Folic Acid vs. Folate

Folate vs folic acid during pregnancy

I’ve gotten several questions lately about folate and folic acid, especially during pregnancy. Folic acid and folate are often used interchangeably and even many doctors will not be able to tell you the difference if you ask.

The body needs folate, especially during pregnancy and folate is the form found in foods. You’ll often hear that folic acid is simply the supplemental form of folate, but there are some key differences. Recent research is supporting the fact that folate should be used in place of folic acid.

What’s the Difference Between Folic Acid & Folate?

Chris Kresser breaks down the important difference between folate and folic acid in this article:

“Folate is a general term for a group of water soluble b-vitamins, and is also known as B9. Folic acid refers to the oxidized synthetic compound used in dietary supplements and food fortification, whereas folate refers to the various tetrahydrofolate derivatives naturally found in food. (1)

The form of folate that can enter the main folate metabolic cycle is tetrahydrofolate (THF). (2) Unlike natural folates, which are metabolized to THF in the mucosa of the small intestine, folic acid undergoes initial reduction and methylation in the liver, where conversion to the THF form requires dihydrofolate reductase. The low activity of this enzyme in the human liver, combined with a high intake of folic acid, may result in unnatural levels of unmetabolized folic acid entering the systemic circulation.

Several studies have reported the presence of unmetabolized folic acid in the blood following the consumption of folic acid supplements or fortified foods. (3) Human exposure to folic acid was non-existent until its chemical synthesis in 1943, and was introduced as a mandatory food fortification in 1998. (4) Food fortification was deemed mandatory due to overwhelming evidence for the protective effect of folic acid supplementation before conception and during early pregnancy on the development of neural tube defects (NTD) in newborns.”

I’d recommend reading his full article, but research is supporting the idea that too much synthetic folic acid can increase risk of some types of cancers (source) and it may not even be as effective in preventing neural tube defects.

Folate (the natural form) has some very important functions in the body:

“What is the role of folate?  Folate is necessary during rapid cell division and growth. In fact, pregnancy is known to actually double the need of dietary folates.

Folate deficiency has been reported to be the most common vitamin deficiency in the US, and is associated with such conditions as:

  • Anemia
  • Incidence and recurrence of Neural Tube Defects (serious birth defects of the spinal cord and the brain which arise during the early development of the embryo, most common being spina bifida)
  • Increased risk of certain cancers
  • Elevated Homocysteine, a risk factor for cardiovascular disease, stroke and many other health conditions

Potential Causes of a Folate Deficiency

  • Inadequate dietary intake
  • Increased requirement, as in pregnancy and lactation
  • Malabsorption
  • Altered hepatic (liver) metabolism
  • Increased elimination of folate” (source)

How to Get Enough Folate

Unfortunately, even high quality prenatal vitamins often contain folic acid instead of folate. I’ve had to create my own supplement regimen for pregnancy to find the natural forms of all the needed nutrients including folate.

Folate is found naturally in foods like liver and spinach. It is also possible to find a natural supplemental form of folate that can be taken in place of folic acid.

Though the recommendation for pregnancy is 400-600mcg of folate/folic acid, this is the minimal amount needed to prevent birth defects. When using folate instead of folic acid (thus removing the added risks to mom with the synthetic form), it is often advisable to take more than the minimum. As always, check with a doctor or midwife before taking or changing anything, especially during pregnancy, but do your research on this one!

What I do: Before and during pregnancy, I take 800-1200 mcg of folate. I have used Pure Encapsulations Folate (slightly higher quality) and Solgar Folate (less expensive) with good results. The one downside to folate is that it isn’t as easily absorbed, so it is often necessary to take more and to get it from real food sources. I also eat liver at least once a week during pregnancy.

Additional Reading:
Designs for Health Article on Folate
Chris Kresser on Folate vs. Folic Acid
Possible link between synthetic form and cancer

Do you take folic acid or folate during pregnancy? How do you make sure to get enough? Share below!

