What Happens When You Stop Taking Folic Acid?

November 28, 2025 •

4 min read

Over 50% of pregnancies in the U.S. are unplanned, which is one reason why continuous folic acid supplementation is important for women of childbearing age. Stopping folic acid can have significant health consequences, particularly for vulnerable populations and those who do not get enough folate from their diet.

Quick Summary

This article explores the potential health risks and consequences of stopping folic acid supplementation, including increased fatigue, anemia, and birth defects during pregnancy. It covers who is most at risk and how to ensure adequate folate intake through diet.

Key Points

Depletion of Body Stores: The body's water-soluble folate stores can deplete within months of stopping supplementation.
Symptoms of Deficiency: Early symptoms can include fatigue, weakness, mouth sores, and mood changes.
Megaloblastic Anemia Risk: Long-term deficiency can cause megaloblastic anemia, affecting red blood cell production and leading to severe fatigue.
Pregnancy Complications: Stopping folic acid during early pregnancy significantly increases the risk of neural tube defects like spina bifida and anencephaly.
Masks B12 Deficiency: Excessive folic acid from supplements can mask a coexisting vitamin B12 deficiency, delaying diagnosis and potentially leading to nerve damage.
Neurological and Heart Health: Chronic deficiency is linked to neurological problems, cognitive decline, and increased cardiovascular risk due to high homocysteine levels.
Dietary Intake is Key: A balanced diet rich in leafy greens, beans, and fortified grains can help maintain folate levels, but supplementation is often more reliable, especially for at-risk groups.

The Role of Folic Acid

Folic acid, the synthetic version of vitamin B9, plays a crucial role in the body, primarily in creating and repairing DNA and producing healthy red blood cells. Folate is the natural form of this vitamin, found in foods like leafy greens, citrus fruits, and legumes. Folic acid is often more easily absorbed by the body than natural food folate and is used to fortify many grain products. When you stop taking folic acid supplements, your body's reserves of this water-soluble vitamin can deplete rapidly, typically within a few months.

Short-Term Effects of Stopping

For individuals with a balanced diet rich in natural folate, stopping a supplement may not cause immediate symptoms. However, for those with insufficient dietary intake or certain health conditions, the effects can manifest relatively quickly. The initial decline in folate levels can lead to subtle signs of deficiency:

Increased fatigue and weakness: As red blood cell production is affected, less oxygen is efficiently transported throughout the body, leading to tiredness and lethargy.
Changes in mood: Psychological problems, such as irritability and confusion, can develop as folate levels drop.
Oral discomfort: A sore, red, or swollen tongue and mouth ulcers are common early indicators of deficiency.
Loss of appetite: A decreased desire to eat can exacerbate the nutritional deficiency.

Long-Term Consequences of Deficiency

Sustained low folate levels can lead to more severe health issues affecting various body systems. These long-term effects underscore why maintaining adequate folate intake is so important.

Megaloblastic Anemia: This is the most well-known consequence. The body produces abnormally large, immature, and fewer red blood cells that cannot function properly. This can cause persistent fatigue, shortness of breath, and pale skin.
Neurological Problems: Folate is vital for a healthy nervous system. Long-term deficiency can lead to issues like tingling or "pins and needles" in the hands and feet, muscle weakness, and more severe cognitive changes, including memory problems and dementia.
Increased Cardiovascular Risk: Low folate levels can lead to high homocysteine levels in the blood, an amino acid linked to an increased risk of heart disease and stroke.
Potential Cancer Risk: Some research indicates a link between long-term folate deficiency and an increased risk of certain cancers, including colon cancer.

Risks During Pregnancy

Stopping folic acid is especially dangerous during pregnancy, particularly in the critical first few weeks. Folate is essential for the proper development of the baby's neural tube, which forms the brain and spinal cord. A deficiency at this time can lead to severe birth defects. This is why daily supplementation is recommended for all women of childbearing age, as many pregnancies are unplanned.

