The little known (but crucial) difference between folate and folic acid

If I asked you which of these vitamins was found naturally in food, folate or folic acid, would you know the answer? If not, you’re in good company. Medical professionals, nutrition experts, and health practitioners frequently mix up the two, simply because the terms are often used interchangeably.

Many health professionals would even argue that folate and folic acid are essentially the same nutrient. While folic acid is often considered to be a supplemental form of folate, there is an important distinction between these two different compounds. For women past childbearing age, and for men in general, excessive doses of the synthetic form of this nutrient are not necessary, and may even be harmful.

What’s the difference between folate and folic acid?

Folate is a general term for a group of water soluble b-vitamins, and is also known as B9. Folic acid refers to the oxidized synthetic compound used in dietary supplements and food fortification, whereas folate refers to the various tetrahydrofolate derivatives naturally found in food. (1)

The form of folate that can enter the main folate metabolic cycle is tetrahydrofolate (THF). (2) Unlike natural folates, which are metabolized to THF in the mucosa of the small intestine, folic acid undergoes initial reduction and methylation in the liver, where conversion to the THF form requires dihydrofolate reductase. The low activity of this enzyme in the human liver, combined with a high intake of folic acid, may result in unnatural levels of unmetabolized folic acid entering the systemic circulation.

Several studies have reported the presence of unmetabolized folic acid in the blood following the consumption of folic acid supplements or fortified foods. (3) Human exposure to folic acid was non-existent until its chemical synthesis in 1943, and was introduced as a mandatory food fortification in 1998. (4) Food fortification was deemed mandatory due to overwhelming evidence for the protective effect of folic acid supplementation before conception and during early pregnancy on the development of neural tube defects (NTD) in newborns.

Risks associated with excessive folic acid intake

While the incidence of NTDs in the United States been significantly reduced since folic acid fortification began, there has been concern about the safety of chronic intake of high levels of folic acid from fortified foods, beverages and dietary supplements. (5) One of the major risks associated with excessive intake of folic acid is the development of cancer. (6) In patients with ischemic heart disease in Norway, where there is no folic acid fortification of foods, treatment with folic acid plus vitamin B12 was associated with increased cancer outcomes and all-cause mortality. In the United States, Canada, and Chile, the institution of a folic acid supplementation program was associated with an increased prevalence of colon cancer. (78) A randomized control trial found that that daily supplementation with 1 mg of folic acid was associated with an increased risk of prostate cancer. (9)

Researchers have hypothesized that the excessive consumption of folic acid in fortified foods may be directly related to the increase in cancer rates. Excess folic acid may stimulate the growth of established neoplasms, which can eventually lead to cancer. The presence of unmetabolized folic acid in the blood is associated with decreased natural killer cytotoxicity. (10) Since natural killer cells play a role in tumor cell destruction, this would suggest another way in which excess folic acid might promote existing premalignant and malignant lesions.

A high intake of folic acid might mask detection of vitamin B12 deficiency and lead to a deterioration of central nervous system function in the elderly. In one study, consumption of folic acid in excess of 400 micrograms per day among older adults resulted in significantly faster rate of cognitive decline than supplement nonusers. (11) Another study found a higher prevalence of both anemia and cognitive impairment in association with high folic acid intake in older adults with a low vitamin B12 status. (12) As vitamin B12 deficiency is a common problem for many older adults, these studies suggest that high folic acid intake could cause serious cognitive consequences in the elderly.

Folate from natural food sources is best

Despite the risks associated with high levels of folic acid intake, it is well established that adequate folate intake from the consumption of folate-rich foods is essential for health. Folate aids the complete development of red blood cells, reduces levels of homocysteine in the blood, and supports nervous system function. It is well known for its role in preventing neural tube defects in newborns, so women of childbearing age must be sure to have an adequate intake prior to and during pregnancy.

Excellent sources of dietary folate include vegetables such as romaine lettuce, spinach, asparagus, turnip greens, mustard greens, parsley, collard greens, broccoli, cauliflower, beets, and lentils. (13) Not surprisingly, some of the best food sources of folate are calf’s liver and chicken liver.

You can supplement with folate if your dietary intake is inadequate. Look for products that contain the Metfolin brand, or list “5-methyltetrahydrofolate” or “5-MTHF” on the label. Avoid products that say “folic acid” on the label. Make sure to check your multivitamin, because most multis contain folic acid and not folate.

Women planning on becoming pregnant should consume between 800 and 1200 mcg of folate per day for several months before the start of pregnancy. Unless you’re consuming chicken or calf’s liver and substantial amounts of leafy greens on a regular basis, it’s difficult to obtain this amount from diet alone. If you’re pregnant or trying to get pregnant, I recommend supplementing with 600-800 mcg of folate per day, depending on your dietary intake. Solgar is a good brand, but there are several others that typically use 5-MTHF including Designs for Health, Thorne, Metabolic Maintenance and Pure Encapsulations.

All other people, such as men and older women, should be able to get plenty of folate in a diet with adequate vegetable consumption, and do not need to supplement.

Like what you’ve read? Sign up for FREE updates delivered to your inbox.

  • I hate spam too. Your email is safe with me.

Comments Join the Conversation

  1. says

    Genovas Organic acids test indicated for me a Folate and other B vitamin deficiencies in multiple markers. I wonder if supplementing would be in any way safer in this situation? Or is the test even reliable. All my Genova tests are visible at my website.

  2. Thomas says

    Hi Chris,
    Thanks for the good work you are doing for everyone. I daily take a New Chapter 40+ Every Man’s One Day Multi and have spoken with the company to inquire about the source of the folate in this product. They explained that they start with a synthetic folic acid and use a double fermented process using Brewer’s yeast to create the folate that they eventually use. Could you kindly shed some light on what this means and if you would recommend switching to a different source of folate? Much thanks for your help and your time.
    Best,
    Thomas

  3. Jennie Parker says

    Good morning Chris!!

    Firstly, this article was greatly beneficial to me!!! Thank you for bringing up the concern with folate v. folic acid. I know you get so many comments and questions everyday, so I will try to keep mine brief. I am currently debated to use a supplement from a company called MyNutrition Source. The product is Doctor’s Choice Thyroid Synergy. It’s second ingredient listed on the label is Folate (as Folic Acid) 600mcg per day. With the way it is worded does that mean that it is just folic acid or could it be folate? What is you advice with taking the product? Thank you so much for your time with answering my question!!! Have a great day!!!

    Jennie

  4. Sheryl says

    My son has severe food allergies. I found Metagenics Ultra-Care For Kids, and I use it in smoothies and it has been very helpful. However, it has folate, listed in the ingredients as Folic Acid. Every other supplement or powder I have seen contains soy, often listed as vitamin E or tocopherols, and he is very allergic to soy. I don’t know what to do now. I don’t want to give my son something he is allergic to, and I don’t want to give him something that causes cancer…

  5. Michael Mooney says

    While I see a big “to-do” about people with a MTHFR genetic defect needing to take folate, because there is a misunderstanding that folic acid does not convert for us, the fact is, according to Gilbody S, Lewis S, Lightfoot T. Methylenetetrahydrofolate reductase (MTHFR) genetic polymorphisms and psychiatric disorders: a HuGE review. Am J Epidemiol. 2007 Jan;165(1:1-13/
    Epub 2006 Oct 30 we DO convert folic acid at a rate of 30% to 60%. And since some people with the MTFHR defect have terrible side effects when we take folate, according to “Methylfolate Side Effects. MTHFR.net. March 1, 2012,” if we take a high dose of folic acid, such as 1,000 mcg or even up to the prescription 5,000 mcg of folic acid, we convert enough folic acid, when added to what we get from food that it appears that just taking inexpensive folic acid is superior to taking more expensive folate, because folic acid does not cause the side-effects that folate can cause for some people. I know that my blood tests show no difference in homocysteine if I take folate or folic acid, because the multivitamin that I take gives me 1,000 mcg of folic acid. After doing blood tests I conclude that buying an extra folate supplement as 5-methyltetrahydrofolate is a waste of money and so I will continue to just get 1,000 mcg of folic acid from the multivitamin that I take. As to which multi to take for pregnancy, Googling shows that Super Nutrition SimplyOne Prenatal, which provides 1,000 mcg of folic acid, gets 5 stars. I know the product well, because my father created it, and it is the best buy in the world, with the highest potencies of critical nutrients for pregnancy for the least amount of money spent (for instance, it has 3,000 IU of vitamin D), so that is my disclaimer. But also, as you can see, I only deal with facts, backed by published data.

  6. Jaclyn says

    Just came across this website.
    I have never been so confused in my life! I’m 32 years old and want to start trying to conceive and I keep procrastinating because I can’t find a consistent answer as to what and how much to take. When I asked my Dr to recommend a brand of pre natal vitamins I was told to just buy whatever is on sale in the store! I’m not a big pill taker and everything I look up has terrible reviews. I do not want to take a vitamin that is going to make me nauseous or vomit all day. I came across metagenics folapro but there is no answer if that is safe to take before or during pregnancy and there customer service had no answer for me. It’s description is its for the MTHFR mutation which I’ve never heard of and have no idea if I have or not. Some on here say we should be taking folate while others are saying that has terrible side effects and just take folic acid. Can someone please help me! I currently take 400mg of magnesium glycerinate and fever few for migraines and just want to know what to take for pre conception and during pregnancy?!

  7. Cindy says

    Just checked out Pure Encapsulations website and the ingredient list for the prenatal contains 1mg of folic acid.

    Chris, do you still recommend this brand?

  8. Nancy Anderson says

    I have elevated rbc folate levels and elevated serum folate levels( not folic acid) I am homo for the 667 gene mthfr. I know thT at least 60. Percent of the folate level that is tested is the methylated form. Any ideas why it is so high fserum is greater than 20 and rbc is 1244. Thank you!!!

  9. Lucia says

    For whatever it’s worth – and I hope this helps alleviate fears in expectant women who have been using folic acid to prevent NTD – I had been taking 400 mcg of folic acid daily for about ten years prior to the birth of my son. I was in my late 30’s by then, taking twice that dose during pregnancy, and I thank God that he was and is a bright, healthy, and handsome fellow (now an honors student in his junior year at college). I realize, after reading Chris’s information, that I may have been blessed with better than average dihydrofolate reductase conversion, but this seems unlikely for an “elderly primipara” originally prescribed folic acid for hypermethioninemia.

  10. Rock says

    L-5-MTHF should only be taken if a person has been tested and found that their body cannot convert Folic Acid into Folate.

    L-5-MTHF is actually a drug that was cleared for over the counter supplementation a few years ago.

    We had it in our Multi-vitamins from Thorne Research and experinced most of the below symptoms. We took multi for alomot 6 months and were always dizzy, couldn’t sleep, had headaches and dry mouth and lips.
    We tried Vital Nutrients and got the same results

    Wet back to Pure Essence Labs with regular folic acid and our symptoms went away inside of 10 days. Tried another multi with L-5-MTHF and symptoms came back within a couple of day.

    No more L-5-MTHF for us.

