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. (7, 8) 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
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.
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{ 121 comments… read them below or add one }
Great Article Chris! It’s sad to see cheap supplement corporations hurt so many women during pregnancy.
The quality of supplements is much more important than quantity. Here is another good option that I tell people about when they switch to the specific carbohydrate diet:
http://www.giprohealth.com/bcomplex-1.aspx
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
I’ve always wanted to know. Which vitamer is found in the foods..it’s not Folic Acid, I doubt it is Folinic Acid…which is it?
O, I tracked it down!
http://www.mthfrease.com/mthfr/2013/02/03/folates/
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
Thanks for the info! What is your recommended dosage for nursing mothers who still take prenatal vitamins that contain folic acid?
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.
Are you speaking of Pure Encapsulations Nutrient 950 with Vitamin K? Thank you.
I’m interested to know which one you are referring to also as that one has folic acid and not folate listed
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.
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.
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.
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?
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.
The amount and type of soy in the Pure product is negligible and could not conceivably contribute to infertility.
Pure Ecapsulations B-Complex Plus contains no soy, and has only the L-5 MTHF (no folic acid).
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.
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?
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.
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
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).
Hi Chris. Can you comment on Folinic Acid (as Calcium Folinate)?
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!
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?
I would definitely recommend giving something like this a try. It’s made for people who have defective MTHFR genes and helps to lower homocysteine and support the methylation cycle. http://www.healthegoods.com/homocystex-plus.html
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.
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!
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?
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?
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!
Just out of curiosity… If we aren’t exposed to folic acid, then why do we have an enzyme that processes it?
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.
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.
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)
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
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.
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
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.
(6S) 5-methyltetrahydrofolic acid is Metafolin/5-MTHF/L-Methylfolate.
Try new chapter perfect prenatal, theirs contains actual folate.
This article begs the question why is it hard to get B9 without supplementation.
Also, Solgar does not sell 5-MTHF.
Solgar sells 5-MTHF (Metafolin/(6S)-5-methyltetrahydrofolic acid/L-methylfolate) in 400 and 800 mcg.
http://www.solgar.com/SolgarProducts/Folate-800-mcg-as-Metafolin-Tablets.htm
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
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.
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.
RAW One for Women is a multivitamin that contains folate, not folic acid, in case that helps anyone.
RAW probiotic for men also has folate, my question is “folate” ok to take?
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.
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).
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/
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.
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
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?
High intake of Folic Acid supplementation is bad with or without MTHFR. http://www.foodconsumer.org/newsite/Nutrition/Vitamins/folic_acid_embryonic_loss_0218130710.html
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?
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
What about this product from jarrows http://www.jarrow.com/product/57/B_Right it says folic acid and folate.Is this a good product to buy?thank you
Great article, Chris! I recently wrote about this very subject on my blog: http://www.holisticchineseherbs.com/weston-price-2/the-problem-with-folic-acid-supplements-and-why-you-should-avoid-fortified-foods/
I have a liquid supplement that has folinic acid in it… what are your thoughts on folinic acid?
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.
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.
What do you recommend as a daily supplement dosage for people with the MTHFR mutation?
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.
Which methylation panel do you favor?
Read where folic acid helps with low mood. Should folic acid be stopped?
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”.
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, what are your thoughts on someone experimenting with taking a supplement like the one below even if they haven’t tested their methylation? I was told that this was one of the best formulas for people who have an MTHFR mutation.
http://www.healthegoods.com/homocystex-plus.html
Don’t forget the beans!
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
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.
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)
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
Pure Ecapsulations B Complex Plus
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.
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.
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?
Love your info!! Thanks….
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!
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.
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.
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.
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.
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?
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
Riboflavin depletes iron in the body, unless one is eating enough iron rich foods. 200 mgs of B2 is a LOT…
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?
Urine turns neon yellow (some people say green) due to the riboflavin (vitamin B2). This is completely normal and expected.
Thanks David!
that only happens with synthetic b vitamins never with whole food vitamins, even if they are high in B vitamins
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?
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!
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
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!
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
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.
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!
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”.
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.
I also too have been using the Thorne 5-MTHF supplement from Thorne Research company. I found this company online and they have been very helpful in answering my questions and generally care about their customers. http://www.momemineral.com/s?searchKeywords=5-MTHF+&Action=submit . I have also been purchasing metagenics and designs for health products in conjunction with Thorne.
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.
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!
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
In the last paragraph I meant to say ;
I have ordered 1000micrograms of “L-Methylfolate”
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?
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!
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
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’
Chris – Also check out the relationship between MTHFR gene mutations and folate.
See http://www.mthfr.net for info on MTHFR, folic acid, and related diseases such as Alzheimer’s, autism, and cancers.
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?
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.
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.
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.
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 ?
Folic Acid has to go through several steps to get to the form your body needs. Methyl Folate does not. The steps of conversions are outlined at http://www.mthfrease.com/mthfr/2012/12/19/supplements-for-mthfr/.
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.
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.
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.
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
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.
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.
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