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StatPearls Publishing 2020-01

Folic Acid

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Brigham Merrell
John McMurry

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Folate is a generic term that typically refers to a group of water-soluble compounds that play an essential role in deoxyribonucleic acid (DNA) biosynthesis.[1] It is also known as vitamin B9 and is different from folinic acid, or leucovorin, which is more technically known as 5-formyltetrahydrofolate (5-FTHF). Folic acid is the synthetic form of folate. Folate converts into tetrahydrofolic acid (THF), a compound that undergoes several transfer/methylation reactions that are important for the synthesis of nitrogenous bases in DNA and ribonucleic acid (RNA) and are necessary for maturation of red blood cells (RBCs). There are small reserve pools in the liver and kidney. A deficiency of folic acid can result in macrocytic megaloblastic anemia and usually results from chronic alcoholism, malabsorption disorders, hemolytic anemia, or increased requirement during pregnancy. Folate appears naturally in some food sources and must be ingested regularly since humans, and all other animals, cannot synthesize it. Sources of folate in the diet include leafy green vegetables, like spinach, broccoli, and lettuce; meats, such as liver; and milk and eggs. Despite the need for regular amounts of folate, however, daily intake levels are frequently lower than the recommended dosage given by national health authorities.[2]

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