Can Folic Acid Help Treat Depression? Here’s What the Research Shows

You may have heard that folic acid is an important vitamin for pregnant women. But did you know that folic acid also helps make brain chemicals that support a steady, happy mood? Over the years, studies have found that diets low in folic acid are linked to depression. 

So, does this mean that folic acid can be used to treat depression? Here we’ll explore what the latest research says about the link between folic acid and depression. 

What is folic acid?

Folic acid is an essential vitamin that your body needs every day. It’s important for a range of things, including making new blood cells and neurotransmitters (the chemicals that aid in brain function and mood regulation).

Folic acid is part of the B-vitamin family. It is also known as vitamin B9. But that’s not the only alternative name for folic acid. To clear the confusion, let’s talk about the names upfront.

Folic acid is also known as:

• Folate: This is the name for the natural form of vitamin B9 that’s found in food. 

• Folic acid: This is the name for the synthetic form of vitamin B9. It’s used in dietary supplements and fortified foods. Folic acid alone is inactive. It needs an enzyme (called MTHFR) to change it into an active form that can be used by the body. 

• Methylfolate: Methylfolate (also called 5-MTHF) is the active form of folic acid. Your body makes methylfolate by converting folate or folic acid. Some supplements are made in the form of methylfolate. 

• Folinic acid: This is sometimes used as another name for folic acid. Though folic acid and folinic acid work similarly in the body, they aren’t the same thing. Folinic acid is present in foods and it’s available in supplement form. It’s a biologically active form of folate. So, unlike folic acid, it doesn’t need an enzyme to make it function. 

This article will use the term “folic acid” when referring to supplements, and the term “folate” when talking about the vitamin in foods.

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What are the benefits of folic acid?

Folic acid is an important vitamin. It plays many roles in the body. It helps:

• Make DNA and other genetic material

• Form red blood cells

• Ensure cells grow, divide, and function properly

• Lower the risk of anemia

• Break down and rebuild amino acids (the building blocks of protein)

• Form neurotransmitters (the chemicals that aid in brain function and mood regulation)

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Folic acid supplements are recommended for people planning to become pregnant. That’s because folic acid helps form the baby’s brain and spine during early pregnancy. Having enough folic acid helps prevent birth defects, such as spina bifida. 

Can folic acid help with depression?

Folic acid supplements may help some people who have depression. However, the studies on this topic show mixed results. But folic acid supplements aren’t helpful for everyone who has depression. 

Depression is complex and can’t be treated with folic acid alone. Folic acid is known as an adjunct therapy. That means it’s used in combination with other treatments. Folic acid can be used alongside prescription medication, nutrition, and psychotherapy to help treat depression. 

Folic acid supplements are more likely to help people with depression if they already have a folate deficiency. Low intake of folic acid is linked to an increased risk of developing depression. And studies show that people with depression have lower blood levels of folate and eat fewer folate-rich foods compared to people who don’t have depression. 

That means if low blood folate levels are contributing to depression, folic acid supplements may help treat the deficiency and the depression. If the depression isn’t linked to folic acid, the supplements may not help. 

Why is folic acid linked to depression? 

Folic acid helps make neurotransmitters, like serotonin and dopamine. These are known as “feel good” chemicals. They help regulate mood. Dopamine is linked to pleasure and serotonin is linked to happiness. 

Folate is linked with depression because if your diet is low in folate, your body has trouble making neurotransmitters. And low levels of neurotransmitters can increase the risk for depression.

Which folic acid supplements are taken for depression?

Studies suggest that treating depression with medication plus methylfolate is more effective than using medication alone. The World Federation of Societies of Biological Psychiatry recommends methylfolate (15 mg per day) as an adjunct supplement to treat depression.

Methylfolate is the easiest form of folate for your body to absorb. It’s also the active form of folate that your body can use to make neurotransmitters. Folic acid in other forms isn’t as helpful for treating depression. 

For most people, their body has the ability to convert folic acid into methylfolate. But some people can’t convert folic acid to methylfolate because of a metabolic defect with the MTHFR gene. In this case, taking more folic acid wouldn’t help — but taking methylfolate would. So, a methylfolate supplement is a form that’s more effective for some people.

If you have depression and you’re considering taking folic acid or methylfolate, talk to a healthcare professional to see if you should get tested for folic acid deficiency. You might also consider doing a genetic test for the MTHFR gene. 

How do you make sure you’re getting enough folic acid?

The recommended dietary allowance for folate is 400 mcg per day. This increases to 600 mcg during pregnancy. 

To make sure you’re getting enough folate in your diet, choose foods that are rich in folate, such as:

• Vegetables (like asparagus and dark leafy greens)

• Fruits (like oranges, bananas, and avocados)

• Beef liver

• Peanuts

• Eggs

• Legumes (such as kidney beans and black-eyed peas)

You can also buy foods that are fortified with folic acid, such as:

• Breakfast cereals

• Enriched flour (used to make bread and other baked goods)

• Corn masa (used to make tortillas and tamales)

• Cornmeal (used to make polenta)

• Rice

• Pasta

You can take folic acid supplements or methylfolate if you don’t get enough folate from foods. Take the supplement on an empty stomach with water for better absorption. 

Are there any side effects of folic acid?

Folic acid is considered safe if you’re taking the recommended dosing. If you do experience side effects, they’re usually mild. 

Side effects of folic acid can include: 

• Nausea

• Bloating

• Gas

• A bitter taste in the mouth

There’s some concern that high doses of folic acid might have risks for your health. Some animal studies have found an increased risk of colon cancer with higher doses, but this hasn’t been shown in humans. The Institute of Medicine has set 1,000 mcg as the tolerable upper intake level. This means that there are no known health risks if you take less than that. 

Note: This dosing recommendation is for folic acid. There aren’t clear guidelines for the maximum dosing of methylfolate. But studies have found that doses of 15mg a day of methylfolate are considered safe. In fact, methylfolate might be even safer than folic acid. This is because the cancer risk seen in animals might come from having too much unmetabolized folic acid in the bloodstream. And this isn’t an issue with methylfolate. 

Folic acid supplements may also interact with some medications. Talk to a healthcare professional before taking supplements. 

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Written by:

Cara Rosenbloom, RD

Cara Rosenbloom, RD, has been a registered dietitian for 22 years. She began her career working as a dietitian at Toronto's Hospital for Sick Children (SickKids).

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

Reviewed by:

Karen Hovav, MD, FAAP

Karen Hovav, MD, FAAP, has more than 15 years of experience as an attending pediatrician. She has worked in a large academic center in an urban city, a small community hospital, a private practice, and an urgent care clinic.

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