What gets rid of folic acid? Understanding the Causes of Deficiency

October 30, 2025 •

4 min read

Overcooking vegetables can destroy a significant portion—up to 95% in some cases—of naturally occurring folate. Numerous factors beyond diet, including specific health conditions, medications, and lifestyle habits, can also reduce or inhibit the body's store and use of folic acid, leading to a deficiency.

Quick Summary

Several factors, such as high-heat cooking, alcohol consumption, and certain medications, can decrease folic acid levels. Malabsorption disorders, genetic mutations, and increased metabolic demands also contribute to deficiency.

Key Points

Heat Destroys Folate: Excessive heat from boiling or canning can significantly reduce the folate content in food due to the vitamin's water-soluble nature.
Alcohol Impairs Absorption: Chronic alcohol consumption interferes with folate absorption in the intestines and accelerates its breakdown and excretion.
Medications Can Block Folate: Certain drugs, including methotrexate and specific anticonvulsants, can inhibit folate metabolism or reduce its effectiveness.
Health Conditions Affect Absorption: Malabsorption disorders like celiac or Crohn's disease and chronic hemolytic anemia can cause folate deficiency.
B12 Deficiency Creates a 'Folate Trap': Low levels of vitamin B12 can trap folate in an inactive state, making it unavailable for the body's needs.
Genetic Factors Can Alter Metabolism: A genetic mutation, such as the MTHFR polymorphism, can impair the body's ability to convert folate into its active form.
Dietary Habits Are Key: Insufficient intake of folate-rich foods like leafy greens, legumes, and citrus fruits is a primary cause of deficiency.

The Surprising Causes of Folic Acid Loss

Folic acid is the synthetic form of the essential B vitamin folate (B9), critical for cellular growth, DNA synthesis, and red blood cell production. While most people get adequate folate from fortified foods and supplements, many are unaware of the various factors that can deplete this vital nutrient. It’s not just about inadequate intake; the way food is prepared, the presence of certain substances, and underlying health issues all contribute to what gets rid of folic acid.

The Impact of Cooking and Food Processing

Folate is a delicate, water-soluble vitamin that is highly susceptible to destruction by heat, light, and prolonged storage. The way food is cooked and prepared can dramatically reduce its folate content, even before it's consumed.

High-Heat Cooking: Methods like boiling and canning result in the most significant folate losses. Boiling vegetables can cause a reduction of 50-80% as the folate leaches into the water, which is often discarded. Canning is also particularly damaging, with losses as high as 77% in chickpeas and 65% in spinach.
Prolonged Storage: Storing food for extended periods, especially when exposed to light, can cause folate deterioration. This is particularly true for pre-cut and frozen vegetables.
The Best Cooking Methods: Not all cooking is detrimental. Steaming and microwave heating, for example, do not cause significant folate losses. Eating fresh, raw leafy greens and fruits is another way to maximize folate intake.

The Role of Alcohol

Chronic and excessive alcohol consumption is a major contributor to folate deficiency. Alcohol affects folate homeostasis through multiple mechanisms:

Impaired Absorption: Alcohol interferes with the absorption of folate in the intestines, inhibiting the activity of the proteins needed for its transport into the body.
Accelerated Breakdown and Excretion: Alcohol accelerates the breakdown of folate in the liver and increases its excretion through the kidneys.
Poor Diet: Individuals with alcohol use disorder often have poor diets, further compounding the problem by not consuming enough folate-rich foods.

Medications That Affect Folic Acid

Several common prescription drugs interfere with the body's ability to absorb or utilize folate. If you are taking any of these medications, it is important to discuss your folate levels with a healthcare provider.

Folate Antagonists: Certain drugs, such as methotrexate, are designed to block the activity of folate to treat conditions like cancer and rheumatoid arthritis. Methotrexate works by inhibiting the enzyme that converts folate into its active form.
Anticonvulsants: Long-term use of anti-seizure medications like phenytoin, phenobarbital, and primidone is known to deplete serum folate levels.
Sulfasalazine: Used to treat ulcerative colitis and Crohn's disease, sulfasalazine can interfere with folate absorption.
Trimethoprim: This antibiotic can inhibit folate metabolism and is a known cause of deficiency.