    Methylfolate Side Effects:

    irritability
    insomnia
    sore muscles
    achy joints
    acne
    rash
    severe anxiety
    palpitations
    nausea
    headaches
    migraines

  11. Carol says

    I have many MTHFR hetero and homozygous mutations. Since I haven’t felt well (very unwell, in fact) for the last 9-12 months, I’ve been tested for bookoos of things and the only test that comes out slightly above reference is my alkaline and a very high B12. I did most of the B12 testing that’s been suggested (serum b12, homocysteine, methylmalonic acid, unsaturated b12 binding capacity, they couldn’t do the holotranscobalamin) as well as many, many other blood tests, but I just noticed I’ve never been tested for folate. I read that labs often don’t test for this any longer because it’s so rare to have a folate deficiency. I’m a little confused about folate because B12 is a folate, but folate includes other B vitamins as well, right? Is folate testing something I should seek? I pretty much decided I must have suddenly turned into a hypochondriac at 57 since my functional doctor (who BTW knows nothing about gene mutations) seems to think I’m fine. Aargh. :-(

    • Wendy says

      You can get MTHFR genetic testing ordered through your GP. Its no different to getting any other blood test except your GP ,if like mine, possibly wont have a clue what it is, will spend a while telling you it makes no sense and will try and talk you out of bothering. If you want it done be persistant!

    • Kathryn says

      This reference disagrees… http://www.fao.org/docrep/004/Y2809E/y2809e0a.htm
      “folic acid is reduced in cells by the enzyme dihydrofolate reductase to the di- and tetrahydro forms. This takes place within the intestinal mucosal cells.” The above article says this takes place in the liver. Seems like this needs to be rectified.
      I appears that folic acid is much more bioavailable than food folate, because folic acid is a predigested form, and could easily lead to overdosing, which is always a problem.

  12. Wendy says

    I know its wikipedia BUT i just read this:

    “And Folinic Acid should not be administered to pregnant woman because it can weaken the unborn baby’s immune system”

    And i was just about to purchase it to use pre-conception and through first trimester. Whether its right or wrong i now see i need to read more!!

    • Kathryn says

      It does say on Wikipedia that folinic acid should not be confused with folic acid. Folinic acid is a chemo therapy. Cheers.

  13. Allie Williams says

    Hi Chris,

    Dr. Lynch (mthfr.net) discusses that the word “folate” is an umbrella term for the various folates out there. In medicine, this ‘folate umbrella’ refers to ‘folic acid’, ‘folinic acid’, and ‘methyl folate’. I noticed you didn’t differentiate folinic acid & methyl folate … and instead just referred to them as “folate”. Wouldn’t this still refer to ‘folic acid’ in some way? Just seeking clarification.

    Thank you. :)

  14. Michwag says

    I am trying to find the 5-methyltetrahydrofolate you mention in the article. I’ve copied below the supplemental facts of a supplement I’m considering getting. Is this the same thing? All the supplements I’ve found so far say hydrofoLIC instead of hydrofoLATE…

    Folate (as Quatrefolic®
    [6S]-5-methyltetrahydrofolic acid equivalent to 1.6 mg of [6S]-5- methyltetrahydrofolic acid, glucosamine salt)
    800 mcg 200%

  15. lance says

    If the FDA has it’s way the word/term “folate” will be banned from the Supplement Fact labels, and only the term “folic acid” will be allowed.

    Note that the FDA is not exactly banning the inclusion of folate and requiring the inclusion of folic acid in supplements. They are simply proposing to ban supplement producers from using the word folate on their labels (and, conversely only allowing the term folic acid). But it would, of course, be fraudulent to put folic acid on your label and then use something else. And, the FDA understands that perfectly.

    In other words, the FDA is playing a much more subtle, sneaky, underhanded game in order to slip one by American consumers. As usual, by the time John Q Public figure out what has happened, it’ll be too late to do anything about it. And, for all practical purposes natural folate will disappear from any/all supplements.

    If approved, this regulation will leave about a third of the human population facing two potential problems: a deficiency in folate (because they are unable to convert synthetic folic acid into the biologically available form), a possible excess of folic acid (because their body can’t metabolize what could become an overabundance of folic acid present in “fortified” foods).

    Marie Antoinette may have said: let them eat cake. Uncle sam says: let them eat garbage.

    Eventually ALL natural foods and substances will be banned. The only thing we will be allowed to eat or drink will synthetic chemicals, natural substances sold as prescription medications, genetically modified or cloned foods produced.

  16. Asia says

    Is this version of folate safe: Folate [as (6S)-5-Methyltetrahydrofolic acid, glucosamine salt]
    Quatrefolic® 800 mcg?

    Took Deplin for 3 months, and it helped. Found the Thorne 5-MTHF too expensive and started on this.

      • Monty Paul says

        Why do you believe that Megafood folate is natural folate? There label makes no such claim. Do they provide information elsewhere that addresses this question?

    • Jen says

      Folate is what you want. Only take the vitamins that say folate. Folic acid is synthetic and if you have MTHFR, you can’t process folic acid.

  17. Israel says

    So glad there are so many comments from people suffering with mthfr. That means word is getting out. Good to see the suggestions for a b complex vitamin with methylated folate and methylated b 12. I’m buying them.

  18. Connie says

    I do not process folic acid. Is folate (as calcium folinate) or folate as 5-methyletrahydrofolic acid what I need?

  19. NY says

    I have spina befida occulta & have been prescribed a high dosage of 5 mg (not mcg) of folic acid by my doctor for trying to conceive. Is that equivalent to 5000 mcg folate per day?? That seems a bit much? Thanks!

  20. Fred Dempster says

    So I need to take a B-50 Complex 2x per day (better than the B-100 1x for me) – what is one where folic acid is not used that is good?

  21. Jen says

    Hi Christine,
    My opinion is – listen to your ND and ask him/ her any follow-up questions. 99% of MD’s are clueless about MTHFR. When you said that your “doctor” said you don’t need the B vitamins, did you mean your MD?
    My MD (OBGYN) couldn’t figure out why I kept miscarrying, even when the blood work she ran said I have 2 MTHFR mutations. I had to go to other sources & do my own research to figure it out. Your ND is a great resource, as well as MTHFR.net so that you can educate yourself.

  22. Christine says

    I found out recently that I am Homozygous for A1298C so my ND put me on a 5-MTHF, 1mg supplement made by Thorne Research. I am supposed to take 4 capsules per day. I have been reading a lot online about people taking B-Vitamin supplements in addition to the MTHF supplement. I asked my doctor about this and she said that I did not need the B vitamins because my bloodwork showed that I am not deficient. Do you only need to take the B Vitamins with the MTHF if you are deficient???

  23. Jen says

    I think what I’m hearing in some of the comments is that this isn’t a one-size-fits-all answer for everyone. Just because you have a MTHFR gene mutation doesn’t mean it’s expressing and it doesn’t mean this is the right treatment for everyone.
    However, I can say for me, it has been life changing/ life saving. After having multiple unexplained miscarriages, I am now taking methylfolate and I have a very healthy pregnancy.

    • Israel says

      I’m very happy for you. I was just diagnosed with heterozygous for C677t. Trying methylated folate and methylated b12. haven’t ever in my life felt this good. I still have some issues here and there…but I’m feeling much better.

  24. Ophelia says

    I do not agree with this article at all. If your into methylation at all, you will understand what I’m saying. If not, I will try to make it easier to understand.

    Folate, 5-MTHF, & Folinic Acid all have free floating METHYL DONORS, hence word Methyl in all their actual names (look them up). Folinic Acid has 1 Methyl Donor, 5-MTHF had 5, and Folate usually has 1. The more Methyl Donors it has, the higher the number will be (hence 5-MTHF). These are good to have if you UNDER-METHYLATE. However, if you are the 1% that Over-methylates and you take something with and extra methyl donor, get ready for the worst ride of your life neurologically. Too many free floating methyls can make your symptoms worse, for example: Anxiety. People that OVER-METHYLATE need FOLIC ACID because it absorbs and pulls out the extra methyl donors. My ND has seen this first hand with me. Please properly educate yourself about your body before believing poorly written vitamin scares like this.

    • Nutranut says

      Thank you, Ophelia, for a moment of clarity.

      This scary article is way overblown and inaccurate.

      I’ve heard this more than once. Someone tests positive for the MTHFR defect, tries 5-methyl-folate and has side-effects, like several fatigue or acne-like skin problems.

      After testing positive I bought 5-methyl-folate and over a period of six months and two blood tests my homocysteine hasn’t changed from when I was just taking folic acid. It’s mid-normal just like it was before taking methyl-folate.

      I read somewhere that we do convert folic acid, but at about 40 – 70% as well as people who don’t have the genetic defect. (I wish I could find that reference.)

      It also turns out that according to the big NHANES study 92% of Americans get enough folate from their diets, so it’s only a small minority that even really need supplementation.

      And if we convert at 40 – 70% we create enough folate from folic acid PLUS dietary folate to maintain health.

      But folic acid doesn’t cause the side-effects that some people get from methyl-folate.

      • Ophelia says

        Your very welcome Nutranut. I get very upset seeing articles like this because there are people out there who don’t have either main methylation gene mutation (Like myself). Most of this methylation mumbo is targeted for people who have the 1298/677 mutations. There’s nothing for the ones who don’t, but do have other mutations.

        I only take 800 mcg of folic acid a daily. I personally believe that to be plenty plus food intake. It has helped me quite a bit over the last few years.

    • Vanessa says

      Ophelia, there are a number of inaccuracies in your post.

      5-methlytetrahydrofolate does not have “methly donors”, it has a ‘methyl group’ and is therefore a methly donor, and 5-methlytetrahydrofolate has only ONE methyl group, not five. The number 5 refers to where this methyl group is located in its structure.

  25. Jen says

    Hi Sarah,
    I’m not an expert but here’s my understanding. People with MTHFR mutations cannot process folic acid (which is synthetic), so it can build up in the system and also cause high homocysteine levels. That is why I avoid folic acid and take methylcobalbamin, which is the active form that my body knows how to process. The website MTHFR.net is a great resource for understanding this.

  26. Sarah says

    Hello- does anyone know why people have to high beyond the norm levels of folate? I just had a blood test that showed high levels of b12 and folate….. Doesn’t the B vitamins flush out of your system if it’s not used?

    • Laura says

      Hi Sarah. I stumbled across your question & I am interested if you found any help and/or answers? I too, have recently been testing really high B12 & Folate levels. I also had a high ANA result of 3.2 & they keep saying it could be a false positive?! My Vitamin D was pretty high, but has come down a bit since I stopped the supplement. But my doctors aren’t helpful at all, only to say to stay away from D & B12 Supplements. From research I’ve done it points to issues with bone marrow or leukemia. They keep saying it’s OK & it’s making me crazy because I’m feeling worse…more fatigued, “foggy” & flushing frequently. I can’t get anyone to take me seriously. If you have any info. that might be helpful, I’d greatly appreciate it.
      Thanks,
      Laura

  27. Julie says

    I have high levels of unmetabolized folic acid in my blood, can anyone please recommend what I can do to bring these levels down.

    thank you

    • Jen says

      Hi Julie,
      I’m no expert, but here are my thoughts:
      1) remove all sources of synthetic folic acid. Avoid foods that are enriched with synthetic folic acid (usually wheat-based cereals, breads, crackers) – read the labels to see if they’ve added B vitamins,
      2) add active forms of folate to your diet. This means changing your vitamins to the active forms including methylcobalbamin – I like Thorne and Seeking Health brands – (unless you have a sensitivity to methylcobalbamin, which a few people do but it seems most do not). Also eat folate-rich foods.

      • Julie says

        Hi Jen
        Yes, I’ve done all those things, in fact I never eat fortified or processed foods anyway. It has been over 2 years and my levels are still high. I supplement with the Pure Encapsulations brand of active B with. I just don’t know how to get my levels down. Maybe I should stop using the supplement all together, but worry about not getting a B complex in.
        thanks for responding.

  28. Akester says

    For anyone asking about folinic acid, here’s my experience.
    (and in case you haven’t been following, we have: folic acid- the synthetic supplement that the body has to do extra work to get folate from. Folate- the natural form, methylfolate- what the body converts folate into , it’s an active form of folate. and.. Folinic acid- another supplement version of folate that is one step better than Folic Acid if I’m understanding correctly.

