Folic Acid or Folate During Pregnancy: Which is Better?
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Folate is the natural and more bioavailable form of Vitamin B9. Folic acid is the synthetic form and less bioavailable of this essential vitamin. Which is why you should avoid taking folic acid and stick to folate during pregnancy.
This article will explain why.
What is Vitamin B9?
Let’s start by talking about vitamin B9.
Vitamin B9 is an essential nutrient that our body uses in red blood cell formation and DNA methylation (the process of gene expression which we talked about in our epigenetics article).
But more than that, vitamin B9 (folate) is really important for your baby. Not having enough folate can cause Neural Tube Defects (NTDs) and other birth defects.
What is Folate?
Folate is the natural form of vitamin B9 unlike folic acid. The active form of folate is L-Methylfolate or 5-methyltetrahydrofolate (5-MTHF).
So, whatever folate rich food you eat or supplement you take, it will first get converted to methylfolate and then be used by the body.
This active form is the most bioavailable form of folate. Bioavailability means that the nutrient will be completely used by the body. If we take a form of a nutrient that is not bioavailable, that means that our body can use all of it. And this is where folic acid comes in.
What is Folic Acid?
Folic acid is the synthetic form of vitamin B9. It’s also known as pteroylmonoglutamic acid.
The reason most people have heard of folic acid and not folate is because folic acid is cheap and shelf stable. So, it is used in supplements and in fortified foods.
Speaking of fortified foods. In 1998, the FDA required that grain based products be “enriched” with folic acid.  They did this to reduce the prevalence of Neural Tube Defects (NTDs) that we mentioned earlier. And guess what? There was a decrease in the prevalence of NTDs in newborns within a few months of the fortification program, according to a 2011 paper. 
How is Folic Acid Converted to Folate?
Folic acid can be used by our body if it is converted to methylfolate (5-MTHF)Here’s what that conversion process  looks like.
Folic Acid → Dihydrofolate (DHF) → Tetrahydrofolate (THF) → L-methylfolate
This means that folic acid has to be converted into two different compounds before it can even be used by the body. This is what we meant by less bioavailable. Because not all of the folic acid is converted to folate.
So, not all of the folic acid you take is absorbed.
But here’s the kicker. Folic acid can’t be converted to folate with methylenetetrahydrofolate reductase (MTHFR). MTHFR is an enzyme that’s needed to complete this conversion. But almost 60% of Americans  have genetic variations that reduce their ability to convert folic acid into folate on their own.
This is why we don’t recommend taking folic acid supplements.
Is Folic Acid Harmful?
Yes, folic acid can be harmful to us.
Our gut has limited capacity to process folic acid. Remember folic acid is converted to DHF. This conversion requires another enzyme called dihydrofolate reductase (DHFR). But folic acid is converted in the liver where there’s low levels of DHFR, which is how unmetabolized folic acid can roam around in the bloodstream and wreak havoc.
Some studies say that folic acid can increase the cancer risk. A 2005 study  also showed that adults who took more than 400 mcg of folic acid had faster cognitive decline than adults who didn’t supplement.
So, instead of taking folic acid supplements, we recommend getting folate directly from your diet.
Sources of Folate
Folate is naturally found in a lot of different foods. A 3 oz serving of beef liver has more than 50% of the recommended daily amount of folate, making it a great source. If you are a vegetarian, a half-cup of boiled spinach can give you 33% of your daily folate needs.
About 15% of your daily needs can be met by a half-cup serving of avocado. Other dark green vegetables aren't far behind, like broccoli, asparagus, and mustard greens. They can give you 13-22% of the folate you need every day. 
Folic acid is added to many grains, like bread and cereal, to make them healthier. Folate, on the other hand, is more likely to be made by the body and absorbed by the body than folic acid. Because of this, eating fortified foods might not give you all the folate you need.
The Bottom Line
Folate is the natural form of vitamin B9 and we recommend taking that over folic acid — especially during pregnancy.
That’s also the reason why we use folate instead of folic acid in our Essentials Shake. Instead of worrying about your genetic disposition to folic acid, you can get your highly bioavailable L-methylfolate through your diet and our essential shake. Plus you don’t have to worry about unmetabolized folic acid either.
 https://pubmed.ncbi.nlm.nih.gov/15824266/ https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/#h3
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