Who needs folate the most?

Folic acid is the synthetic version of vitamin B9 known as folate, a substance that naturally occurs in food and is key to red blood cell formation as well as healthy cell growth and function. Besides using folic acid as a source of folate, vitamin B9 is available in its active form in supplements like Quatrefolic®

While many confuse the terms ‘folic acid’ and ‘folate’, they are not the same.  Folates can be naturally found in food and often are in supplements in the form of folic acid. However, before the body is able to use folic acid or food folates, they must be converted to reduced folate in its active form. This metabolism step is not needed for reduced and methylated folates like Quatrefolic® since they are already in the active form.

Active folates avoid unwanted effects that could be associated with excess folic acid in the system. Excess folic acid has been linked with masking or exacerbation of low vitamin B12 status, cognitive decline in older people and even certain cancers, such as prostate, breast and colorectal cancer. 

So when can folate benefit you?


Leading health bodies including the European Food Safety Authority (EFSA) and the U.S. Food and Drug Administration (FDA) recommend folate through dietary supplements, folic acid or food folates in the weeks before conception to prevent neural tube defects (birth defects affecting the brain, spine or spinal cord).

Folate can also play a key role in the ability to conceive. 

Both women and men experiencing fertility issues have been shown to present with low folate availability. This is problematic, since folate is indispensable for rapid cell expansion pre-ovulation and during conception.

Folate deficiency is, in turn, often linked with a genetic trait known as 5,10-methylene tetrahydrofolate reductase (MTHFR) polymorphism. In a nutshell, the gene produces the enzyme which converts folate into the active form – the form which Quatrefolic® already takes. 

In the womb

Once pregnant, women require 5 to 10-fold higher levels of folate for rapid periods of cell synthesis, growth, division and DNA repair associated with embryo growth. This equates to 400 to 800 micrograms of folic acid daily, according to the FDA. 

Given MTHFR polymorphics cannot benefit from folic acid supplementation in the same way, active forms like Quatrefolic® are becoming an increasingly popular choice worldwide. 

Continued pregnancy-appropriate folate levels are also crucial to prevent neural tube defects for the baby. For certain women, the risk is even higher, and greater levels of dietary supplements are often recommended, including when;

  • either parent has a neural tube defect or a family history of these birth defects
  • the mother has had a previous pregnancy affected by a neural tube defect
  • the mother is diabetic
  • taking anti-epilepsy medicine
  • taking anti-retroviral medication for HIV


Folate deficiency also has consequences for children. Combined with vitamin B12 deficiency, folate deficiency can impact brain development and carries a greater risk of depression during adulthood. 

U.S. recommendations for dietary folate equivalents (DFE) in children are;

  • 65 mcg per day for babies 0–6 months
  • 80 mcg per day for babies 7 – 12 months
  • 150 mcg per day for children 1 – 3 years
  • 200 mcg per day for children 4 – 8 years
  • 300 mcg per day for children 9 – 13 years
  • 400 mcg per day for children over 13 years

Folate can be introduced through folate-rich foods, including spinach, peas, asparagus, broccoli, avocado, and orange. However, folate content in food is unstable; it breaks down easily and levels may have degraded before consumption. Plus, as children grow – in-line with their folate requirements – parents will all be well aware of the difficulties behind the phrase “eat your greens”. 

Potential advantages of folate dietary supplementation with active folates like Quatrefolic® include that the ingredient is naturally occurring, has increased bioavailability compared to folic acid, as well as reported benefits such as mood-balancing properties, and cognitive support and improvement. 


Hot flashes are the most common symptom of menopause, experienced by up to 75% of menopausal women. The symptoms last on average 5 to 10 years and can trigger further problems, including insomnia, anxiety and depression, memory and concentration issues, and lower libido. 

Although hormone replacement therapy is the first treatment option for hot flashes, there are some small but still relevant associated risks, including blood clots, breast cancer, heart disease, and stroke. 

Folate has been shown as a natural way to significantly reduce symptoms and is recommended as an affordable and accessible part of hot flash treatment regimens. In its active form, it is essential for the biosynthesis of the monoamine neurotransmitters, increasing mood-stabilizing serotonin activities and lowering stress-inducing noradrenaline.

Golden years

Studies also show that approximately 30% of people aged 65 and over are deficient in folate – a problem only set to increase as we prepare for 22% of the world to be over 60 in 2050. 

Healthy ageing researchers notes that folate – alongside vitamin B12 – is part of the essential dietary makeup needed for nerve function, brain, red blood cell and DNA health. Low folate levels are also associated with worse immunity. 

Yet older people are often found to be folate deficient, a problem which has been found to increase with age. Studies have found that upwards of 23% of adults over the age of 80 are low or deficient in folate.

The active form of folate is believed to help to re-establish folate levels and counter the issues associated with low folate, with EFSA-approved health claims that active folate can improve psychological function, reduce fatigue, and have positive effects on cell division, normal homocysteine metabolism and immune system function.

By providing the natural and bioactive dose of folate directly, without the need for metabolization or enzymes like MTHFR, Quatrefolic® is immediately available for use in the body.


  • Folate is an EFSA and FDA-recommended factor in maintaining health at every stage of life.
  • Deficiencies of the active vitamin B9 could have various detrimental effects for people of all ages.
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