    Anyway.

    Everyone is praising Methylfolate as the best supplement. Honestly, I’ve had the worst experience with methylfolate. It makes me feel like my brain is poisoned and I have serious mood swings which are hard to describe.. I dont normally have these types of mood swings, though I used to have them when I was a teenager, now I never do. Methylfolate also makes me extremely tired. I’m guessing this would indicate that I could be an overmethylator, but I’m not sure.

    Folic acid on the other hand doesn’t have much apparent side effect , it helps to stabilize my mood and I think that it POSSIBLY may cause some fatigue- though Im not sure because I already have some fatigue. I’ve tried folinic acid as well and I think I prefer this, for many reasons stated above by other people (I agree with some of it) and again I don’t notice any side effects, except perhaps some fatigue, but I’m not sure if it does cause fatigue or if that’s just my regular fatigue (and if I can’t tell , then perhaps it’s not causing that effect, as I think it’d be more pronounced otherwise).. i might drop into thread to update

    • Akester says

      sorry I forgot to add that the Methylfolate side effects happened at every dose, even 50 mcg (I dissolved 1 mg into water so that each mL = 1 mcg and used measuring spoons to dose)

      • Ophelia says

        It’s because you over-methylate (have too many free floating methyl donors hence the name Methylfolate). I can’t take it either without going into full blown anxiety attacks until it clears my system. Stick with a clean form of Folic Acid to clear out the extra methyls and ignore poorly written farces like this article.

  29. Alex says

    The flaw (however well-intentioned) in this article is that no medical study (that I’m aware of) has tracked folate intake (that is to say, intake from vegetables). It’s possible that downstream activity of _any_ form of B7 is associated with the negative outcomes. The article shows risk of harm from folic acid intake but does not show that folate intake is harmless. As a primary facilitator of BH4, and thus nitric oxide (a highly reactive free radical molecule), vitamin B7 in any form could have deleterious effects.

  30. Nutrafan says

    Some of us that test positive for the MTHFR gene find that when we take methyl-folate have bad reactions, like acne. What people don’t understand is that we do convert folic acid, but at 40 – 70% as well as those who don’t have the defective MTHFR gene. Since folic acid doesn’t cause the adverse effects it’s just a matter of getting a high enough potency so that we get enough. It’s called an “inborn error of metabolism” and the answer I learned from an alternative doctor is to take high potencies, so that the amount we convert is enough. So I take 1,000 mcg of folic acid, knowing that I’m getting the equivalent of 400 – 700 mcg converted, but without the side-effects that methyl-folate causes.

  31. Jen says

    Hi Noel – my only issue with the Baby and Me vitamins is it doesn’t state the form of the vitamins. For example, it is important that B-12 is in the form of methylcobalbamin, and never in the form of cyanocobalbamin. Personally, I won’t take a prenatal unless I know that the B vitamins are in the active forms.

    • Noel says

      Is there a brand of vitamins and combination that you would recommend. My thinking for taking a prenatal is that it’s an all-in-one, but I can certainly take a variety if necessary.

  32. Noel says

    I found a generic prenatal vitamin at Wegmans that has folate and not folic acid. I also noticed that the Baby and Me prenatal does as well. I’m getting ready to start a family and this is an important issue for me. Thank you for the article and the people that have commented with valuable information.

  33. Susan says

    As someone who is B12 deficient and now supplementing with daily B12 injections I have a greater need for folate as B12 and folate cannot go through the methylation cycle without each other. I have tried active forms of folate and they just don’t work for me, I get neurological symptoms back.

    I seem to do best with cyanocobalamin (I tried hydroxocobalamin and methylcobalamin injections) and folic acid. There is no one size fits all, what should be best is not for some of us!

    Keep in mind that folate deficiency still exists in the age of folic acid fortification and high daily doses are required, absorption from food just won’t do the trick due to genetics.

  34. says

    Additionally, for those of us, like myself, who test positive for the MTFHR gene, David Getoff, ND, says that he frequently sees people being put on methyl-folate and have drastic reactions to it. These include cleansing reactions, like bad acne. Folic acid doesn’t cause those kinds of reactions.

    • Akester says

      Why is it even called a “cleansing reaction”? It’s reminiscent of all the “detox” hullabaloo in “natural health” cults. What’s the toxin being “detoxed” ? what dirt is being “cleaned away”? by what mechanism does this happen? Is acne really the result of “cleansing” or is it simply a side effect? I’m going with the latter. It’s a well known side effect. Saying it’s cleansing would imply that there was something specific to be cleansed , or some mechanism associated with cleansing which methylfolate would assist with in a broken mechanism. I doubt it does

  35. says

    Reference number 11 shows the misunderstanding that Chris demonstrates here. That study was shown to have a misinterpretation of the results – high folic acid is not a risk factor for cognitive decline. You’re missing the boat on this one, Chris. Folic acid does not present these problems. In fact, other studies have shown that folic acid supplementation improves memory in seniors. http://www.ncbi.nlm.nih.gov/pubmed/17240287

    • Jennifer says

      Hi there Chris great article.

      I have to say I work for Whole Foods Market here at Mass General/Boston Mass. I am in the supplement section and my husband is a rep for Standard Process. I can’t believe you vocalized Thorne, and Pure Encapsulations as some products to consider. You didn’t even mention SP which is a precursors to all vitamins sold in the United States. Standard Process has been with us for 84 years. There are even some great brands I sell at Whole Foods like Mega Foods. Just a thought.

      All the best
      Jennifer

  36. says

    Chris made the mistake of thinking that folic acid caused seniors to have cognitive impairment when they had low B12 and high folic acid. The study he cites said, “Conclusion:In seniors with low vitamin B-12 status, high serum folate was associated with anemia and cognitive impairment. When vitamin B-12 status was normal, however, high serum folate was associated with protection against cognitive impairment.”

    The problem was low B12, not high folic acid, because when B12 status was normal, high folate was associated with protection against cognitive impairment.

    I find this article to be biased against folic acid and therefore, scientifically imbalanced and lacking in crediblity.

    • Michelle says

      Michael you are using Folic and Folate interchangeable – they are not the same. Folic Acid can cause cognitive impairment while Folate will give protection. If you read the article he explains the difference.

  37. Jana says

    Hi there, I am taking methotrexate for RA by injection once a week. I take 40mg of methotrexate and am currently taking 5mg of folic acid the other 6 days. I have noticed significant hair loss so my Rheumatologist has prescribed folinic acid now. He said he has heard good things about this compared to folic acid for hair loss. Do you have any information on this?

  38. Girlfromeurope says

    Hi ,when I started to supplement with b12 and metafolin I started to have severe low potassium symptoms.
    I got high anxiety, drained feeling, palpitations, muscle spasms, insomnia,…
    But I don’t find great relief with supplements and foods high in potassium don’t help at all. I’m scared to overdo potassium as I have adrenal fatigue, so high potassium can be a problem. I’ve also experienced a potassium overdose where I got relief from sea salt. So he problem is that my symptoms of high potassium and low potassium are the same.
    also I stopped the b12 and metafolin for a couple of days now but I keep having the low potassium symptoms.I supplemented potassium yesterday and felt better. But today I feel bad again even though I haven’t taken any b12/metafolin.

    Now I don’t know how much to take. I really need the b12, I felt wonderful the first week, until the potassium problems began. Does someone experience the same?

    • Marie says

      Girlfromeurpe,
      I’m not sure if it’s connected, because there was a delay and also several other confounding factors (higher salt, decreased sunlight, etc), but after I increased B12 I got muscle cramping at night. This cleared up the day after taking a magnesium supplement. Because of all the other factors (especially increased salt) and the rapid response, I’m not sure the magnesium was the deciding factor, but it’s something to try.

    • David says

      Hi Girlfromeurpe, I have the same reactions to B12 and folate as you do.

      Sometimes I take B12 or folate and feel great. And then after I feel worse. I have tried eating a very high potassium diet + drinking coconut water while taking b12 but the results are confusing. Sometimes I feel better, sometimes worse….heart palpitations, anxiety, tiredness… too much potassium or not enough????

  39. Jen says

    She should not take folic acid. Folate is good. It should be labeled that it is L-5-methyltetrahydrofolate. She should take the active forms of b vitamins. Metanx is a good prescription, and good over-the-counter B vitamins are found on Seeking Health’s website. MTHFR.net is a great resource to explain this better.

  40. Angie says

    H Chris,

    I have the MTHFR C677T problem, as does my sister. Her doctor has her on amino acid products that contain “folate”. One of them has Folate – 200 mcg.

    So I understand that when someone has this disorder, they should avoid all folic acid in supplements, and take the metholated form of folic acid such as 5-mthf since they’re unable to process the folic acid.

    I’m confused about what she’s taking. Does the 200 mcg of Folate have metholated folic acid, or does it have plain old folic acid? Will her body have to convert the folate?

    Is this okay for her?

    Thanks!

  41. Ashley says

    Hi Chris,

    I’m currently six weeks pregnant, and have yet to find a supplement suitable to take. I had to stop at my locally owned “heath food store” for a few things today, and grabbed a bottle of Solgar Folate. I’m unpleasantly surprised to find that “Metafolin” is a product of Merck, a major pharmaceutical company, and it is also trademarked. I’m finding this very worrisome, as they tout Western medicine and are a key player. Thoughts? The connection alone to Merck finds questions about Solgar’s standards. I know i’m stretching it too far, but where do we draw the line? Does anyone have information about Mega Food Baby and Me Multi.? Thanks!

  42. Ben says

    I’m not so sure about your claim that folic acid causes cancer. You really are just hand waiving and guessing. I wonder if you’ve read any other sources about folic acid. I just read the Wikipedia page on folic acid and they state that there is no correlation with cancer and increased exposure, their article comes with references.

    http://www.ncbi.nlm.nih.gov/pubmed/23352552

  43. Madge says

    Folate vs folic acid, technically they are actually the same, except term “ate” is used by chemists to denote the salt of a carboxylic acid group, thus folic acid has a carboxylic acid group on it and when the sodium salt is made it would be called sodium folate. Thus, the sodium salt of benzoic acid would be sodium benzoate. The sodium salt of acetic acid is sodium acetate.

  44. S says

    Sorry, what I meant to add was, if I’m consuming greens, should I also consider taking a supplement of folate? Any way to measure if I’m getting enough? What is enough per day?

    And is folacin the same as folate or folic acid?

  45. S says

    Hi Chris,
    and thank you for a great article. Like you, I trust Solgar as a reliable brand.

    Three Qs –

    1/ Im not pregnant nor trying to, so I’d like to know what folate will do for me and how regularly I should be taking it, i.e. what can the average joe expect to gain from it and how much should adults be consuming? And kids?

    2/ if I juice my veggies (spinach, kale, parsley, lettuce) am I still getting folate or is it lost in the fibre?

    3/ is there such a thing as a folate overdose? I eat tons of rocket (aragula) and drink green juices as often as I can, should I be cutting down? If overdosing is possible, what kind of side effects should I be expecting?

    Thanks much.

  46. misa says

    Hi Chris
    I would like to ask you I am heterzygot c667t and a1298c, how much of folate would you recommend to keep healthy pregnnacy?

    Would I need anything else?

    Thanks a lot

    • Honora says

      Yep, genetic genie talks about this: geneticgenie.org. I’ve made notes on my methylation panel results that they do for free (derived from 23andme data). It mentions a possible link between MTRR A66G mutations (I’ve got one) and spina bif. It recommends B12. Because I don’t have any COMT mutations and only one of 6 possible CBS mutations listed, I should be alright to take methylcobalamin and 5 methyl folate.