You may also enjoy these posts...

Reader Comments

  1. I am coming off birth control this week and was advised to start prenatal vitamins again in case we conceive. I am looking into a well rounded b-vitamin to help me detox too. I also suspect I have a MTHFR defect, so folic acid is number one on my supplement list this week!
    I am glad both of the folate supplements you recommended are methylated. I had Thorne Research’s 5-MTHF on my wish list since it is therapeutic level and clean. But expensive! I’ll research your recommended brands too. Thank you!

    • Hi–I had a wild bad reaction to Thorne’s 5-MTHF, I was basically a zombi for a week, really scary foggy mind. The weird thing is that I don’t have bad reactions to Folic Acid, I’ve no clue why…

      • The difference between the two is one is methylated the other is not. Some of us with MTHFR defects actually have too much methyl already (google overmethylation) and don’t need additional methyl. Mensah Medical is a great place to start for more info on over and undermethylation. I am overmethylated and Dr. Mensah has me taking folic acid. I hope that helps!

        • “Folinic acid” (form in between folic acid and methylfolate) is better if you are MTHFR and sensitive to methyl donors (I am too. I am COMT++). I wouldn’t take any folic acid if you are MTHFR. You shouldn’t overmethylate on folinic acid and won’t get the “build up” of folic acid.

  2. So will folate help you get pregnant? Sorry if that’s a stupid question, but it didn’t seem to be stated clearly in the post. Great post though!

    • I know this is an old post so hopefully you’ve had your baby by now, but for others ending up here I thought I’d comment. I’m not a doctor and I don’t know anything about you, your congenital predispositions or what condition your lifestyle has left you in, but I can say that if anything natural can help it would be this…

      A diet completely void of grains, vegetable oil, and sugar (basically a low carb, primal/paleo diet) abundant in healthy fats such as mono-unsaturated and saturated (loads of pastured eggs, grass-fed butter, coconut oil, avocado oil, avocados, grass-fed fatty cuts of meat) and non starchy vegetables (particularly those leafy greens).

      A lifestyle low in stress, high in restful sleep (that means undisturbed sleep in a very dark room, without bright lights or the use of glowing screens i.e no TV /iPad/computer/Phone within 2 hours before bed, of course it might help not to drink caffeinated drinks in the afternoons) with lots of very-low strenuous exercise (such as walking), a small amount of body-weight exercise (pull-ups, push-ups, squats and planks) and very tiny amounts of high intensity (literally a 7-10 minute session of sprint-rest-sprint-rest-sprint-rest) once every 7-10 days. No chronic cardio exercise 7 days a week!!

      This goes for both partners but it’s particularly important for the female. After all, nobody will deny that most the hard work creating babies is done by the female.

      One thing’s for sure, any pharmaceutical fertility support offered by doctor will stand a much greater chance of success following this advise.

      Oh and just to re-iterate, the grass-fed/pastured part above is very important, grain-fed/CAFO meat is high in omega-6 and low in omega-3.

      I don’t know if links work in this forum, here’s the link: If it doesn’t work just search YouTube for “dietdoctor fertility” and look for the interview with Michael D. Fox, M.D.

      Good Luck! :)

      • I think that’s a great diet unless you suffer from some conditions like Gilbert’s syndrome (very common condition) and or Porphyria (which according to Dr S.Rochlitz is more common than we think) I didn’t know I had these conditions and I tried the diet mentioned above for a long time with really bad results :( After getting super sick I discovered that what it works for me and for many is a high carb, low protein and super low fat diet. BTW I really like meat but it makes me super sick. I guess one size does not fit all when we talk about diet. cheers,

  3. Remember that there is a difference between folic acid and activated (or methylated) folic acid. 20-40% of the population has a defect in the MTHFR enzyme, which is what tags that methyl group onto the folic acid. That methyl group then gets transferred to B12, SAMe, and ultimately leads to the activation of your neurotransmitters and many other metabolic products in the body (CoQ10, creatine, and more). So it is extremely important to use the methylated form of folic acid if you have an MTHFR defect or suspect you do. I recommend using it under a physician’s guidance, though, because if you have other genetic defects it can trigger anxiety, depression, or bad detoxification reactions.

