The small vitamin with a big effect

What are folic acid and folate?

These are two different forms of the same vitamin – vitamin B11, also known as B9. It’s an essential nutrient the body needs for numerous processes, such as cell division, blood formation and nervous system development – especially during pregnancy.

The main difference is the form in which the vitamin occurs. Folate is the natural form found in many foods, such as green leafy vegetables (e.g. spinach), avocados, legumes, citrus fruits or liver. Folic acid is the synthetic form used in dietary supplements or fortified products like breakfast cereals.

While folate can be used directly by the body, folic acid must first be converted into an active form – usually 5‑methyltetrahydrofolate (5‑MTHF). This conversion happens in the liver and can be less efficient in some individuals. The synthetic form used in preparations is called pteroylmonoglutamate (PMG).

Why does the body need folic acid and folate?

They are true multitaskers in the body – they perform many central functions for health, growth and wellbeing. Without them, many processes would not function properly.

Folate plays a central role in the formation of new cells – whether for the regeneration of skin, mucous membranes or blood. It is particularly needed where cell division is rapid, for example in the production of red and white blood cells or the renewal of intestinal cells. That is why folic acid is so important for blood formation and a functioning immune system.

Inside cells, folic acid ensures that amino acids – the building blocks of proteins – are processed correctly. The homocysteine metabolism is particularly important here. Homocysteine is an intermediate of amino acid metabolism that, at high concentrations, can damage blood vessels. Folic acid helps to break down this substance healthily and thus protects the cardiovascular system.

Folate is converted in the body into the active form tetrahydrofolate. This form is essential for the formation of DNA, the genetic blueprint. Without it no cell can divide and develop properly. That is why it is indispensable, especially during pregnancy, for the healthy development of the unborn child.

Less well known, but no less important, folic acid also matters for mental health. It contributes to normal emotional balance and helps reduce tiredness and fatigue. People who are frequently tired or lack drive may therefore benefit from an adequate intake.

How much folic acid does my body need?

Daily folic acid requirements depend greatly on life stage and lifestyle. In general, the requirement for adolescents and adults is about 600 micrograms per day. The need, however, increases significantly when trying to conceive or during pregnancy.

Women trying to conceive are advised to ensure an adequate intake before pregnancy – ideally 800 micrograms per day. During pregnancy the requirement is even higher; up to 1100 micrograms daily are recommended to optimally support the unborn child’s development. Breastfeeding mothers should take about 900 micrograms per day, as the nutrient is also passed on through breast milk.

How can a folic acid deficiency show itself?

A folic acid deficiency can manifest in many ways and affect both body and mind. Because folic acid is important for blood formation, fatigue, paleness and general exhaustion are among the first signs. The body still produces red blood cells, but their function is impaired. This can lead to a so‑called folate deficiency anaemia, where oxygen transport in the blood is no longer optimal. Consequences often include shortness of breath with physical exertion, reduced performance or even palpitations.

Mucous membranes also react sensitively to a deficiency. Inflammation of the gastrointestinal tract, diarrhoea, as well as loss of appetite and weight loss are possible outcomes. Changes to the tongue are also notable – such as burning sensations, tingling or an unusually smooth, reddened surface. Headaches, dizziness and an increased tendency to bleed can also indicate a longer‑standing deficiency.

In addition to physical complaints, psychological symptoms may occur. Irritability, depressive moods or concentration problems are not uncommon when the body lacks folate for an extended period.

Why is folic acid so important during pregnancy?

It is important during pregnancy – from the very first moment. Many critical development steps of the baby occur before a woman even knows she is pregnant. Already in the first weeks after conception – between days 22 and 28 – the so‑called neural tube forms, from which the brain and spinal cord later develop. A folic acid deficiency at this stage can cause the neural tube not to close completely. The result is severe malformations such as spina bifida (the “open back”) or other neural tube defects, which can lead to permanent birth defects.

To minimise this risk, women trying to conceive and those in early pregnancy are strongly advised to take folic acid via dietary supplements, as sufficient supply through food alone is often not guaranteed in this sensitive phase.

Folic acid does even more. It supports the growth of maternal tissues, promotes – together with vitamin B12 – the formation of red blood cells and strengthens the immune system. The development of the placenta, which supplies the baby, also depends on good folate supply.

Even after birth it remains important. During breastfeeding it is passed to the newborn through breast milk and thus continues to contribute to healthy development.

Does taking folic acid have side effects?

Folic acid is generally considered well tolerated and is an important part of health prevention for many people – especially during pregnancy. A overdose from normal food alone is practically impossible, since naturally occurring folate in foods has no harmful effects. Being water‑soluble, excess folic acid is typically excreted in the urine.

Still, more is not always better when it comes to dietary supplements. If persistently high amounts of folic acid are taken – for example through high‑dose preparations – an excess of unmetabolised folic acid can accumulate in the blood. The liver, responsible for further processing, has a limited capacity. According to various health authorities, long‑term overdose can among other things negatively affect the immune system.

Although side effects are rare, in individual cases excessive consumption has been associated with symptoms such as nausea, gastrointestinal complaints, loss of appetite, taste changes or inner restlessness. With prolonged overconsumption, mood swings, depression, nightmares or epileptic seizures can even occur – but only with very high doses over an extended period.