    • Jenny D. says

      @MTHFRease –

      Do you have any sources for researching various treatments for different MTHFR mutations? For example, I’m compound heterozygous, so should I be supplementing differently than someone with homozygous 677 mutations? Is there any research on this? Thx!

  47. Simona says

    Hi Jen, thank you so much for yiur reply , im wating to hear from genetics to go in for the test, im in the uk and it can take long time till that will happen :-(, I was wondering if anyone knows if taking 5mg of folic acid for 4months and swicthing to 4 mg of folate is going to affect anything in my quest of trying to conceive in 3 months time?I should also mention that I have never suffered a miscarriage, neither my sister or my mum. But my son was born with spina bifida myelomeningocele and I suspect one of my sister boys has spina bifida occulta this type apparently15% of the popolation has most are not even aware about it. This is the reason why I think we might have a problem processing folic acid but that could not be the case , no one knows why spina bifida is happening as a lot of women with no gene mutation at all still give birth to kids affected by some sort of neural tube defect and have siblings perrfectly health.

  48. Jen says

    Hi Simonas,
    I’m so sorry about your first baby having spina bifida. Please spend time on MTHFR.net, please get tested for mthfr ASAP (blood test or 23andme), and find a nutritionist who is knowledgeable about mthfr (not all of them are!) and who can advise you on your specific situation.

  49. Simonas says

    Hello,

    Ive been taking 5mg of folic acid for the past 4 months preparing to start trying for a baby, my first was born with spina bifida, I want to switch to folate 4mg/day, am I ok to start trying after being on folate for 3 months as recomended with folic acid? Do I need to take a break in between , does the amount of folic acid taken already is going to affect the absorption of folate I intend to take the 3 months before trying to get pregnant? I wish I knew about folate before Ive taken so much folic acid that I suspect I cant even absorb it properly, I havent been tested for mthfr yet.

  50. Tootle Peep says

    Now I’m even more confused.

    The labels on supplements carelessly use “folic” and “folate”.

    Is 5-methyltetrahydrofolate the same as 5-methyltetrahydro folic acid?

    What does “folate (from folic acid)” mean? Is it folate or folic acid?

    It’s all very confusing and there is no consistency anywhere? What is actually INSIDE these supplements? Why do they write folate on the front, yet write folic acid in the supplement facts label?

    Someone, help me…

  51. Jen says

    Hi Joy,
    Try the Optimal kids multivitamin from SeekingHealth.com. I have gone dairy-free and gluten-free for 2 months and I think it is helping, though I’m sorry I do not know the explanation behind it.

  52. Joy says

    Great article. I am curious if you have much experience dealing with the MTHFR gene mutation? I am homozygous for this mutation and that has lead to my learning about folic acid and 5-MTHF. I am trying to figure out a good multivitamin for my toddler and middle schooler that has 5-MTHF instead of folic acid. I already take a 5MTHF/B6/B12 supplement. Also interested in if you put any validity towards a gluten-free diet for those with MTHFR? Is it necessary? Another site has recommended gluten-free and dairy-free, but I’m not sure of the WHY.

  53. Fiona says

    Is 5-methyltetrahydrofolic acid the same as folate? Just bought Methyl Folate from Jarrow and am reading the label. I want to be taking folate and not folic acid. Is this the right stuff?

    Thanks,
    Fiona

  54. Kelly says

    Hi Chris & everyone, I am a little confused. Not sure if have MTHFR but possiblity .. am in New Zealand and very tricky to get that testing done. However, we want to start TTC for #2, so I need to know what is a good prenatal to take that doesn’t have folic acid or the vits that are harder to break down .. what is a good prenatal that will give me my folate and iodine etc needed for pregnancy? Cheers

      • Honora says

        Hi Kelly – I’m from NZ too and have just ordered the genome testing kit from 23andme for the MTHFR mutations (and APOE genotyping to see if it’s OK for me to carry on eating saturated fat). It cost US $71 for the postage as well as the US$99 for the cost of both genotyping profiles. It came here really quickly. I’m going to try to have it shipped via DHL Express from the lab where I work as you have to sign it in the presence of the courier guy when they come to pick it up here in Chch before it is sealed. So our dispatcher can do that for me as I’m all over the place.

  55. Cathy says

    Since reading the article on Folic Acid I have stopped taking this vitamin supplement. I am going to start the Solgar Folate 800 mcg. I was wondering if it needs to be taken with a B-complex 100 or any one particular B vitamin to help with the metabolism of the Folate? If so can you recommend a good supplement to take with the Folate? I am 56 years old non childbearing age!!

    • says

      Thorne has an active B complex at http://amzn.to/16YMWQC, I think the only thing this complex is missing is Benfotiamine. I would find a sublingual or topical source of B12 since some say the amount found in a pill is only 1% absorbed. The 5-MTHF in this is at the RDA for the non-pregnant/lactating adult.

    • William says

      Freedom of choice is paramount, Government often gets it wrong. In Australia we have just started compulsory addition of folic acid to bread.

      What’s being added to bread is not folate but folic acid. Folate is an essential B group vitamin richly found In organ meats and green leafy vegetables but less so in other plant sources. Folic acid is a completely artificial substance unknown in nature first synthesised in 1947 in lederl labs and not ever consumed by man or woman prior to then. It must be synthesised to folate by the liver but this is an inefficient process that leads to an excess buildup of both folic acid and folate in the body. In the US the reduction of neural tube defects that resulted from the 1998 mandated supplementation of bread flour by folic acid (not folate) was at best from 1582 to 1337 for the entire US population; a dubious 245 reduction. Folic acid however continues to show up as a risk factor in studies for prostrate, breast and colorectal cancer. Worse it is now suspected of being responsible for an increase in Aspergers and Autism. Can you imagine all those scientists and politicians now recanting? A much better strategy would be selective folate supplementation of folate but not folic acid. My wife and I eat leafy greens, I eat organ meats. We must now eat organic bread to avoid this substance.

      • Honora says

        I met someone who had just been prescribed methotrexate for an autoimmune condition. I was pleased to hear the public health specialist prescribes folate not folic acid for these patients. So the message is getting through. Apparently it takes about 18 years for these things to filter through to the mainstream medicos.

  56. Jen says

    Merle,
    Do you know how I can send you a private message? I would be happy to give you my phone # so we can talk. I am not a doctor, but I have spent most of 2013 learning about and dealing with MTHFR and TTC.
    Jen

    • merle says

      That’d be great! Do you mind email? michlny hotmail
      Love to hear from you!

      I reached out to my RE and asked him to prescribe Metanx – we’ll see what he says….

    • Kelly says

      Hi Jen, am I able to email you too? I have a few questions re pre natals and MTHFR before trying for #2. cheers, Kelly (mikeandkel@xtra.co.nz)

  57. Jen says

    Merle- have you looked at MTHFR.net? There is also babycenter.com’s group for MTHFR. I avoid all synthetic b vitamins, including those in bread and cereal and crackers. I take all active forms. Swanson vitamins and Thorne have some. I take Metanx too. That is in addition to Thorne. I asked my OB for the Metanx RX, and she gave it to me.

    • Merle says

      Jen –

      Thanks so much for your reply. I’m worried to go off the Folgard because my RE has used it for so long as he insists it works. But I’ve also started taking the Thorne PreNatals and Thorne B-Complex.
      I’m wondering if I can take both?

      But I will see if he can prescribe Metanx as per your suggestion….

  58. Merle says

    PLEASE HELP with an answer::
    I am TTC (two miscarriages) and have the MTHFR mutation. My RE prescribed Folgard – with synthetic Folic acid (which he insists studies have proven it works). I have decided to take Thorne Prenatal (with active folate) and Thorne B-Complex to make sure I’m getting enough of the active form.

    Can I take the Folgard and the Thorne supplements? I’m afraid to go off Folgard bc he insists it works and he always uses it….

    PLEASE reply…..

  59. steve says

    My folic acid level always tests very high way out of range. I have very diffusive hair loss since 28 and now I am 47. Is there any correlation between hair loss and high folic acid in the body. How can I lower my folic acid level?

  60. Lynn says

    I just started taking the Pure Encapsulations 950 + K for pre natal vitamins while trying to conceive. Is anyone else not freaked out by the %RDA? Is it okay to have 1000%-16000% of RDAs?

  61. Pernilla says

    It is difficult/impossible to find a prenatal vitamin in Sweden not containing folic acid. Is it ok to supplement this with 400mcg metafolin (5-MTHF) which I found in England… or will they “cancel each other out”? is it dangerous?
    (The prenatal I take has 800mcg folic acid.) I need a bit more then the average person as I am heterozygous for MTHFR variant C677T.

  62. Catherine says

    I’ve started taking Solgar folic acid 800 mcg 5 days ago and all my symptoms are just increasing for now especially muscle twitching all over body. Is it normal at the beginning of taking folic acid and shall go with time? Or I shall not get stronger symptoms and it means it is not folic acid deficiency what is causing them? Thanks.

  63. Catherine says

    I just found out that I have low folate – 4.8 nmol/L . My B12 level is 359 ng/ml. I experience dizziness, feeling unsteady, and terrible leg muscle twitching, which won’t let me fall asleep. How much of 5-MTHF shall I take for these symptoms to dissapear (as dosages do vary a lot) and how soon shall they dissapear or start reducing after starting some extra folate? Should I add some methylcobalamin along with 5-MTHF for better benefit? Thanks in advance for answers.

  64. mthfrease says

    My sympathies about your loss. Some people when starting out on methyl folate can tolerate higher doses, but then they end up reducing the amount because of side effects. Deplin, is a pescription of methyl folate at 7.5mg and 15ngs of Methyl Folate. Another prescription is 3mg (Deplin). If you take high amounts (which are over the RDA) like the prescriptions will you have a knowledgeable physician to monitor?

    • Liesl says

      Thanks for replying mthrease. I am in Australia and there is very little knowledge of mthfr and methylfolate here. I see a naturopath, but mostly am researching on my own. My doctor said (and I have found online) that the recommended supplement dosage following a neural tube affected pregnancy is 4 or 5mg ‘folic acid’. As I prefer to take methylfolate, I am wondering if 4mg methylfolate is equal to 4mg of folic acid, or if I should take a lower dosage of methylfolate because it is better absorbed?

      I have begun taking 4.8mg methylfolate and will monitor for side affects. Thanks for again for your reply.

  65. Liesl says

    I have just experienced pregnancy loss with a nural tube defect. (I was taking folinic acid pre-conception) I see that the recommended supplement dosage for a future pregnancy is 4000mcg ‘folic acid’. I would rather take methyl folate, should I take 4000mcg of methylfolate or should I take less due to it being better absorbed? Is there any danger to taking high doses of methylfolate?

    My partner is homogynous C667T MTHFR mutation (and taking Dr.Ben’s supplements), I have no mutations. Any advice is appreciated. Thanks

    • Wendy says

      I was moved by your story, I had a baby born sleeping 11-6-12 she had spina bifida and hydrocephalus. I am pregnant again, 16 weeks and have been taking perfect prenatal and solgar folate 800mcg. Not had any support from the medical profession regarding not wanting synthetic folic acid. So had to go it alone.

      • Wendy2 says

        Hi I am Wendy too! Sorry for your loss and good luck. From what i know the methylfolate is also synthetic but just in the same form as what the body would convert to and further along in the conversion process.

  66. says

    It’s really late at night, but it seems even food sources of folate will not convert to the form you need efficiently if you have mutations in MTHFR. Whether it’s a whole vitamin, or leafy greens, you still need to go through the final conversion step.

