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Prenatal Vitamins: Folate or Folic Acid

Folate vs. Folic Acid: the Vitamin B9 Discussion

This discussion will be a long one, but I am planning on making this as simple as possible to understand. The quick summary is this – Yes, there is a difference. You want folate, not folic acid. But let’s dive a little deeper and understand the difference.

Folate and Folic acid, what’s the difference?

Folate is the active form. Folate is found in food and can be easily converted into L-5-methyltetrahydrofolate (5-MTHF). This active form of folate can now be found in certain prenatal vitamins.

Folic acid is the synthetic form of folate. This is generally found in supplements and added to processed foods. Folic acid absorbs readily into the blood, but it is very difficult to convert into active folate.

What in the world is MTHFR?

There is one more thing to this story that needs to be mentioned. In order for the body to convert folic acid and folate into the active 5-MTHF, they need a specific enzyme called methyltetrahydrofolate reductase (MTHFR). The body makes this by reading your genes, which most people have two copies of, and make plenty of the enzyme. However, approximately 50% of the population (this number may go up and down depending on what source, so I averaged it out) has a mutation in a least one of their genes, leading to a decreased rate of production of their MTHFR enzymes. That leads to a decreased rate of conversion of folic acid and folate into the active form. To find out if you have the mutation, you can get genetic testing performed for this gene specifically.

Why do we need folate?

Let’s look at how it helps the baby grow. Folate helps with neural tube development by facilitating DNA replication. The neural tube eventually becomes the brain and spinal cord. Inadequate folate can lead to defects in the neural tube. The two most common defects include spina bifida (inadequate closure of the vertebrae, allowing the spinal cord to be exposed, which may develop additional problems) and anencephaly (missing all or parts of their brain, and usually do not survive long after birth).

So why is folic acid bad?

It takes a long time to convert folic acid into folate, so you may not be getting as much folate as you need, especially if you have the gene mutation. If you are pregnant, this could be especially harmful for the baby during the first trimester, when the neural tube is developing. Excessive amounts of the synthetic folic acid have been linked to cancer growth and development. Folic acid may also mask a Vitamin B12 deficiency, which can lead to dementia or other nerve damage.


Wow, that was a lot. I’m going to try and summarize now. Folate, found in foods, is important because your body can easily process it, and during pregnancy it can help reduce the development of neural tube defects. Folic acid can be beneficial if you have a deficiency in that vitamin, but it takes longer to process and could potentially be harmful to the baby and mother.

The folate vs. folic acid debate is a relatively recent one, as the research and evidence regarding MTHFR gene mutation is rather new. At the current time, the medical community continues to recommend prenatals with folic acid as opposed to folate.

Food Sources

Best food sources of folate include green leafy vegetables, asparagus, avocados, and brussels sprouts.


All values are based on daily serving size.

Thorne 1000 mcg
SmartyPants 800 mcg
Kirkland 0 (1000 mcg)
VitaFusion 0 (800 mcg)
NatureMade 0 (800 mcg)
Metagenics 1000 mcg
Klaire 800 mcg

Needed during pregnancy – 600 mcg

Our Take: Seeing how important folate is for the development of the baby’s nervous system, I’d look for a prenatal with a substantial amount of folate. Thorne and Metagenics take the cake here. Three of these contain folic acid, which I highly discourage from taking. It will likely be a while before the medical community begins to change their recommendations for prenatals with folic acid to prenatals with the proper form of folate to ensure proper fetal development. If you don’t plan to test for the MTHFR mutation, stick with folate and make sure your prenatal’s label says L-5-methyltetrahydrofolate (5-MTHF) as many labels can be tricky by saying “Folate (from folic acid)”.

The next post will be discussing vitamins A, C, and D.

These blogs will be posted on Tuesday & Friday throughout the month of July. Click here to subscribe so you don’t miss a post!

Click here to read the first blog of the series: Why should I take a prenatal?

Click here to read the second blog: Prenatal Vitamins: Overview

Click here to read the third blog: Prenatal Vitamins: Calcium and Iron

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