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High Folic Acid: What Can You Do?

Geschreven door: Ebrina van der Bijl

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Leesduur: 6 min

Folic acid is important for your health, especially during pregnancy or if you're trying to conceive. But there's a downside: you can unknowingly consume too much of it through supplements, with unpleasant consequences.

In this article, you'll learn about the risks of high folic acid levels, the causes, and what you can do about them. You'll also receive a clear step-by-step plan, and I'll explain when it's wise to seek medical advice.

High folic acid levels can be caused by overdose through supplements, a B12 deficiency or an MTHFR mutation, which causes unused folate to accumulate in the body.

Accumulation can mask a B12 deficiency, cause circulation of unprocessed folic acid, and potentially weaken the immune system.

Have your blood levels tested, reduce the dosage if necessary or switch to 5-MTHF, and consult a doctor if symptoms persist.

Table of contents
What is folic acid and why is it important? Causes of high folic acid levels Risks of high folic acid levels What are the signs of high folic acid levels ? Step-by-step plan: What can you do if you have too much folic acid in your blood? 1. Have your blood levels tested 2. Check your supplements and diet 3. Consider switching to active forms of folate 4. Consult with your doctor about underlying causes

What is folic acid and why is it important?

Folic acid is a form of vitamin B11 that is converted in your body to folate, the active form you actually use.

  • This is why folate is important:
  • Helps in the production of blood
  • Supports your immune system
  • Contributes to the growth of the child during pregnancy
  • Folate contributes to the formation of the placenta
  • Helps with fatigue
  • Is beneficial for a good mental balance

So you definitely need it, but too much is not good, especially if it comes from supplements.

Causes of high folic acid levels

Did you find out through a blood test that your folic acid levels are elevated? Then it's wise to investigate the cause. In many cases, supplement use plays a role.

  • High-dose supplements - Folic acid from supplements must first be converted into the active form (5-MTHF). At high doses, this doesn't happen completely, leaving unmetabolized folic acid circulating in your blood. Researchers call this unmetabolized folic acid.
  • Vitamin B12 deficiency - B12 is necessary for folic acid to enter your cells. With a B12 deficiency, folic acid remains in your blood, while your body can't use it properly. Your blood levels may appear high, but that's a misleading indication.
  • Genetic predisposition (MTHFR mutation) - Some people convert folic acid less effectively, often due to a genetic variation, such as the MTHFR gene, which slows down the conversion process. This causes unprocessed folic acid to accumulate more quickly, especially when taking supplements.

Good to know : High folic acid levels are rarely caused by eating too many folate-rich foods. Only supplements can increase the risk of high blood levels.

Risks of high folic acid levels

A value that is too high does not necessarily have to be immediately dangerous, but can pose risks in the long term, especially if it concerns unconverted folic acid that accumulates in the blood.

  • Masking a vitamin B12 deficiency - This is the most well-known and well-substantiated risk. If you consume too much folic acid, the symptoms of a B12 deficiency can temporarily disappear, while the underlying problem persists. This can lead to unknowing nerve damage. The EFSA cites this as the main reason not to exceed 1000 micrograms per day. (1)
  • Accumulation of unprocessed folic acid in your blood - Your body can only metabolize a limited amount of folic acid. What remains remains in the blood as unprocessed folic acid, especially with long-term supplement use. During pregnancy, this is not passed on to the baby; they primarily receive usable folate. However, it remains measurable in the mother's blood. (2) (3)
  • Possible effect on the immune system - There are indications that too much unprocessed folic acid can reduce the function of some immune cells. This effect has not yet been fully proven, but is taken seriously by authorities such as EFSA, which calls for further research. (4)

What do you notice if your folic acid level is too high?

If your folic acid levels are too high, it usually does n't cause any obvious symptoms . However, in some cases, symptoms can arise, especially if the high folic acid level masks a vitamin B12 deficiency.

  • Pay extra attention if you suffer from:
  • Tingling or numbness in hands or feet
  • Fatigue or muscle weakness
  • Memory problems or loss of concentration
  • Sadness or irritability
  • Problems with your balance

These complaints may indicate a B12 deficiency that is not recognized in time by folic acid.

Step-by-step plan: What can you do if you have too much folic acid in your blood?

