Folate vs. Folic Acid

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Folate vs folic acid during pregnancy
Wellness Mama » Blog » Health » Folate vs. Folic Acid

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

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

What’s the Difference Between Folate & Folic Acid?

Chris Kresser breaks down the important difference 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 natural form 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:

“It is necessary during rapid cell division and growth. In fact, pregnancy is known to actually double the need of dietary folates.

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

Unfortunately, even high quality prenatal vitamins often contain folic acid instead of the natural folate-forms. In the past, I’ve had to create my own supplement regimen for pregnancy to find the natural forms of all the needed nutrients (though there is now a high quality prenatal that contains the natural methylated form)

Folate is found naturally in foods like liver and spinach. It is also possible to find a natural supplemental form 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 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. UPDATE: I now take this prenatal instead which contains adequate levels.

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!

Katie Wells Avatar

About Katie Wells

Katie Wells, CTNC, MCHC, Founder of Wellness Mama and Co-founder of Wellnesse, has a background in research, journalism, and nutrition. As a mom of six, she turned to research and took health into her own hands to find answers to her health problems. WellnessMama.com is the culmination of her thousands of hours of research and all posts are medically reviewed and verified by the Wellness Mama research team. Katie is also the author of the bestselling books The Wellness Mama Cookbook and The Wellness Mama 5-Step Lifestyle Detox.

Comments

126 responses to “Folate vs. Folic Acid”

  1. Gabrielle Avatar
    Gabrielle

    You’re not a clinical nutritionist. I wouldn’t recommend advising readers on supplementation. Whether you state you’re not a medical practitioner somewhere, doesn’t seem appropriate.

    1. Katie - Wellness Mama Avatar

      I’m not advising anyone on what supplementation they should take. I share my own experiences and the research that I’ve found and advice readers to do their own research as well…

  2. Adam Avatar

    I appreciate you putting all sorts of good pro-nutrition information out there, but respectfully you confuse the folic acid/folate issue. Folate is not “the natural form” vs. synthetic folic acid. Folate is the umbrella term. Folic acid is a type of folate, as are methyltetradydrofolate, folinic acid, etc.

    I understand there are other sources on the internet that say the same thing you do. But again respectfully, they are incorrect.

    Thanks

  3. Margot Avatar

    I just purchased the Folate that you recommended. Should I also purchase a multi vitamin if i am trying to conceive?

    Not sure which individual vitamins are important other than folate for conception, and whether it’s safe to take a multi in addition to 800mg of folate.

  4. Kimberly Werner Avatar
    Kimberly Werner

    I love this article! Before getting pregnant, I had no idea about prenatals or folic acid vs. folate. But thanks to my personal health assessment, when I got pregnant, I learned that folate is better, and added it into my customized vitamin pack! Now I’m breastfeeding, and it’s still important to take as needs for it is still 50% higher than before and even when its doubled during pregnancy – mind. blown.

  5. Henna Avatar

    Hi, I took Thorne Research Basic Prenatal Vegetarian Capsules during pregnancy, but it made me feel really sick. Would you have any suggestions why that is? I never found out the reason and just stopped using it.

  6. michael Avatar

    there is conflicting info on the inter webs as to whether methylfolate can be obtained from whole foods by those with mthfr mutations

    what does your research tell you about this?

    is supplementation the only way to get methylfolates into your body i you have a mthfr mutation?

    1. Katie - Wellness Mama Avatar

      The research does seem mixed. I do personally thin, from what I’ve read, that a person can get them from enough leafy greens but I also don’t think most people eat enough to get anywhere close.

  7. Amber Avatar

    Hi! The prenatal you say you take has a link to a bunch of them. Which one do you use?

    Thanks!

  8. Cecilia Avatar

    Hello,
    Just wanted to point out that the Seeking Health prenatal contains a CAL PROP 65 warning for ingredients known to cause reproductive issues or birth defects. I’m personally fairly disappointed by this because this seemed at a first (quick) glance to be a good option for a prenatal.

    Do you have any info on why this vitamin gets this warning?
    Thank you!

  9. Chloe Avatar

    Thank you for this post! It cleared up a lot of questions I had about folic acid and folate. I checked the prenatals I’ve been taking and I was so pleased to see that they use folate from natural food, not folic acid. Just thought I’d post the link so people can see another prenatal option that offers this. I might buy a bottle of just folate from natural food as well though since there’s only 600 mcg of folate in the prenatals. I’m not sure how much folate a day is too much. Any ideas? https://www.amazon.com/Garden-Life-Prenatal-Multivitamin-Supplement/dp/B00K5NELR0/ref=as_li_ss_tl?th=1&linkCode=ll1&tag=wellnessmama-20&linkId=f009ab591c9ce75893799a54b71b8e26&language=en_US

  10. Kaley B Avatar

    Innate Response Baby & Me has folate and was recommended to me by a homebirth midwife.

