Should you take folic acid if you have acid reflux?

October 10, 2025 •

4 min read

Some research indicates that higher folic acid intake may reduce the risk of acid reflux complications. But should you take folic acid if you have acid reflux? The decision requires careful consideration of potential benefits, risks, and your current medication regimen.

Quick Summary

Taking folic acid with acid reflux can offer potential benefits for mucosal health, but also carries risks, especially at high doses or when combined with certain medications like antacids and PPIs. Dietary sources of folate are often a safer alternative. Consultation with a healthcare provider is essential for proper guidance.

Key Points

Moderate Evidence Exists: Some studies suggest that folic acid, a B vitamin, may offer protective benefits for the stomach lining and reduce the risk of reflux-related complications, though more research is needed.
Potential for Digestive Upset: High doses of folic acid supplements can cause digestive side effects like nausea, bloating, and stomach cramps, which could aggravate acid reflux symptoms.
Medication Interactions: Antacids and long-term proton pump inhibitor (PPI) use can interfere with the absorption of folic acid and other B vitamins.
Risk of Masking B12 Deficiency: High-dose folic acid supplementation can potentially mask the symptoms of an underlying vitamin B12 deficiency, which can have serious neurological consequences.
Food Sources are Preferable: The safest way to increase folate intake is typically through dietary sources like leafy greens, legumes, and citrus fruits, which do not carry the same risks as high-dose supplements.
Consult a Doctor First: It is crucial to consult a healthcare provider before taking a folic acid supplement to assess your individual needs, check for deficiencies, and ensure it is safe with your current medications.

Understanding the Link Between Folic Acid and Acid Reflux

Folic acid, or vitamin B9, is a water-soluble vitamin essential for cell growth, repair, and metabolism. Given that acid reflux can cause inflammation and damage to the esophageal lining, understanding the role of nutrients like folic acid is crucial. Studies have explored the relationship between B vitamins, including folate, and gastroesophageal reflux disease (GERD). However, the picture is complex, involving interactions with medications and the different forms of the vitamin.

The Potential Benefits of Folic Acid for Acid Reflux

Some research suggests that maintaining sufficient folate levels could be beneficial for those with acid reflux, particularly in addressing long-term complications. Here's what some studies indicate:

A study in the Journal of Basic and Applied Zoology suggested that folic acid supplementation may protect the stomach lining, reduce inflammation, and accelerate the healing of ulcers.
Another older study noted that increased intake of folate and other B vitamins might decrease the risk of reflux esophagitis, a condition involving inflammation of the esophagus caused by GERD.
One source mentioned a study where higher folic acid intake was found to reduce acid reflux symptoms by approximately 40%.
B vitamins, including folate, are also essential for tissue repair, which is relevant for managing the damage caused by frequent reflux.

Potential Risks and Side Effects

While potential benefits exist, supplementing with folic acid, especially at high doses, is not without risk, particularly for those with existing digestive issues.

High-Dose Side Effects: High doses of folic acid can cause digestive issues such as nausea, stomach cramps, loose stools, bloating, and gas. These side effects could mimic or worsen acid reflux symptoms.
Risk of Masking B12 Deficiency: A key concern with high-dose folic acid is that it can mask the symptoms of a vitamin B12 deficiency. Long-term use of certain acid reflux medications, like proton pump inhibitors (PPIs), can already interfere with B12 absorption, making this a critical consideration.
Interactions with Medications: Over-the-counter antacids containing aluminum or magnesium can hinder the absorption of folic acid if taken within two hours of each other.

Folic Acid vs. Dietary Folate

It is important to distinguish between folic acid (the synthetic form) and dietary folate (the natural form). Studies have raised questions about the safety of high-dose folic acid supplements, suggesting that while folate from food sources may be protective, supplementation might carry risks for certain complications. For this reason, many health professionals prioritize dietary intake whenever possible.

Comparison of Folate Sources for Acid Reflux Patients


Feature	Folic Acid Supplementation	Dietary Folate (from food)
Potential Benefits for Reflux	May aid in mucosal repair and reduce inflammation.	Associated with a lower risk of reflux complications.
Potential Risks for Reflux	High doses can cause nausea, bloating, and stomach cramps.	Generally poses no risk related to acid reflux.
Effect on Medication Absorption	Antacids interfere with absorption if taken within 2 hours.	No known negative interactions with antacids or PPIs.
Risk of B12 Deficiency	High doses can mask symptoms of B12 deficiency.	Does not mask B12 deficiency.
Primary Source	Tablets, fortified foods (cereals, breads).	Leafy greens, legumes, citrus fruits, eggs.

Best Practices for Supplementation

If you and your doctor decide a folic acid supplement is appropriate, following a few guidelines can help minimize digestive upset and maximize absorption:

Take with food: This can help buffer the stomach and reduce the risk of gastrointestinal side effects.
Time it correctly: Avoid taking folic acid supplements within two hours of taking antacids to prevent absorption issues.
Consider lower doses or active forms: Taking lower doses or using a form like L-5-methyltetrahydrofolate may be more suitable for some individuals.
Prioritize dietary intake: Consuming folate-rich foods is generally the safest way to ensure adequate intake for most individuals.

Consultation is Key

Before you start any new supplement, including folic acid, it is crucial to consult a healthcare provider, especially if you have acid reflux or are taking related medications. They can help determine if there is a deficiency, weigh the potential risks and benefits, and advise on the safest approach for your specific health situation. Your doctor can perform blood tests to check your B vitamin levels and make an informed recommendation.

Conclusion: A Balanced Approach to Folic Acid and Acid Reflux

The question of whether to take folic acid if you have acid reflux depends on several factors, including your current nutrient status, diet, and medications. While some research points to the potential benefits of folate for protecting the stomach and reducing the risk of complications, high-dose supplementation carries risks of digestive side effects and masking a B12 deficiency. For most people with acid reflux, focusing on a diet rich in natural folate is the safest and most effective strategy. If supplementation is necessary, consulting a healthcare provider to manage dosage and timing is paramount.

NIH Office of Dietary Supplements - Folate Fact Sheet

Frequently Asked Questions

Yes, high doses of folic acid supplements have been reported to cause side effects such as nausea, bloating, stomach cramps, and gas, which could potentially worsen or trigger acid reflux symptoms.

Yes, common acid reflux medications, including antacids containing aluminum or magnesium, can inhibit folic acid absorption if taken within two hours. Long-term use of proton pump inhibitors (PPIs) may also interfere with the absorption of folate.

For most people, getting folate from food sources is the safer option. Dietary folate (found in leafy greens, legumes, etc.) is less likely to cause digestive issues than high-dose synthetic folic acid supplements. Some studies also raise concerns about high-dose supplementation risk.

Good sources of folate that are typically well-tolerated by individuals with acid reflux include leafy greens (spinach, kale), legumes (beans, lentils), and certain fruits like bananas and papaya.

Yes, high doses of folic acid can mask the symptoms of a vitamin B12 deficiency. Since long-term use of PPIs can also lead to B12 malabsorption, it is especially important to monitor levels with a healthcare provider.

To avoid malabsorption, do not take folic acid supplements within two hours of taking antacids. Always consult your doctor for personalized advice on timing supplements around your medication regimen.

Yes, you should always consult a healthcare provider before starting any new supplement. They can help assess your need, check for deficiencies, and determine the safest course of action, especially if you are on medication.