By following the steps below, you can keep your values ​​healthy and prevent possible long-term complaints.

1. Have your blood values ​​tested

Ask your doctor to check your folic acid levels. This is an essential step to determine whether your levels are indeed elevated.

In the Netherlands, people usually look at serum folic acid : The amount of folic acid in your blood plasma.

  • According to Dutch laboratory guidelines, the normal value is between 7 and 45 nmol/L
  • A value above 45 nanomoles per liter (nmol/L) is often considered elevated

Tip : Have your vitamin B12 tested as well to determine if a B12 deficiency is a contributing factor. Elevated folic acid levels can mask a B12 deficiency, and you'll want to detect this early.

2. Check your supplements and nutrition

Are you taking a multivitamin, B-complex supplement, or pregnancy supplement? Pay close attention to your folic acid intake.

The EFSA sets a safe upper limit of 1000 micrograms per day for adults, including pregnant women. The recommended daily amount is much lower:

  • 300 micrograms for adults
  • 400 micrograms if you want to become pregnant (5)

Are you taking too much? Reduce your dosage or stop temporarily.

3. Consider switching to active forms of folate

Some supplements contain 5-MTHF , the active form of folate that your body can use directly. This is better processed and leaves less unprocessed folic acid in the blood.

This can be useful, especially in the case of genetic variations such as the MTHFR mutation.

Tip: Learn more about the difference between folate and folic acid and discover the best and safest folic acid supplements.

4. Consult with your doctor to determine if there are any underlying causes.

An elevated folic acid level is usually caused by supplements, but sometimes there's more to it. It could indicate a vitamin B12 deficiency , for example, or a problem with how your body converts folic acid to its active form.

Therefore, always discuss your blood results with your doctor, especially if you have symptoms such as fatigue, tingling, memory problems or a depressed feeling.

Ebrina van der Bijl - Natural Performance

Ebrina van der Bijl

Ebrina is a nutritionist with a deep commitment to healthy eating and a sustainable lifestyle, based in beautiful Portugal. Her passion for natural and organic products is at the heart of her work. With a background in Nutrition & Dietetics and experience in product development and writing, she translates complex scientific information into practical advice for a balanced lifestyle.

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Sources used

  1. European Food Safety Authority (EFSA). (2009). Folic Acid: an update on scientific developments. In EFSA Meeting Summary Report (pp. 1–22). https://www.efsa.europa.eu/sites/default/files/event/corporate090121-m.pdf
  2. Tam, C., O'Connor, D., & Koren, G. (2012). Circulating Unmetabolized Folic Acid: Relationship to Folate Status and Effect of Supplementation. Obstetrics And Gynecology International, 2012, 1–17. https://doi.org/10.1155/2012/485179
  3. Obeid, R., Kasoha, M., Kirsch, S. H., Munz, W., & Herrmann, W. (2010). Concentrations of unmetabolized folic acid and primary folate forms in pregnant women at delivery and in umbilical cord blood. American Journal Of Clinical Nutrition, 92(6), 1416–1422. https://doi.org/10.3945/ajcn.2010.29361
  4. Troen, A. M., Mitchell, B., Sorensen, B., Wener, M. H., Johnston, A., Wood, B., Selhub, J., McTiernan, A., Yasui, Y., Oral, E., Potter, J. D., & Ulrich, C. M. (2006). Unmetabolized Folic Acid in Plasma Is Associated with Reduced Natural Killer Cell Cytotoxicity among Postmenopausal Women. Journal Of Nutrition, 136(1), 189–194. https://doi.org/10.1093/jn/136.1.189
  5. 5. Turck, D., Bohn, T., Castenmiller, J., De Henauw, S., Hirsch‐Ernst, K., Knutsen, HK, Maciuk, A., Mangelsdorf, I., McArdle, HJ, Pentieva, K., Siani, A., Thies, F., Tsabouri, S., Vinceti, M., Crous‐Bou, M., Molloy, A., Ciccolallo, L., De Sesmaisons Lecarré, A., Fabiani, L., . . . Naska, A. (2023b). Scientific opinion on the tolerable upper intake level for folate. EFSA Journal, 21(11). https://doi.org/10.2903/j.efsa.2023.8353

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