Folic acid (vitamin B9) at a glance:
- Folic acid plays a key role in blood formation, cell division, and immune function.
- From the age of 13, the recommended daily intake is 300 micrograms.
- Some of the best dietary sources include leafy greens, legumes, and wheat germ.
- Symptoms of deficiency can include pale skin, fatigue, and irritability.
- Properly dosed folic acid supplements can help correct a deficiency.
What is folic acid, and why is it important?
Folic acid is the synthetic form of vitamin B9, while folate is its natural counterpart. Although these terms are often used interchangeably, they have distinct biochemical properties that affect how the body absorbs them. This water-soluble vitamin is essential for various bodily functions, including cell division and immune system support.
It also contributes to:
- Normal blood formation
- Normal amino acid synthesis
- Normal psychological function
How much folic acid do we need?
Folic acid intake is measured in folate equivalents, with 1 microgram of dietary folate equating to 0.5 micrograms of synthetic folic acid. The recommended intake varies by age, life stage, and overall health.
- The German Nutrition Society (DGE) advises a daily intake of 300 micrograms for individuals over 13 years old.
- Pregnant and breastfeeding women require significantly more, with recommendations of 550 and 450 micrograms per day, respectively.
- Infants and children under 13 need between 60 and 240 micrograms per day, depending on their age.1
Which foods are high in folic acid?
The body cannot produce folic acid, so it must be obtained through diet. Good sources include leafy green vegetables, certain other vegetables, legumes, and wheat germ. Animal-based foods typically contain less folate, except for liver, which is an exception.
Folic acid content in foods (µg per 100g)
| Food | Folic Acid (µg) |
| Wheat germ | 520 |
| Lima beans | 360 |
| Chickpeas | 340 |
| Wheat bran | 195 |
| Kale | 187 |
| White beans | 187 |
| Brussels sprouts | 182 |
| Lentils | 168 |
| Peas | 151 |
| Lamb’s lettuce | 145 |
| Spinach | 145 |
| Pork liver | 136 |
| Cauliflower | 125 |
| Broccoli | 111 |
| Endive | 109 |
| Asparagus | 108 |
| Leeks | 103 |
| Eggs | 67 |
| Strawberries | 65 |
| Cherries | 52 |
| Camembert | 44 |
| Cocoa powder | 38 |
How to prepare folate-rich foods properly
Folate is not only water-soluble but also sensitive to heat and light. As a result, improper storage and cooking methods can significantly reduce its content. To minimise loss, store foods in a cool, dark place, consume them soon after purchase, and cook them briefly.
What are the symptoms of folic acid deficiency?
A lack of folate usually does not cause immediate symptoms because the body stores about 5 to 10 milligrams of folic acid, mainly in the liver. It can take around four months for these stores to become depleted and deficiency symptoms to appear.
Long-term folic acid deficiency can have serious health effects. As folic acid is essential for blood formation, a deficiency can lead to enlarged red blood cells and anaemia, resulting in symptoms such as pale skin, breathlessness, and fatigue.
Other signs of deficiency may include:
- Inflamed mucous membranes
- Tingling or burning tongue
- Cardiovascular issues
- Loss of appetite
- Weight loss
- Diarrhoea
- Irritability
- Low mood or depression
What causes folic acid deficiency?
While it’s possible to get enough folate from food, many people still don’t meet the recommended intake. According to the German National Nutrition Survey II, the median daily folate intake is 252 micrograms for women and 283 micrograms for men2, which is below the recommended 300 micrograms, particularly for women.
Other causes of folic acid deficiency
Folate deficiency can result from more than just poor diet. Other factors that may contribute include:
- Digestive disorders such as Crohn’s disease
- Certain medications
- Use of oral contraceptives
- Excessive alcohol consumption
How to treat a folic acid deficiency
To replenish folate stores, high-dose folic acid tablets may be prescribed. The German Federal Institute for Risk Assessment (BfR) recommends a maximum of 200 micrograms per day in standard supplements.3
High-dose folic acid should only be taken under medical supervision to avoid side effects or masking a vitamin B12 deficiency.
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Folic acid in pregnancy and breastfeeding
Studies show that folic acid supplementation can significantly reduce the risk of neural tube defects in babies.
Women trying to conceive should take 400 micrograms of folic acid daily, starting at least four weeks before conception and continuing through the first trimester.
Is too much folic acid harmful?
Excessive intake of folate from natural food sources generally does not cause health problems. However, this is not the case for supplements and fortified foods. Consuming too much folic acid from these sources may lead to side effects such as nerve overactivity and digestive issues. In the long term, an overdose could even trigger epileptic seizures and depression.
To avoid such complications, it is important to follow the recommended maximum daily intake. According to the European Food Safety Authority (EFSA), a daily dose of up to 1,000 micrograms is considered safe for adults. This amount includes both folic acid supplements and fortified foods but does not take into account naturally folate-rich foods.4
When are folic acid supplements beneficial?
Despite the essential role of folic acid in health, many people do not meet their needs through diet alone. A folic acid supplement can help ensure adequate intake and prevent deficiency symptoms. This is particularly important for women trying to conceive or who are already pregnant. However, anyone with a folic acid deficiency may benefit from supplementation.
When should you avoid taking folic acid?
Folic acid supplements are generally safe when taken at appropriate doses. However, they may interact with certain medications, including drugs used for cancer, malaria, or infections. If you are taking prescription medication due to a health condition, consult a doctor before using a folic acid supplement to avoid potential interactions.
- 1 German Nutrition Society (Deutsche Gesellschaft für Ernährung e.V.): Recommended folate intake (as of 2015). URL: https://www.dge.de/wissenschaft/referenzwerte/folat/ (last accessed: 25/10/2024).
- 2 Max Rubner Institute: Final Report, Part 2 of the National Nutrition Survey II (published: 2008). URL: https://www.mri.bund.de/fileadmin/MRI/Institute/EV/NVSII_Abschlussbericht_Teil_2.pdf (last accessed: 25/10/2024).
- 3 German Federal Institute for Risk Assessment (BfR): Update (2024): Maximum level recommendations for folic acid in foods, including food supplements (published: 22/02/2024). URL: https://www.bfr.bund.de/cm/343/aktualisierung-2024-hoechstmengenvorschlaege-fuer-folsaeure-in-lebensmitteln-inklusive-nahrungsergaenzungsmitteln.pdf (last accessed: 25/10/2024).
- 4 European Food Safety Authority (EFSA): Overview of tolerable upper intake levels as determined by the Scientific Committee on Food (SCF) and the EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA) (published: June 2024). URL: https://www.efsa.europa.eu/sites/default/files/2024-05/ul-summary-report.pdf (last accessed: 25/10/2024).
