Folate: Friend or Foe?

By Samantha Gilbert, FNC, CHNP, CNC     Last updated on September 23rd, 2021

Could folate be your friend or foe?

Yesterday I was perusing my fitness magazines and couldn’t help but notice all the dietitians touting the importance of including more folate, from both food and supplements, for everyone.

And this got me thinking about how we are one of the wealthiest nations in the world, yet experience higher rates of disease and injury, and die sooner than people in other high-income countries.

So how did we get this way?

Well, it all started during the Industrial Revolution when removing the bran from the germ of grains through milling and mass refining seemed like a good idea because it meant that grain products could sit on store shelves much longer without spoiling.

Then at the end of World War II, bakeries in America began using large amounts of chemicals, additives, bleaches, and preservatives (as much as 25 different chemicals are added to refined grain and bread products) to create even longer shelf life. Because this process strips all the vitamin and mineral content from the original source, these foods are “fortified and enriched” with vitamin and mineral forms our bodies do not recognize.

And at the top of the fortified and enriched list? Yep, you guessed it, folic acid.

What’s even worse is that in the United States and Canada, fortification became a mandatory practice in the 1990’s.

And the result of this practice?

Higher rates of cancer and a massive increase in things like autism, depression, bipolar disorder, autoimmune diseases and diabetes to name a few. You can read more about that here and here.

Or to put it another way, we began experiencing changes to our DNA in the form of genetic mutations or SNPs (pronounced snips) that create disease states. These are epigenetic in nature, which means that with diet, lifestyle, and nutrient therapy, we can correct these imbalances. By the way, we all have SNPs, they just manifest differently for each of us.

So what is folate?

Folate is a general term that denotes a group of water-soluble b-vitamins (B-9), while folic acid stands for the synthetic compound used in supplements and to fortify foods. Much has been said about these two forms, with the general consensus being that it’s ok in food form, but not so much in supplement form.

And herein lies the problem.

For those of us, that struggle with cognitive impairments, any form of folate, folic or folinic acid will function the same over time, regardless of whether it comes from food or supplements.

And when it comes to methyl folate, it’s not a better form, it’s simply a different form.

In other words, if you are undermethylated, you need to be very careful with folate because it is a serotonin reuptake promoter, (anti-depressants (SSRI’s) are reuptake inhibitors and undermethylated persons respond well to these medications) so it will make you feel worse. This explains why my years as a raw vegan on a high folate diet yielded devastating results for me.

Now I know what all that green juice was really doing to my body. And why one man’s food is another man’s poison.

Overmethylated individuals, however, thrive on folates because they have too much methyl and folate is a powerful demethylating agent.

Folic acid works in different ways in different parts of the cell. The part we need to be concerned about is the nucleus because it’s inside the cell that we see methyl loss and all forms of folic acid (even food-based) strip more methyl than they provide. 1

Researchers involved in the treatment of cancer now realize that folic acid is directly related to an increase in cancer rates. Methotrexate, a drug used to treat cancer, acts by inhibiting the metabolism of folic acid. It’s a great cancer agent, but unfortunately, the patient’s got worse and many died because folic acid was added back in. This is a good indicator as to why undermethylated persons have a greater propensity to develop cancer and do worse on folates. 2

If you know of someone who could benefit from this post, please share it. It is through sharing that we create community, eliminate guilt and shame, and bring about healing.

[1] [2] Mensah, Albert. MTHFR and Mental Health: Understanding The Overall Effect of Individual Genetic Mutations (SNPs)

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89 thoughts on “Folate: Friend or Foe?”

  1. Second question is… to work as a nutritionist in functional medicine do you have any study recommendations? Here in New Zealand I could do a two year diploma in Nutrition but i’m not sure if that will be enough preparation to study functional medicine & nutrient therapy. I would like to work as a nutritionist alongside a functional medicine doctor or as a private consultant/health coach focused on nutrient therapy. Essentially what you do. Any thoughts?

    1. Hi Erika,
      I recommend a masters degree program from an accredited institution that focuses on functional medicine and human nutrition.

  2. Hi Sami G,

    Interesting reading these comments. Another consideration for individuals not doing so well on a vegan/vego diet could be that these diets are high in copper and lower in Zinc, and also essential proteins. High copper, low zinc can contribute to negative mental states, also protein deficiencies. Is it possible that these factors are an issue rather than excessive folate?

    1. Hi Bec,
      Yes, there is also a connection with high copper, low zinc, and protein deficiency, which I’ve gone into great detail here. However, folate is a primary factor with methylation imbalances and must be taken into consideration for proper treatment.

      1. Thanks for your reply Sami! I have a similar story to you: Undermethylated, copper overload. Also have pyroluria, and a number of secondary issues. I have had a consult with a “walsh” practioner, however they recommended 1,000 mcg of methyl folate amongst other things and more red meat, protein based diet as apparently I am a fast oxidizer and “para-sympathetic” metabolic type. I have spent a small fortune on trying to feel well, with some results but certainly not enough to substantiate the cost involved. Like yourself I have tried acupuncture, vegan, aromatherapy, several naturopath’s, and a hundred other outlets. But I think you may have a few missing pieces to the puzzle for me. Since I dont have the energy to study a masters degree, I would love to consult with you and gain further insight 🙂

      2. Hi Bec,
        I look forward to speaking with you soon. Please note the practitioner you mentioned in your booking is not Walsh trained.

