Prenatal Vitamins During Pregnancy: Folate
Written by Yuchen He, BS degree in biology and public health, MS candidate in nutrition at Tufts University
Medically Reviewed by Lauren Manaker, MS, RDN, LD, CLEC, CPT
Introduction: What's the difference between folate, methylfolate, and folic acid
Folate and folic acid are a popularly discussed vitamin during pregnancy – and it’s important. However, while popularly discussed, people still find themselves asking what the difference is between folate v. methylfolate v. folic acid. Before we dig into the definition of each and the differences, let’s start with a few basics on why this vitamin is important. Research suggests that supplementation may help prevent neural tube defects and other pregnancy-related outcomes such as pre-term birth. The neural tube develops into the brain and spinal cord early on during pregnancy – in the first 17-30 days after conception – before someone may even know they are pregnant.
What is folate?
While the importance of folate during pregnancy is often discussed, you may have asked what is folate v. methylfolate v. folic acid. If this sounds like you, you may have heard the many names of vitamin B9: folate (the general term for all forms of vitamin B9), folic acid (the most common synthetic form), and methylfolate (the active form of folate). So, in summary, folate is the general term for all forms of vitamin B9 – including folic acid and methylfolate.
Folate is naturally present in a wide variety of foods, including the following with some of the highest folate levels:
- Beef liver (Folate, total: 253 mcg in 100g)
- Asparagus (Folate, total: 149 mcg in 100g)
- Black-eyed peas (Folate, total: 142 mcg in 100g)
- Spinach (Folate, total: 114 mcg in 100g)
However, it turns out that it is hard to obtain enough folate from food alone, especially if you are pregnant. So, it is important for pregnant people and those who are trying to conceive take a supplement, based on the Dietary Guidelines for Americans, 2020-2025.
What is folic acid?
Folic acid is a synthetic form of folate commonly used in dietary supplements. Additionally, there are foods fortified with folic acid, such as enriched bread, pasta, rice, and some breakfast cereals.
As it relates to absorption, folic acid is better absorbed when consumed with food. Additionally, our body absorbs more folate from folic acid and folic acid fortified foods than it absorbs folate that occurs naturally in foods.
What is methylfolate?
When it comes to methylfolate vs. folic acid, it’s important to know that methylfolate, also called 5-methyl-THF, L-5-MTFH, 5-MTHF, or L-methylfolate, is the active form of folate.
What is an active form of folate? When consumed, folates in food or folic acid in supplements go through a chain of metabolic reactions and become methylfolate. Methylfolate is the main form of folate circulating in our blood. Sound complicated? In other words, since methylfolate is the active form of folate, the body can use it directly upon consumption and no further metabolic reactions are needed.
One population who especially benefits from methylfolate are those with a mutation in the MTHFR gene. People with this mutation have fewer active enzymes and may benefit from the methylfolate form because no metabolic reactions are needed.
However, since there is not enough research on the efficacy of methylfolate supplementation on preventing neural tube defects, the current Dietary Guidelines for Americans still recommend taking supplements in the folic acid form.
Conclusions: From our prenatal smoothie nutrition team
Always talk to your doctor to figure out what is right for you when evaluating methylfolate vs. folic acid. However, based upon the research, here are a few data points and takeaways to help you make an informed decision:
- Eat foods with folate (like leafy greens – fresh or frozen are great!) as well as take a supplement - the recommended supplement amount is in addition to the amount of folate in a healthy eating pattern
- The United States Preventative Service Task Force (USPSTF) recommends those who are trying to conceive to take a daily supplement of 400 to 800 mcg of folic acid
- The American College of Obstetrician and Gynecologists recommends taking 400 mcg folic acid supplement starting at least one month before pregnancy, and during the first 12 weeks of pregnancy
- Folic acid supplements are better absorbed when consumed with food
Looking for more? Read up about folate from the Folate Fact Sheet from National Institutes of Health.
Disclaimer: The information provided on this site is for educational purposes only, and does not substitute for medical advice. Always consult a medical professional or healthcare provider related to medical advice, diagnoses, or treatment.
Yuchen He is a current student working towards her MS degree in nutrition at Tufts Friedman School of Nutrition Science and Policy, and dietetic certificate at Simmons University. She graduated from Brandeis with a BS in biology and public health.
Medically Reviewed By Lauren Manaker
Lauren Manaker is the Leto Foods Nutrition Advisor. Lauren is an award-winning registered dietitian nutritionist, certified lactation educator-counselor, and book author. She specializes in women's health and holds a position on the executive committee of the Women's Health DPG of the Academy of Nutrition and Dietetics. Lauren earned nutrition degrees from the University of Florida, Rush University, and University of California, San Diego. Follow her at @LaurenLovesNutrition on Instagram.