Common neural tube defects linked to folate deficiency:

Spina Bifida: A birth defect where the baby's spinal column does not close completely.
Anencephaly: A severe birth defect in which the baby is born without parts of the brain and skull.

Comparing Folic Acid Supplements vs. Food Folate


Feature	Folic Acid Supplements	Food Folate (Natural)
Source	Synthetic form of Vitamin B9.	Naturally occurring in foods.
Absorption Rate	High absorption (up to 85%), even higher on an empty stomach.	Lower absorption (around 50%) due to food matrix.
Reliability	Consistent, measurable dosage in each pill.	Varies depending on cooking method and food freshness; heat can destroy folate.
Convenience	Easy to take daily as a pill or liquid.	Requires careful meal planning to ensure adequate daily intake.
Risk of Overdose	Possible with high supplemental doses, which can mask a Vitamin B12 deficiency.	Very low risk of toxicity from food sources alone.
Best for	Ensuring adequate levels, especially during high-demand periods like pregnancy.	Long-term maintenance of general health for individuals with balanced diets.

How to Prevent Deficiency

If you have stopped taking a supplement, it is crucial to ensure you are meeting your daily folate needs through diet. Fortunately, many foods are either naturally rich in folate or fortified with folic acid.

Increase intake of folate-rich foods: Incorporate more dark leafy green vegetables like spinach and romaine lettuce. Other sources include beans, lentils, asparagus, broccoli, peas, and oranges.
Eat fortified grains: In many countries, foods like cereals, bread, and pasta are enriched with folic acid. Checking the nutrition label for the word "enriched" can help.
Consider a multivitamin: For many, especially women of childbearing age, a daily multivitamin provides a simple and consistent way to get the recommended 400 mcg of folic acid.

Conclusion

Stopping folic acid supplementation can lead to a deficiency over time, carrying a range of health risks. While a person with a robust diet may initially feel no ill effects, those with dietary limitations or increased needs—such as pregnant women—face serious consequences, including megaloblastic anemia, neurological issues, and increased birth defect risk. Maintaining consistent folate intake, whether through supplements, fortified foods, or a balanced diet, is essential for overall health, particularly for those of childbearing age. Always consult a healthcare provider before stopping a supplement to understand your specific needs and risks.

Frequently Asked Questions

The immediate effects of stopping folic acid may be subtle, especially if you have a healthy diet. However, your body's reserves of the water-soluble vitamin will begin to decrease, potentially leading to symptoms like increased fatigue and irritability over a few weeks or months.

Healthcare professionals generally recommend that women who can become pregnant continue to take a daily folic acid supplement, even after the first trimester. While the risk of neural tube defects is highest early in pregnancy, maintaining adequate folate levels is important for overall health and development throughout pregnancy and for preventing folate-deficiency anemia.

It is possible to get enough folate from food alone by eating a diet rich in leafy greens, beans, citrus fruits, and fortified grains. However, folic acid from supplements is more easily absorbed by the body. For women of childbearing age, experts often recommend a supplement to ensure consistent intake.

Folate is the general term for all forms of vitamin B9, which occurs naturally in foods. Folic acid is the synthetic, man-made form of vitamin B9, used in supplements and to fortify foods. The body can absorb folic acid more readily than food folate.

Megaloblastic anemia is a blood disorder that occurs when a lack of folate or vitamin B12 causes the body to produce abnormally large, immature red blood cells. Stopping folic acid supplementation can lead to this condition if dietary intake is insufficient to cover the body's needs.

Neurological symptoms associated with low folate levels can include tingling or numbness (pins and needles), muscle weakness, memory problems, confusion, and other cognitive issues. These are often more pronounced in cases of severe or prolonged deficiency.

Yes, a severe folate deficiency can sometimes cause temporary infertility. When adequate folate intake is resumed, fertility often returns to normal.