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)


89 thoughts on “Folate: Friend or Foe?”

  1. I think this is what’s happened to me. I’ve supplemeneted b12/folate for years as needed. It recently has thrown me into terrible anxiety attacks and panic. Worst 2 weeks of my life. I finally started feeling better 2 weeks out, yesterday had some spinach and all my symptoms started coming back. Now I know. Not even food folate. Is there anyway to move this out of my system fast??

  2. Hi Sami,

    Thanks so much for this great article. It is very informative! I am homozygous for mthfr c677t and I get terrible anxiety/a racing heart with any methylated vitamins. However, I felt great after taking regular folic acid several years ago. Do you know why this might be? I know you said that all folates act the same way over time, but did the folic acid have some initial effect that made me feel better?

    Thank you

  3. Hi Sami, this is interesting… I have been supplementing sam-e for a few years, because methyl folate b complex and lots of green juices made me depressed over time. However, I currently have low serum levels of folate, and clinical signs of b vitamin deficiency such as sore red tongue, lips, sores on side of mouth. Not to mention extremely elevated anxiety right now. I had a 7 hr surgery 4 weeks ago, so that hasn’t helped my levels. Sam-e at low doses or high doesn’t seem to help anxiety. I have been prescribed a B complex from my naturopath that includes semi-active vitamins. BUT Im scared to take. Not sure what to do…all i know is I am feeling very undermethylated. Should I take sam-e and B-vits too in order to replenish the b levels? Or will Sam-e inhibit methyl folate reductase enzyme and make me lower?

  4. Hi. loved this article. i’m wondering: If you are undermethylating and take too much folate. how long will it take after stopping folate for the symptoms of too much folate go away? are we talking days or months?

    how long after you quit your raw vegan lifestyle did you notice improvements especially with cognitive problems ?

  5. Hi Samantha, I have bipolar disorder and when I take B vitamins or a multivitamin then I end up feeling worse off. Could it be from the folate? A multivitamin gives me some energy but it also makes me feel a little off so im not sure if it could be interacting with one of my meds(latuda, lamictal, clonazepam)? Also even if I take a vitamin d supplement then it makes me really tired and off. I can take a b12 sublingual and thats about it. Im very sensitive to supplements. But i do think i need to take a low dose multi because of the lamictal depleting vitamin mineral content. Have you ever came across any of this before? Thank you

    1. Hi Scott! This is difficult to answer without lab testing but I see this a lot with leaky gut/dysbiosis. Without proper testing, there’s no way to determine your specific nutrient requirements. Keep in mind you don’t have to have GI symptoms to have gut inflammation.

  6. Hi Samantha,

    i would really like to ask please, if someone is homogenous 677T, and subsequently has a folate deficiency (which i think means that he should take folate to correct this deficiency), but he is also an undermethylator (which means he shouldn’t take folate), what happens in this situation?
    Thank you in advance.

  7. Heather Brusseau

    Hi Samantha!

    I am an undermethylator who also has the MTHFR deficiency. I take L-methyl folate. I’m confused as to how my body can run the methylation cycle if I do not take l-methyl folate? How can I avoid taking folate when it’s needed for the methyl cycle to function properly?

    Thank you in advance for your advice.

    Heather B.

  8. Hi Samantha!

    Thanks for writing this article. They are very helpful when it comes to methylation! This week I’m about to get my histamine results, but since I have OCD (Pure O) I guess I’m an undermethylator. Therefore I’ve already supplemented with Sam-e. I took 800 mg a day. The first 5 weeks it worked very well, but this week I don’t feel the effects anymore. Do you know perhaps what’s the reason because of this? Thanks in advance!

    1. Hi Sarah – nutrient therapy requires a wide range of antioxidants and other important nutrients to create change at the level of DNA. SAMe on its own is wonderful for UM’s but we need much more than that for lasting change to occur. In addition to methylation, I also look at copper, zinc, and pyrrole levels to name a few. You may also have one or more of these conditions, something I commonly see in my clinic.

      1. Hi Samantha,

        Thanks for your reply. Today I’ve received my blood results of the histamine test and turns out I’m probably an overmethylator with a histamine of 23. Could that be possible with Pure OCD? Could you help me out? I’m still taking the Sam-e, but now I feel very emotional.

  9. Hi Sami,
    I did the DHA package test (Pyrolle, Zinc, Copper, Ceruloplasma and histamines) and am wondering a few things.

    1. Is over methylation status determined solely by histamin level? If not, what else? I just want to know the test names please?

    For example, can someone just have false over methylation status because they were supplementing with methylated folate for a long time? It makes sense that if you are taking folate then your test will show you have low histamine due to the body taking methylated folate?

    2. For borderline overmethylated folks what version of b12 is best? I know it can’t be methycobalamine so which one?
    What brand Bcomplex do you recommend what has the correct b12 and folate for over methylated folks? I can’t for the love of god find one that has no copper, plus in methylated b12 and calcium colonic acid!
    Please help!

  10. Sorry I meant to say b complex that has no copper, and has the UN methylated versions of b12 and calcium folinate (I read this version is better than folic acid because it is converted better ?)

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