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. Andrea says

    Hi– I’m so glad I found this site. I am a 56 year old woman in menopause, and recently had a blood panel run as part of a functional medicine exam. (Lots of issues that no one seems to be able to figure out…but I digress…) The doctor said I my folic acid was low and that I should take a supplement. (She recommended a brand, but I can’t remember what it was off hand.) This direction seems contrary to what I’m reading here. Should I pursue further information before taking a supplement? Thank for any help!

  2. Bar says

    Hi all – I’m looking for a trustworthy, reliable resource where I can find the max levels of vitamins and minerals recommended during pregnancy. As one example, the prenatal I am taking contains 800mcg of folate, but I also need to take a calcium supplement as the prenatal doesn’t afford enough (125mg) per the recommendations I’ve found (1,300mg). The calcium supplement I’m looking at will add another 400mg. Thanks, I appreciate any assistance.

    • Bar says

      To clarify – I’m looking for the maximums … There are plenty of resources readily available where I can find the RDAs. Thanks! :)

  3. PAR4 says

    Quite a lot of info to absorb regarding gene mutations. My DNA results show several issues including the MTHFR/A1298C, C677T and a few others. I had a supplement program (called “your natural prescription”) customized for me by xRMD Corp. Has anyone had positive or negative experience with this company or program? Do you have any comments on this?

  4. Sarah says

    I have MTHFR and my doctor has me taking a multi vitamin as well as 1mcg of folic acid. Should I not be taking this? I had a blood clot in 2013 and this is how the found my blood disorder. After reading this I’m unsure as to whether I should even be taking the folic acid.

    • Lynette says

      Correct. You need folate or folinic acid, not folid acid. Your body cannot deal with the folic acid if you have that gene situation. I have it too and just found out about it. I am taking folinic acid 800 mg and in just a very short time like a week or two the joint pain in my hand went away. Really amazing. I just assumed I would have it the rest of my life since I am getting older!

      You can buy multiple vitamins that are healthy (such as having folate or folinic acid rather than folic acid, etc,. They cost a little more, but hey, what is worth more than health? Very little.

    • David says

      1 mcg is a tiny amount so maybe you mean 1 mg (which is a very large amount). Either way, yes I’d avoid it if it is really folic acid. I’d also look at what is in the multi as you are probably getting a double-dose of folic acid. If you really need a multi (most people don’t) find one that has an active form of folate rather than folic acid.

  5. says

    My wife is getting over a blood clot caused by folic acid poisoning, when she never bothered with folic acid supplements. Is there a union of people being organized with a web site that can stop all foods from being fortified with folic acid. In my opinion folic acid is a dangerous replacement for folate and should be highly regulated.

  6. Judy G says

    Dear Chris (Kresser),
    In this article regarding Folate vs. Folic Acid you give reference footnotes to the facts stated in your article: where can one access these references as I do not see them listed at the end of the article where one usually finds them??? Thx.

    • Catherine Wessling says

      Throughout the article, you’ll see number links formatted like this: (3). Click on the blue number to view the reference.

  7. says

    INTERESTING, I just read some of the comments.
    Whether one needs Folate or Multi-vitamin,.. or not – some of the main issues are:
    1- Consuming wrong combination of foods, like meat with bread
    2- Taking supplements that have unallowable impurities
    3- Taking one type of vegetable for a certain need, like spinach for folate, discarding the fact that Spinach has too much oxalate that affects kidneys and even arteries.
    4- Low consumption of raw materials and too much cooked food
    5- Certain GMO’s – like arsenic, folate, dyes in grains, azo dyes in certain vegetables
    6- OVER-EATING, as well as eating in certain hours without being hungry, some consume too much sugary stuff others eat NO fat and NO cholesterol, both contributes to many health problems.
    7- Too much animal proteins that provide, arsenic, anti-biotic, hormones,…
    8- Un-balanced microbiome owing to undigested food or wrong combination.

  8. Bonnie says

    Hi all. I have a question. I am pregnant and my diet is very healthy. I eat every day spinach, fruits, vegeies. I do not take prenatal vitamins or folate. I search before one cup of spinach it’s appr 250 mcg or folate. For pregnant woman need to take 400 mcg each day or more. But as I told I eat a lot of fresh vegies. I ve got terrible skin problems from all vitamins in a pills especially vitamine group B (wich is folate/folid acid). So huge problem so once I even had to go on roaccutane after taking vitamins. My doctor still incourage me to take folate as a pill. But I explained her and also as I know our mothers 50 years ago did not take any vitamins while they were prignant by us. Of course I am still worry bc the sociaty and internet almost push you to take vitamins (pills) as it something without what human could not be. Are there many people like me who prefer to eat natural food than pills?

    • David says

      Hi Bonnie. Yes, there are people like you who prefer to get vitamins from diet and yes you can get what you need without supplements. The history of the link between folate intake and birth defects is that some groups of women around the world had been found to have higher rates of birth defects associated with low dietary folate intake, particularly when pregnancies were in winter months and there was inadequate access to green vegetables. Various governments decided to combat the issue by fortifying foods with artificial folate (folic acid) and recommending that people take supplements. With a healthy diet, none of that is necessary and, as the original article suggests, eating a lot of folic acid is probably not healthy.