    A little bit more about safety of vitamins (and other factors involved) on my own blog:

    ~Dr. Erika

  4. So should I take my prenatal vitamin (with folic acid) and an additional folate supplement? Or us that too much? If I just take the folate, I don’t want to miss out on the other stuff in my normal prenatal vitamin.

  5. You mentioned that you created your own supplement regimen for pregnancy to find the natural forms of all the needed nutrients do you mind sharing what you take in addition to the folate?

    • I will try to post the whole list soon, but typically: a whole food multi, folate, fermented cod liver oil, omega-3s, tons of probiotics, liver pills, magnesium, and gelatin with some others added at different times in the pregnancy.

      • Yes! That future post would be so helpful. I am almost 6 weeks pregnant and have not seen my doctor yet, but when I do I would like to talk to him about the different options other than “taking a prenatal vitamin.”

        Thank you in advance!!

      • Love your site. I have been reviewing several different posts while my husband and I are deciding exactly when to start trying for our first baby. The info is incredibly helpful!

        Like Anna, I would love to see your exact supplement regiment and possibly a detailed list outlining a suggested day/week of eating while pregnant.

        I’m one of the few members of my family (immediate and extended) whom cares about doing things as naturally as possible (in all aspects of my life), so your website has been incredibly encouraging and informative. Thanks so much!

  6. I’ve been looking around, and I know that Garden of Life Vitamin Code (I think there’s a Prenatal) that has folate, I believe, as does MegaFood Baby & Me (but that’s expensive), and Thorne Research has a Basic Prenatal that has it too. Thorne doesn’t look too terribly expensive.

    I picked up Sisu (a Canadian brand) Prenatals (I had a coupon from the Healthy Shopper) before I read about this, so I’ll finish that off and try to order Thorne.

    Another Canadian brand, Trophic, has several multis that contain folate instead of folic acid, and they seem less expensive too.

    Right now we’re at the trying to conceive stage, having some fertility issues.

  7. Hi Katie, great information! I think it is wonderful that you are sharing so much crucial and fairly unknown information with the public. You are helping so many people out there!

  8. I take rainbow light prenatal and just ordered enough for the duration of my pregnancy. It has folic acid! So I ordered the natural jarrow brand folate to take also. Is it ok to take both? Now I am concerned. Rainbow light has 800 mcg of folic acid and jarrow is 400 of folate. Would it be safe to take both or maybe alternate?

  9. I take Isotonix Prenatal. It has the natural folate, as well as the proper ratio of other nutrients. I like it, also, because it’s a liquid as opposed to those horse pills I used to have to choke down – during pregnancy my gag reflex is stronger. It also has higher absorbability than a pill, so I literally feel the difference. Love that stuff. :)

  10. How much Folate is too much while pregnant? I can’t seem to find this information anywhere. Is it bad to get too much during pregnancy?

    • I JUST bought these and I’m incredibly disappointed. The label clearly says “Folate (As folic acid from culture media)” I have not been able to find any information anywhere on the web as to what that means, but the best I can guess (with a microbiology background) is that they grow a probiotic culture on whole foods, suck off the supernatant (juice they’re growing in), spin it down and isolate the folic acid from that. I am quite angry that everywhere it claims it’s “folate” then suddenly in tiny print on the back it says it’s folic acid. How many companies do this and don’t disclose it? Is it actually ok to take, based on the way it’s processed? If anyone has any info on this, I would really like to hear it. For now I am going to take these and buy an additional folate supplement (one of the ones Katie suggested), but I’m still mad. I spent a lot of money on these thinking they contained folate…

      • I don’t know either, but I have the same question! Just bought some because it was one of the brands listed on another site as containing folate and not folic acid. But if that is true, why does it say folic acid? I may return the bottle.

