Why I Don't Recommend Folic Acid

fertility Nov 12, 2019

Wait a second, you don't recommend folic acid? Huh?

If you're planning a pregnancy, I'm sure you know how important this nutrient is....

But if you are like the majority of my clients, you probably don't know that folate and folic acid are two different things.

In this article

You'll discover how folate and folic acid differ and why folate is a better choice.

We'll talk about the downsides of folic acid & how you might be consuming it without even knowing it!

I'll also explain how you can choose a high-quality supplement and because you asked for it over on Instagram, I'll give you some brand recommendations.

What’s the difference between Folate and Folic Acid?

Folate is an organic group of water-soluble b-vitamins (various tetrahydrofolate derivatives) known as B9. It's found, naturally occurring, in green leafy vegetables and other whole foods.

Folic acid, on the other hand, is the common term used to describe the synthetic compound (pteroylmonoglutamic acid) which is used in supplements and fortified foods.

So - folate occurs naturally and folic acid does not.

 

Why is folate important for women trying to conceive?

Folate is critical during the very early stages of a baby's development.

By the time you find out you're pregnant, a deficiency may have already caused some issues for your growing baby.

A deficiency can lead to Neural Tube Defects (NTDs) in early embryo development - this is why it's so important to start supplementing during your preconception phase....before you're pregnant.

The most common NTD is spina bifida but other conditions are also linked, include anencephaly, malformations of the limbs, and heart complications.

How Your Body Processes Folate vs Folic Acid

Folate is metabolized by the lining of your small intestine. It goes through a simple change and becomes the active form, tetrahydrofolate (THF) which can then be used by the body.

Folic acid is metabolised differently.

It must be processed in the liver where an enzyme called ‘dihydrofolate reductase’ converts it to THF. But the problem is, this enzyme isn’t very efficient.

An inefficient enzyme paired with an unnaturally high intake of folic acid (due to fortification and supplements) means that some folic acid doesn’t get converted to the active form. 

So, it enters the bloodstream as unmetabolized folic acid.

Folic Acid in our food supply

Because a deficiency in vitamin B9 can cause complications before a woman even know she's pregnant, many countries, including Australia, have mandated folic acid food fortification.

So, if you eat wheat-based bread that isn't organic, it will have folic acid in it.

The great news is that this mandated fortification has achieved what it was set to do - decrease the amount of NTDs in newborns.

However, the risks associated with overconsumption of the synthetic version of B9 compounds have been overlooked and are rarely discussed.

 

Why I don't recommend Folic Acid supplements

  1. Folic acid can potentially mask a deficiency of B12. This is particularly concerning for women eating a plant-based diet as they are more likely to be deficient in this important nutrient.
  2. Anyone with an MTHFR gene mutation has a reduced ability to metabolise folic acid. This mutation is believed to affect roughly 30-50% of the population! 
  3. Folic acid supplements have been associated with an increased risk of respiratory issues and childhood asthma.
  4. There are also concerns around folic acid and cancer, including colorectal cancer.

In most cases, the best way to get any nutrients is through real, whole foods because our body knows exactly how to digest and utilise these nutrients!

Getting folate from whole foods

Below is a list of 7 real-food sources of folate.

As a guide, a healthy adult requires 400 mcg, and a pregnant woman should aim for 800-mcg daily.

  • Lentils: 1 cup = 358.38 mcg, 45% DV
  • Asparagus: 1 cup =  268.20 mcg, 33.5% DV
  • Spinach: 1 cup = 262.80 mcg, 33.3% DV
  • Turnip Greens: 1 cup = 169.92 mcg, 21% DV
  • Broccoli: 1 cup = 168.48 mcg, 21% DV
  • Beets: 1 cup = 136 mcg, 17% DV
  • Romaine Lettuce: 2 cups = 127.84 mcg, 16% DV

The daily value (DV) percentages above are based on an 800 mcg dietary intake – the amount generally recommended during pregnancy.

What About Folate Supplements?

If you choose to take a prenatal supplement, check the label to ensure that you’re supplementing with folate, not folic acid. If it contains folate, the label will say “5-methyltetrahydrofolate” or “5-MTHF”.

High-quality options you can purchase online:

Frequently Asked Questions

Q. When should I start increasing my intake of folate and/or supplementing?

A: I recommend a 3-month preconception phase as the minimum, 6 months if you've recently stopped using combined hormonal birth control.

Q. How long should I continue with the increased amount?

A: Throughout pregnancy and for 6-12 weeks after delivery or for as long as you are breastfeeding, unless otherwise advised by your doctor.

Q. How much folate is too much when you're pregnant?

A: The body does not store whole food-derived folate and this is why I recommend it over folic acid.

Remember -  even during the earliest stages of pregnancy, rapid cell duplication is taking place, and your body needs proper nutrition!

Consult with your doctor or health care practitioner (as soon as you make this exciting decision) to discuss any health concerns you may have.

 

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