  9. Kristy says

    I tested positive for a DHFR mutation but not an MTHFR mutation. Any suggestions on prenatal vitamins that I should look into? Thanks!


  10. Alicia says

    I’m utterly confused as to why you would say it was hard to reach the RDA of folate through diet. There are a large number of common foods that have 25% or more of the RDA per serving. I don’t see how anyone on a “real food” diet could possibly be folate deficient. Some leafy greens and nuts every day, a little liver once a week, maybe some legumes from time to time, and you’re good to go. I did notice that this is one nutrient that spinach is much higher in than kale, so I’ll go back to letting myself eat some spinach.
    Also, all you people in the comments section who are fretful that you’ve been on prenatals for years while trying to conceive, note that the only substantive difference between a woman’s multi and a prenatal is the whacking high dose of iron in the prenatal. Since the need for iron increases only in the second trimester, taking the prenatal before you are pregnant is just extra years of constipation and nausea. A women’s multi will have the folate/folic acid needed to prevent neural tube defects (although note that neither has the choline necessary for that purpose, so keep up with the egg yolks).

    • Suzanne says

      I believe he was referring to pregnancy and the extra needed and not those who aren’t pregnant.

    • Kelly Richards says

      Might be an issue if you have a MTHFR gene mutation, in which case a serious combination could leave you folate deficient regardless of how ‘healthy’ you diet is. With this mutation methyl folate would be a better choice.

      • David says

        How would an MTHFR polymorphism leave you folate deficient if you are eating a healthy diet and getting adequate folate from natural sources? The known MTHFR polymorphisms affect the body’s ability to convert folic acid to folate, but folic acid is a synthetic food additive, not naturally occurring in food. MTHFR polymorphisms do not affect one’s ability to utilize naturally occurring folate.

        • Anne says

          That is not entirely true. Mthfr affects the body’s ability to process B9. Those of us with the gene mutation cannot process folic acid at all. It just builds up as a toxin in our system. Different combinations of the mutation affect the enzymatic activity differently. For example, if you are compound heterozygous (one mutation on each of the two markers), your enzymatic activity , i.e. the ability to methylate folate, is at approximately 40% of someone who has no mutation. So while I could get a lot of my folate from my food, I would have to eat more than a “normal” person. If you are homozygous on the 677 marker (a mutation on both dna strands), your enzymatic activity is closer to 15%. For those individuals, supplementation with folinic acid or methylfolate really is a must.

          • David says

            Sorry but what you said is not correct in a few ways. First, your statement that “Those of us with the gene mutation cannot process folic acid at all” is incorrect. The percentages that you cited actually refer to to the ability to convert folic acid into useable form so, although they are reduced, they are definitely not zero. For someone heterozygous for C677T, the rate is around 65% meaning that the majority of folic acid is still converted into useable form (if homozygous it’s lower, like 10-30%). This is why many physicians tell people with MTHFR polymorphisms to just take more folic acid. If you take enough, you will eventually get enough converted to usable form. However, that logic ignores the fact that too much folic acid is not healthy, which brings us back to natural folate in food. The MTHFR polymorphisms do not in any way affect the body’s ability to convert that into useable form; (the percentage that you cited had to do with folic acid), so you in fact do not have to have more of it than someone without the polymorphism. Finally, although you see the term all over the internet, “mutation” is not the scientifically correct term for what we are talking about. They are polymorphisms, which are very common. Mutations, by definition, are very rare, and affect 1% or less of the population. Kind regards.

            • Chuck says

              David with due respect you are wrong and Anne is right. Folic acid is synthetically produced and is not tolerated by someone with a C677T Polymorphism. The reduction that you write about is in regard to natural folate in our diet. I have personal experience with this. My wife had me taking supplements for male fertility it was a high amount of Folic Acid in about a weeks time I had a neurological attack. Ankles swelling, hand and feet numbness, muscle twitches etc. Scary time! Had every type of test done and no answers. Symptoms went away because I was not taking any supplements. Started taking the supplements again and guess what happen. Did some research on MTHFR, took a test from 23&ME and found out that I am Homozygous for C677T.

              Here is Dr. Ben Lynch’s take on it:

              “supplemental and enriched folic acid foods should be avoided by those afflicted with MTHFR C677T mutations because the MTHFR mutation has partially destroyed the MTHFR enzyme which is required to process folic acid completely.

              Natural foods with folate should be consumed by all with MTHFR mutations as food folate helps make other forms of folic acid which are needed for various functions.

              Those with C677T MHTFR mutations do not process folic acid into 5-MTHF.

              If folic acid does not turn into 5-MTHF, folic acid levels build up. Elevated folic acid has potential to stimulate pre-existing cancer cells.

              That said, it is unwise to provide supplemental folic acid to anyone with MTHFR C677T mutations.

              However, what one should understand is there is an already methylated, active form of folic acid available. This is L-5-MTHF and is available via supplement form over the counter and is also available by prescription only.”

              • ruthie says

                Chuck I have C677T and A1298C mutations. Do you know if it’s ok for me to be taking the 266 mcg folate (“as folic acid” the label says) per day? Based on what I think I’m reading here it is NOT ok. Thanks in advance.