  67. Kat says

    I am looking for a whole foods multivitamin for my 8 yr old son and doing tons of research and label reading on line. I thought I found a good one but am VERY confused by the labeling and cannot find info anywhere to explain it. Maybe you can help.
    The list looks great until I get to the Folate ingredient. It states:

    Folate (as folic acid)….. 200mcg

    WTH does this mean? Is it natural or synthetic? After reading your article I am very confused because I thought folate was different from folic acid. So how can it be both on this label? So confusing. It seems like I will never find the “perfect” supplement for my child. It is either they contain folic acid or the cyanocobalamin form of B12….Grrrrrrr!
    Thanks in advance if you can clear this up for me. :)

    • David says

      The discrepancy in terminology is a common imprecision in the supplement industry. But if it says “as folic acid” then it is not what you want.

      For children, you might consider Pure Encapsulations’ “Junior Nutrients” (which contains 5-MTHF instead of folic acid): http://www.pureencapsulations.com/products/shop-by-product-category/multivitamins/junior-nutrients.html

      Or if you’re really wanting a “whole food” multi, check out Innate Response Formulas’ “Kid’s Multi,” which has natural folate from broccoli: http://www.innateresponse.com/product-p/40026.htm

      • Kat says

        Thank you David for the wonderful info. Now, if I could only figure out if “vegetable lubricant” is the same as Magnesium stearate. :) These companies are some tricky bastards when it comes to renaming things to get people to buy their product. I am finding that some people say that vegetable lubricant is the same as magnesium stearate and that is something I DO NOT want in a vitamin supplement. Thanks again for your help.

        • David says

          Pure Encapsulations definitely does not use magnesium stearate. Not sure about Innate Response. I don’t think they use it, as they specify elsewhere that they avoid it.

          That being said, I have my doubts about the dangers of magnesium stearate. I know it’s catching a lot of flak right now, but I do wonder if the concerns are unfounded. Magnesium strearate is simply a magnesium salt of streaic acid. It is actually 96% stearic acid (the rest is magnesium). A typical supplement capsule with magnesium stearate contains less than 5 mg of stearic acid. By comparison, a 3 oz beef patty contains about 1,600 mg. I’m just not sure how this could be a problem. I know folks like Mercola claim that it contributes to biofilm formation in the gut, but again, no real evidence for this other than the general fact that magnesium is a divalent cation that could find its way into a biofilm no matter what the source. But you’d probably get more magnesium from a single almond than you would in a capsule containing Mg stearate.

          Anyway, those are just my thoughts. I’ll be interested to see what more research shows.

  68. says

    It has been a nightmare for me trying to figure out a good multivitamin so I don’t find myself buying everything separately. My diet was poor for a very long time and my body devastated as a result. I’m still functional, but I don’t think I’ve ever been at my best, even less so since I started having children (quickest way to give yourself deficiencies, especially with the sub-par nutritional information they give you at prenatal appointments, and even worse if you’re poor). I’m slowly figuring out the diet thing but my body can’t wait anymore. It needs help NOW.

    One of my big obstacles was finding something with the methyl form of B12. I finally just plugged “methylcobalamin multivitamin” in Google. If you click on my name above my comment you will go to the sale page for the multi I found by that method.

    I was pleasantly surprised to see that not only did it contain methyl B12, it also contains the form of folate that Chris recommends here. And that’s not even the reason I bought it.

    I’m not pleased that there is no real vitamin A in it, but I figure it’s a tradeoff because A works best in an oil softgel (and yes, I found one without soybean oil in it), and this multi comes as a powder-containing capsule. So I just take my A separately, as I have yet to convince myself to eat liver. :(

    I think you’ll be happy with the other ingredients in the multi as well. I think they went all out compared to most supplement companies including, I’m sorry to say, some supplement dealers in the Paleo/Primal/ancestral health community.

  69. Nisha says

    For those of you that asked about the Perfect Prenatal from New Chapter, I emailed them and this was their response. I am very confused as a result lol. Any clarification would be helpful:

    We are happy to share that New Chapter’s Organic Probiotic Nutrients multivitamins, which includes Perfect Prenatal, are delivered in the form of whole-food complexes. They do not contain the isolated forms of vitamins and minerals found in conventional supplements. While we use folic acid as a culture catalyst, this is not the form that is found in the final product. The dual-stage probiotic food culturing process we use creates a whole-food complex form of folate. Whole-food complexes serve as carriers for the nutrients across the gut and signal the cells of the body to utilize the nutrients with greater ease and efficiency.

  70. Alex says

    Chris ,

    I have both a multi with folic acid and the garden of life multi with Folate…..I’m 4 weeks pregnant and have been taking them intermited for a couple months. Reading this makes me so confused. I tend to want to take the one with folate, but I worry that it won’t absorb and I won’t get enough for the baby…. On the other hand I love that they are capsules and I feel I can digest a lot better vs the one with folic acid which is a huge tablet that I wonder if it even gets digested. But again the absorption of folate worries me …. Thoughts ?

  71. Cathryn Cardellino says

    I recently discovered that chicken feet are a decent source of folate: 86 mcg in 100 grams as compared to broccoli with 108 mcg in 100 grams. These numbers are for both items boiled. The feet can be added to leftover roasted chicken bones to make a nice, gelatinous stock, then removed and reheated gently with an Asian style sauce (or whatever). Delicious double whammy. It also requires meditative eating so as not to choke on tiny bones.

  72. Kelly says

    Hi Veronica,

    Of course I don’t know you, but I would recommend trying not to label all your conditions, first of all because it will then seem like you need to address each one separately. Certainly many of these various issues may indeed be helped by some methylfolate, but it is very wise to start out with a very small dose and work up from there. I too have CFS and have had a lot of anxiety related to it (and possible salicylate intolerance issues), and found that methylfolate helped, but had to start slowly. The most recent addition is TMG, or trimethylglycine, which has helped a lot — but it all depends on so many issues — MTHFR is just one of many different genetic polymorphisms that might be an issue for you. Folate could mask b12, so it might be wise to add in some methylb12 and ad-b12 after a few weeks. I’m not a doctor…just a patient…so take what I say and what ANYONE says with a grain of salt.

    The main advice is to start slow with low, low doses. I started with 200 mcgs a day, and now take 800-1600 mcgs, along with the TMG.

    Kelly

    p.s. I too have low stomach acid, as do many with CFIDS, and have to supplement with betaine HCL (Thorne), but also found out I’m very low in zinc, which is needed for HCL production, so am hoping that supplementing with zinc will help that.

  73. Veronica says

    I suffer from the following conditions: clinical treatment (medication)-resistant depression, anxiety, adhd, adrenal fatigue syndrome, hypoglycemia, reverse T3 dominance, candida, gluten-sensitivity, and mercury toxicity from amalgam dental fillings. It is believed that I may also be suffering from the following conditions: hypochlorhydria/ achlorhydria, pyroluria, chronic fatigue immune dysfunction syndrome, and high functiong autism/ Asperger’s syndrome even. Does it seem most likely the case that I have an mthfr mutation? If so, would supplementing with a high dosage (10 mgs.) of methylfolate (per se the Metabolic Maintenace brand) most likely be effective but safe for me? Would supplementing with a high dosage of methylfolate mask a vitamin B-12 deficiency as folic acid would? And, finally, like methylcobalamin, is it best if methylfolate is taken sublingually? I would consult with a doctor about my having an Mthfr mutation and undergo the necessary testing, but cannot afford to have this or any other testing done. If someone could please get back to me regarding this, I would greatly appreciate it. Thanks.

  74. Reanna says

    I’m curious about Lewis Labs Brewers Yeast — it says it contains Folic Acid, but it also says no additives, and you mention that folate is the food-source form, and folic acid is synthetic. Any insight?

  75. Deirdre says

    Hi Chris,

    I usually take Vitasynergy for Women as it’s made from wholefoods but see you recommend the Pure Encapsulations Nutrient 950 with Vitamin K when planning a pregnancy – my question is should I be concerned that many of the ingredients listed are synthetic?

    ‘The nutrients found in Nutrient 950 are derived from the following:
    •Beta carotene: Blakeslea trispora
    •Lycopene: natural tomato concentrate
    •Lutein: marigold flower extract
    •Zeaxanthin: synthetic
    •Vitamin C: corn dextrose fermentation
    •Vitamin E: soybean
    •Vitamin K: synthetic (vitamin K1 and vitamin K2 (MK-4)) and natto (vitamin K2 (MK-7))
    •Vitamin D3: cholesterol from wool fat (lanolin)
    •Vitamin B1 (thiamine HCl): synthetic
    •Vitamin B2 (riboflavin): corn dextrose fermentation
    •Niacinamide and Inositol hexaniacinate: synthetic
    •Vitamin B5 (calcium pantothenate): synthetic
    •Vitamin B6 (pyridoxal HCl): synthetic
    •Vitamin B12 (methylcobalamin): corn dextrose fermentation
    •Folate (as Metafolin, L-5-MTHF)
    •Biotin: synthetic
    •Minerals: naturally derived from limestone

    Sources of the mineral chelates include:
    •Aspartate: derived from soy protein hydrolysis
    •Citrate: corn dextrose fermentation
    •Glycinate: synthetic
    •Picolinate: synthetic’

    • Deb says

      just stumbled upon your question…unless it specifically says that the corn and soy are non-GMO they most likely are. I wouldn’t touch it!

  76. Dan says

    Folic acid supplementation assists cell division. In cancer and healthy cells. Same thing for methylfolate supplements? http://nutritiondiva.quickanddirtytips.com/folic-acid-and-cancer-risk.aspx

  77. Misty says

    Great article. Thanks for the info.
    I am currently taking Pure Encapsulations UltraNutrient and I LOVE them… never had a multivitamin make me truly feel better before I found these. However, I am currently trying to get pregnant.
    This means I need to start taking something else due to the herbs in UltraNutrient.
    Would Nutrient 950 with K be okay to use as my Prenatal?? I have been looking at several others, but hate how most prenatals have so little in the B vitamins. Was thinking my best option if I went with an actual prenatal would probably be the Country Life Maxi Prenatal, but it has folic acid.
    Also, all of this talk about lead in multivitamins and prenatals has me a little nervous. Any input about that area?
    Thanks!

  78. grace says

    I just wanna know that is it necessary that only at least 3x a week should a man could take foods rich in folate even though its all came from natural food? i mean is it bad eating and absorbing natural foods rich in Vit b12 more often? does it really require an amount of taking foods rich in folate and Vit b12 considering that its all natural?

  79. wendy says

    If only 10% of the population metabolise synthetic folic acid and a further 40% only convert a limited amount into l-methylfolate, then why in the UK are women with high risk pregnancies prescribed it?

    I had a baby with spina bifida and I’m worried it might happen again. My doctor doesn’t advocate L-methylfolate because she said ‘the studies have only been done on folic acid’ so she could only prescribe this. Before this happened I had never heard of Metafolin or Neevo and I didn’t even know folic acid was sythetic.

    I have ordered 1000micrograms and was planning to take this with my 5mg folic acid the doc prescribed but after reading your article… I’m not sure.

    Please help

  80. Kim K. says

    Hi Chris,

    Someone may have already asked this, but there are a lot of comments to get through! I’m looking for a good B-complex vitamin, but they all seem to have folic acid instead of folate. What are your thoughts on this, and can you recommend a good B-complex? I’m also already on one of the folate supplements you suggested. I take a probiotic and I’m starting on Natural Calm magnesium as well. I’m working to fix some adrenal fatigue issues. Thanks!

