Is Folate (Vitamin B9) Important for Mental Health?

Folate, Folate Receptor Autoantibodies and Adults

Folate, also known as vitamin B9, is crucial for various bodily functions, and its importance extends beyond infancy and childhood into adulthood. There are many reasons why folate is essential for adults:

  1. Cell Division and DNA Synthesis: Folate plays a vital role in cell division and DNA synthesis, which are essential processes for the growth, repair, and maintenance of tissues throughout the body. Adequate folate levels are particularly important during periods of rapid cell division, such as pregnancy and wound healing.
  2. Red Blood Cell Formation: Folate is necessary for the production of red blood cells (erythropoiesis). Red blood cells are responsible for carrying oxygen to tissues and organs throughout the body. A deficiency in folate can lead to a type of anemia called megaloblastic anemia, characterized by larger-than-normal red blood cells that are unable to function properly.
  3. Cardiovascular Health: Folate plays a role in the metabolism of homocysteine, an amino acid. Elevated levels of homocysteine in the blood are associated with an increased risk of cardiovascular disease. Adequate folate intake, along with vitamins B6 and B12, helps to regulate homocysteine levels and support cardiovascular health.
  4. Brain Function and Mental Health: Folate is important for maintaining cognitive function and mental health. It is involved in the synthesis of neurotransmitters such as serotonin, dopamine, and norepinephrine, which play crucial roles in mood regulation, stress response, and cognitive function.
  5. Immune Function: Folate supports the immune system by promoting the production and function of white blood cells, which are essential for fighting off infections and pathogens.
  6. Prevention of Certain Cancers: Some studies suggest that adequate folate intake may help reduce the risk of certain cancers, such as colorectal cancer. Folate is involved in DNA repair and methylation processes, which are important for preventing the development of cancerous cells.
  7. Prevention of Neural Tube Defects: Folate is crucial for the prevention of neural tube defects, such as spina bifida and anencephaly, in developing fetuses. Adequate folate intake, particularly during the early stages of pregnancy, is essential for proper neural tube formation.

Because the body cannot produce folate on its own, it must be obtained from dietary sources or supplements. Good dietary sources of folate include leafy green vegetables, legumes, fruits, nuts, seeds, fortified cereals, and fortified grain products. A number of food products in our food supply are fortified with folic acid (synthetic form of Vitamin B9) as mandated by the US government since 1998.

Pregnant women, individuals with certain medical conditions, and those taking certain medications may require higher levels of folate and should consult with a healthcare professional regarding supplementation.

Recommended Daily Allowance - Adult

    • Pregnant women: 600 mcg (RDA)
    • Breastfeeding women: 500 mcg (RDA)

If you are considering taking a folic acid supplement, ask your doctor to help you determine the right dose and format for you. Because of the potential for side effects and interactions with medications, you should take dietary supplements only under the supervision of a knowledgeable health care provider.

For adults, folate acid is crucial for proper brain function and plays an important role in mental and emotional health. Folate also works closely with vitamin B12 to help make red blood cells and help iron work properly in the body.

Sometimes adults may have low levels of folate caused by certain conditions such as alcoholism, inflammatory bowel disease (IBD), and celiac disease. Additionally, certain medications may lower levels of folic acid in the body. Folate deficiency may cause:

    • Tongue inflammation
    • Gingivitis
    • Loss of appetite
    • Shortness of breath
    • Diarrhea
    • Irritability
    • Forgetfulness
    • Mental sluggishness

Heart disease

Folate has been implicated in heart health through several methods. There is some evidence that folate in your diet may reduce the risk of heart disease. This is connected through folate’s relationship with homocysteine.

Many studies suggest that people with high levels of the amino acid homocysteine are 1.7 times more likely to develop coronary artery disease, and 2.5 times more likely to have a stroke than those with normal levels. Folate, and its supporting involvement with other B vitamins, helps lower homocysteine levels. More evidence is needed to elucidate this theory, but the connection is highly plausible.

Age-related hearing loss

One study suggests that folic acid supplements help slow the progression of age-related hearing loss in elderly people with high homocysteine levels and low folate in their diet. Further investigation into this is warranted.

Age-related macular degeneration (AMD)

One large study found that women who took 2,500 mcg of folic acid along with 500 mg of vitamin B6 and 1,000 mcg of cyanocobalamin (vitamin B12) daily reduced their risk of developing AMD, an eye disease that can cause vision loss.


The evidence about whether folic acid can help relieve depression is mixed. Some studies show that 15 to 38% of people with depression have low folate levels in their bodies, and those with very low levels tend to be the most depressed.

Most recently, a new condition referred to as Cerebral Folate Deficiency Syndrome has been discovered. In this condition, it is determined that folate cannot properly be transported into the brain and cerebrospinal fluid. The main cause of Cerebral Folate Deficiency Syndrome is the presence of folate receptor autoantibodies. Folate receptor autoantibodies attack and render the main receptor (Folate Receptor Alpha) that transports folate into the cell dysfunctional. This ultimately means that folate may not be properly absorbed into cells that need it, especially in the brain. In many of these cases, patients have reported depressive symptoms.

Remarkably, those that have tested positive for folate receptor autoantibodies responded very well to folinic acid, another form of a reduced folate. It is thought that in these cases, the reduced folate (folinic acid) bypasses the blocked folate receptor alpha and enters the brain through another receptor known as the reduced folate carrier. This is an exciting development, and additional studies are ongoing!

Folate receptor autoantibodies may be tested through a diagnostic test known as FRAT®.

As with all medical conditions and treatments, please consult your medical professional for information and guidance.

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