                • Chuck says


                  I would say do not take it if it comes in the form of Folic Acid. Go on
                  Lots of good info here.
                  Check out this link
                  Everyone is different but you need to start slow. I started taking 400mcg of L-5 methylfolate and 1000mcg of B12 methylcobalamin and felt great for a week. Wow is all i can say. I have never had any supplement make such a positive dramatic change in me. But then the honeymoon was over. I got irritable, strung out, depressed. I over did it. My body was not use to handling this new supply of methylated b9& b12. Stopped taking for a few days then started again with a quarter of what i originally started out with. And gradually worked my way up. It has worked for me but it is a balancing act and a work in progress. Start with website there are others like

              • David says

                Hi Chuck. Thanks for the comments, but the facts remain that everything I have said is correct, most of what Anne said is incorrect, and your experiences do not in any way disconfirm what I have said.

                My original point was that MTHFR polymorphisms do NOT affect the body’s ability to deal with natural folate in food. I’m not talking about folate added to food in the form of folic acid, but natural folates (as mentioned in the original article). That point is a scientific fact, and the fact that you had a bad experience taking too much folic acid from supplements in no way questions my point.

                My second point (made in my reply to Anne) was that people with MTHFR polymorphisms have a REDUCED ability to metabolize folic acid, NOT A COMPLETE INABILITY. How much that ability is reduced depends on the polymorphism, but even people homozygous for C677T have about 30% activity.If you were taking very large doses of folic acid, I don’t doubt that it could cause you problems (I said that earlier) but that doesn’t mean that people like you (or me) have a complete inability to metabolize folic acid. Although I would recommend consulting the primary scientific and medical literature rather than relying on information coming from people who sell supplements, even the source that you cited confirms my point. You quoted him as saying ” MTHFR mutation has PARTIALLY destroyed the MTHFR enzyme which is required to process folic acid COMPLETELY.” You cannot just ignore the words “partially” and “completely” and conclude, as Anne wrote above that “Those of us with the gene mutation cannot process folic acid AT ALL”. That is simply false and, as I noted, is even inconsistent with the information on the site that you mentioned.

                However, this doesn’t mean that folic acid is a good thing, and I do try to avoid it. You will not find anything on the site you mentioned that says people with MTHRF polymorphisms have a reduced ability to metabolize natural folate, because they do not. You can also easily get the RDA or even the upper tolerable limit for folate from foods (such as those mentioned above). The only reason why you should take a methylfolate supplement would be to take in an excessive amount of it. For example, prescriptions folate is 7.5 X the upper tolerable limit for folate intake. Is that actually helpful for people with MTHFR polymorphisms? That is an empirical question that has yet to be answered scientifically.

                So, to summarize, two facts remain:
                1) MTHRF polymorphisms do not affect the body’s ability to utilize natural folates in the diet.
                2) People with such polymorphisms have a REDUCED ABILITY, but not INABILITY to utilize folic acid.
                Kind regards.

                • David says

                  For some reason, I am unable to reply to the comments of Kelly, so I’ll reply here. Neither of the references provided by Kelly even mention MTHFR, so they are not relevant to the question of how MTHFR polymorphisms affect conversion of folic acid. A good, recent review of the overall subject, in a peer-reviewed journal, is at Nazki, F. H., Sameer, A. S., &, Ganaie, B. A. (2014). Folate: Metabolism, genes, polymorphisms and the associated diseases. Gene, 533, 11-20.

                  As I stated earlier, the rate of enzyme activity (for converting folic acid into useable form) is about 65% for C677T heterozygous and about 30% for homozygous.

                  Whether or not that is “greatly reduced” depends on your definition of “greatly”, but it is definitely not “completely” as repeatedly stated earlier by other people commenting on the article.
                  Kind regards to all.

  11. Susan Pearce says

    I have been taking Hallelujah Acres brand B12 B6 & Folate sublingual tablets because they have the word Folate on the label. However, I have a question about what they say on the back of the bottle. It says: “Folate (as [6S]-5-Methyltetrahydrofolic acid, glucosamine salt) Quatrefolic.” When I first saw that it said that, I wondered if it really is folate like it says. I still take them but today when I reread your article, I decided to ask my question. I hope someone can reassure me that I really am taking folate and not folic acid when I take these tablets.

    • James Geiger says

      Many B100 brands list in order- Folate (folic acid).

      Is this listing both next to each other incorrect in that folate is NOT the prefered form folic acid?

      • Lynn_M says

        Folate is an umbrella for many different forms of Vitamin B-9. Folic acid is a folate. L-5-MTHF (methyltetrahydrofolate) is a folate. 6S]-5-Methyltetrahydrofolic acid is a folate. There are also many intermediary forms of folate that get formed in the folate cycle.

        When a manufacturer lists Folate (folic acid), folic acid is the specific form of folate found in that supplement. If a manufacturer just says folate, you can expect that it contains folic acid. Other folate forms are much more expensive and I would expect the manufacturer to specifically state if it is a form of methyltetrahydrofolate.

        Also, you don’t want to buy just methyltetrahydrofolate, because that probably means it is in a racemic form (L & R) where only half is the right configuration to be active. You want either L-5-methyltetrahydrofolate or 6S]-5-Methyltetrahydrofolic acid, because those are the biologically active forms of MTHF.

