Folic Acid vs. Folate in Fertility
What's the difference and what are the downsides/benefits?
Folic acid is the general requirement for ‘trying to conceive’ couples and pregnant ladies, recommended as a means to support embryo development and gene expression. However, growing research indicates that it’s actually the natural form of vitamin B9 (folate) which is found in food sources such as spinach, lemons, avocados and lentils, that the body needs. In fact, many women may not be able to absorb folic acid leaving them prone to miscarriage, blood clots, endometriosis, heart disease and genetic mutation.
But what’s the difference?
Folic Acid is a synthetic form of B9 most common in supplements and fortified foods. Developed in 1943, it started being added to foods in 1998 (US only, currently), including gluten based products, vitamin waters and many more.
The body cannot metabolise folic acid readily. Folic acid first needs to undergo reduction and methylation in the liver before getting converted into a folic acid derivative known as tetrahydrofolate (THF). This process requires a sufficient amount of the key enzyme dihydrofolate reductase (DHFR), and because DHFR maintains very little activity in the liver where metabolism occurs, the body can only convert a small amount of THF. This results in varying and potentially harmful levels of unmetabolised folic acid circulating your system with nowhere to go.
**HOWEVER** About 40% to 60% of the population has genetic mutations (MTHFR Gene Expression) that impairs the conversion of supplemental folic acid to its active form, l-methylfolate.
What is MTHFR?
This is a gene mutation found in both men and women, that affects a significant amount of the global population.
MTHFR is an enzyme that adds a methyl group to folic acid to make it usable by the body. The MTHFR gene produces this enzyme that is necessary for properly using vitamin B9. This enzyme is also important for converting homocysteine into methionine, which the body needs for proper metabolism and muscle growth and which is needed for glutathione creation . The process of methylation also involves the enzyme from the MTHFR gene, so those with a mutation may have trouble effectively eliminating toxins from the body.
People with a MTHFR gene mutation have a highly reduced ability to convert folic acid or even folate into a usable form. Leading expert in this area, Dr Lynch, goes on further to say that folic acid blocks the folate receptors, preventing us from absorbing natural folate (B9) from food sources.
Folate on the other hand is the more bioavailable and full-spectrum form of B9. Folate is the most natural form of vitamin B9, naturally occurring in citrus fruits, beans, leafy greens, and other foods. Folate is the ideal form of B9 supplementation because unlike synthetic folic acid, folate does not need to undergo reduction and methylation in the liver before the body can use it. Folate is metabolized in the small intestine where it converts to tetrahydrofolate and is then ready to enter the folate metabolic cycle. Because of this, folate is also a good option for those with MTHFR. Folate has not been widely recognized as a supplement compared to folic acid largely because it has a shorter shelf life. When folate is isolated from its food source, it loses nutritional value quickly, which is why manufacturers oxidate it, creating folic acid. However, supplement manufacturing has come a long way in the past five years, and folate supplements are becoming more shelf stable and easier to come by.
What is B9 and why do we need it?
B9 is one of the eight B vitamins essential to the body. We need it for its support of the skin, eyes, hair, and liver. B9 helps our bodies convert the foods we eat into energy that gets us through the day. This vitamin also works alongside vitamin B12 and vitamin C to help our bodies break down the proteins in our diet. B9 is especially important for cell and tissue growth as well as supporting the production of genetic material (RNA/DNA). Vitamin B9 is also crucial for brain function.
Folate is found in a variety of wholesome foods. This delicate nutrient is sensitive to heat, light, and oxygen, so try to store these foods away from sunlight, and prepare them in their most raw, unprocessed state. These foods are among the highest in folate:1
Beans (mung beans, chickpeas, pinto beans, lima beans)
Spinach (and other greens like collard greens, cabbage, lettuce)
Citrus fruits (mangoes, oranges, lemons)
9 is an essential part of DNA and RNA production, which makes it a vital nutrient during infancy, adolescence, and pregnancy, when cells are growing more rapidly than normal. B9 also provides support for the moms by combining with B12 to make red blood cells and help iron work properly in the body.
What’s Right for Me? Weighing the Pros and Cons
Now that you know the different forms of vitamin B9, you can decide which one will work best for you. Let’s review your options:
Both cultured folic acid and regular folic acid should be avoided, especially if your body has problems converting folic acid to methlyfolate.
Methylated folic acid is a good option if your body is unable to convert folic acid to methlyfolate, but it is the most expensive option.
Folate supplements are best whether you have no known issues with folate absorption, or if you have a methylation defect. One big pro is that folate is usually reasonably priced in comparison to folic acid; however, one con is that it can be hard to find in stores.
Looking for a good source of folate
Supplement Guidelines for folate
Always look for 5-MTHF in supplements or Folenic Acid, ruling our supplements with any form of Folic Acid. If in doubt, call the supplement company and ask the yes/no question, “does this supplement contain folic acid”? If yes, keep searching!
The supplement company I always recommend is Cytoplan as they ethically and locally source their ingredients, where possible. As a registered practitioner, I get 10% off which I like to share with my patients, so we can all benefit from a cheeky discount. Just quote SK10 at checkout.