Folate vs. Folic Acid: What's the Difference?

Short answer: The CDC recommends that anyone who could become pregnant take 400 mcg of folic acid daily, and the USPSTF recommends 400–800 mcg. Folic acid is the synthetic form of folate (vitamin B9) used in supplements and fortified foods, and it is the only form shown to help prevent neural tube defects. Folate is the umbrella term for vitamin B9 and the natural form found in foods like leafy greens and beans. Methylfolate (5-MTHF) is the active form your body circulates, and some prenatals use it instead of folic acid. It raises blood folate, but it hasn't been tested in neural-tube-defect prevention trials. 

According to the CDC, people with MTHFR gene variants can still use folic acid.

• Before and during early pregnancy: The CDC recommends 400 mcg of folic acid daily. The USPSTF recommends 400–800 mcg, starting at least 1 month before conception and continuing through the first 2–3 months of pregnancy.
• Daily target from all sources: 600 mcg DFE in pregnancy and 500 mcg DFE while breastfeeding.
• After a previous pregnancy affected by an NTD: 4,000 mcg folic acid daily, under a doctor's care.
• MTHFR: variants are common, and the CDC says they are not a reason to avoid folic acid.

Folate vs folic acid vs methylfolate: the short answer

Folate, folic acid and methylfolate are all forms of vitamin B9. Folate is the natural form in food, folic acid is the synthetic form in supplements and fortified foods, and methylfolate (5-MTHF) is the active form that circulates in your blood. Folic acid is the form used in the trials showing that folate helps prevent neural tube defects (NTDs).

What "mcg DFE" means: labels list folate in micrograms of dietary folate equivalents, which adjusts for how well each form is absorbed. For example, 400 mcg of folic acid taken with food counts as about 680 mcg DFE.

What the CDC, USPSTF and ACOG recommend

The CDC says all women capable of becoming pregnant should get 400 micrograms of folic acid daily, and that folic acid is the only type of folate shown to help prevent neural tube defects (NTDs). The USPSTF gives the same advice a Grade A rating: a daily supplement containing 400–800 mcg of folic acid for anyone planning to or who could become pregnant. ACOG recommends 400 mcg of folic acid before pregnancy.

What is methylfolate, and why do some prenatals use it?

Methylfolate (5-methyltetrahydrofolate, or 5-MTHF) is the main form of folate found in blood. Your body makes it from both food folate and folic acid. As a supplement, it skips the conversion steps folic acid undergoes, which is why some prenatals use it instead.

Studies show that methylfolate supplements raise blood folate levels. A 2013 review by Obeid and colleagues discussed 5-MTHF as an alternative to folic acid in pregnancy, and a 2011 interview-style piece by Greenberg and Bell offered a clinical opinion along the same lines. These are a review and an opinion piece, not outcome trials.

Methylfolate has not been tested for NTD prevention (see below). For an explanation as to why official guidance still names folic acid, read why ACOG and CDC still recommend folic acid.

What about MTHFR?

MTHFR is a gene that helps the body process folate, and gene variants are more common than you may think. According to the CDC, more people in the United States have one or two copies of the MTHFR C677T variant than no copies.

The CDC is clear on what that means:

• People with an MTHFR gene variant can process all types of folate, including folic acid.
• People with two copies of the variant (the TT genotype) show only slightly reduced folate levels in their blood.
• There are no clinical recommendations to test for MTHFR status, or to take a different amount or form of folate based on it.
• Common MTHFR variants are not a reason to avoid folic acid.

Some healthcare practitioners prefer methylfolate for patients with MTHFR variants. That is a clinician-by-clinician choice, not official guidance, so talk to yours.

Does methylfolate prevent neural tube defects?

It hasn't been studied for that. Trials show that only folic acid helps prevent NTDs (CDC). Methylfolate raises blood folate levels, which researchers link to lower NTD risk, but there are no NTD-outcome trials of methylfolate. A new placebo-controlled NTD trial is unlikely, because withholding folate would be unethical now that folic acid is known to work. 

For the policy side of this question, see why ACOG and CDC still recommend folic acid.

Unmetabolized folic acid (UMFA): what we know and don't

When you take more folic acid than your body can convert right away, some circulates unchanged as unmetabolized folic acid (UMFA). Researchers are studying it; here is where the evidence stands.

• It is common in the U.S. – Pfeiffer and colleagues (2015) detected UMFA in nearly all serum samples from U.S. children, adolescents and adults. 
• Removing folic acid lowers it. In a 2024 randomized trial, Sulistyoningrum and colleagues assigned 103 pregnant women at 12–16 weeks to a prenatal supplement with either 0 or 800 µg of folic acid. UMFA was lower in the group without folic acid, as were serum and red blood cell folate levels. 
• It shows up in breast milk – In a 2023 trial, Cochrane and colleagues assigned 60 pregnant women at 8–21 weeks to 0.6 mg of folic acid or an equivalent dose of (6S)-5-MTHF. About a week after birth, UMFA made up 28% of milk folate in the folic acid group versus 2% in the 5-MTHF group. Total milk folate did not differ.

It is unclear whether UMFA affects health. The milk study authors say that the question needs further investigation, and the USPSTF notes that folic acid at usual doses is not associated with serious harms.

Can you get too much folic acid? 

Yes. The tolerable upper intake level (UL) for folic acid is 1,000 mcg per day for adults and 800 mcg per day for ages 14–18, including during pregnancy. It counts folic acid from supplements and fortified foods combined. Folate from food has no upper limit. There isn’t a separate UL for methylfolate.