  12. Analucia says

    I had a wild, scary bad cognitive reaction to a low dose of T.R. 5-mthf. It took me months to recover-although the worse was on the first week :( after I took the first dose
    I think that folate is not for everyone. Interestingly I don’t have bad reactions to Folic Acid but I still don’t know if is helping, too early to tell.

      • Kelly Richards says

        I agree, I found with a few extra supplements my tolerance to methyl folate increased. Try niacin, MSM and inositol. Avoid folic acid if you have methylation issues.

  13. Jo says

    Hi, I have severe anxiety and am wanting to try a combination of folinic acid and methyl b12 as it has worked well for some. I have tried almost everything, so am hoping this is the one. I was wondering if anyone could give me advice on dosages on both the above. TIA

    • Kelly says

      Hi Jo,

      I started with folinic alone, and did so by taking 800 micrograms a couple times a day, and very soon realized that it really helps with sleep (and thus anxiety), and so ended up making sure that I take one (I empty the capsule) under my tongue about 45 minutes before bed — works really well, for me anyway.

      Then you can add methylb12 or hydroxob12 in a few days to a couple weeks or so, but take it (under your tongue) in the mornings, as it’s known to help reset circadian rhythm, so it could keep you awake if you take it too late.

  14. Shauna says

    I just wanted to add that I had a negative reaction to methylfolate at just 200 mcg that I don’t see listed by others very often: venous insufficiency. I am 31 years old, at a healthy weight, and possessive of no risk factors for that condition. It was the methylfolate. Blood pooled in my feet, turning them purple, and caused painful sores on my toes. It happened in my hands also, but with less severity. My doctor prescribed horse chestnut, which had no effect. Cutting way down on the methylfolate is what finally caused the venous insufficiency to resolve fully. But it took me a full YEAR to discover the cause, because no one else lists it. So I hope this helps someone, somewhere, who suddenly developed venous insufficiency upon supplementing with methylfolate!

    • Lucia says

      Wow, Shauna! So sorry to hear about that horrendous time you went through, but really happy to hear you discovered what was causing the problem. All of us are so different from one another, and this is a great example of that, and encourages us to remember there are no “cookie-cutter” answers. Thank you so much for sharing this. Blessings!

    • Donny says

      Hey Shauna,

      I’ve just been reading about the MTHR gene and the two ways it can affect people. I know thrombosis is involved in one mutation of this gene called C677T and you may have been overdosing on folate when your body already produces too much but I’m not an expert so maybe read these and ask your doctor – also Hope this helps you. This is all related so found this article really helpful for me.

    • Analucia says

      I’m sorry to hear that. I felt like a zombie after the first-and last- dose of folate. I’ll never take that supplement again :(

  15. Gillian says

    The basic idea is to eliminate Folic acid from the diet. The US government requires it to be added to all grain based foods, so it’s tough to do! Folic acid blocks your ability to use Folate. Folate is good, Folic acid is bad. You can supplement your folate intake by taking Optimized Folate or Methylfolate (same thing, different name). 1000 mcg = 1 mg. Start out small 800-1000 mcg. It is safe to take, even if you don’t know if you have a genetic deficiency. Too much might make you jittery so proceed with care. You should also add B-12 to your diet if you think you might be folate deficient. Unlike folic acid, the bi-products of folate are not toxic to the body.

    • Eberhardt Huhn says

      Well, that’s easy: stop eating grains. Humans shouldn’t be eating grains anyway.

      That way, you’re not eating foods that are pre-packaged, hence, fall under specific legislation that requires addatives, either as preservatives, or as nutrients that are commonly deficient in diets.

      The funny thing is, grains (and dairy – but that’s another subject) actually make us deficient. Whole grains have phytates that render minerals less absorbable. Refined grains have less minerals and vitamins, but they also have less phytates, and a lower lectin unit count.

      So there are two problems that we encounter with grains of any type: they sap vital nutrients from your diet, and they have a high agglutinin (lectin) unit count. This is enough for me to find any nutrients that I could get from grains in a source of REAL food.


  16. Anya says

    I am a 24 year old female with pretty sever anxiety and depression. Is it safe to use B12 and Folinic Acid even though I haven’t been checked for any gene mutation?

  17. David Wood says

    Dr Terry Whals recommends using nutritional yeast.

    Looking at the supplement facts, they all say “folic acid”.

    I assume that’s not methlyfolate.

    Any opinions on the safety or otherwise of the folic acid in nutritional yeast or on nutrtional yeast overall?

    • Melissa says

      I believe nutritional yeast is fortified but brewer’s yeast (though not as tasty) has the naturally occurring B vitamins including natural folate.

  18. Mada Potle says

    This would be huge. The petitioners forgot to mention that rice is also fortified. So, this affects everyone.

    Sign the White House Petition to End Mandatory Flour Fortification with Folic Acid linked to Cancer

    Help spread the word. Tweet it. Share it on Facebook!

  19. ruthie says

    Hello and thanks for the post. I hope you can help me. My multi says that it has folate (as folic acid). Does that mean the folate source is folic acid? If so I may change to one that has Folate (as Quatrefolic®‡ [6S]-5-methyltetrahydrofolic acid glucosamine salt). I have 2 different MTHFR mutations. Thanks for your help. Im still learning about MTHFR and wow, there is a LOT of information to digest and filter through.

