained in biochemistry or in interpreting animal and clinical studies, the science becomes too intricate to gauge a proper stand on the matter. Without discrediting the work and research of other professionals, there is a reason research on nutrition is still happening. Unfortunately, this type of back and forth leave most consumers alarmed or confused.
Why Do We Still See Folic Acid Over The Counter?
Despite the efforts of many individuals to replace folic acid with methylfolate, for all purposes, folic acid is still the first choice of most physicians. There is simply more research supporting the effectiveness of folic acid than that of methylfolate, and folic acid has proven successful in reducing NTD’s during pregnancy. Furthermore, much of the research regarding the adverse effects of excess folic acid remains unclear.
Is Methylfolate A Better Choice?
Methylfolate is a more expensive choice, perhaps, but not necessarily better unless there is a condition present. This is where many professionals get into heated debates. This is often due to certain individuals in the population suffering from a defect in the MTHFR (Methylenetetrahydrofolate reductase) gene. The MTHFR encodes for an enzyme that aids in folic acid metabolism and methylation. This is significant because folic acid is the biologically inactive form which must be transformed into methylfolate for use. In such cases, methylfolate is perhaps the better choice, and it is usually accompanied by supplementation of vitamin B12.
Bottom-line, nutrition is much more than dietary supplements. If one is worried about a potential vitamin deficiency, try supplementing your diet first. A diet supplemented with foods rich in nutrient density are better sources of any vitamin. If concerns do arise about a potential deficiency despite a healthy, well-balanced diet, then one should consult a (qualified) health professional to answer questions about potential vitamin supplementation.
- Ebbing, MD Marta. “Cancer Incidence and Mortality After Treatment With Folic Acid and Vitamin B12.” JAMA, American Medical Association, 18 Nov. 2009, jamanetwork.com/journals/jama/fullarticle/184898.
- Chaney, Stephen G. “Videos.” Health Tips From The Professor, 26 Aug. 2015, healthtipsfromtheprofessor.com/videos/
- Moss, Jeffrey. “What You Should Know About Folic Acid.” YouTube, functmed1, 15 Dec. 2009, www.youtube.com/watch?v=_QFl7BnWhpQ.