    The midwife I am using now has given me a prenatal that uses folic acid instead, so I am nervous about switching.

  11. Brittney Avatar
    Brittney

    I clicked on the link to the prenatals you suggested because I am in search of one and in the picture of the bottle in “big bold letters on the Optimal prenatal it states “this product contains a chemical known to the State of California to cause birth defects and other reproductive harm”!!!! Why would anyone want to risk their lives and their babies lives with this prenatal?? Scary! Always read and re-read labels because that was a huge deal braker for me!

    1. Wellness Mama Avatar

      Many vitamins are considered “dangerous” in California, including necessary trace minerals. Defintiely do your own research, but I personally would never use California’s labeling laws as a guide for what is actually healthy.

  12. Lily Marquez Avatar
    Lily Marquez

    Hi,

    Wonderful blog! Thank you for the valueble information. I’d like to know what other supplements you recommend taking along with Seeking Health Optimal Prenatal? Thank you!

  13. Jessi odonnell Avatar
    Jessi odonnell

    So I I’m trying to find a prenatal vitamin with methylfolate in it because I have the MTHFR homozygous c677t in which case I have active blood clots I was looking through the ingredients in it on their website and this brand is synthesized. I’m also reading in the ingredients that there’s milk thistle which also thins the blood.which is not safe while I’m on blood thinners. can you recommend another brand that possibly has iron in it and no milk thistle and isn’t synthesized thank you

  14. Bekah Avatar

    So, if I am TTC and am taking a prenatal with folate (New Chapter Prenatal), do I need to worry about taking an actual folate supplement?

  15. Faith Avatar

    I’ve been taking Mega Foods Baby & Me prenatals for my last pregnancy and for three months prior to this one. It claims 800mcg folate. But I see someone’s comment above stating they use a chemical form since it’s not possible to get that much in one pill.
    I’ll look into the ones you suggest above but I had a question about recommended amounts. I am currently pregnant with twins and my RE recommended I take 1000mcg folic acid to help support a twin pregnancy.
    Thoughts? Obviously, I can’t go back to before the pregnancy at is point, just curious if the recommended amount of folic acid from your dr equals the same amount of folate?
    I’m sorry if it’s already been asked or answered….

  16. Jessi Avatar

    Hi i have mthfr c677t homozygous gene i, have active blood clots and I’m currently pregnant. This gene has caused my blood clots and I’m indefinitely on lovenox and have been for 2 years. I want to take a good pre natal and looking at garden of life.I’ve Looked into the pre natals with methylfolate but really,iffy on taking those as i am scared of it causing anxiety, which i already suffer from. I just made a magnesium spray which you recommended and we will see how i, do.I’m on a no grain no gluten,no dairy and limited sugar diet. I want to start taking a vit d supplement in place of fermented cod liver oil as i dont know,if thats safe for my condition. My drs are mds with no,knowledge of mthfr so I’m in the process of finding an dr knowledgeable about my condition. Any input would be great.thanks ?

  17. River Baggins Avatar
    River Baggins

    Amy Yasko uses folic acid in her vitamin blends, and for a very specific reason, for those that struggle with genetic issues. It is generally needed to balance the GABA/glutamate within our bodies (we often have way too much glutamate built up… not pretty). If you want to read a quote from her about why she chose folic acid for those of us with these genetic issues, check this out:
    https://4beautyinthechaos.wordpress.com/2016/05/22/genetic-shut-offs-through-food/

    1. Wellness Mama Avatar

      I personally stick with the seeking health one, but someone without an MTHFR defect would definitely be able to handle folic acid better.

  18. Mary Avatar

    I posted this on your FB page as well. My questions are as follows:
    I’m taking MoRS methylation donor with methylated folate that includes some other ingredients as well. I heard on a video the other day about treating methylation issues last because the supplementation can strengthen other microbes or bugs that could be a problem in the gut. Should one be concerned about that if they have candida or some other digestive issue? Also do you take your supp with food or without? I saw on one site that said to take MoRS without food. Thank you.

    1. Wellness Mama Avatar

      As far as the microbial/gut interactions, I’d check with a specialist to find out what will work best for your specific mutations and gut bacteria. I take folate without food.

  19. Megan Avatar

    Just realized by kiddos multi vitamin I thought was so great and “clean” has folic acid and not folate. Any recommendations for a kid friendly vitamin? Thank you!

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