Health Conditions and Genetic Factors

Beyond external factors, various internal health issues can compromise your folate status.

Malabsorption Disorders: Gastrointestinal conditions that impair nutrient absorption, such as celiac disease and inflammatory bowel disease, can prevent the body from effectively absorbing folate.
Chronic Hemolytic Anemia: This blood disorder involves the rapid destruction of red blood cells, which significantly increases the body's need for folate to produce new ones.
Kidney Dialysis: Patients undergoing kidney dialysis experience increased folate loss during the treatment process.
Vitamin B12 Deficiency: Folate and vitamin B12 work together. A severe B12 deficiency can lead to a 'folate trap,' where folate becomes trapped in an unusable form, resulting in a functional folate deficiency.
MTHFR Polymorphism: A genetic mutation affecting the MTHFR gene can reduce the body's ability to convert folate into its active form, 5-MTHF. Individuals with this polymorphism may require a different form of supplementation.

Comparing Factors That Decrease Folic Acid


Factor	Mechanism of Action	Impact Severity	Prevention/Mitigation
Heat (Cooking)	Destroys the water-soluble vitamin structure; leaches folate into cooking water.	High for boiling/canning, low for steaming.	Opt for low-heat cooking methods, minimize cooking time, use cooking water for soups.
Chronic Alcohol Use	Impairs absorption, increases hepatic breakdown, and boosts renal excretion.	High, especially with poor diet.	Moderate or abstain from alcohol; ensure sufficient dietary intake.
Certain Medications	Inhibit folate's metabolic enzymes or interfere with absorption.	Varies by drug and dosage; can be high.	Consult a doctor; may require folic acid or 5-MTHF supplementation under medical supervision.
Malabsorption Disorders	Damage to the intestinal lining prevents effective absorption.	High, requires targeted management.	Treat underlying condition; may require oral or parenteral supplementation.
Vitamin B12 Deficiency	Creates a 'folate trap', making folate unavailable for metabolic processes.	High, can mask anemia symptoms.	Check B12 levels; address B12 deficiency before or with folate treatment.

Conclusion: Preventing Folate Deficiency

Maintaining adequate folate levels is crucial for overall health, from preventing birth defects to supporting cardiovascular health. Recognizing the many factors that get rid of folic acid is the first step toward prevention. While dietary intake is foundational, lifestyle choices like alcohol consumption and awareness of medication side effects are equally important. For those with malabsorption issues, genetic predispositions, or conditions like pregnancy, supplementation under medical guidance may be necessary. Choosing appropriate cooking methods, focusing on a balanced diet rich in raw and lightly cooked folate sources, and consulting a healthcare professional about potential drug interactions are key strategies for ensuring optimal folate status.

For more information on the critical roles of folate, visit the National Institutes of Health's fact sheet on the topic.

Frequently Asked Questions

Yes, cooking can destroy folic acid, as it is a water-soluble vitamin. Boiling and other high-heat cooking methods cause significant folate loss, while methods like steaming help preserve it.

Yes, chronic and excessive alcohol consumption is a major cause of folate deficiency. It interferes with absorption, reduces dietary intake, and speeds up the body's processing and excretion of folate.

Common medications that interfere with folic acid include methotrexate (used for cancer and autoimmune disease), some anticonvulsants (like phenytoin), and certain antibiotics (like trimethoprim).

Yes, health conditions such as malabsorption disorders (e.g., celiac disease), chronic hemolytic anemia, and kidney dialysis can all contribute to low folic acid levels.

A vitamin B12 deficiency can lead to a 'folate trap,' where folate is synthesized but cannot be used by the body. This creates a functional deficiency, and treating it with only folic acid can mask the underlying B12 problem.

Yes, some people have a genetic mutation in the MTHFR gene, which affects the body's ability to convert folic acid into its active form. This can lead to reduced folate availability and requires special attention.

Symptoms of folic acid deficiency can include fatigue, weakness, mouth sores or a sore tongue, reduced sense of taste, pale skin, and diarrhea.