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I understand that folic acid is a synthetic (man-made) form of folate. I read that folate is the pure and unaltered form of vitamin B9 that the body recognizes. Why is folic acid in most multivitamins instead of folate? P.A.

Dear P.A.:

Folic acid and folate are both forms of vitamin B9. Natural folates lose activity in foods over periods of days or weeks, but folic acid is stable for months or even years. The bioactivity of food-based folates is reduced considerably during harvesting, processing, storage, and food preparation. It is estimated that up to three-quarters of initial folate activity may be lost by the time a food is eaten. Folic acid is stable so that it can be used as a supplement or to fortify foods. Both forms must be converted in the body (in the intestines and liver) to L-5-Methyltetrahydrofolate, which is the active form of the nutrient in the body. Authorities differ on which form is most bioavailable, but most suggest that folic acid is much more easily absorbed.

The terms “natural” and “synthetic” are not always helpful in determining how the body will respond to a given nutrient. The important question is “How does the body respond to this chemical?” In the case of folic acid it responds very well. For example, since folic acid fortification of foods began in 1997, the incidence of birth defects in which the spinal cord is exposed has fallen by nearly fifty percent.

Dr. Dale

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