What to watch with Folsäure and Wechseljahre?

During menopause, hormonal shifts can affect nutrient needs. Folic acid (vitamin B9) is involved in homocysteine metabolism. Elevated homocysteine is linked to cardiovascular risk and bone loss – both concerns that increase after menopause. Some evidence suggests that adequate folic acid intake (e.g., 400–800 µg/day) can lower homocysteine, but the evidence for preventing heart disease or osteoporosis specifically through folic acid is not strong. Additionally, folic acid supplementation may interact with hormone replacement therapy (HRT) or with genetic variants like MTHFR C677T. A key safety note: high doses (>1 mg/day) can mask vitamin B12 deficiency, which is more common in older women. Before supplementing, individual status should be assessed via blood tests (homocysteine, B12, folate). A DNA test for MTHFR can provide insight but does not replace clinical advice. Overall, a balanced diet rich in natural folates (leafy greens, legumes) is usually sufficient. The evidence is moderate, based largely on observational studies; robust RCTs for the specific menopause + folic acid combination are lacking.