Article at a Glance
- Folate is the natural form of vitamin B9, found in food.
- Methylfolate is the bioactive form of vitamin B9 that is taken as a supplement. In order to use folate eaten in food, the body converts folate into methylfolate using an enzymatic process. In some people, folate doesn’t convert as well into methylfolate, so methylfolate supplements are taken directly.
- Folic acid is the synthetic form of folate, often used in fortified foods, and some supplements.
- Folate is the natural form of vitamin B9
- Methlyfolate is the bioactive form of folate
- Folic Acid is the synthetic form of folate
- How Do You Know You Have a Folate Deficiency?
- Does Cooking Folate-Rich Foods Destroy the Folate?
- How to ensure you don’t get too much or too little folate
- Can you take methylfolate and folic acid at the same time?
- Folate and Pregnancy
The subject of B vitamins sound pretty straightforward, but the issue is more complex than many realize. For example, folate, methylfolate, and folic acid are all different forms of vitamin B9. There have been decades of scientific research about the effects of vitamin B9’s various forms, how they positively and negatively interfere with foods and drugs, as well as the best forms of B9 to take for optimal health.
Although we can choose different forms of B9, the ‘absorbability’ in the body and where they fit into the folate pathway differ significantly. Here, I aim to break down the different forms of folate by unpacking the difference between methylfolate and folic acid, as well as how they’re processed by the body.
Folate is the natural form of vitamin B9
Folate is the natural form of vitamin B9. By natural, I mean that it’s found in several types of foods. During pregnancy, folate nourishes your baby’s developing nervous system and helps protect against certain birth defects, including spinal cord and brain abnormalities.
You can get folate naturally from foods like leafy green vegetables and citrus fruits, but it may become challenging to rely on diet alone to get the right amount needed for you and your growing baby. This is why supplementing with folic acid is strongly recommended, not only during pregnancy, but months before conception.
Methlyfolate is the bioactive form of folate
For your body to utilize the folate found in your kale salad, it must first be converted into methylfolate. Methylfolate is the active form of folate that 100% of people can fully absorb.
Methylfolate is also a synthetic form of folate, however, it is already broken down/converted into its bioavailable form and is recommended for those who cannot break down folic acid efficiently due to relatively common variants in the MTHFR gene.
If your goal is to find a methylfolate supplement, look out for any one of these terms on the labels of your supplement to ensure that you’re getting the bioavailable (methylfolate) form:
- L-methylfolate calcium (only if it’s bound to calcium salt)
- Levomefolic acid
The “L” in some of the above names indicates that it can be absorbed. If you see “6(S)” instead of “L”, it can also be absorbed. If the “L” is replaced with “6(R),” then the formulation is probably not particularly well absorbed and you should avoid it.
Folic Acid is the synthetic form of folate
Folic acid is the synthetic form of folate and is found in most leading prenatal vitamin brands. Its conversion to methylfolate works in the same way as when your body needs to convert folate into methylfolate. Unfortunately, 50% of women cannot fully absorb folic acid because they possess an MTHFR gene mutation that prevents this conversion. It is important to understand that even those of us with variants in our B vitamin metabolism genes can metabolize and absorb some folic acid, which is why the CDC still recommends a folic acid supplement during pregnancy regardless of SNPs.
A study published in the British Journal of Pharmacology compared the body’s absorption of 6(S)-5-MTHF to folic acid in healthy women who had MTHFR mutations. The study found that 6(S)-5-MTHF was far superior at increasing vitamin B9 levels in the blood plasma.1
That’s why advanced prenatal vitamins with methylfolate can be important; they ensure moms can successfully provide this crucial nutrient to their developing babies.
How Do You Know You Have a Folate Deficiency?
Folate deficiency is a highly prevalent vitamin deficiency throughout the world and in the Western Hemisphere, it often occurs as a result of impairment in the intestinal absorption process of the vitamin.
Here are some symptoms to look out for when a lack of folate is causing anemia (red blood cell shortage):2
- Chronic sluggishness & fatigue
- Memory issues
- Shortness of breath
- Short temper, annoyance & irritability
- Pale skin
Does Cooking Folate-Rich Foods Destroy the Folate?
Folate intake is strongly influenced by various methods of cooking that can degrade the natural forms of the vitamin in foods. The effect of cooking on reducing the folate content in food depends on the food, cooking method, and cooking time.3
Folate losses during cooking and preparation are the result of a combination of heat degradation and leaching of the vitamin into the cooking water. Normal boiling times can eliminate about half of the folate in spinach and broccoli, but steaming does not reduce folate at all. Boiling potatoes and grilling meat do not affect folate content either, even if you cook them for longer than normal. 3
Boiling onions reduces folate by 35% while baking them only destroys 15% of it. It has also been found that boiling peas retain the most folate compared to other cooking methods. Boiling beans for two hours and then either baking or frying them, cause them to lose 50% of their folate content. One study recommends soaking beans in salt water and then boiling them in fresh water to preserve the most nutrients.4
How to ensure you don’t get too much or too little folate
Firstly, read the labels on your multivitamins – do they contain too much folic acid? Most adults should get about 0.5mg of folic acid per day, so use this as a guideline.
Read the labels on your bread and cereals, too. The U.S. National Institutes of Health’s Office of Dietary Supplements has set a recommended daily upper limit of 1mg for folic acid that comes from fortified grains and supplements (i.e. bread and cereals).5 They have not set a limit for folate that comes from vegetables or 5-MTHF supplements.
Can you take methylfolate and folic acid at the same time?
Folate is an essential nutrient, however, it is possible to have “too much of a good thing.”
Taking both forms of B9 at the same time could cause an excess of folate. If you’re taking a 5-MTHF supplement, then reduce the folic acid from fortified foods to a minimum and avoid multivitamins containing folic acid.
According to the Harvard Health Letter, the total amount of folic acid from grains can add up quickly.6 I have included their list below.
Common Foods Fortified with Folic Acid:
- Bowl of Special K Cereal: 0.394mg
- Serving of pretzels: 0.172mg
- 1 cup of cooked spaghetti: 0.166mg
- 1 multivitamin: 0.4mg
Total = 1.132mg
As you can see, it’s easy to reach that upper limit of folate in one day, so be mindful of your grain and vitamin intake, especially if you have an MTHFR mutation. You also want to make sure you’re getting enough B12 and that your body is using it.
Folate and Pregnancy
It is now universally accepted that keeping folate levels up during pregnancy is essential. It most likely prevents serious birth defects, and this strong correlation is well-established.
If you’re struggling with fertility, your doctor may have recommended folate or folic acid supplements to improve fertility and embryo survival, but the question you may find yourself asking is “Am I getting enough folic acid?”.
This is an important question to ask, especially if you a part of the 50% of women that can’t fully absorb folic acid due to possessing an MTHFR mutation.
Fertility doctors commonly prescribe doses as high as 5 mg (5,000 micrograms) of folic acid for both prospective parents (folate deficiencies affect male fertility as well). Five milligrams is over 12 times the required dose to prevent neural tube defects (400 micrograms), however, it’s still unclear whether doses as high as these are safe and beneficial.
Supplementation with 5-MTHF is the surest way to know your body will absorb and use the folate it requires, whether you know your MTHFR status or not.