  20. Sandy says

    There is a lot of confusion due to articles like this which pick and chose research and recommend brands. Folic Acid has higher absorption over folate. Synthetics are used for higher doses and absorption as most people are deficient. If you are using “whole food” tablets it is better to invest in real food.

    • Kelly says

      Hi Sandy,

      Just because folic acid may be better absorbed (which I would question w/out seeing a study comparing the various forms), doesn’t mean it’s utilized once it’s absorbed.

      Again, in my case, testing showed high levels of “folic acid”, but very low levels of the active folates.

  21. Elizabeth says

    I want to start by saying I do not know if I have the mutation connected to folic acid metabolism. I am a woman in my late 40s, good health. But after several years of thinning hair, I found a web site where a nutritionist was advocating mega-dosing folic acid 800 mcg tablets (like up to 10 of these, twice daily) to combat hair loss. She reasoned that some people are just genetically pre-dispositioned not to process folic acid as well; that they cannot utilize it as efficiently as others; and so it tends to run in families, i.e. all the women in a family line tend toward thinning hair for instance. She cited two cases, a mother and a young (child) daughter who got on the protocol and were able to restore their hair to normal fullness.

    After communications with the nutritionist, I tried this protocol. I was a mess. It seemed to make my hair grow faster but not fuller, as it kept falling; it created havoc with my menstrual cycle and symptoms, plus I had strange tingling sensations in my limbs and issues with my heart rhythm. Scared, I stopped the folic acid protocol and the symptoms went away.

    A couple years later, I learned about MTHFR and methylfolate. I still had not been tested for the mutation but decided to try a methylfolate supplement (solgar, 800 mcg). I had 4 children in five years and breastfed for a decade solid and I questioned whether I had depleted stores of a number of things in my body. (Choline was another one I was depleted in.) Within just weeks of taking methylfolate (with no ill effects), I had dramatically less hair fall when I brushed or showered. Now my eyebrows are coming back. I am otherwise a healthy person, but I think I must have been depleted, AND unable to process folate as efficiently as others, or even as efficiently as I did when I was younger, perhaps (just a theory).

    I may be misunderstanding the science of it, as some of you are much more eloquent and well-versed on this, but I wanted to share my experience of a health symptom (thinning hair) and the difference in my experiences with folic acid vs methylfolate. The nutritionist was onto something when she made the connection between folate and thinning hair for some people; but it harmed me to take so much folic acid, and helped my health issue to take a comparatively modest dose of methylfolate. I want to share my experience with the nutritionist but as it turns out, she is a little defensive about anyone suggesting deviations from her protocol.

    • Becky says

      If you have the COMT mutation, you won’t be able to tolerate too many methyl groups, such as methyl folate and methylB12. I also have the compound heterozygous MTHFR so I was on a lot of 5mthf. This caused anxiety for me along with the methylB12. Once I switched to hydroxylB12 and decreased my folate to just 400 mcg a day, my anxiety went away.

    • Carmen says

      Elizabeth, thank you so much for your comment. I am going to tell my daughter, who I KNOW is deficient in a lot of areas ( she practically lives on ‘drive thru’, and is losing her hair.

      • Elizabeth says

        Hi Carmen,
        Diet definitely can play a role as well. But for me, I had an excellent, organic diet and was low on protein which I had read can be a reason for thinning hair. So I tried adding more protein. I tried Viviscal which made my hair grow fast but did not thicken it/stop it from falling out, and broke out in a month-long itchy rash. I tried myriad other less expensive hair vitamins or hair/skin/nail supplements. I added methionine. I tried choline/inositol. Pumpkin seed oil. Burdock oil. Quercetin. All of these options had people who testified to good results, so they apparently help some. But none of these were my issues. I tried biotin. That made my lashes grow full again, but didn’t reach my hair or brows. The choline/inositol made my nails grow like crazy and I have weak, thin nails. I tried taking 1-2 tbls blackstrap molasses daily, supposing perhaps that I could be anemic, as I have had that issue throughout my entire life to some degree, since childhood. Folate, (NOT folic acid) stopped the hair fall in its tracks; and my brows are growing back. Before that, I thought the amount I lost in the shower was normal. Now I realize it wasn’t, and my hair was probably shedding before it went through its full cycle. I don’t know whether I was deficient in folate from depleted stores after pregnancies and breastfeeding, OR if as we age, we assimilate certain nutrients less effectively. In the case of biotin, I have the lashes I had a child/teen now, but without the biotin, my lashes return to a much sparser look. As I am in perimenopause, we are told to anticipate some thinning of hair etc but I question whether we just don’t absorb the nutrients at age 40 as we did at age 10 or 20. Just my thoughts. I tried approaching my hair issue from a protein angle, amino acid angle, B vitamins angle, nettles and other herbs angle, “special marine complex garbage for $40 a month” angle, etc. After three years of trying things that worked for others and not for me, I figured out what my body needed. I think it made my first cycle (follicular phase) considerably longer than normal, but the next cycle it was a lovely normal cycle, no PMS. It may or may not be your daughter’s problem, but it is worth a try!