        • FYI, I returned my bottle and bought Garden of Life prenatals. Much better. There are some conversations on the web about New Chapter’s form of folate and the company’s reply to a customer’s letter was too sketchy for my taste.

      • Here’s what New Chapter wrote back to me after I expressed concern about the folic acid in their Perfect Energy vitamins. I plan to ask them if they test the end product to know that it really is B9 with no folic acid left:

        “Thank you for your inquiry and interest in New Chapter. Please know that the MTHFR gene provides instructions for making an enzyme called methylenetetrahydrofolate reductase. This enzyme plays a role in processing amino acids, the building blocks of proteins and is important for a chemical reaction involving forms of vitamin B9 (folate). Folic acid is the synthetic form of folate that cannot be used by those with a MTHFR defect. Specifically, this enzyme converts a molecule called 5,10-methylenetetrahydrofolate to a molecule called 5-methyltetrahydrofolate. This reaction is required for the multistep process that converts the amino acid homocysteine to another amino acid, methionine.

        While New Chapter does use folic acid as the base catalysts for B9, it is not the form found in the final product. The dual-stage probiotic food culturing process we use creates a whole-food complex form of B9 and biotransforms folic acid to folate. These whole-food complexes are basically pre-digested by yeast and probiotics serving as carriers for the nutrients across the gut, and signal the cells of the body to utilize the nutrients with greater ease and efficiency.

        Lastly, please know that New Chapter is unaware of any contraindication for individuals with the MTHFR gene mutation using New Chapter folate. However, if you are unclear about what the best approach would be for your individual needs please consult with your health care provider.

        We hope this information is helpful.

        In good health,

        Amerigo Pennoni
        Take Care Consumer Specialist
        New Chapter, Inc.

  11. I take Pure Prenatal from the Synergy, It has 800mcg of folate per serving including MANY other important vitamins.

  12. My husband and I are going to try and conceive soon so I’m looking for the best prenatal vitamin. I am hypothyroid and have the MTHFR gene as well. Is Garden of Life Kind Organics prenatal vitamin a good brand? Is says it contains folate 800 mcg? Also what can you recommend for hypothyroidism in relation to pregnancy? Thanks for any suggestions!!

  13. Great info Katie! I am a newlywed and my gyn told me at my last visit that I need to be taking some form of vitamin with folic acid since I choose not to take any form of contraceptives. Are there any natural brands of vitamins you reccomend that I could take currently? I’m not sure if I should take actual prenatals considering I am not trying to conceive.

  14. Garden of Life’s Raw Prenatal is a great prenatal vitamin I found with 800mcg of folate. Also gluten and dairy free with no binders or fillers. Only downside they are a bit pricey at WF where I bought them, but they are available on Amazon for much less.

  15. I finally got some Solgar Folate (as metafolin) 400mcg for now. I’m not trying to conceive but surprises happen so I want my body to be prepared. When we are ready to conceive I plan to increase the dose and add some other supps. I looked into b complex vitamins before deciding on just folate and I feel like I’m getting enough of those other vitamins through diet. I have seen first hand what too much b12 does to a person (being in healthcare field) and its scary stuff!!

  16. I am 5 weeks pregnant and just realized that my prenatal contains folic acid. I ordered a new one that contains folate which should arrive tomorrow.. Should I be worried? I wish I had realized this sooner as I have miscarried once before. I’m not sure if my body converts folic acid or not…

  17. are the two brands of folate that you recommend from whole food sources? I couldn’t find that information on amazon.