Which foods contain folic acid or vitamin B9?

Folic acid – the synthetic form of vitamin B9 – and its natural counterpart folate are found in many foods. Plant‑based products in particular are rich in this vital vitamin. Knowing where vitamin B9 occurs often allows you to meet your daily needs without supplements.

Chickpeas are among the top sources. 100 g of dried chickpeas contain roughly 340 µg of folic acid. They are not only nutrient‑dense but also versatile – whether as hummus, in curry or in salads.

Peas – especially fresh garden peas – contain 213 to 340 µg of folic acid per 100 g. Best prepared fresh or frozen immediately to minimise nutrient losses. Kale, the green superfood, provides 187 µg per 100 g and also supplies provitamin A, vitamin K, iron and calcium. A quick blanch or even raw consumption preserves folate best.

Macadamia nuts contain particularly high amounts, with 437 µg per 100 g. Other nuts such as peanuts (169 µg/100 g), hazelnuts (90 µg/100 g), walnuts (73 µg/100 g) and almonds (44 µg/100 g) are also good sources.

Soybean sprouts contain 160 µg per 100 g. They are light, crunchy and can be eaten raw or cooked – ideal for Asian dishes. Lamb’s lettuce is not only a vitamin C star but also provides 145 µg of folate per 100 g – a perfect winter salad that can be eaten raw to retain the nutrient. Leaf spinach contains 141 µg of folate per 100 g – raw in a smoothie or briefly blanched as a side dish, a classic. Leek provides around 103 µg per 100 g and is excellent for soups, quiches or vegetable pans. Brussels sprouts provide 101 µg per 100 g and are a typical winter vegetable with cancer‑fighting plant substances. Gentle steaming preserves the folate content best.

Animal foods also contain folate, albeit in smaller amounts. Eggs supply about 74 µg per 100 g – particularly the yolk is rich in vitamin B9 (up to 162 µg/100 g). Liver, milk and dairy products are also worth mentioning.

Folic acid: how to benefit from proper use

• Take folic acid preferably on an empty stomach. Although the timing is generally flexible, it is recommended to take folic acid before a meal with plenty of liquid. An empty stomach improves absorption of the vitamin. Therefore, avoid taking folic acid immediately after eating.
• Combine folic acid sensibly with vitamin B12. These two vitamins work closely together in the body, in particular in homocysteine metabolism. A balanced ratio supports not only cardiovascular health but also blood formation and psychological functions. If one is missing, the effect of the other can be impaired.
• Prevent tiredness with folic acid. Folic acid contributes to reducing tiredness and fatigue. Especially under high mental or physical strain, a good supply can be noticeable. This makes folic acid relevant for everyday life for workers and parents alike.
• Prepare early if you want to conceive. Folate levels should already be built up before conception, as the first weeks of pregnancy are crucial for neural tube development. Gynecologists therefore recommend taking folic acid when trying to conceive. This helps to specifically prevent malformations in the child.
• During breastfeeding, the infant receives many nutrients through breast milk – including folic acid. This supports cell growth and blood formation in the baby. Therefore, breastfeeding mothers should also ensure an adequate intake.
• Be aware of interactions with medications. Certain drugs, such as some antibiotics or chemotherapeutics, can impair the effect of folic acid. Oral contraceptives (“the pill”) can also lead to a deficiency in the long term. Inform your doctor about all medications you take.
• Choose folate‑rich foods deliberately. Legumes, wholegrain products, nuts and liver are good natural sources of folic acid. A varied diet is in many cases sufficient to meet requirements. Supplements are particularly useful in special life stages such as pregnancy.
• Avoid high heat when preparing food. Folic acid is heat‑sensitive and can be easily lost during cooking. Steam vegetables briefly and use little water. Even better is to eat some foods – such as salad or tomatoes – raw.
• Observe the recommended maximum daily amount. The European Food Safety Authority recommends a maximum of 1'000 µg of folic acid per day from dietary supplements. If this amount is exceeded continuously, unwanted effects can occur, such as masking a vitamin B12 deficiency. The folate naturally present in foods is, however, harmless.
• Symptoms such as tiredness, pale skin or difficulty concentrating can be signs of folate deficiency. It often becomes particularly noticeable through a so‑called megaloblastic anaemia – a specific form of anaemia. People with high alcohol consumption or a one‑sided diet are also at risk.
• Folic acid can also support your skin. It helps form new skin cells and supports regeneration. It can protect the skin from external influences such as the sun and provide more moisture. In addition, folic acid has been linked to an improvement in skin appearance in cases of acne.
• Seek medical advice if you are unsure. Individual dosage and duration of intake depend on many factors – e.g. diet, existing medical conditions or life situation. Your doctor can help determine your actual needs. This ensures you neither take too little nor too much.

Folic acid plays a decisive role in cell division and blood formation and is particularly indispensable during pregnancy. As it cannot be produced by the body itself, an adequate intake through diet or supplements is important. A deficiency often remains unnoticed for a long time but can have serious health consequences.