The dangers of excessive folate intake

Excessive intake of folate, particularly from supplements and fortified foods in the form of folic acid, can pose several health risks. While folate (vitamin B9) is essential for DNA synthesis, cell growth, and red blood cell formation, too much of it—especially beyond the Tolerable Upper Intake Level (UL) of 1,000 micrograms (mcg) per day for adults from fortified foods and supplements—can lead to negative effects. Here are the key dangers:

1. Masking Vitamin B12 Deficiency

Most significant risk of excessive folic acid intake.

High folic acid levels can correct the anemia caused by vitamin B12 deficiency without addressing the underlying neurological damage.

This can lead to irreversible nerve damage before the deficiency is diagnosed.

2. Possible Increased Cancer Risk

Some studies suggest that excessive folic acid might promote the growth of existing precancerous or cancerous cells, particularly in the colon or prostate.

This is controversial, and research is ongoing, but high folic acid intake may be a double-edged sword: protective at adequate levels but potentially harmful in excess.

3. Immune System Impairment

Very high folic acid levels may impair natural killer (NK) cell activity, a part of the immune system that helps destroy infected or cancerous cells.

4. Unmetabolized Folic Acid in Blood

Excessive intake of synthetic folic acid can lead to unmetabolized folic acid (UMFA) circulating in the bloodstream.

UMFA may be linked to immune dysfunction and other metabolic issues, although the long-term effects are still being studied.

5. Potential Effects During Pregnancy

While adequate folate is crucial to prevent neural tube defects, excessive folic acid supplementation might be associated with:

Increased risk of autism spectrum disorders (controversial and not confirmed)

Epigenetic effects on fetal gene expression

Recommendations:

Adults should not exceed 1,000 mcg/day of folic acid from supplements and fortified foods unless advised by a healthcare provider.

Prioritize natural folate from foods like leafy greens, legumes, and citrus fruits.

Check labels of supplements and fortified foods to avoid excessive intake, especially if you're also taking a multivitamin or prenatal supplement.

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