Benefits of folic acid for women

Medically reviewed on March 8, 2022 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

From the antioxidant properties of vitamin C to the positive effects potassium can have on blood pressure, the body relies on many vitamins, minerals, and other nutrients to stay healthy. One nutrient you may have heard a lot about is folic acid.

But what is folic acid? And what are the benefits of taking folic acid supplements?

From brain health to heart health to help prevent birth defects, folic acid can potentially do a lot for the body. And although folic acid is good for all bodies, consuming the proper amounts may present a range of benefits for women and those assigned female at birth.

Here’s some key points to know about folic acid, including what it is, where to get it, and the benefits of folic acid for women.

What is folic acid?

Folic acid is the synthetic form of folate, a kind of B9 vitamin. Folate occurs naturally in a variety of foods and drinks, such as:

• Asparagus
• Leafy green vegetables
• Tomato juice
• Orange juice
• Corn
• Seeds
• Nuts
• Beans
• Okra
• Cauliflower
• Some fruits like mangos, cantaloupes, pomegranates, avocados, and kiwis

But folic acid is in more places than where it occurs naturally. Because of the health benefits that have been linked to folate consumption (we’ll touch on those in a moment), federal law requires that certain foods be fortified with folic acid, plus a range of other vitamins and minerals. Fortification is the process of adding certain vitamins and minerals to foods to increase their nutritional value.

Food and beverages that are commonly fortified with folic acid include:

• Bread
• Breakfast cereals
• Cornmeal
• Flour
• Pasta
• Rice

Additionally, folic acid is available in supplement form.

Is folate the same as folic acid?

Folate and folic acid are often conflated terms that get used interchangeably. Although they are both forms of vitamin B9, there are key differences between the two, particularly regarding how each interacts with the body:

Folate – Folate is the naturally occurring form of vitamin B9. The digestive system converts folate into the biologically active form of B9 before it enters the bloodstream [1].

Folic acid – Folic acid is the synthetic form of B9. Not all the folic acid you ingest gets converted in the digestive system. Instead, whatever the digestive system doesn’t manage to convert is passed on to other parts of the body for conversion, like the liver and other tissues.

Is folic acid good for you?

Vitamin B9 is an immensely important nutrient that helps the body perform a range of vital processes, including:

• Growing red blood cells
• DNA repair
• Cellular division

It also generally helps keep cells healthy. That’s why many healthcare professionals recommend that the average adult gets about 400 micrograms (mcg) of folate every day [2].

Research suggests that folate intake may also be linked to:

Brain health – According to the National Institutes for Health, folate intake may affect brain function. Studies suggest that even slightly low levels of folate could lead to mental decline or impairment, even dementia [3].

Heart health – Folate aids in the metabolization of homocysteine, increased levels of which can put you at a higher risk of heart disease and stroke. A 2016 study published by the American Heart Association found that participants who received folic acid supplements were 10% less likely to experience stroke and 4% less likely to experience other kinds of heart disease, suggesting a link between folate intake and heart health [4].

Despite these benefits, there can be risks involved when it comes to folate intake, especially in its synthetic form.

Because the body takes time to convert folic acid into a form it can use, taking folic acid supplements can lead to high rates of unmetabolized folic acid in the bloodstream, even at the recommended doses [5]. This, in turn, can lead to several undesirable health situations. You should always consult a healthcare provider before beginning new supplements.

Folic acid and women’s reproductive health

Feeding the body the proper amount of folate is a wise health decision no matter one’s gender, but for women the benefits of folic acid can be particularly strong, especially if pregnant or planning to become pregnant.

If you’re pregnant, medical professionals recommend getting slightly more than the recommended amount of folate—about 600 micrograms to start—especially if levels are already low [6].

But it can be difficult to get this amount just by seeking out foods high in folate. Healthcare providers recommend beginning a folic acid supplement right away if pregnant. Here’s why.

Can help prevent birth defects

One of the most well-known benefits of folic acid for women is that it may decrease the risk of birth defects.

Studies suggest that in women who maintain a healthy amount of folic acid or folate in their bloodstream prior to becoming pregnant, the increased risk of certain birth defects is significantly decreased [7]. Specifically, folic acid may help prevent two types of common neural tube defects that occur when the spinal cord or brain don’t close properly:

Spina bifida – Spina bifida refers to the incomplete development of the spinal cord, brain, or their protective coverings (known as meninges). There are three types of spina bifida: myelomeningocele, spina bifida occulta, and meningocele, each presenting with its own symptoms and related complications.

Anencephaly – This neural tube defect is when a baby is born missing pieces of its brain or skull. Parts of the brain that are affected are usually the forebrain and the cerebrum, which are responsible for cognitive functions and coordination.

