Erin Stokes, ND | March 2022

Unless you have a degree in nutrition, understanding vitamins, minerals, and the roles they play in your health can be rather daunting. Add to that the unique nutritional needs during pregnancy and beyond, and navigating your health needs can feel like a minefield.

At the top of the list of potentially-confusing nutrients is Vitamin B9, though it’s likely more familiar to you as folate or folic acid, and it plays a huge role in pregnancy and women’s health. Folate/folic acid are needed throughout pregnancy - though most important in the first trimester - to support the development of baby’s brain and spine.* If you’re pregnant or considering pregnancy, you’ve likely heard of the potential for neural tube defects in early pregnancy (often before many women know they are pregnant), which can directly be prevented with adequate intake of vitamin B9. For this reason, the CDC recommends at least 400 mcg of folic acid daily for women in their reproductive years, and up to 600-800 mcg during pregnancy.

Folate v Folic Acid

When it comes to supplementing with this nutrient, there are two common forms vitamin B9 is found in - folate (the active form, often referred to as methylated, or 5-MTHF) and folic acid (the in-active form).

Naturally, the most common question is - which is better?

To answer this question, we reached out to both a naturopathic doctor and a medical doctor to get their take, and here’s what they had to say:

Both folic acid and 5-MTHF increase folate concentrations to the level that is considered to be protective for neural tube defects. Folic acid is a synthetic compound that has no biological function until it is reduced to dihydrofolate and tetrahydrofolate. Most individuals are able to make this conversion. However there are some genetic variations that can impact our ability to convert folic acid to the active form. 5-MTHF is the predominant form in our body that is readily available for transport and metabolism.

As far as safety goes: Dietary supplementation with L-5-MTHF-calcium has several advantages over folic acid. As the predominant naturally present form of folate in food, serum and breast milk, ingested L-5-MTHF requires only glutamation during absorption and then it can directly enter the circulation, whereas folic acid does not occur naturally in foods in significant amounts and before being used must first be converted to L- 5-MTHF in several enzymatic steps.

What this means for you: At the end of the day, it is all about what works best for your body. Folic acid is a safe compound known to prevent common complications in early pregnancy (when consumed under 1000mcg according to the NIH), and it requires conversion in the body - something many of us can do! Folate is considered the biologically active form of this nutrient, and requires less work by the body to absorb, while still providing protection against neural tube defects.

1. https://www.news-medical.net/health/Folic-Acid-Biology.aspx
2. https://www.cdc.gov/ncbddd/folicacid/about.html

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.