Folic Acid vs. Folate Supplementation: What You Need to Know

We often hear people ask us these questions:

• Is folate or folic acid better for pregnancy?

• Can I take folate and folic acid together?

• Folate vs Folic acid for anemia?

• Methylfolate vs folic Acid

• Is folic acid bad for you?

When it comes to supporting preconception and pregnancy care, ensuring optimal folate levels is essential. However, there’s often confusion about the difference between folic acid and folate, particularly for those with genetic variations like MTHFR mutations. Understanding the distinction between these two forms can significantly impact your health and your baby’s health.

What’s the Difference Between Folic Acid and Folate?

• Folic Acid: This is the synthetic form of vitamin B9 found in supplements and fortified foods. Folic acid must be converted into the active form of folate (5-MTHF) by the body to be used effectively.

• Folate: Folate is the natural form of vitamin B9 found in foods such as leafy greens, legumes, and citrus fruits. When consumed in this form, it is more readily converted into its active form, 5-methyltetrahydrofolate (5-MTHF), which the body uses in important processes like DNA synthesis and cell growth.

The Role of DHFR in Folic Acid Metabolism

One of the key enzymes involved in folic acid metabolism is DHFR (dihydrofolate reductase). This enzyme is responsible for converting folic acid into a form that can be further processed into active folate. However, DHFR can only metabolise small amounts of folic acid effectively. Research shows that when individuals take high doses of folic acid (often found in prenatal vitamins and fortified foods), the DHFR enzyme becomes overwhelmed. This leads to unmetabolised folic acid circulating in the bloodstream, which may pose risks, such as:

• Masking vitamin B12 deficiency.

• Potential links to immune dysregulation or cancer risk in some cases.

For this reason, many health professionals now recommend activated folate or natural folate sources to ensure proper absorption and metabolism, especially during pregnancy.

MTHFR Mutations and Folate Metabolism

The MTHFR gene (methylenetetrahydrofolate reductase) plays a crucial role in converting folate into its bioactive form, 5-MTHF. Variations or mutations in the MTHFR gene can significantly impair this conversion process. The two most common MTHFR variants are C677T and A1298C:

• Individuals with one or two copies of these mutations may have reduced enzyme activity, meaning their bodies are less efficient at converting both folic acid and folate into the active 5-MTHF form.

For those with MTHFR mutations, supplementing with methylated folate (5-MTHF) instead of folic acid is crucial to ensure that their bodies can use it effectively. This can help support healthy levels of homocysteine (an amino acid associated with cardiovascular health) and promote better overall well-being, especially during pregnancy.

Why is Folate Important for Preconception and Pregnancy?

Folate is essential for:

• Preventing Neural Tube Defects (NTDs): Folate is critical for the development of the neural tube, which forms the brain and spinal cord of the foetus. Adequate folate intake before conception and during early pregnancy can reduce the risk of spina bifida and other NTDs.

• DNA Synthesis and Repair: Folate is involved in producing and repairing DNA, a process that’s especially important as cells divide and multiply rapidly during pregnancy.

• Reducing Homocysteine Levels: Folate helps regulate homocysteine, an amino acid that, in high levels, is linked to increased risk of miscarriage and other pregnancy complications. Folate, particularly for those with MTHFR mutations, helps keep homocysteine levels balanced. High homocysteine is a risk factor for health issues such as:

o   Cardiovascular disease: High homocysteine can damage blood vessel linings, leading to atherosclerosis (hardening of the arteries), increasing the risk of heart attacks and strokes.

o   Blood clots: Elevated homocysteine can promote the formation of blood clots, potentially leading to deep vein thrombosis (DVT) or pulmonary embolism.

o   Hypertension (high blood pressure)

o   Increased risk of stroke

o   Cognitive decline: Linked to dementia and Alzheimer’s disease in some studies.

o   Osteoporosis: High homocysteine levels may weaken bones, increasing the risk of fractures.

Recommendations for Preconception and Pregnancy

1. Choose the Right Supplement: For those planning to conceive or already pregnant, it’s crucial to choose a prenatal supplement that contains methylated folate (5-MTHF) or folinic acid instead of synthetic folic acid, especially if you have MTHFR mutations. This ensures better absorption and usage by the body.

2. Incorporate Natural Folate Sources: Eating a folate-rich diet is equally important. Include foods such as:

   • Leafy greens (spinach, kale, arugula)

   • Legumes (lentils, chickpeas, black beans)

   • Avocados

   • Citrus fruits (oranges, lemons)

   • Asparagus and broccoli

3. Get Tested for MTHFR Variants: If you suspect you may have an MTHFR mutation, consider getting tested. This can provide valuable insight into how well your body metabolises folate and guide your supplementation strategy.

Conclusion

At Morkare Natural Health, we emphasise the importance of choosing the right form of folate for preconception and pregnancy care. By testing your MTHFR status and opting for activated folate and focusing on a folate-rich diet, you can support your body’s needs and promote a healthy pregnancy. If you have concerns about folate metabolism or suspect an MTHFR mutation, our team is here to guide you through personalised nutrition and supplementation options to ensure the best outcome for you and your baby.