      • dianekjs says

        Hi, you may want to have a full iron panel run, if you haven’t already. You can be iron deficient while Hgb and Hct are still in the normal range, at least for quite a while. My hair loss struggles were solved when a dermatologist checked my ferritin, % saturation, etc. and told me we needed to get my ferritin at 70 or above. He said the hair loss might stop when we brought it back to 50 or so, but that in his experience healthy regrowth occurs at 70 or above. My hair is once again thick, healthy, and grows fast! Gluten sensitivities can also aggravate hair loss in some. Best of luck.

  22. SumMum says

    After talking with a pharmacists about this, he did some research on prenatals (or multivitamins without folic acid in general) and reported to me that a prescription called NEEVO does not contain folic acid!! But a Folate supplement would need to be taken for baby growth or even if not pregnant due to MTHFR. I’m just as frustrated as most of you all with uncertainty.

  23. Kristina says

    I am currently taking New Chapter’s “Perfect Prenatal” multivitamin. I have taken this for almost one year (2 pills/day) but now that I am pregnant I take the full dose of 3 pills/day.

    This multivitamin has 600 mcg of folate. I emailed the company asking if their folate contains 5-methyltetrahydrofolate and they said that it contains “cultured folate, not folic acid.” They use folic acid as a culturing catalyst for their folate. It is cultured using organic yeast and live probiotics.

    This article doesn’t state anything about cultured folate. Is this a good/safe form of folate?

    Here’s a link to the vitamin.

  24. Karen says

    I have celiac disease. I Am deficient in folate. I’ve tried pills and injections. All hurt my stomach. I Ali cannot tolerate B12. Thoughts?

    • dee says

      an own vitamin brand from Whole Foods store was great, they moved store thou, so I was searching for equivalent. I just bought Mega Food One Daily Multivitamins. From what I read now it’s a better choice then the artificial vitamins supplement. Btw I take vitamins now bcs Im on a crazy cabbage diet!

  25. Chloe Perry says

    Thank you for a very insightful article. I was recently told I had MTHFR. I was put on Deplin, a very expensive form of 5-methyltetrahydrofolate. I was unaware I could find this o.t.c and for far less money. This was discovered because I had treatment resistant depression. This along with quality high dose fish-oils worked wonders. Just in case anybody reading is suffering the way I did, please find a psych. doctor who tests for this. I was never told to stay away from folic acid, and I was just thinking if its not good for people without this genetic error, what’s it doing to people with it? And you answered that question beautifully. My daughter was born with a significant speech delay, and they couldn’t rule out autism for what felt like a very long few months. We were finally given the news that she is not autistic, and she is flourishing now that she had speech therapy. I now know that this may have been caused by the MTHFR. I have to ask, why aren’t OB/GYN docs. testing for this as part of their obstetric work ups?! That’s more of a rant than expecting an answer, it angers me that its not being done as well as forcing folic acid on us. My real question is can I take a B-complex vitamin with folate from lemon peels? Its hard to find a B-complex 100 without folic acid, so I’m hoping folate derived from lemon peels is ok.

    • Colleen says

      I also have MTHFR. I was diagnosed 10 years ago after having multiple miscarriages, as the having high homocysteine levels and being unable to retain any B or Folate from my food, my body took it as a reason to miscarry. Your daughter can be tested for it at some point, the next time they do a blood draw for any reason. I would guess with her showing signs of autism that she does have a version of it. Taking B6, B12 and Folate are all you need to do to keep your homocysteine levels down if you have MTHFR. This is a life long supplement program you must keep to keep you levels down. I work with a naturopath, many doctors don’t understand MTHFR. She has me taking 5-MTHF 1mg daily and Basic B Complex, both fre from Thorne Research. Recently had my Homocycsteine levels checked and they are doing great. There are links to dementia,autism, stroke, heart attack, miscarriage all due to MTHFR. Partially because your small blood vessels tend to clot if you have it. Good luck. Take your vitamins, then forget you have it.

      • Lucia says

        Colleen, thanks for your very helpful comments here. I just wanted to add my 2 cents about staying on B6, which I took for years, along with other B’s and, of course, folic acid. I didn’t even know this could happen, but I developed B6 toxicity, which led to neuropathy. Neuropathy is no fun, so if you can avoid it, please do. Just mentioning this in hopes that the awareness will prevent others from making the same mistake.

        Blessings to you and your dear ones!

    • Alicja says

      I have MTHFR and you can take wright supplements , you have website and Dr.Lynch he specialized in MTHFR .you will find whole protocol for it. Garden for Life is the company ,they have multivitamin with folate not folic acid.

      • says

        Garden of Life is priced at about triple the profit margin of much better companies. If you buy from them you are way overpaying and giving them about three times more than other good companies for what you get.

          • says

            I’ve seen many quality science-based companies noted by people here.

            I suggest that people avoid the so-called “whole-food” vitamin companies. There’s little if any good science involved and none of them give good value for the dollar.

            They’re just good marketers.

  26. MISTY says

    Think my comments got buried…

    How about The Honest Company 1 A Day Prenatal for pregnant or nursing Mothers?
    I love Pure Encapsulations, but can’t handle 6 pills a day when pregnant. 1-3 max. Is there a good option for me? Not sure if it matters, but I am 5′, 90#

    • Rocksmith says

      Eclectic Institute makes a great prenatal multi called”Vita Natal”
      You still have to take 6 a day, but it is well worth and far less expensive then Pure Encapulations.

