What is the recommended dosage for Folate (Vitamin B9)?

General: 400 mcg DFE/day; Homocysteine Reduction: 400-800 mcg/day folic acid (with B12 and B6)

What are the side effects of Folate (Vitamin B9)?

Potential side effects include: Generally very well-tolerated, May mask vitamin B12 deficiency at high doses, Rare: mild gastrointestinal discomfort.

What is folate and how may it relate to cardiovascular health?

Folate (vitamin B9) is essential for homocysteine metabolism. Elevated homocysteine is an independent risk factor for cardiovascular disease. Folate supplementation effectively lowers homocysteine levels. However, large trials have not consistently shown that homocysteine lowering with B vitamins reduces cardiovascular events.

What dosage of folate has been studied for cardiovascular health?

Studies have used 400–5,000 mcg of folic acid per day for homocysteine reduction. The China Stroke Primary Prevention Trial (CSPPT) found that 800 mcg folic acid combined with enalapril reduced first stroke by 21% in hypertensive adults without prior stroke. The RDA is 400 mcg for adults.

What are the potential side effects of folate supplements?

Folic acid is generally safe at recommended doses. High doses may mask vitamin B12 deficiency, which can cause irreversible neurological damage. There is debate about whether excess folic acid may promote growth of pre-existing cancers. The tolerable upper intake level for synthetic folic acid is 1,000 mcg daily.

Folate (Vitamin B9)

vitamin

Also known as: Folic Acid, L-Methylfolate, 5-MTHF, Vitamin B9

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About

Folate is essential for one-carbon metabolism and converts homocysteine to methionine, directly reducing plasma homocysteine — an independent cardiovascular risk factor. The CSPPT trial (20,702 hypertensive adults) found folic acid at 800 mcg/day reduced first stroke by 21%, though Western trials in folic acid-fortified populations showed less benefit.

How It Works

Essential cofactor in one-carbon metabolism; converts homocysteine to methionine via methionine synthase (with B12), directly reducing plasma homocysteine levels — an independent cardiovascular risk factor; supports endothelial function by enhancing nitric oxide production through tetrahydrobiopterin (BH4) recycling.

Evidence For Conditions

Condition	Grade	Studies	Participants
Elevated Homocysteine (Hyperhomocysteinemia)	B	30	30000	View →
Coronary Artery Disease (CAD)	C	10	40000	View →

Side Effects

Generally very well-tolerated
May mask vitamin B12 deficiency at high doses
Rare: mild gastrointestinal discomfort

Drug & Supplement Interactions

Methotrexate (folate may reduce efficacy)
Antiepileptic drugs (phenytoin, carbamazepine — mutual interference)
Vitamin B12 (co-supplementation recommended for homocysteine reduction)

Always inform your healthcare provider about all supplements you take.

Related Ingredients

Niacin (Vitamin B3) Vitamin D Vitamin E Vitamin K2

Quick Facts

Dosage: General: 400 mcg DFE/day; Homocysteine_Reduction: 400-800 mcg/day folic acid (with B12 and B6)
Forms: tablet capsule lozenge liquid
Natural Sources: Dark leafy greens (spinach, kale), Lentils, Chickpeas, Asparagus, Broccoli, Fortified grains
Upper Limit: 1,000 mcg/day folic acid from supplements
Best Time: With or without food; consistent daily timing preferred

Evidence Summary

Elevated Homocysteine (Hyperhomocysteinemia) B

Coronary Artery Disease (CAD) C

FDA Disclaimer: These statements have not been evaluated by the Food and Drug Administration. The products and information on this website are not intended to diagnose, treat, cure, or prevent any disease. The evidence grades presented are based on our analysis of published peer-reviewed research and do not constitute medical advice. Always consult your healthcare provider before starting any supplement regimen.