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Can I Take Folic Acid With Hypothyroidism? 

Learn about folic acid and its relationship to hypothyroidism—and why it may not be as straightforward as you think.
Can I Take Folic Acid With Hypothyroidism? 
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Essential nutrients play a huge role in our health. When we don't get these key nutrients, our body does not work optimally. Indeed, nutrient deficiencies are often the culprit behind many chronic illnesses or at least are a factor in why people get a disease in the first place. For example, folate is one of those critical nutrients that we must get from our diet. When we do not get a sufficient amount of folate, it can lead to problems like hypothyroidism

How essential nutrients affect thyroid function

Like every other system in the body, the thyroid depends on us ingesting certain nutrients so it can do its job. Iodine is one of the primary nutrients the thyroid needs to make thyroid hormone. If a diet is deficient in iodine, it can lead to an underproduction of thyroid hormone and eventually a goiter

Other essential nutrients for thyroid function include B vitamins, seleniumzinc, and vitamin D. Each nutrient plays some role in helping the thyroid work as it should. So, when a nutrient is lacking or missing, it can throw the whole system off. 

What does folic acid do in the body?

Folic acid (the human-made version of folate or vitamin B9) is an essential B vitamin the body needs to form red and white blood cells. Red blood cells carry oxygen to all tissues in our bodies, and white blood cells protect the body from foreign invaders like bacteria and viruses. 

Folate is especially important when rapid growth occurs, like in pregnancy, infancy, and childhood. For example, women who do not have a sufficient folate intake during pregnancy put their babies at risk for congenital disabilities in the brain and spinal cord (like spina bifida). 

Aside from its role in making red and white blood cells in the bone marrow, folate also helps convert carbohydrates to energy and supports RNA and DNA formation. 

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The link between folate and hypothyroidism

Hypothyroidism is when the thyroid gland does not produce enough thyroid hormone to support the body's metabolic needs. The thyroid is located at the nape of your neck and is a small butterfly-shaped organ. It is considered underactive when it does not produce enough thyroid hormone and can lead to numerous symptoms.

Common symptoms of hypothyroidism: 

  • Fatigue
  • Cold intolerance
  • Constipation
  • Dry skin
  • Weight gain
  • Puffy face
  • Hoarseness
  • Muscle weakness
  • Elevated blood cholesterol levels
  • Muscle aches, tenderness, and stiffness
  • Joint pain, stiffness, or swelling 
  • Heavier or irregular menstrual periods
  • Thinning hair
  • Slowed heart rate
  • Depression
  • Impaired memory
  • Infertility
  • Enlarged thyroid gland (goiter)

An underactive thyroid is often due to an autoimmune disorder called Hashimoto's thyroiditis. However, people who have had part or all of their thyroid removed may also be at risk for hypothyroidism. 

Low folate levels and hypothyroidism

People with hypothyroidism often have low folate levels. However, the relationship between folate and hypothyroidism is highly complex because it, of course, involves other players.

Low folate can cause homocysteine levels to increase in your body. Homocysteine is an amino acid the body makes that can increase a person's risk for cardiovascular disease like atherosclerosis, blood clots, stroke, and heart attack. Folate is needed to help break down homocysteine. So, when the body does not have enough folate, it cannot break down these harmful amino acids. 

Challenges converting folate into its usable form

Typically, the body converts folic acid into L-methyl folate in the liver, a form of this vitamin that your body can use. Intriguingly, hypothyroidism decreases your ability to produce L-methyl folate. More specifically, hypothyroidism decreases the activity of methylenetetrahydrofolate reductase, an enzyme that helps make L-methyl folate. 

When you don't have enough L-methyl folate to combat homocysteine levels, you may see an increase in adverse cardiac events. Therefore, people with hypothyroidism are at risk for cardiovascular diseases.

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What vitamins should you take with hypothyroidism?

We know that a folate deficiency can cause cardiovascular problems, especially in people with hypothyroidism. However, even people who do get enough folate sometimes struggle to convert folate into L-methyl folate. Thus, many people with hypothyroidism and autoimmune disorders (and people struggling with infertility) take the active form of folate (L-methyl folate, also known as 5-MTHF) to help the body get this nutrient in its most active form. 

Aside from L-methyl folate, people with hypothyroidism will want to consider boosting their intake of the following nutrients:


Zinc supports your immune system, helps to heal leaky gut, and assists in thyroid hormone production.

Vitamin D

Vitamin D supports the immune system, improves your skin and hair health, and may help with weight management.

Vitamin B12

Vitamin B12 helps boost energy and improves cognitive functioning and mood.

Vitamin A

Vitamin A is an anti-inflammatory agent that may improve the function of the pituitary gland.


Selenium decreases thyroid antibodies, serves as an antioxidant, and helps convert T4 to T3.


Magnesium helps with over 300 enzymatic reactions in the body and supports digestion, nerve and muscle function, blood sugar, blood pressure, and protein synthesis.

You can obtain each of these nutrients through a healthy diet. However, meeting your recommended daily intake of each nutrient can be challenging, so taking a thyroid supplement that contains these nutrients can help support your thyroid health.

A note about buying supplements

Not all supplements are created equal, and some that claim to offer thyroid support may do more harm than good. The reason for this is because some thyroid supplements contain trace amounts of glandular tissues from animals that may increase your thyroid hormone levels. Be wary of taking a thyroid glandular supplement and consult a Paloma Health thyroid doctor before adding any vitamin or supplement to your thyroid regimen. 


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Julia Walker, RN, BSN

Clinical Nurse

Julia Walker, RN, BSN, is a clinical nurse specializing in helping patients with thyroid disorders. She holds a Bachelor of Science in Nursing from Regis University in Denver and a Bachelor of Arts in the History of Medicine from the University of Colorado-Boulder. She believes managing chronic illnesses requires a balance of medical interventions and lifestyle adjustments. Her background includes caring for patients in women’s health, critical care, pediatrics, allergy, and immunology.

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