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Head-to-head evidence comparison — which supplement is right for you?
Folic Acid vs Raloxifene (Evista): Folic Acid has the stronger overall evidence (8 vs 5.3/10); the best pick depends on your goals. Take the 60-second quiz for a pick tailored to your goals.
Folic Acid wins 2 of 3 categories. Both are solid choices — the best pick depends on your specific goals.
Verdict
Mostly mechanism / observational
Verdict
Mostly mechanism / observational
Top outcomes
400 mcg/day for anyone planning or capable of pregnancy (USPSTF: 400-800 mcg); adult RDA 400 mcg DFE/day, 600 mcg DFE in pregnancy, 500 mcg DFE in lactation (IOM)
any
Folic acid (pteroylmonoglutamic acid)
Approved (postmenopausal women) / off-label (male) — clinician-directed. For osteoporosis treatment/prevention and breast-cancer risk reduction the standard, validated dose is 60 mg once daily (the MORE, CORE, RUTH and STAR trials all used 60 mg/day; MORE also tested 120 mg/day with no clear added fracture benefit and more side effects). For off-label male gynecomastia the small published pediatric series used roughly 60 mg/day; there is no FDA-approved male dose and the male evidence is thin and retrospective.
any
Raloxifene hydrochloride 60 mg tablets (approved for postmenopausal osteoporosis and breast-cancer risk reduction)
Periconceptional
Weeks
Weeks to months
Months to years
Years
Throughout use
Throughout use
Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation.
N Engl J Med (1992) · Rct
Randomised trial of periconceptional vitamin supplementation for prevention of a FIRST neural tube defect (PubMed publication types: Randomized Controlled Trial, Clinical Trial)
Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group.
Lancet (1991) · Rct
Randomised, multicentre trial of periconceptional folic acid for prevention of RECURRENT neural tube defects (PubMed publication types: Randomized Controlled Trial, Multicenter Study, Comparative Study)
Effects and safety of periconceptional oral folate supplementation for preventing birth defects.
Cochrane Database Syst Rev (2015) · Meta analysis
Cochrane Database of Systematic Reviews CD007950, third edition (PubMed publication types: Meta-Analysis, Systematic Review)
Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators.
JAMA (1999) · Rct · n=7705
MORE: multicenter, randomized, double-blind, placebo-controlled trial of raloxifene 60 or 120 mg/day in 7,705 postmenopausal women with osteoporosis, followed up to 36 months
The effect of raloxifene on risk of breast cancer in postmenopausal women: results from the MORE randomized trial. Multiple Outcomes of Raloxifene Evaluation.
JAMA (1999) · Rct · n=7705
Pre-specified breast-cancer analysis of the MORE RCT (7,705 postmenopausal women with osteoporosis), followed a median 40 months
Continuing outcomes relevant to Evista: breast cancer incidence in postmenopausal osteoporotic women in a randomized trial of raloxifene.
J Natl Cancer Inst (2004) · Rct · n=5213
CORE: extension of the randomized MORE trial giving 4 additional years of raloxifene 60 mg/day (n=3,510) vs continued placebo (n=1,703)
Folic Acid has a higher evidence score (8/10 vs 5.3/10) and wins in 2 of 3 categories.
No known interactions between Folic Acid and Raloxifene (Evista) have been documented in our database. However, always consult a healthcare provider before combining supplements.
The right pick depends on your goals. Answer a few quick questions for a personalised recommendation — or dig into the full evidence on each.