    • Honora says

      My Metagenics Meta B Complex says it contains folic acid, not folate. I’m assuming this is the synthetic variant as I think they’d be very keen to state the ingredient if it was from a natural source. I’ll finish the bottle then change my brand.

  81. Barry says

    It’s funny how year after year they find that individual synthetic nutrients are dangerous so people stop taking that one synthetic vitamin but keep taking all the others. They are studies on all kinds of synthetic vitamins, A, E, C, folic acid causing problems, increasing cancer risk, altering DNA etc. Just stop using all of them. Fortified foods were deadly in studies on dogs.

  82. Lisa Bowman says

    I don’t understand why but folinic acid does not work for some of us. I’ve read that others have experienced similar problems taking it. It makes both myself and my son feel like we have the flu. Metafolin agrees with us. Dr. Ben Lynch only recommends Metafolin and active folates that start with “L”.

  83. Heidi says

    Hi Chris,
    I’ve currently 12 weeks pregnant, and I’ve been taking the Thorne 5-MTHF supplement. I’ve read conflicting things on when one should stop taking a folate supplement though – some midwives seem to say there’s no point in continuing it past the first trimester and that it can actually be harmful in large doses in later pregnancy, while others say to continue until breastfeeding starts. Do you have any thoughts on this?
    Thanks!

  84. Lisa Bowman says

    We’re still waiting for our genetic results but I already can tell you that these mutations run rampant on both sides of my family. We have a long history of heart disease, cancer, and now my dad has peripheral neuropathy do to low B12. Of course the idiot doctors think 289 is within range and won’t treat for symptoms. I’ve had problems my whole life and have two kids with even more problems. My son is recovering from autism and also has pyroluria and suffers from B12 deficiency. My daughter has pyroluria and other issues too. My son’s nurse practitioner prescribed folinic acid in his compound supp. I take everything he takes and let me tell you that folinic acid causes problems in some of us! I felt like I had the flu and couldn’t move for three days. My son was just as bad. Metafolin agrees with us just fine and I’m mad that we spent $150 on supplements that will never be used. We also have issues taking B12. I think the problem is that it affects potassium levels. Oh the lessons I’ve learned. I’m tired of learning and just want to get on with it.

  85. Markus says

    Firstly, I have to admit, I just skimmed over the article (exam time, quite stressful), so this might have answered my question, but I doubt it. Anyway, so if the packaging of (fresh) vegetables says folic acid they actually mean folate and just got hat wrong?
    Cheers

  86. Britt says

    Hey Chris,
    I started taking Pure Encapsulations Nutrient 950 with Vitamin K about a month ago. Before that I made sure to include Solgar Folate supplements a few months prior.
    Just wanted to comment that when I asked my OBGYN if Pure Encapsulations… was safe to take during pregnancy (we plan to start a family soon). She said not to take them and offered that I take 2 kid flinstone vitamins a day. Her concern was that it included vitamin k. I could not believe that was her answer and when I asked why, she did not have a reply.
    Thank you for the article and the Healthy Baby Code! They have helped me tremendously!

  87. Delia says

    Hi Chris, thanks for this article. I am 7 weeks pregnant and started taking prenatal supplements from xymogen which contain folate. I started the supplements on and off about 9 weeks ago and obviously when I found out I was pregnant I started to take them every day. My question for you is should I be worried because I didn’t start taking them months ago.? I have lupus and though I am now in remission I have always had problems with absorbing B12 and Iron and have shots a few times a year. Thanks you, Delia

  88. Donna says

    Folate reduces homocystine levels – YES! I hope followers don’t miss the important point that folate assists in the conversion of homocystine, which is essential for cardiac function. Monitoring folate levels in those who have a family history of heart attacks would benefit greatly from now knowing METHYLATED folate is not the same as folic acid. This info can save lives! Outstanding article!

  89. Beth says

    I had a baby with anencephaly. After that loss, the high risk OB that I saw told me to take 4000 mcg of folic acid to help prevent that again and I did for 5 years…….I stopped after having my second child. Now I am worried about the effects that taking the folic acid had, specifically cancer. Any thoughts? Can I reverse any bad results from the folic acid?

  90. Linda says

    I started on Pure Encapsulations several weeks ago and my urine at first was neon green. I have decreased my water intake and try to take the pills in the middle of the meal and the color has improved (pale yellow). Why did this happen?

  91. e says

    Does this apply to other B-Vitamins? Specifically Riboflavin?

    I take over 200mg of vitamin b2 a day, 25mg of which are “activated b2″, but is there a natural vs synthetic form sold for that as well?

    • Barry says

      Just about any vitamin you take is synthetic unless it specifically states that it is derived from food. Synthetic vitamins are made by pharmaceutical companies and are big money. If your B vitamin has a chemical name after the vitamin name then it is synthetic. The sad thing is that even the most expensive so called high end natural supplement companies are just a bunch of over priced synthetic junk Stick to whole food supplements and superfoods. The best way to get concentrated whole food nutrients is too eat foods/supplements like Bee pollen, dessicated liver, green powders, brewers yeast etc or use companies like Mega food, New Chapter, Standard Process, Innate Response

    • Kelly says

      Riboflavin depletes iron in the body, unless one is eating enough iron rich foods. 200 mgs of B2 is a LOT…

  92. says

    I don’t know about folate/folic acid, but us chemists refer to everything sometimes as the base, sometimes as conjugate acid. These tend to be in equilibrium in a solution, going back and forth, thus, at least in solution oxalates = oxalic acid, folate = folic acid, etc. Especially in biology, as nothing is standalone and all is in solution in the body (or you have problems) When are a standalone chemical, such as a dry powder, or a strong acid or base, not named that way. Acetic acid, even a week solution is not usually called acetate unless it’s the salt form, such as sodium acetate, even when it’s as weak as vinegar.

  93. Jessica says

    Hi Chris,
    I’m 10 wks pregnant with twins. My doctor just prescribed 200mcg folic acid in combination with my prenatal vitamins (New Chapter) which contain 600mcg folate (they also have K-2). Thanks to your article, I will skip her folic acid. Should I supplement my prenatals with 200mcg Solgar instead, or do I require more for twins? I do eat a paleo diet with some liver and lots of veggies.

    Thanks!

    • Chris Kresser says

      I would try to find a multi with folate instead of folic acid, like Nutrient 950 with vitamin K. If you’re eating liver 2-3x/wk, and plenty of leafy greens, 400 mcg of folate should be fine.

      • Jessica Mann says

        Do you see any problem with eating raw liver during pregnancy (I’d prefer to freeze small pieces and take them like capsules). I use grass-fed sources from US Wellness Meats.

      • says

        Hi Chris,

        If the supplement facts say Folate does that mean it’s OK? We got the “Perfect Prenatal” from New Chapter and it has 600mcg of Folate, but I can’t find if it comes from 5-MTHF or if it’s just re-badged folic acid….

        Thanks.

  94. Debbie Davis says

    Do you have any idea of underlying cause for vitamin deficiencies. I have recently found that, I too, have very low levels of these two vitamins. Also have increased blood sugar. All diagnosed after being exposed to mold in my workplace for the last three years. Have made that connection on my own, but cannot get approval from workers comp to see anyone with mold exposure expertise to see me. Very concerned about other issues I may be having. Already have allergies, asthma, decreased heart rate, elevated BP……..but having to fight daily with WC to get the medical professional I need to tie all this into the mold issue or to rule out that possible cause. HELP.

    • Mark says

      I’m in the middle of testing for Pernicious Anemia but I think for me it’s diet – I’ve been a vegetarian for 12 years and never got much sun.

      It’s normal I’m told for these two deficiencies to cause a spike in Blood Sugar.

      • Debbie Davis says

        I have also found a connection between Pernicious Anemia and mold exposure. My B12 level was 168 on scale where 232 is lowest normal and 1140 highest normal. I don’t have the paperwork with me right now and am not sure about the Vitamin D, but doc has prescribed a Vitamin D tablet to be taken once weekly for 4 weeks. Manifested with low heart rate and visit to ER with referral to a cardiologist to diagnose. Don’t quite understand the entire physiology and what the mold does to interrupt normal absorption of B12 and D, but there is a definite connection. I do get a lot of sun despite knowing the dangers so that should not be an issue for me. Could you be in an environment with mold?

  95. Mark says

    Hi Everyone,

    As someone that found themselves with big B12 (156) and D3 (14.9) deficiency’s, I have been supplementing with Methyl B12 and D3 and have started to see all my symptoms disappear. I then started to add the Now Foods Co-Enzyme B Complex (because it was the only “B Multi” I could find with Methyl B12 – although I am also using the Jarrow B12 5000 mcg Losengers but I didn’t want a “B Multi” with Cyancobalamin B12)

    http://www.nowfoods.com/Supplements/Products-by-Category/Vitamins/Vitamin-B/M046554.htm

    to make sure I was getting all my other B Vitamins, although I am eating two big helpings of spinach every day and so far my Folic Acid Blood work has been fine.

    On looking on the Now Foods ‘ingredients’ for the B Complex, it has 400 mcg of Folate but as ‘Folic Acid’ and I’m now wondering if I should keep taking these and if not, do I still need to be considering a ‘B Multi’ and if so, can someone recommend a brand with Methyl B12 and Folate ??

    Thanks

    Mark

  96. Nathan says

    Hi dr. Kresser

    I’m confused by the distinction being made. From a biochemical standpoint, folate and folio acid coexist depending on pH. If you eat folate, it’s going to be reduced to folic acid in the stomach, then it could shift back to folate after being reduced by a healthy pancreatic secretion. Nevertheless, absorption of folate/folic acid has to take place in its reduced form (folate) to cross the cell membrane if GI epithelial cells. I don’t really understand the importance of the distinction since the pH of intracellular, extra cellular, and intra-compartmental environments is going to reduce/oxidize the vitamin as needed for different reactions. Thanks, dr. Kresser (writing from temple med)

  97. says

    This is one of the reasons why I am not a big fan of supplements.

    By the way, this seems to apply to a number of conjugate bases/acids, which are often assumed to be the same thing – e.g., lactate vs. lactic acid.

    Ned

    • Dana says

      I am a huge fan of supplements. IF you know what you are getting. The real problem lies in the lack of information or the outright misinformation, people thinking they can prescribe this stuff just because they’re a registered dietitian. If that’s all it took to give good advice then folic acid shouldn’t even be on the market, and I shouldn’t have to search on the Internet for a multi that has proper methylcobalamin in it for my B12 either.

      I mean, none of us have nutritional assay equipment in our households as far as I know. That stuff’s expensive. So we have no idea what the nutritional quality is of the food we’re eating. And everyone’s diet takes a nose dive every now and again, but their bodies still need the nutrients.

    • Chris Kresser says

      Active folates – not folic acid – may help mood if mood issues are related to poor methylation, and poor methylation is caused by folate deficiency or MTHFR deficiency. As I’ve pointed out in this article, folic acid is a synthetic form of folate that is not well metabolized, and should be avoided for that reason. Unfortunately it’s never so simple as “take this supplement for this symptom”.

      • Frank says

        In my country (Germany) the health department publishes recommendations containing the ‘folate equivalents’.
        They say that folate is only half as bioavailable as folic acid because of its poly-glutamate structure.

        Who’s right ?

    • Chris Kresser says

      It depends on a number of factors. Deplin (prescription form of folate) which is often given in these circumstances has 15 mg of folate. Most people don’t need that much, in my experience. I usually start with about 1 mg. It’s a good idea to run a methylation panel and make sure that overmethylation isn’t occurring with very high dose supplementation.

