Natural Folate vs. Folic Acid, Fertility & Pregnancy
If you find yourself asking what’s the difference between folate and folic acid, or perhaps you didn’t even realize there was a difference, you’re not alone. Many health care professionals mix up the terms and use them interchangeably.
They are not the same.
Folate and folic acid are two distinct compounds with two key differences in function. Folate is the natural version of vitamin B9 and folic acid is a synthetic form. They are not interchangeable because they have different paths in the body.
Doctors and even some nutritionists are prescribing the synthetic form, especially to women trying to conceive or those with fertility challenges.
In terms of providing the body with bioavailable nutrients, dietary folate, the form found naturally in foods like liver, eggs, asparagus, broccoli, brusel sprouts and dark leafy vegetables is healthier to the synthetic folic acid found in many supplements and manufactured processed foods.
Why Is There a Synthetic Version like Folic Acid?
The Food and Drug Administration (FDA) requires that manufacturers in the United States add folic acid to many foods, and 42 other countries around the world have similar requirements.
About 20 years ago the FDA mandated that folic acid be added to processed grain products (i.e., bread, pasta, rice, and cereal).
This was deemed necessary due to overwhelming evidence that increasing folate before and during early pregnancy could protect against neural tube defects (NTDs). Neural tube defects are issues with spinal cord development (e.g., spina bifida) and brain development (e.g., anencephaly) that happens during an early period of growth in the womb.
I know it goes without saying, but this is a big deal!
In fact, according to the Centers for Disease Control and Prevention (CDC), at least half of the 300,000 cases of neural tube defects around the world each year can be prevented by getting adequate amount of folate in your diet.
Why Is Folate Needed?
Folate is an essential nutrient critical for the growth of healthy cells and DNA creation. Folate helps your tissue grow and your cells work. This B vitamin also works with vitamin B12 and vitamin C to help the body break down, use, and create new proteins.
Folate also works with vitamins B6 and B12 to control blood levels of the amino acid homocysteine. High levels of homocysteine are associated with heart disease and as well as recurrent pregnancy loss.
Folate helps form red blood cells (prevents anemia) and supprt proper brain and immune function. This is why it’s extremely important to get plenty of folate during pregnancy, and it’s a key component of my prenatal vitamins.
Differrent Paths of Folate and Folic Acid
The biologically active form of folate is 5-methyltetrahydrofolate (5-MTHF). This is the form your body uses. Your body takes the folate you eat and converts it into 5-MTHF within the digestive tract with the help of an enzyme called methylenetetrahydrofolate reductase (MTHFR).
However, when it comes to folic acid the body is unable to convert it all to the active form in the gut, and relies on other organs like the liver to create a form the body can use. This is an inefficient and slow process, which is why some women end up with elevated levels of folic acid in their blood, which can lead to a number of health issues.
This is why you'll sometimes hear it said that people with an MTHFR genetic abnormality should be advised to eat whole food forms of folate and avoid supplements with folic acid. The idea is to provide a form of folate that is more readily absorbed and utilized by the body.
What Are The Health Benefits Of Folate?
Folate has many health benefits, unlike the synthetic folic acid. The most notable benefits of folate include:
- Healthy fetal development during pregnancy
- Support mature egg quality and health
- Potentially protective against cardiovascular disease
- May reduce the risk of cancer
- Could help protect against Altzheimer’s disease
- Possibly effective for depression
Importance of Folate For Fertility
In case you’re curious about the details, the researchers found a 62% greater probability of live birth among women with the highest levels of folate in their bodies (>26.3 ng/mL) compared to the women with the lowest levels of folate (<16.6 ng/mL).
Also research shows that women who are mindful of ther folate comsumption before IVF treatment have been found to have a higher proportion of mature eggs as well as eggs of higher-quality.
Importance of Folate For Pregnant Women
Getting the right amount of folate is important for pregnant women, especially very early in pregnancy. Sufficient levels of folate during pregnancy help to reduce the risk of birth defects, and help to ensure healthy growth and development of baby.
Low folate levels has been associated with decreased risk of neural tube defects, congenital heart defects, and oral clefts, i.e. cleft palate. Some research has also suggested that pregnancy outcomes may be affected by folate intake, likely due to the role folate plays in the very early stages of the development of the placenta.
Also, because natural folate is used so liberally by the developing baby, it’s important for the mother to increase folate consumption, BEFORE pregnancy.
As I always explain, I’d love for women to start preparing their bodies for pregnancy well before conceiving. Aim for a minimum of six months’ preparation to ensure the best outcomes for you and baby.
Beyond just folate supplementation, it’s also critical to get your microbiome in top form (since it becomes your baby’s foundation for his or her immune system). The Super Gentle Cleanse is a great start.
What Are Symptoms Of Folate Deficiency?
Symptoms are folate deficiency include:
Symptoms of children born to women who had folate deficiency during pregnancy
- Low birth weight
- Neural tube defects
- Developmental delays and seizures
Sometimes people are unable to absorb adequate folate, even if they’re consuming enough. This is true for people with digestive disorders like Crohn's, ulcerative colitis, or celiac disease. Other people struggle to process B vitamins efficiently due to a common genetic mutation that’s referred to as Methylenetetrahydrofolate reductase (MTHFR) gene variant.
Do You Need Folate Even If You’re Not Pregnant?
While pregnancy is the most crucial time to focus on folate, it’s certainly not the only time. Surely if you’re even thinking about conceiving, folate intake should be at top of mind.
How Much B9 Do You Need?
The recommended daily allowance (RDA) for folate is 400 micrograms (mcg). For pregnant women, the recommendation rises to 800 mcg.
Again, this is a recommendation for folate, not folic acid.
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