      Doctors brands are way over priced and no better then off the shelf brands. They use the same ingredients, but set the minimum pricing so you think you’re getting a superior product because it costs more.

      We have tried several, Thorne Research, Ortho Molecular, Pure and Vital Nutrients, but we always go back to Eclectics Vital Force.

      You can check them out at They have a link to Eclectics website. Copy and paste the below link

    • Kate says

      I take Garden of Life’s Kind Organics Prenatal Multi. It’s 3 pills a day and is a little pricey but everything in it is from a natural food source instead of synthetic. It also has ginger and peppermint to help with morning sickness!

  27. Angie says

    For those of you who are stating that taking methylfolate made you sick – Isn’t it true that when starting methylfolate, it allows your body to start detoxing and it allows your immune system to start fighting? This can be the cause for not feeling well on this supplement. If you move too quickly you won’t feel well.

    For me, I had to ramp up very slowly – first opening a capsule and taking a tiny amount, and now I’m up to about 3400 mg a day. I had to do the same thing with the methylb12’s and other methylation supporting vitamins. I actually had to back down on my dose a few times throughout the ramping process because I didn’t feel well, and when I stabilized, I was able to go back upwards. Ultimately I was able to get to a substantial dose.

    Everywhere that I read about methylation disorders, I see that it’s important to avoid any supplements with non-methylized folate. I personally will stick to the methylfolate.

    • Rachel says

      For those feeling sick after taking methylfolate it’s important to understand the pathways and how they can get backed up if other necessary nutrients are missing. Dr. Ben Lynch has written a great article about this at his blog at It really helps break down how and why there can be issues and what to work in at each point.

  28. says

    Just wanted to let you know that nutreince – the first patented multivitamin with Anti-competition technology also has 5-MTHF. And we welcome you to come and try our formulation. You can learn more at abcsofsupplementation dot com.

  29. lidcmd says

    I’ve been curious by the repeated replies posted by Mr. Mooney urging the use of folic acid. So, I clicked on his handle and was directed to a website that states at the top his association with his family’s nutritional supplement company. Using folic acid in supplements is typically a cheaper route for the manufacturer, unless people rebel against folic acid and want the more expensive forms of folate in their supplements. Just coincidence or interesting connection?

    • Rebecca says

      Hi I’m the original poster of the question. Just wanted to say that I’m doing well on this vitamin. My homocysteine is normal and I don’t have the irritability that I get with the methylfolate. I don’t eat any fortified foods and I also get a lot of folate through natural foods. My energy is decent and I plan to keep taking the vitamin.

      Also, Mr. Mooney has explained in previous posts that his family makes this product. However, how I found it was my functional medicine doctor carries this product and recommended that I try it because I was having side effects with the methyl folate.

      • Elizabeth says

        I am assuming I’ll have s problem with the methylated form but can’t find the name of the dorm / brand you allude to. Could you please share it – again? Thanks!

    • says

      To lidcmd, it is no coincidence that I disclose that my family makes vitamin in the first part of my personal website’s front page, because I am fully transparent.

      Further, you will notice that each of my statements are accompanied by either citations to the published medical literature or a reference to the statements of long-time nutritional authority and traditional naturopath David Getoff, who is on the board of the Price-Pottenger Nutrition Foundation, one of the most credible nutritional research groups in the world.

      As to my family business’s multivitamins containing folic acid, I am the formulator of products as of two years ago.

      Because I thought that it doesn’t matter – based on reading and my own experience with methylfolate – I was going to change our formulas to use methyl-folate just so that we don’t have to deal with the “noise” about folic acid.

      However, I called to ask David Getoff what he thought of changing our form of folate to methylfolate and he replied, “Absolutely do not change to methylfolate.”

      He then went on to tell me about numerous of his patients that, like I, test positive for one or both of the MTHFR genes, and their doctor prescribed methylfolate to them and they had terrible effects, from extreme fatigue to acne-like skin breakouts – a long list that is elucidated in detail at Methylfolate Side Effects. MTHFRnet. March I, 2012.

      Getoff works with patients all day long, and is of supreme ethics, so he tells the truth and rips the false face of many notions that people and even some healthcare professionals take for gospel.

      So, when I have something that is beyond the scope of published studies, which I read all day long – when I need to hear the experience of a brilliant healthcare practitioner – Getoff is one of the sources I contact.

      And anyone can imagine that not having to deal with the notion that methylfolate is better would make the company’s job easier.

      However, we cannot, in good conscience bend to the illusions that consumers are subject to, when we might harm someone who has the negative effects that methylfolate causes some people, and then have that consumer likely not know what’s causing it.

      And we will not create formulas that require warnings on the labels.

      So, once again, lidcmd. I have provided third party references, via Getoff and and am consistently being fully transparent.

      It is up to the reader to decide whether there is reason to be skeptical of what I say, as you inferred that I have a conflict of interest, I have clarified everything that I can. Now, please decide for yourself.

      And, to clear up lidcmd’s misunderstanding about costs – from a manufacturing perspective the cost difference between methylfolate and folic acid is very small anymore. The cost of methylfolate has come down tremendously as it gained popularity and increased sales volume caused a price decrease. And we are talking about micrograms, tiny amounts, so the cost difference is unimportant.