The limit exists because high folic acid intake can correct the anemia caused by a vitamin B12 deficiency while the deficiency itself goes unnoticed. If you take more than 1,000 mcg a day, for example, 4,000 mcg after a previous NTD-affected pregnancy, do so under a doctor's care.

 Foods rich in folate

Even with a prenatal, food remains an important source of folate. Per the NIH Office of Dietary Supplements, these are some of the richest natural sources:

Two practical notes:

1. Folate is heat-sensitive: Boiling may reduce folate content, especially in leafy greens. Steaming, sautéing briefly or eating raw preserves more of the nutrient.
2. Relying on food alone is hard in early pregnancy: The daily target rises from 400 to 600 mcg DFE, a 50% increase, and morning sickness or food aversions can make it harder to eat folate-rich foods.

How to read a prenatal label for folate

The Supplement Facts panel is the only way to know which form of folate you are getting. Look at the words in parentheses after "Folate":

• "Folate (as folic acid)" is folic acid.
• "Folate (as L-methylfolate)", "(as 5-MTHF)" or "(as L-5-methyltetrahydrofolate)" is methylfolate.
• The word "folate" alone in the nutrient column is not enough to tell.

Labels list folate in mcg DFE, often followed by the actual weight in parentheses, for example, "920 mcg DFE (552 mcg folate)". The DFE number is the one to compare against daily targets. 

What to look for:

1. It meets the 400 mcg folic acid recommendation, or your healthcare practitioner's advice. [FLAG F5]
2. It clearly states its form of folate.
3. It includes vitamin B12.
4. It is third-party tested.
5. Your healthcare practitioner knows which form you are taking.

Why Needed uses methylfolate

We chose methylfolate as a formulation option. Needed's Prenatal Multivitamin contains 920 mcg DFE (552 mcg folate) per 3-capsule serving, as L-5-methyltetrahydrofolate (Optifolin+®), and no folic acid.

If your healthcare practitioner specifically recommended folic acid, follow their advice.

See what's in Needed's Prenatal Multivitamin →

Need more choline? Prenatal Multivitamin Pro has the same folate with 400 mg of choline per 8-capsule serving.

FAQ

How much folic acid should I take before pregnancy? The CDC recommends 400 mcg of folic acid daily for anyone who could become pregnant, and the USPSTF recommends 400–800 mcg, starting at least one month before conception and continuing through the first 2–3 months of pregnancy. If you have had a pregnancy affected by a neural tube defect, the CDC recommends 4,000 mcg daily under a doctor's care.

Is folate or folic acid better for pregnancy? The CDC and USPSTF recommend folic acid because it is the only form of folate shown to help prevent neural tube defects. Folate from food also counts toward the pregnancy target of 600 mcg DFE a day. Some prenatals use methylfolate instead, which raises blood folate but hasn't been tested in NTD-prevention trials. Talk with your healthcare practitioner about which form is right for you.

Can you take too much folic acid? Yes. The upper limit for folic acid from supplements and fortified foods is 1,000 mcg a day for adults and 800 mcg a day for ages 14–18, including during pregnancy. Food folate has no upper limit. Higher doses, such as 4,000 mcg after a previous NTD-affected pregnancy, should be taken under a doctor's care.

Is folate the same as folic acid? No. Both are forms of vitamin B9. Folate is the umbrella term and also the natural form in foods such as leafy greens and beans. Folic acid is the synthetic form used in supplements and fortified foods. Methylfolate (5-MTHF) is the active form that circulates in the body.

What's the difference between folate and folic acid in prenatal vitamins? The label tells you. "Folate (as folic acid)" means the prenatal uses folic acid. "Folate (as L-methylfolate)" or "(as 5-MTHF)" means it uses methylfolate. Both are listed in mcg DFE, the unit to compare against the daily target.

Does Needed's prenatal have folic acid? No. Needed's prenatal multivitamins use methylfolate (L-5-methyltetrahydrofolate) instead of folic acid, at 920 mcg DFE per serving. If your healthcare practitioner has advised folic acid, talk to them.

Sources

1. Centers for Disease Control and Prevention. Folic Acid: Facts for Clinicians. Updated July 15, 2026.
2. Centers for Disease Control and Prevention. MTHFR Gene Variant and Folic Acid Facts. Updated July 16, 2026.
3. U.S. Preventive Services Task Force. Folic Acid Supplementation to Prevent Neural Tube Defects: Preventive Medication. August 1, 2023.
4. NIH Office of Dietary Supplements. Folate: Fact Sheet for Health Professionals. 
5. American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 762: Prepregnancy Counseling. Obstetrics & Gynecology. 2019.
6. Pfeiffer CM, et al. Unmetabolized folic acid is detected in nearly all serum samples from US children, adolescents, and adults. J Nutr. 2015;145(3):520–531.
7. Sulistyoningrum DC, … Best KP. Maternal serum unmetabolized folic acid concentration following multivitamin and mineral supplementation with or without folic acid after 12 weeks gestation: a randomized controlled trial. Matern Child Nutr. 2024;20(4):e13668.
8. Cochrane KM, Elango R, … Karakochuk CD. Human milk unmetabolized folic acid is increased following supplementation with synthetic folic acid as compared to (6S)-5-methyltetrahydrofolic acid. Sci Rep. 2023;13:11298.
9. Obeid R, Holzgreve W, Pietrzik K. Is 5-methyltetrahydrofolate an alternative to folic acid for the prevention of neural tube defects? J Perinat Med. 2013. (Review) 
10. Greenberg JA, Bell SJ. Multivitamin supplementation during pregnancy: emphasis on folic acid and L-methylfolate. Rev Obstet Gynecol. 2011. (Opinion)