How do I know if I’m not absorbing folic acid properly?

Typical symptoms include tiredness and weakness, anaemia and low folate in blood tests. Low results may indicate that you have absorption issues even after you have been using supplements.

Should I switch from plain folic acid to methylated folate supplements?

In the case of variation of MTHFR genes or absorption problems, methylated folate supplements can prove to be more effective. Make sure to consult your physician when changing.

Can food alone provide enough folate?

Folate in the body can be increased by eating a diet abundant in leafy green vegetables, beans, and citrus fruits. However, during pregnancy or the pre-conception period, supplements are typically recommended at higher rates.

Why Some Women Struggle to Absorb Folic Acid Properly

Have you ever taken folic acid supplements faithfully, only to be told by your doctor that your levels are still low? You are not alone. The same challenge affects many women. Folic acid, an important constituent of reproductive health, pregnancy and overall well-being, is not always absorbed by all bodies.

What Is Folic Acid and Why Do You Need It?

Folic acid is a synthetic form of folate, a kind of vitamin B (B9), which you need to perform many important processes in your body. Folate aids:

Producing healthy red blood cells
Supporting cell growth and repair
Forming DNA and genetic material
Preventing certain birth defects in babies, especially neural tube defects

Women who are pregnant or attempting to conceive are typically advised to take a daily supplement of 400-600 micrograms of folic acid. However, for some women, the issue isn’t the amount of folate they take, but how effectively their bodies can use it.

Why Some Women Struggle to Absorb Folic Acid

Your body may not efficiently absorb or process folic acid for several reasons:

1. Genetic Variations (MTHFR Gene Mutation)

One of the most common causes is a mutation in the MTHFR gene (Methylenetetrahydrofolate reductase). This gene plays a role in assisting your body to convert folic acid into its active form, known as L-methylfolate.
When you have this variation, your body may struggle during this conversion. In turn, this leads to the fact that even with the intake of supplements, there are chances that one can have a deficiency of folate.
What you can do:
Discuss with your doctor how to test the MTHFR gene mutation and if, in your case, methylated folate supplements would be better than ordinary folic acid.

2. Digestive Disorders

Your intestinal health is a great determining factor in nutrient absorption. Conditions like:

Celiac disease
Crohn’s disease
Irritable bowel syndrome (IBS)
Inflammatory bowel disease (IBD)

Chronic inflammation of the intestines can damage this organ and reduce your body's ability to absorb folic acid from food or supplements.
What you can do:
When you often experience symptoms such as bloating, diarrhoea, and abdominal pain, it is worth discussing them with your doctor. Absorptions can be enhanced by addressing the gastrointestinal problems underlying this phenomenon

3. Certain Medications

Certain medications may affect the absorption of folic acid. These include:

Anticonvulsants (for epilepsy)
Methotrexate (used in arthritis or cancer treatment)
Metformin (commonly used in diabetes)
Proton pump inhibitors (PPIs) for acidity

After prolonged use, these medicines can reduce the level of folate in the body
What you can do:
Do not stop taking your medicines unless directed by your doctor. Rather, discuss with your physician the need to increase folate doses or use a different supplementation.

4. Alcohol Consumption

The consumption of alcohol regularly may complicate the way the body uses and absorbs folate. Alcohol also enhances the loss of folate via urine, leaving you with lower reserves.
What you can do:
It is highly advised that when you are trying to conceive a child or are pregnant, you should avoid any sort of alcohol use. Even when not pregnant, reducing consumption will enhance folate absorption and health.

5. Poor Diet

Unless you have foods rich in folate in your meals, supplements may not be sufficient. In natural foods, folate can be found in:

Dark leafy greens (spinach, kale)
Citrus fruits (oranges, lemons)
Lentils and beans
Avocados
Fortified cereals and breads

Eating these foods in small amounts, along with an imbalanced diet, can lead to low folate levels, even if you take supplements.
What you can do:
Include a variety of folate-rich foods in your daily meals to support your body.

6. Other Health Conditions

Some health conditions also have the propensity of interfering with the absorption of folic acid, and they include:

Kidney problems requiring dialysis
Liver disease
Pregnancy complications that increase nutrient demand

Your body needs more folate than usual during these times, and routine supplements are not sufficient.
What you can do:
Under such medical conditions, folate in high doses or special forms may be prescribed by your doctor.

How to Improve Folic Acid Absorption

In case you feel you are not receiving the folic acid properly, you can do the following:

Tell your doctor: Get a blood test to measure the deficiency of folate.
Consider methylated folate supplements: Your body can utilise them much better, especially when you have an MTHFR variant.
Add folate to your diet: Eat foods that have folates, such as leafy vegetables, kidney beans and orange juice, among others.
Treat bowel issues: Treat digestive disorders and such disorders as IBS or celiac disease.
Limit alcohol consumption: Consumption of alcohol is to be avoided, particularly in cases when a woman either plans to conceive or is pregnant.
Prescriptive drugs: Request your physician to check whether your prescription medication is affecting folate levels and what you can do to cope.

Not all females have the same body to act upon folic acid. The effectiveness of the absorption of this essential nutrient can depend on genetics, the condition of the gut, medications, and lifestyle. The silver lining is that when you implement the appropriate awareness, diet, and medical management, you can be sure your body gets the amount of folate to help support a healthy pregnancy and overall health.
You’re not alone in your journey when trying to conceive. Join our supportive community to connect with others, share experiences, and find encouragement every step of the way.

FAQs on Why Some Women Struggle to Absorb Folic Acid Properly

How do I know if I’m not absorbing folic acid properly?
Typical symptoms include tiredness and weakness, anaemia and low folate in blood tests. Low results may indicate that you have absorption issues even after you have been using supplements.
Should I switch from plain folic acid to methylated folate supplements?
In the case of variation of MTHFR genes or absorption problems, methylated folate supplements can prove to be more effective. Make sure to consult your physician when changing.
Can food alone provide enough folate?
Folate in the body can be increased by eating a diet abundant in leafy green vegetables, beans, and citrus fruits. However, during pregnancy or the pre-conception period, supplements are typically recommended at higher rates.