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Folate

Synonyms/Common Names/Related Substances:

  • l-LV, 5-formyltetrahydrofolate, 5-methyltetrahydrofolate, B complex vitamin, d,l-LV, folacin, folic acid, folinic acid, Folvite®, heptaglutamyl folic acid, hexaglutamyl folic acid, L-5-methyltetrahydrofolate, levoleucovorin, leucovorin, methyltetrahydrofolate, monoglutamyl folic acid, polyglutamyl folic acid, pteroylglutamic acid, pteroylmonoglutamic acid, pteroylpolyglutamate, vitamin B9, vitamin M.

Clinical Bottom Line/Effectiveness

Brief Background:

  • Folate and folic acid are forms of the water-soluble B9 vitamin. Folate occurs naturally in food, and folic acid is the synthetic form of this vitamin. Folic acid is well-tolerated in amounts found in fortified foods and supplements. Sources of folate include cereals, baked goods, leafy vegetables (spinach, broccoli, lettuce), okra, asparagus, fruits (bananas, melons, lemons), legumes, yeast, mushrooms, organ meat (beef liver, kidney), orange juice, and tomato juice. Folic acid is frequently used in combination with other B vitamins in vitamin B complex formulations.
  • Folate is considered a type 1 nutrient, which is required for specific functions in the body (1). Folate deficiency will occur if the body does not get the adequate amount of folic acid from dietary intake. Folic acid has been shown to be effective in the treatment of megaloblastic and macrocytic anemia due to folate deficiency. Folic acid is effective at increasing folate levels in blood and decreasing symptoms associated with inadequate folate status. Folic acid supplementation, with or without other B vitamins, has been shown repeatedly to reduce homocysteine levels in blood in individuals with normal levels or in those with hyperhomocysteinemia.
  • Folic acid supplements are suggested for use in women of childbearing age in order to prevent neural tube defects (NTDs). NTD risk appears to have decreased in many countries since folic acid fortification of flour and cereals.
  • Folic acid is used commonly in combination with various antineoplastic agents and folic acid antagonists to decrease potential side effects. Fluorouracil and leucovorin (folinic acid) or levoleucovorin are commonly used together in cancer therapy, sometimes in combination with other agents. Folic acid has been suggested for patients that use methotrexate (2;3;4;5;6;7), although the effect of methotrexate may decrease if combined with folic acid (8). However, folate has been reported to increase cancer incidence (9;10;11;12;13;14) and may affect the action of some antineoplastic agents, including folic acid antagonists (15).
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Dosing/Toxicology

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Precautions/Contraindications

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Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

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Mechanism of Action

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History

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Evidence Table

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Evidence Discussion

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Products Studied

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Author Information

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References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

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The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.