  18. I’m 24 years old, currently 17 weeks pregnant and I don’t feel like I’m taking enough supplements for my first pregnancy. I have a hard time taking vitamins becaus I end up puking afterwards. Currently I’m taking Nutrition Now Prenatal Gummy Vitamins and that’s it. I Got it from Kroger in the natural section. I asked my doc it that was okay and she said it was fine…well, I just realized that it doesn’t contain iron, so I’m freaking out that I’m not consuming enough iron for the baby. I’ve been trying to live a holistic lifestyle by eating organic and no processed food, though there’re times that I do cave and have some chick fil-a fries, or ice cream. I haven’t gained any weight during my pregnancy, which kinda scares me, though, my nurse said its normal. I try to eat healthy and workout everyday, and I’m constantly told to eat a lot of food, but I cant. I also don’t think I eat enough protein. I REALLY would love to have some help because I want to be healthy for my baby and I want my baby to be healthy. Any suggestions of a supplement that I could really benefit from? Also, is it too late to take the supplements at 17 weeks. Again, this is my first pregnancy. Thank you!

  19. Folic acid is important for Histapenia (only in my opinion). Methylfolate (glucosamine, not calcium, salt preferred) is for MTHFR C677T and A1298C gene mutations and also for drugs that delete folate such as Phenytoin.

    • Additionally methylfolate is also quite helpful allergies and probably for asthma.
      For C667T start with a small dose and gradually, slowly increase. Limited doses of GABA amino acid supplements can offset the initial side effect for homozygous people and for people with severe allergies.

        • Thanks Mike! I’m hetero for C667T and researching different prenatals. One I came across listed “Folate (as folic acid from culture media)” – what on earth does that mean? Is it safe since it is formed naturally, or should I avoid this one all together? My fertility nurse told me she spoke with the rep for their prenatals and they told her they use folic acid because it is too expensive to formulate the folate without the patent…something like that. Crazy that they only give IVF patients prenatals with folic acid….

  20. I’m taking 1mg daily Thorne 5-MTHF. I read that it’s great to take even if you don’t have the gene issue.
    I DONT want to take Folic Acid!
    I’m trying to conceive and my OBGYN just told me to take 5mg folic acid daily until 3 months pregnant. I’m trying to find some kind of conversion. Should I take more than 1mg of 5-MTHF?
    If it’s more biologically active than folic acid I should be good with that dose?
    Sorry, just can’t seem to find much info. Want to be sure I’m doing the right thing.

  21. I am taking the prenatal vitamin & mineral supplements, TheraNatal Complete. Can I still take the fermented cod liver oil along with it?

  22. Hello! I know I’m late to the game but need some help. I just recently (within the last 5 weeks or so found out that I am mthfr positive for 2 kinds of a1298c. I have been on 2 supplements (methyl protect and 5-mthfr es) but I know I need a pre natal as well as I just found out yesterday that I’m pregnant (with my second child). I don’t know if taking additional folate is bad or ok since I’m already taking the 2 supplements). I am having the hardest time trying to find something. I looked into new chapters but they use folic acid. I’m considering nutrigold’s whole food prenatal gold and they use folate. Any recommendations would be greatly appreciated!

    • Hi Shannon, I have the same question!
      Just found out I am heterozygous for the MTHFR C677T and A1298C variants. Had a recent miscarraige and now having inflammation issues and headaches. I have been taking a prenatal vitamin with folic acid this entire time! The research I have found states that taking folic acid with the MTHFR gene mutation can plug up the receptor cites and the body is prevented from being able to use the folate they receive from natural food. My doctor also just put me on 5-MTHF (Thorne brand), but if I am still taking the folic acid in the prenatal vitamin, wouldn’t that counteract my attempts at getting methyl folate in the 5-MTHF. Should I find a prenatal vitamin without folic acid? Any suggestions Wellness Mama?

      • Garden of Life “My Kind Organics” prenatals contain 800mcg folate (from food sources, no folic acid) and are a good brand. I take them. I get them at Whole Foods.

  23. Those of you with MTHFR talk to your doctor’s about NEEVO-DHA. I had a pharmacist do some research and this prenatal was made specifically for us. The only probLem is the price you might be looking to pay after insurance covers part. I’m currently trying to find a alternative to the NEEVO

Join the Conversation...

Please read my comment policy.