What’s the difference between folate and folic acid?

Did you know that folate and folic acid aren’t the same thing? Although many health professionals use the terms interchangeably, understanding the difference is important—especially for women who are pregnant or trying to conceive.

Folate is the natural form of vitamin B9, found in whole foods like leafy greens, lentils, and liver. It supports healthy red blood cells, brain function, and fetal development—particularly the prevention of neural tube defects (NTDs) in early pregnancy. Folic acid is the synthetic form used in most supplements and fortified foods.

Here’s the key difference: folate from food is readily absorbed and used by the body, while folic acid must go through several steps in the liver to become active. However, many people don’t efficiently process folic acid, which can result in unmetabolized folic acid building up in the bloodstream—a condition linked to increased cancer risk, cognitive decline in older adults, and reduced immune function.

For most adults—especially men and women past childbearing age—extra folic acid isn’t necessary and may even be harmful. For women planning to become pregnant, adequate folate intake is essential. Since diet alone may not provide enough, high-quality supplements using 5-methyltetrahydrofolate (5-MTHF)—a safe, bioavailable form—are recommended.

What to Look For:

• The best food sources of folate: spinach, romaine lettuce, lentils, beets, asparagus, and liver.

• Best supplement forms: labels that say “5-MTHF” or “Metfolin,” not just “folic acid.”

• Suggested intake for women planning pregnancy: 800–1200 mcg of folate daily for several months before conception. During pregnancy, 600–800 mcg daily is typically sufficient, depending on your diet.