May help prevent cleft lip and palate

According to the National Institutes of Health, folic acid may also be responsible for reducing the risk of cleft lip and palate syndrome in newborns [8].

Citing a study published in British Medical Journal, the National Institutes of Health reports that women who consumed 0.4 milligrams of a folic acid supplement early in pregnancy experienced reduced risks of cleft lip and palates by up to a third, suggesting a relation.

Can help reduce the risk of complications during pregnancy

The benefits of folic acid for women who are pregnant don’t extend only to the baby. Folic acid may also be beneficial for preventing certain complications during pregnancy that can harm the mother as well, such as:

Preeclampsia – Preeclampsia refers to increased blood pressure in women who have been pregnant for 20 weeks or more. A serious condition, it can lead to organ damage or even death of the mother and child. Research indicates a link between appropriate folate levels and a reduced risk of preeclampsia [9].

Gestational diabetes – According to research conducted by the National Institutes for Health, women who take less than 400 micrograms of a folic acid supplement before becoming pregnant were 22% less likely to experience elevated blood sugar or glucose levels known as gestational diabetes during pregnancy [10]. Gestational diabetes can lead to complications such as hypertension, cardiovascular disease, and increased necessity of cesarean delivery.

May help with fertility

For women who are hoping to become pregnant, it’s possible that taking a folic acid supplement may help improve the chances of conceiving.

Research suggests that when combined with medical reproductive technology, women who receive folic acid supplements may be more likely to become pregnant. In a study conducted by the National Institutes for Health, participants who received greater than 800 micrograms per day of a folic acid supplement were 20% more likely to become pregnant than those who received less than 400 micrograms per day, suggesting a link between folate intake and fertility [11].

Folic acid can be used to treat folate deficiency

Another benefit of folic acid for women is that it can be used to treat folate deficiency. People of all genders can suffer from a lack of folate in their system, but women who are pregnant or still nursing are often at particular risk.

A folate deficiency can lead to several health complications, including anemia, depression, and immunodeficiency [12, 13]. It can also lead to severe birth defects.

References

1. Patanwala I, King MJ, Barrett DA, Rose J, Jackson R, Hudson M, Philo M, Dainty JR, Wright AJ, Finglas PM, Jones DE. Folic acid handling by the human gut: implications for food fortification and supplementation. Am J Clin Nutr. 2014 Aug;100(2):593-9. Epub 2014 Jun 18.

2. Folate – Consumer. National Institutes of Health. URL. Accessed March 8, 2022.

3. Jang S, Han JW, Shin J, et al. Normal-But-Low Serum Folate Levels and the Risks for Cognitive Impairment. Psychiatry Investig. 2019;16(7):532-538.

4. Li Y, Huang T, Zheng Y, Muka T, Troup J, Hu FB. Folic Acid Supplementation and the Risk of Cardiovascular Diseases: A Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc. 2016 Aug 15;5(8):e003768.

5. Obeid R, Kirsch SH, Dilmann S, Klein C, Eckert R, Geisel J, Herrmann W. Folic acid causes higher prevalence of detectable unmetabolized folic acid in serum than B-complex: a randomized trial. Eur J Nutr. 2016 Apr;55(3):1021-8. Epub 2015 May 6. PMID: 25943647.

6. Folate: Health Professional Fact Sheet. National Institutes of Health. URL. Accessed March 8, 2022.

7. Greenberg JA, Bell SJ, Guan Y, Yu YH. Folic Acid supplementation and pregnancy: more than just neural tube defect prevention. Rev Obstet Gynecol. 2011;4(2):52-59.

8. Folic Acid May Prevent Cleft Lip and Palate. National Institutes of Health. URL. Accessed March 8, 2022.

9. Serrano NC, Quintero-Lesmes DC, Becerra-Bayona S, et al. Association of pre-eclampsia risk with maternal levels of folate, homocysteine and vitamin B12 in Colombia: A case-control study. PLoS One. 2018;13(12):e0208137. Published 2018 Dec 6.

10. Megaloblastic Anemia. StatPearls [Internet]. URL. Accessed March 8, 2022.

11. Gaskins AJ, Afeiche MC, Wright DL, et al. Dietary folate and reproductive success among women undergoing assisted reproduction. Obstet Gynecol. 2014;124(4):801-809.

12. Reynolds EH. The neurology of folic acid deficiency. Handb Clin Neurol. 2014;120:927-43. PMID: 24365361.

13. Daily Folic Acid Supplement May Reduce Risk of Gastrointestinal Diabetes. National Institutes of Health. URL. Accessed March 8, 2022.