Folate vs. Folic Acid: What’s the Difference and Why Does it Matter?

It’s become the poster child of prenatal vitamins. Folate or Folic Acid is often the one vitamin that is most often recommended as key to take, especially in early pregnancy, to prevent neural tube defects. 

But even though you’ll see these two terms - Folate and Folic Acid - used interchangeably, the truth is, there is a big difference between the two of them. So, we’re getting into that discussion - what’s the difference between Folate and Folic Acid, and why does it matter?

Why is Folate important in pregnancy?

Let’s start with the basics to make sure we’re all on the same page about why Folate is so important during pregnancy. 

In addition to helping to prevent neural tube defects in baby, Folate also supports baby’s normal midline development (including the mouth), DNA and red blood cell synthesis, and cell division (i.e., how baby grows). In mama, Folate supports mood as it helps produce several key neurotransmitters. It also supports heart health, healthy red blood cells, immunity, and detoxification.

The importance of Folate was established back in the 1970s when research first made a connection between Folate deficiency and birth defects related to the spine and neural tube. At that time, supplement companies began to add a cheaper synthetic substitute, Folic Acid, to their vitamins, and food manufacturers did the same to fortified breads and breakfast cereals. Since then, much more research has emerged and we’ve learned far more about the role of Folate in pregnancy and how the different forms of this nutrient are used by the body.

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Why food sources of Folate aren’t always reliable

Folate is found in many common foods like broccoli, leafy greens, legumes (lentils, beans, peas), eggs, asparagus, and citrus fruits. So you might be thinking, “I eat lots of Folate, do I really need more in my prenatal?” The answer is, most likely, yes. 

Folate can break down easily when chopped or cooked, and it’s tough to know how much of what you eat your body actually uses. In other words, the amount of Folate you see listed for a particular food like spinach might not be what you’re actually getting if you’re blending it in a smoothie or sautéing it in some olive oil. So, even if you load up on Folate-rich foods daily (which we suggest you do!), a supplement is a wise way to ensure you and baby are getting enough to meet your needs.

In addition, while many women eat Folate-rich foods regularly before pregnancy, the First Trimester hits many of us hard. When nausea and food aversions strike, these healthy fruits and veggies are suddenly no longer appealing to many. And of course this comes at a time our bodies need them most. Again, a supplement can help support your Folate requirements to ensure you and baby are getting what you need, as can taking a prenatal vitamin before becoming pregnant.

What’s the difference between Folic Acid and Folate?

In short, Folic Acid is the synthetic form of Folate. But why does this matter? Because your body can’t just use Folic Acid as it is. It has to go through a conversion process in the body first before the body (and your baby) can actually use it. The body converts Folic Acid into a form called Methyltetrahydrofolate, or MTHF, in order to be able to use it. 

But here’s the problem: 40-60% of women have genetic variants that can get in the way of this conversion process. That means women with this variant (the MTHFR mutation) can’t utilize Folic Acid efficiently and if they’re only taking Folic Acid, their babies may not get enough. The only way to know if you have this genetic variant is to test for it, and if you’re curious to know, we recommend doing so. But, with such a high rate of occurrence, and a high risk of complications if you aren’t consuming enough Folate in pregnancy, your best bet is to assume you have this variant, and to take Folate rather than Folic Acid. 

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The risk of too much Folic Acid

In addition, research has shown that it isn’t just those with the MTHFR mutation that do not properly metabolize Folic Acid. Unmetabolized Folic Acid has been found in samples from children and adults of all ages, as well as in breastmilk.

In addition, new research is pointing to some possible negative effects of consuming too much Folic Acid, such as impaired fetal growth, increased risks of childhood diseases like asthma and autism, and promoting the growth of some cancer cells. While the research is still new, these negative effects are observed in those taking synthetic Folic Acid, not Folate. Especially if your diet already includes sources of Folic Acid (through fortified bread, cereals, or other grain products), it’s wise to be wary of Folic Acid supplementation in pregnancy. 

While studies around excess Folic Acid tend to associate unmetabolized Folic Acid with higher incidence of certain diseases in children, it’s wise to keep your supplemental dose of methylfolate below the tolerable upper limit for Folic Acid of 1,000 mcg.

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Our approach 

We set out to create a Prenatal Multi that would support all women--not just the 50% (or less!) who lack the MTHFR mutation. So, we formulated our Prenatal Multi with 918mcg DFE of methylfolate. Methylfolate is an active form of Folate, meaning it is already converted into a form that your body can use - it doesn't have to go through the same conversion process as Folic Acid to be used by all women’s bodies. 

We also acknowledge that no nutrients really work alone, and Folate is no exception. Folate requires the support of Vitamins B6 and B12, and Choline in order to perform optimally in the body. Therefore, we’ve included safe and supportive doses of each of these nutrients - meeting or exceeding the RDA for each in pregnancy. 

We’ve been talking a lot about how nutrient form matters. It’s worth noting that the amount matters, too. While too little Folate can put mama and baby at risk, too much has also been associated with mood disorders in mama. In addition, clinical experience suggests excessively high levels of methyl nutrients is correlated with midline development issues in babies.

We believe in empowering mamas with information, and we hope this comparison of two similar, but different nutrients helps you feel informed when reading your prenatal supplement and nutrition labels.

Sources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704156/

https://pubmed.ncbi.nlm.nih.gov/26269367/

https://pubmed.ncbi.nlm.nih.gov/25449200/

https://www.sciencedirect.com/science/article/abs/pii/S0301211520303754 

https://onlinelibrary.wiley.com/doi/full/10.1111/1541-4337.12193

https://medlineplus.gov/genetics/gene/mthfr/#conditions

Nutrient Power: Heal Your Biochemistry and Heal Your Brain, by William J. Walsh.