      • Jennifer D says

        What is a methylation panel? I take 15mg l-methyl folate. It saved me. I backed down to 7.5 because I seemed to be getting too much. I feel the drop for sure. I was deficient in a lot of b vitamins. The functional medicine dr I was seeing was too expensive so I am going to see a registers dietician. I decided to do that after listening to your nutritionists on the ancestral rds podcast. I called your office for recommendations in my area but didn’t hear back.

  98. Mr. D. says

    Folinic Acid is fine. Even those with genetic disorders can metabolize it, which is what the issue is in the first place. Folinic Acid does not require dihydrofolate reductase in order to be reduced to the active form of folate in the body.

    • Chris Kresser says

      I agree with Mr. D – folinic acid (a.k.a. 5-formyl tetrahydrofolate) is one of the active folates and does not have any of the issues that folic acid does.

      • Wendy says

        the never wrong wikipedia says:

        And Folinic Acid should not be administered to pregnant woman because it can weaken the unborn baby’s immune system

        ??

  99. Grace says

    I am currently taking 25mg of methotrexate for an autoimmune condition. My physician prescribes 2mg of folic acid a day to help with the side effects (mainly hair loss). Should I be supplementing with folate instead?

    • says

      methotrexate reduces availability of one precursor of methylfolate. So doctors use a different pathyway and prescribe folinic acid instead. Both pathways lead to the goal of having methylfolate available. You shoul consider asking your doctor about methyl folate

  100. says

    Hi Chris,

    I’m really surprised you made no mention of the fairly common MTHFR C677T gene defect (or SNP).
    I think you missed a big opportunity to educate your audience on this. For many with invisible and seemingly unexplained illnesses such as chronic fatigue, fibromyalgia and autism, they are finding they have gene defects causing all sorts of sub par function in the methylation cycle which affects pretty much every bodily process. MTHFR specifically has also been implicated in recurrent pregnancy loss though that is somewhat controversial.

    I only recently discovered I am homozygous for MTHFR C677T meaning I have pretty much zero ability to convert dietary folate or folic acid to the type of folate the body uses – 5MTH which you mention in the article. It’s thought that 10% of the caucasian population are homozygous and 50% are heterozygous, meaning they have limited function of this enzyme.

    There is a great site – mthfr.net – which explains this much better than I can, lists all the current research to date and explains the consequences that C677T and A1298C (the two most studied SNPs for MTHFR) can have.

    And yes, MTHFR is THE best acronym EVER for a gene defect….in some circles we lovingly call it “motherplucker” :)

    Good sites for more information:

    MTHFR : mthfr.net
    Methylation: http://www.knowyourgenetics.com/The%20Methylation%20Pathway.html
    http://www.enzymestuff.com/methylation.htm

    Amy Yasko is a pioneer in this field: http://www.dramyyasko.com/

    • Chris Kresser says

      I plan to write about this in detail later. I can only do so much in one article – when they get too long, fewer people read them. I’d like to give this topic the attention it deserves.

      • says

        Fair enough, but even a sentence would have been enough to at least advise people this is one reason why so many will get no benefit from dietary folate or folic acid. Look forward to the future article :) cheers, Allison

      • Willa Michener says

        There is an association between folic acid supplementation in pregnancy and increased rates of autism but whether the association is causal is unknown. It is possible that folic acid supplementation is fine for most mothers, but puts mothers with the C677T or A1298C mutations at risk for having an autistic child. The mothers with these SNPS will not be able fully to metabolize folic acid and will have more unmetabolized folic acid. This could be the culprit. See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2980954/. Maybe pregnant women should take only 5-MTHF supplements, if we have safety findings on that. What do you think?

      • Jennifer D says

        I agree the topic of mthfr gene mutations need to be covered. My husband, myself and my daughters all have one of the mutations. I was experiencing a myriad of symptoms and started taking l-methyl folate 15mg and it changed my life. What a difference. The problem I’ve found is that there are main stream physicians that give it no credence but functional medicine practitioners do. Mthfr.net is a great resource for personal research and finding a doctor that can help. Going to a registered dietician is a good place to start as well. Would love to see you cover this topic.

  101. Dan says

    Chris,

    I’m not sure that I would be so quick to exonerate natural folate.

    The hypothesis that the results of the randomize controlled trials (there are now a few RCTs showing folic acid => cancer) relate to unmetabolized folic acid is compelling. That said, it is just a hypothesis!

    There is some evidence that folate, itself, could be problematic. For example, here is a study finding that people who consumed more dietary folate had more cancer: http://www.ajcn.org/content/83/4/895.abstract. And, here’s another one: http://www.ncbi.nlm.nih.gov/pubmed/15991278. There’s also a large recent meta analysis finding that vegetable consumption does not reduce the risk of cancer. Since people who eat the most vegetables are the healthy people, that result is surprising and (I think) actually suggests that vegetable higher consumption could cause cancer…

    From a plausibility perspective, if high consumption of folate causes cancer, epigenetic effects might be to blame. Here’s a study finding that higher RBC folate is correlated with promoter hypermethylation (gene silencing that may lead to cancer): http://cancerpreventionresearch.aacrjournals.org/content/3/12/1552.abstract.

    I recognize that more evidence should be required before incriminating things-natural, like folate (or animal fat) than would otherwise be required to incriminate things-artificial, like folic acid (or industrially produced vegetable oil). That said, there are plausible mechanisms by which folate, itself, could cause cancer. For example, as mentioned above, folate may induce promoter hypermethylation and, thereby, silence tumor-suppressor genes.

    Incidentally, other B-vitamins, like choline (and probably betaine too) may prevent promoter methylation. So, maybe the problem arises when otherwise choline-deficient people consume too much folate… I note that any animal-food source of folate also contains lots of choline.

    • Chris Kresser says

      Dan,

      I’ve seen those studies, and yes, it highlights the importance of obtaining nutrients from whole foods whenever possible. But I think the evidence supporting sufficient folate intake during pregnancy and nursing is strong, and that’s why I recommend supplementing for those populations. I don’t recommend that men or women who are not pregnant, trying to become pregnant or nursing supplement with high doses of folate (unless they know they’re deficient and are correcting a methylation problem).

      • says

        Ray Peat has some ideas about the consumption of PUFA and cancer. Simply eating folate may increase cancer because I have read that cancerous cells use folate to grow. If you are creating a heavy oxidation burden on your body with toxins like PUFA (polyunsaturated fat) then it’s likely that also eating folate might feed cancerous cells – especially if you also supplement with folic acid which can build up and deactivate Natural Killer cells. This is my hypothesis any way.

        • Kelly says

          Not entirely true. There’s a huge difference between ‘folic acid’ and folate — the former being synthetic, not really useable by the body. Increased folate is associated with lower risk of colon cancer. As for the supposed increased risk of breast cancer — that came from FOLIC ACID, not food folate:

          “Furthermore, although food folate intake was not significantly related to breast cancer risk, total folate intake, mainly from folic acid supplementation, significantly increased breast cancer risk by 32%.”

          http://www.ncbi.nlm.nih.gov/pubmed/17063929

          • says

            http://preventcancer.aicr.org/site/News2?id=15467

            This link explains the theory, cells require folate to make and repair DNA and cancer cells can also use it. Unconverted Folic Acid cannot be used in this way, but has been reported to deactivate Natural Killer Cells which are a defense against cancer.

            Only active folate can be used for DNA growth/repair, so this article is talking about converted folic acid or food folate feeding cancer.

            This is known as the folate paradox. It’s possible the folic acid both deactivates natural killer cells, and possibly feeds cancerous cells according to the articles I’ve read.

            However PUFA and other environmental burdens promote cancer and impair the immune system. PUFA’s ability to supress the immune system is well documented.

      • Wendy says

        Chris i think in fact women trying to become pregnanct are actually supposed to consume the folic acid or methylfolate supplements as its upon conception through to the 29th day i think they say that it is most important to have the extra dose of 400mcg over and above the 600mcg required during pregnancy

  102. Aaron says

    First of all, awesome summation post Chris. Question: you say 800-1200mcg/day is best for childbearing women, but no specifics for the rest of us. Would you agree with the RDA that 400mcg is the amount the rest of us should be aiming for from food or supplementation? Thanks also for including specific recommendations on a brand.

    • Hannah says

      At the end of the article he states that food sources provide plenty of folate for those not growing a baby. Supplement recs are insurance for pre-conception/pregnancy.

  103. Amy Shouse says

    Chris,

    This article caught my attention recently. I am 16 weeks pregnant and was curious about how many physicians were telling me to make sure I take a bunch of folic acid all the time. I was searching around the internet and saw there was some musings about an autism-folic acid connection. I realize that there are a lot of theories on autism…but thought this interesting enough to look into.
    http://www.ncbi.nlm.nih.gov/pubmed/21454018

  104. tim says

    This article begs the question why is it hard to get B9 without supplementation.

    Also, Solgar does not sell 5-MTHF.

  105. amber says

    i thought that i was taking a “folate” supplement for this very reason. however, upon closer inspection, it shows 5-methyltetrahydrofolate, and then in parentheses, it shows: (elemental, as 800 mcg (6S) 5-methyltetrahydrofolic acid, glucosamine salt). should i be concerned here?

    i’d also love the answer to amanda’s question regarding pure encapsulations nutrient 950 with vitamin k. we’re trying to conceive & i’ve had a tough time finding prenatals that don’t contain folic acid. i did see that this particular supplement (nutrient 950) says that it contains “soy”…that’s too bad.

    thanks, as always, for the great info – i really appreciated the article.

      • Nat says

        Amber, Megan and others,
        I actually contacted New Chapter asking them to specify what form of folate is in their Perfect Prenatal and they were very evasive in their response. They did say they use Folic Acid as a culture catalyst to end up with a “whole-food complex form of folate”…whatever that means. I asked them to clarify and they said they don’t test the final product for what specific form of folate it is. I’m not happy with this response and am still in search of a better prenatal which uses a biologically active form of folate.

      • Nutranut says

        New Chapter pulls a fast one trying to make it look like it’s not folic acid, but it is, just processed to look like it’s folate. ask any food scientist at a university lab and you’ll see what they’re really providing. folic acid re-dong to looks like it’s folate. shame on them.

  106. Marie says

    Just out of curiosity… If we aren’t exposed to folic acid, then why do we have an enzyme that processes it?

    • says

      For many people this enzyme does not work – MTHFR C677T. I am homozygous for this meaning that I have almost NO function to convert dietary folate or folic acid. It’s thought 10% of the caucasian population are homozygous and 50% are heterozygous meaning limited function. I was surprised Chris didn’t cover this in the article.

      • Marie says

        I meant the DHFR. Redundant or unnecessary genes tend to be lost due to mutations being passed harmlessly from parent to offspring. If we have an enzyme, the general rule is that we’re using it for something.

      • Dar says

        I agree Allison…my daughter has the heterozygous MTHFR C677T and 1298C mutation. She is very prone to blood clots and this mutated gene means she can’t metabolize Folic acid..she has to take Folate, B12 and B6.The methylfolate is a good one.( they had her on Warfarin too but another doctor promptly took her off it..thank goodness..she is allergic to aspirin so I have her on Nattokinase)

      • Dawn says

        Hi Allison, I just found out I have C677T and A1298C mthfr mutations. My doctor didn’t give me any information really. I’m trying to learn as much as I can. His treatment program doesn’t seem to be the best option… I’ve started taking metafolin after doing my own research instead of folinic acid like he had me on. Do you have any good articles you could recommend? Where’d you find out those statistics, I haven’t seen any listed anywhere I’d like to find something to read about it. Thank you!
        Dawn

    • KimE says

      The enzyme that processes folic acid is the same one that processes folinic acid, the form of folate found in vegetables, and that is why we have that enzyme. Only berries have the activated form of folate, as far as food goes.

