Folate supplementation is one of the first recommendations made by health professionals to any woman planning to have a baby or who is in the early stages of pregnancy.  It’s a nutrient involved in many body processes. One of its most important roles is in the development of baby’s nervous system.  When it comes to choosing a folate supplement, there are a lot of options out there. Many ask what the difference between folic acid and folate is and whether they can get enough in their food. So I thought I would wrap all up into one snappy blog post for you.

 

Let’s Start at the Top: What is folate, and what is it in?

Folate was discovered in 1941, and its name comes from ‘folium’ which is Latin for ‘leaf’. Folate is a naturally occurring B-vitamin (vitamin B9) found in raw, green leafy vegetables and to a lesser extent in organ meat.

The tricky part is, it is susceptible to heat. So a bed of steamed spinach – while beautifully healthy – has very little folate left.  Due to this slight handicap, scientists developed a synthetic version called folic acid which proved to be much more heat stable. Folic acid is what is still used to fortify many breads and cereals in Western countries.

Us humans have evolved eating a diet rich in raw greens. As a result, our nutritional requirements for folate are high. Research has shown that even fortification of folic acids in bread and cereals is not enough for modern pregnant women to get the optimal amount to prevent pregnancy complications.

There are a handful of different folate supplements out there on the market, some superior to others. Folic acid was the first synthetic version of folate produced. The benefits are it is cheap and widely available.

Research and more sophisticated methods of manufacture have produced two other forms that are “activated folate”. “Activated” means our bodies are better able to absorb them and put them to use.  These are folinic acid and methyl-tetrahydrofolate (MTHF).  I recommend taking one of these two.

 

Why folate is so important in preconception and early pregnancy?

Folate plays an essential role in DNA synthesis.  Quick biology lesson! DNA is genetic material found in every single cell in our bodies. It is our unique recipe book of information that tells the body how to function. We inherit half from our mum and a half from our dad. The process of growing a baby involves a lot of cells multiplying and growing! For all those cells to be healthy and developed, proper DNA synthesis needs to occur.

If this step is not completed, it can lead to complications including neural tube defects (also called spina bifida), cleft lip and learning disabilities in baby. For Mumma, it can be a risk factor for preeclampsia and miscarriage.  In short, it is a very, very important nutrient!

 

Folate and MTHFR Explained

Methylenetetrahydrofolate reductase (MTHFR for short) is simply an enzyme that is determined by our genetics, as to whether it can turn folic acid into activated folate that the body can then use. Some people lack this enzyme, or the enzyme doesn’t work as actively as others, and it is challenging to get folate levels up to a level that is essential for a healthy pregnancy.

If you have a personal of family history of any of the following, it’s worthwhile getting tested:

•  fertility challenges
•  cancer
•  mental health conditions
•  cardiovascular disease

It’s a straightforward blood test that you may have to pay out of pocket for, but it’s typically between $50 – 60 (AUD). Taking a good quality prenatal that already has folate in an activated form is another simple strategy you could use. I highly advise working with a practitioner with holistic training to rule in or out whether you have a genetic mutation that impacts your ability to use folate if you have a personal or family history of recurrent miscarriages.

 

Folate Supplementation

The companies that I recommend are (please note I don’t have any affiliation with these companies, I just like their products):

Bioceuticals: Folinic Acid or Methyltetrahydrofolate.
Thorne Research’s: Basic Pre-Natal and 5-MTHF.

If you’re planning on having a baby in the next 3–6 months, you can start now.  The general recommendation is to start one month before trying to conceive and to continue throughout pregnancy. The most crucial window being in those first two months. 

The dosage of folate is 500 – 1000mcg of folate is recommended.  Make sure you are eating a diverse, healthy diet and getting plenty of natural folates too. Think lovely big green salads, raw kale or spinach in smoothies and cold-pressed green juices.

If you would like a simple down to earth preconception plan, make sure you download this checklist that will include other essential factors to concentrate on as you prepare for pregnancy.

 

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Resources & References:

Bjelland, I., Tell, G. S., Vollset, S. E., Refsum, H., & Ueland, P. M. (2003). Folate, vitamin B12, homocysteine, and the MTHFR 677C->T polymorphism in anxiety and depression: The Hordaland Homocysteine Study. Archives of General Psychiatry, 60(6), 618–626. https://doi.org/10.1001/archpsyc.60.6.618

Chen, H., Yang, X., & Lu, M. (2016). Methylenetetrahydrofolate reductase gene polymorphisms and recurrent pregnancy loss in China: A systematic review and meta-analysis. Archives of Gynecology and Obstetrics, 293(2), 283–290. https://doi.org/10.1007/s00404–015–3894–8

Gaskins, A. J., Mumford, S. L., Chavarro, J. E., Zhang, C., Pollack, A. Z., Wactawski-Wende, J., Perkins, N. J., & Schisterman, E. F. (2012). The Impact of Dietary Folate Intake on Reproductive Function in Premenopausal Women: A Prospective Cohort Study. PLoS ONE, 7(9). https://doi.org/10.1371/journal.pone.0046276

Puri, M., Kaur, L., Walia, G. K., Mukhopadhhyay, R., Sachdeva, M. P., Trivedi, S. S., Ghosh, P. K., & Saraswathy, K. N. (2013). MTHFR C677T polymorphism, folate, vitamin B12 and homocysteine in recurrent pregnancy losses: A case control study among north Indian women. Journal of Perinatal Medicine, 41(5), 549–554. https://doi.org/10.1515/jpm–2012–0252

Trimmer, E. E. (2013). Methylenetetrahydrofolate reductase: Biochemical characterization and medical significance. Current Pharmaceutical Design, 19(14), 2574–2593. https://doi.org/10.2174/1381612811319140008

Yadav, U., Kumar, P., Yadav, S. K., Mishra, O. P., & Rai, V. (2015). Polymorphisms in folate metabolism genes as maternal risk factor for neural tube defects: An updated meta-analysis. Metabolic Brain Disease, 30(1), 7–24. https://doi.org/10.1007/s11011–014–9575–7

Zhang, T., Lou, J., Zhong, R., Wu, J., Zou, L., Sun, Y., Lu, X., Liu, L., Miao, X., & Xiong, G. (2013). Genetic Variants in the Folate Pathway and the Risk of Neural Tube Defects: A Meta-Analysis of the Published Literature. PLoS ONE, 8(4), e59570. https://doi.org/10.1371/journal.pone.0059570

Zhu, X., Liu, Z., Zhang, M., Gong, R., Xu, Y., & Wang, B. (2016). Association of the methylenetetrahydrofolate reductase gene C677T polymorphism with the risk of male infertility: A meta-analysis. Renal Failure, 38(2), 185–193. https://doi.org/10.3109/0886022X.2015.1111086