    2. Hi my name is Tyler,
      I recently had a blood histimine test done and it was high 86 and a homo cysteine test also high 8.6 so I know I’m undermethylated starting methyl B12 and B6 was told to take Methyl folate is that a no- no any thoughts?

      1. Hi Tyler,
        Unfortunately, I cannot provide specific guidance without consulting with you but with your numbers, I would be very cautious with methylfolate.

  3. Hi there

    Due to epilepsy I took 5mg of folic acid for a few years during conception/pregnancy etc. My blood levels remain very high and don’t seem to have gone down despite having not taken folic acid for at least a year. I’ve been taking methyl folate on and off. Would this be indicative of being an overmethylater and therefore being more consistent with my methyl folate would help clear it? Thanks!

    1. Hi Rebecca,
      Thanks for your comment, but this is impossible to answer without proper testing and assessment from a qualified practitioner.

  4. Great read! What about those people who are undermethylated and wanting to become pregnant? Ordinarily doctors would recommend taking a pre-natal multi V with folate to prevent birth defects. Is this the case with U.M. individuals? Also, are there B-complex supplements on the market available without B9? Other B’s are quite important and I struggle to find supplementation without folate.

  5. I’m a little confused. Isn’t dietary folate a methyl-donor? So if a person is over-methylated, Dr. Walsh says the person should take folate since Overmethylated individuals have too much methyl and folate is a powerful demethylating agent.

    Even Dr. Ben Lynch says that when a person is overmethylated with Mb12 and methyfolate, s/he should take niacin to “mop up” the methyls.

    My question is, how is folate a powerful demethylating agent, when I read other statements saying that folate is a methyl-donor?

    1. What many people (especially practitioners) fail to understand is folic acid’s role of duality. In one area, it’s a donor of methyl, so for an undermethylator, they think folic acid or methylfolate is a great thing. In actuality, that’s not correct because in the nucleus where we’re trying to affect change, where the command center is, folic acid removes methyl, which can inhibit any detoxification process. This is because all forms of folate strip methyl at the level of DNA. DNA level is in the nucleus of the cell where all the instructions are made. That same folic acid works differently outside the nucleus of the cell where it actually gives lots of methyl into the system.

  6. I am completely depleted in all my B vitamins except for B9 (weird) according to my NutrEval test from Genova last month. A also have 2 copies of C677T for the genetic MTHFR mutation. I have also suffered life long depression and anxiety. My thinking is that if I am so depleted in these vitamins due to a “faulty” methylation system, then why, upon taking Active B-12 with L-5-MTHF along with a b complex (minus b12 and folate), do I feel so much worse with depression and fatigue? How do I replete these vitamins if I cannot tolerate them? I have even been eating lots of healthy dark greens in the hopes of helping this. I am completely lost and feel very sick! What would be the next logical step to take if a patient came to you with this info? Thanks in advance so very much!

    1. Hi Beth,
      The testing methods you mention are neither an accurate assessment nor an appropriate guide for true methylation disorders in the area of mental health, so I encourage you to get properly tested. Click here to schedule a complimentary session with me to see how I can help.

      1. Thank you but I only mentioned one test – NutrEval from Genova. What tests to you recommend for proper testing?

      2. Lastly, do you follow Dr Walsh’s protocol and order the appropriate tests as well as interpret them? I understand you are a nutritional expert? Thanks again.

  7. Don’t veggies have duality of folate and methyl donors? Don’t spinach have several times more methyl donors than folate?

    I understand the need to not supplement folate if one is undermethylated. But as an undermethylator, I actually feel great eating veggies absorbing methyls that way and just forgoing excess folate supplementation.

    I also supplement DMG or TMG or SAMe. I’ve lost 10 lbs within a months time on a methyl rich veggie diet along with protein and fats and some healthy carbs.

    1. I’m glad you are doing well Ted, and I trust you were properly tested. Plants do not provide appropriate methyl donors for undermethylated individuals. Plant-based diets may feel good initially, but over time, can create a decline for the undermethylated person. Of course, it’s always important to be sure other levels are tested, such as homocysteine, which does require folic acid to reduce, and would be used in a very target dose for a specific amount of time until levels are normalized.

  8. Could i please ask something? What if someone with a homogenous c677t is an undermethylator, but has also tested for low blood folic acid?

  9. Hi,

    I am fairly new to this nutritional approach.
    I have a patient with low folate, who has treatment resistant depression.
    He is an undermethylator (high histamine, low zinc) and has high pyrroles.

    Due to the low folate – would there be a role of some supplementation with l-methylfolate? (He had a poor response to SSRIs – they made him worse).

    I read some studies that show l-methylfolate can be helpful in treatment resistant.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3869616/

    Thoughts?

    Thanks..

  10. my questions were: how does one become a mensah patient? it sounds like you’re down with the walsh biotypes, is that right? what do the acronyms by your name stand for?

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