      People with the C677T MTHFR polymorphism have less efficient processing of even the form found naturally in food and since folic acid is an unnatural form that easily passes into the blood stream it can build up in people who have problems processing it and then it can block usage of the correct form in the body, so it isn’t surprising that it contributes to diseases since it interferes with their being able to use what activated folate they have.

      My son has one copy of the C677T gene (meaning the other gene is normal) and even with about 60% function he still had problems with constant fatigue after having mono and we searched for over a year to find out why he wasn’t getting better and after a few days of taking 5-MTHF 5mg his energy levels went up dramatically because he couldn’t process enough folate to meet his increased need while he had mono and it put him into a downward spiral health wise. So sometimes a person who has one of these defects (or both) needs to take higher levels of the correct form of folate.

      • DannyB says

        Hi Kim,

        I know we’re all different, but can I ask how much methylfolate your son is taking? Also did you start with a low dose and increase it? Finally, is he taking any methylb12 or other form of b12?

        Thanks in advance,

        Dan

  107. says

    Thanks for the clarification on the difference between those two terms.

    It’s just another reminder that we should be regularly eating liver. Good thing it’s pretty tasty!

  108. Dave says

    Like many other RA suffers, I take meds that can affect the liver, (in my case, methotrexate, Arava, Embrel) my rheumatoligist ordered Folic acid 3mg daily. Would using B9/Folate have the same affect on the Liver? I started Paleo in Jan 2012, and love greens, can the correct levels be reached by diet alone?

  109. lenny says

    If the amounts you recommend for mothers attempting to get pregnant are difficult to get from natural sources, then why are you recommending them via supplement?

  110. Lahoma Howard says

    I have pernicious anemia that went undiagnosed for 20 years, I take very frequent (every other day) injections of b12 currently and my doctor has me taking a special heme iron polypeptide supplement with folic acid to try to get my blood production back to normal. I know a lot of people with my condition supplement with higher levels of folic acid than the normal populace would get in their multi – I will have to see about finding the natural form next time I buy supplements, and will pass this along to the pernicious anaemia society as well. Thanks!

    • Donna says

      For a food Folate supplement, try Doctors’ Research Brand by Dr. Robert Thiel, who for years has warned about the synthetic folic acid and its overuse in our food. Go to docrtorsresearch.com. Look at the ingredients in B6, 12 and Folate.

  111. Ann says

    Chris,
    I had blood work done recently and my MTHFR: C/T with homocysteine: 11. The blood work suggested I consider supplementing with active methylfolate. What would you suggest?

      • Dar says

        I agree. My daughter has the mutated MTHFR gene and I found a great product from a website..Dr. Ben Kim. He sells a whole food supplement for Homocysteine care. He also has Proteolytic Enzymes .I have put my 25 year old daughter on both of these products. They come from whole food so the body utilizes them better.

  112. Deborah says

    Chris;
    Any comments on formyltetrahydrofolate? This is in one brand I am curious about, along with Methyltetrahydrofolate (without the 5- prefix).
    Thanks as always for your informative posts!

  113. rodeo says

    Nice article Chris.
    I think it’s worth to mention that betaine has the same effect on homocysteine as folate. Betaine is found mostly in wheat-products.
    If one does not want to eat wheat for some reason, choline works just as wellsince its a precursor for betaine. Choline is found in more paleo-friendly food stuffs such as liver and egg yolks (both are good sources of folate as well).

  114. Kim says

    Thanks for the info! What is your recommended dosage for nursing mothers who still take prenatal vitamins that contain folic acid?

    • Chris Kresser says

      I would strongly recommend that nursing mothers not take prenatal vitamins that contain folic acid. There are other options for multis that don’t contain it, such as Pure Encapsulations with Vitamin K.

        • Aaron says

          I’m interested to know which one you are referring to also as that one has folic acid and not folate listed

        • David says

          Yes, that’s the one he’s talking about. Avoid Pure Encapsulations’ actual prenatal multi — for some reason it has regular folic acid instead of folate (I think it’s — ironically — the only one that does). The entire Nutrient 950 line has folate and not folic acid.

          • says

            The product information sheet for the 950 line says: “Folic acid (Metafolin®, L-5-MTHF): synthetic.” So it says the 5-MTHF, but it also says folic acid instead of folate. . . . Does it say that because folic acid and folate are related, in the sense that folic acid exists to convert to folate? It’s a bit confusing.

            • David says

              They’ve simply confused terms. This is extremely common, unfortunately. However, as long as the “folic acid” is specified as 5-MTHF or Metafolin, you can be sure it’s folate and not folic acid that they mean.

              • Karina says

                Unfortunately pure encapulations vitamins have soy which has been linked to infertility, not a good option for women trying to concieve, does anyone know of a vitamin that have neither folic acid or soy?

                • David says

                  The amount of soy is probably not enough to be an issue, but you might check out Designs for Health “Prenatal Pro” if this is a concern. It is soy-free and does not contain folic acid.

                • Chris Kresser says

                  The amount and type of soy in the Pure product is negligible and could not conceivably contribute to infertility.

                • Jennifer says

                  Pure Ecapsulations B-Complex Plus contains no soy, and has only the L-5 MTHF (no folic acid).

                • Casey says

                  Yes, Seeking Health’s Optimal Prenatal is soy-free and has methylfolate instead of folic acid. It is specifically formulated for women who have the MTHFR genetic defect and cannot process folic acid.

            • says

              Folate is the category. Folic Acid while synthetic needs several enzymes to convert to the form used by the cell ->Methyl Folate. All the different types of vitamin B9 (Folic Acid, Folinic Acid, Methyl Folate) are vitamers. Meaning they have significant properties of the vitamin. Folinic acid needs a different pathway than Folic Acid to be made bioavailable. Methyl Folate needs no pathway at all, it’s the active form.

      • Alex says

        Are you familiar with Vitamin Code from Garden of Life? These are all vegetable derived and they have prenatals which include 800 mcg of Folate. But how do you know the brand you are consuming is really what the label says?

        • Jennifer says

          I would trust the Nutritional Facts list of vitamin/mineral content and ingredients list, as this is regulated. However, how a product is processed can sometimes hide unwanted ingredients. The raw food vitamins look great, but they all seem to be created through fermentation, and/or contain yeast directly, as do the Garden Of Life Vitamin Code. This can lead to candida overgrowth (yeast infections), especially if you take antibiotics or are prone to this type of infection.

      • will says

        just a reminder on mega food their label say 100% whole food state but that is not actuly true they do spick their vitamins with synthetic chemicals, got this from there own mouth, very deceptive labels

        • Mark says

          What is “spick” ? And by your statement, “from their own mouth”, you mean MegaFood told you they stuffed their supplements full of chemicals? Somehow, I doubt that is quite the case.

          Mark

      • Nutranut says

        Folic acid has shown benefits in thousands of published studies. it works. and it’s stable in tablets, absorbing 40% better than folate in foods. elitism masked as saying that it doesn’t work is just that.

      • Nutranut says

        I keep hearing people say we that have the defective MTFHR gene can’t process folic acid. My understanding is that we convert folic acid between 40 and 70% as well as those who don’t have the defect. Can anyone, especially you Chris, cite a publication that says we cannot convert folic acid at all? I think that a lot of people misunderstand this and think in absolute terms that folic acid is worthless. I have known three people who have the MTFHR gene defect who feel terrible when they take methylfolate, but feel good when they take folic acid. They usually feel extreme fatigue and/or get acne-like skin breakouts. One alternative doctor told me that he thinks they are having a detox reaction. My homocysteine measures the same whether I take 2,000 mcg/day of methyl-folate or 1,000 mcg of folic acid. Therefore, for me, either form works well enough.

        • Jennifer D says

          I have mthfr. L-methyl folate 15mg made all the difference for me. However, I learned that people who have a methylation problem, before starting a vitamin protocol, should also be tested for CBS an SIOX defects. This has to be addressed first. Folate, and methylation issues must be addressed in order for the body to properly detoxify.

    • CP says

      Great info! I think you forgot to include Megafood whole food supplements. They have naturally occuring folate in their B Vitamin and Multi-vitamin formulas, since their supplements are 100% whole food! Worth looking into!
      http://www.lovemegafood.com

      • will says

        im sorry i will have to correct you on megafoods vitamin they are 100 wholefood (STATE) NOT 100% whole food very big diffrence, the wording food based or food state or food source only means that they do have food in them but are mixed with synthetic chemicals, mega food vitamins are spicked with chemicals, got that from the horses mouth myself, there dosages are to high to be 100% whole food because in nature that does not exsist, the only company that i found in researching about 150 companys that FOOD BRAND from doctors research is the only 100% whole food, on the market, just wanted to share that hope you dont mind cheers

        • Ethan says

          Hey Will I would really like to know some info about the doctors research vitamins. Iv been looking at their product for the last few days and am impressed but I am still hesitant to drop a load of money on them, only for them to turn out using similar practices using USP isolates in their process and calling it natural as some other companies I know of do. Would you mind getting in touch and sharing some of the results from the research that you said you did? Thanks.

      • Nutranut says

        If you believe the megafood nonsense, you deserve to spend $150/pound on tabletted dried food that doesn’t have any published data to support the nonsensicle claims.

        • suzanne says

          try Dr. David Wong’s ND line .. ( Canadian
          www,Pranin.com Amazing !! 100% pure food ! Organic
          Vegan , Non GMO
          no additives or preservatives
          gluten free
          great in-clinic results for stress related conditions, weight gain, fatigue, mood swings, chronic inflammation, and infections Suzanne

      • Monty Paul says

        I’m curious why the Megafoods products don’t list the form of folate, other than listing broccoli? I don’t get it and would love to be educated. I’ve been told in the past, but I can not confirm, that they grow broccoli sprouts in a media fortified with folic acid. If this is true I wonder what an HPLC analysis of their products would show as the real form of folate they claim, as broccoli sprouts could otherwise never provided anywhere near a concentrated level of folate sufficient for a nutritional supplement capsule. Maybe someone here knows?

    • Adam says

      Okay, here’s what I don’t get. Excessive folic acid is bad for us- so then why do we then demonize folic acid as a whole? And why do people then dose with 300, 600, 800 mcg and up to 1 mg and above? Wouldnt the solution be to knock our folic acid intake down if we were going to supplement in the first place? How about 100 mcg? Why not? and why arent supplements with this low amount easily availible?

      • Kelly says

        I guess you didn’t read the article. “Folic acid” is synthetic, a completely different compound than folate. The solution is to not take folic acid at all, but talk to your doctor about taking folinic acid or methylfolate.

    • Multivtz says

      Homocystine converts to methionine if folate is present. High Homocystine levels make lymth fluid thick and allows fungus to grow inside you. Systemic fungus infection gives you mycotoxic gene changing posions. That leads to lypomas, that leads to cancer, cancer is your own bodys survival atempt to eat the excessive acidic compounds. Oxygen is alkalinic and restores cancer cells back to normal, or kills them. Folate ensures the antibody cell have the correct DNA keys to attack the parasites like fungus. Silk worm enzymes work well but make sure you have a functioning liver i.e good Bvitamins and adiquate minerals like selenium, zinc, to repair and clear the damaged tissues. An good amino suppiment and phosphotidyl should also be considered if healing is stuck. And don’t forget organic mushroom extract D3!! And LOADS of vegatables. Its the cell wall that dicides what the cell is doing not the DNA! Sorry about the spelling, I haven’t got OCD lol

Join the Conversation

Current ye@r *