Folic Acid vs. Folate

What is folic acid exactly?

Folic acid is the synthetic form of the nutrient folate. Otherwise known as vitamin B9. Folic acid in itself cannot be utilized by the body, it must be converted to its active form, 5-MTHF before the body can use it. 

You’ll mainly see folic acid in many conventional foods and supplements because it is easier to produce, more shelf stable and much more affordable, but you should think twice about using products with folic acid in them.

The short story is that once again, this comes down to bio individuality- what nourishes one body may be doing harm for another.

Folate / Folic Acid Uses

You’ve probably heard about the necessity of sufficient folic acid/folate in women for proper fetal development, but Folate is necessary in the body for a variety of reasons. 

  • Proper Fetal Neural Tube Development (5)
  • Heart Health (4)
  • Red Blood Cell Production (3)
  • Neurotransmitter Synthesis (2)
  • DNA Synthesis + Repair (1)
  • Promotes a Healthy Immune System (6)(7)
  • Regulates Homocysteine Levels

So you can see that this is a vital nutrient for our health.

Due to a rise in neural tube defects, the United States and many other countries began to fortify foods with folic acid.

Folic Acid in our Food Supply

In 1998, it was mandated to fortify cereal grain products with folic acid to prevent neural tube defects in babies. (7) This public health initiative was very successful, reducing the occurrence of neural tube defects by 19-32%. Other countries following suit saw decreases in NTD as high as 55%.

Since then it has been recommended that women capable of becoming pregnant should be getting at least 400 µg of folic acid daily.

So, what’s so wrong with folic acid then? Why would this be an issue if it’s helping babies being born without defects?

It isn’t much of a problem for the 60% of people who are successfully able to convert that folic acid into the active form of folate in the body. But for the 40% of people who cannot, (more on that below) that folic acid can lead to big problems.

Folic Acid and MTHFR

40% of the population have a genetic mutation called MTHFR (8). MTHFR is a genetic snp that interferes with the way our body does something called methylation, a process by which methyl groups are added to a DNA molecule. This is a process that affects how the body ‘reads’ genes after a methyl group has attached to a DNA molecule… Yeah, it’s a bit complicated. 

Basically, this particular gene, MTHFR that stands for methylenetetrahydrofolate reductase, just in case you were wondering, gives genes their instructions for converting folic acid into the active form methylfolate, or 5-MTHF in the body.

Those with the mutation MTHFR C677T cannot convert folic acid into the active form of folate in the body. As a result, supplemental folic acid will build up toxic levels in the body. This could explain why those with this gene mutation experience more miscarriage (9). Elevate folic acid levels has also been found to stimulate pre-existing cancer cells. (10)

Women who are thinking about conceiving may want to check themselves for this mutation through genetic testing, such as 23andme and run their raw genetic data through another report such as https://geneticgenie.org/.

Given this information, you can see that supplementing with folic acid is not ideal. So what’s a better option.

Firstly, it’s always preferable to get your nutrients from real and whole foods. Secondly, if one chooses to supplement then supplementing with methylfolate is a much better choice.

Whole Food Sources of Folate

Folate can be found in the following foods:(11)

  • Dark green leafy vegetables
  • Romaine lettuce
  • Beans
  • Peas
  • Legumes
  • Avocado
  • Broccoli
  • Eggs
  • Liver
  • Asparagus
  • Brussels sprouts

Supplementation

Methylfolate is a much more safe supplement alternative than folic acid. This supplementation is optimal regardless of your MTHFR status because it comes from whole food nutrients, and is not created in a lab.

I hope this article has helped to clear up some confusion about the differences between folic acid and folate and which is a better alternative for you!

Sources

  1. https://www.ncbi.nlm.nih.gov/pubmed/15539274/
  2. https://www.ncbi.nlm.nih.gov/pubmed/18950248
  3. https://www.ncbi.nlm.nih.gov/pubmed/17209196?dopt=Abstract
  4. https://www.ncbi.nlm.nih.gov/pubmed/10554704
  5. https://www.ncbi.nlm.nih.gov/pubmed/18803309
  6. https://www.ncbi.nlm.nih.gov/pubmed/1887065
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257747/
  8. https://drwillcole.com/what-you-need-to-know-about-the-gene-mutation-that-affects-40-of-the-world/
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5887178/
  10. https://www.ncbi.nlm.nih.gov/pubmed/15531657
  11. https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/