      • Cathy says

        I have a question and would appreciate help if anyone knows the answer. After years of bad health and even seeing alternative practitioners and spending a ton of money I just figured out myself that I have low B-12. I am currently in a wheelchair and have “classic” symptoms and yet……….no one figured it out. I have MTHFR issues and so I would like to know………my doctor is pushing the methyl B-12 shots and I am not sure if it is going to help me or overmethylate me. Is it just the methylfolate that could be an issue or is it methyl B-12 also? I need to hurry up and get the shots before I have permanent neurological problems. There is also hydoxocobalamin which my doctor claims will not give the same results. They have agreed to leave out the methylfolate but are really pushing the methyl B-12.

        • says

          Hello Cathy.
          I don’t know that one can be “overmethylated,” as methyl groups are important for healthy metabolism and most people have too little methylation. I have not heard of having too much methylation.

          The simple answer to anyone with a B12 deficiency is to try taking the sublingual methyl-B12.

          There are many companies that make it, but I usually buy Jarrow’s product –

          It’s easy to take, so I quit using the injectable stuff that I got my doctor to prescribe. I just put one sublingual tablet under my tongue and let it melt, usually once a day, but I am not worried about being deficient, as I take loads of vitamins.

          The Jarrow product that I linked above to is 5,000 mcg per tablet, so it loads us up with B12, and in all recorded medical literature there has never been anyone that has OD’s on vitamin B12. It’s safer than milk.

          The multi I take has 1,000 mcg of the cyanocobalamin form of B12, and with all the blood testing that I do there has never been evidence of B12 deficiency. So, I am getting enough from food (animal products) and supplements. I mostly eat fish, which doesn’t give us as much as red meat, but I don’t have much taste for red meat anymore.

          However, I am taking 850 mg of glucophage (Metformin) twice a day because it is one of the best anti-aging compounds. However, glucophage inhibits B12 absorption.

          So, to cover my bases I include sublingual methyl-B12.

          I take high doses of B-vitamins, and have loads of energy at 61, so I’m not a candidate that might need the other B-vitamins to be co-enzymated.

          But if I had health problems and had the MTHFR issues I would consider getting some of the co-enzymated forms of some of the B-vitamins or the special forms – and see if they help.
          Vitamin B1 – benfotiamine
          Vitamin B6 – pyridoxal-5-phosphate

          Or one easy way to go is to get the sublingual co-enzymated B-complex made by Source Naturals, which contains several of the B-vitamins in their co-enzymated forms, while providing folic acid, not methylfolate.

          However, if I had a B12 deficiency I would take both the Source Naturals co-enzymated B-complex and the Jarrow sublingual B12, too.

          • says

            Hello Cathy,

            However, if I had the problems you have I would seek out a traditional naturopath, like those that are involved with Price-Pottenger Nutrition Foundation or othe qualified alternative practitioner to guide me. The conventional medical people will miss many things that would help you without the toxicities that generally come from conventional Western medicine. The enlightened alternative practitioner could very well help solve your issues.

          • Kelly says


            I’m not sure exactly where to start, but I will try to keep this short, because I’m very ill, and don’t have a lot of ‘energy’ to expound on the many, many errors in your arguments on this page.

            You’ve never heard of overmethylation, yet elsewhere on this page you talk about patients describing the effects of various amounts of methylfolate. Now that may not always be from overmethylation — it could be due to methyl-trapping as a result of not getting enough B12 — but in many cases the effects from excess methylfolate can be due to overmethylation.

            You said “if I had health problems and had the MTHFR issues I would consider getting some of the co-enzymated forms of some of the B-vitamins or the special forms – and see if they help.”

            But I’m guessing from your other comments that that would not include methylfolate, which is the ultimate coenzymated (broken-down) form of folate?

            And FYI, benfotiamine a man-made synthetic form of thiamine — it is not the coenzymated form. Thiamin diphosphate, also called thiamin pyrophosphate or caraboxylase, is the active, coenzyme form of vitamin B-1.

            • says

              I will answer Kelly after business quiets down. Kelly’s reply is worthwhile. However, he has several misunderstandings and errors, which I will answer when I have a moment,.

            • says

              Well, Kelly, one learns something new every day, if we’re lucky and there’s still more to learn.
              Reading up on overmethylation, it seems like there may be some confusion whether overmethylation is causing deleterious effects or the effects are some kind of detox reaction. David Getoff said that his experience is that these effects are mostly detox reactions, usually because the liver and/or kidney aren’t working optimally. When he supports liver and kidney and starts a patient with MTHFR problems on a very small dose of methylfolate, gradually raising it over a period of months, he can usually get them to be able to take a full dose of methylfolate eventually.
              As to your comment about me saying that benfotiamine was a co-enzymated form of B1, I did not say that. My statement put benfotiamine under “special forms” of B-vitamins.

              • Kelly says

                Thanks for your reply Michael.

                I would again urge you to contact Dr. Lynch, or Dr. Neil Nathan for the most accurate information regarding methylation and the dangers or risks of “folic acid”.

                Getoff is correct to the extent that some of these reactions may be due to detoxification, but it’s my understanding that this ‘detox’ is finally occuring, because the proper forms of folate are finally being used.

                Anyway, best of luck, and thanks again for your reply.

        • Lisa says

          It could be empowering if you were to try some alternative options.
          Thorne methylcobalamin is well a tolerated form of active B-12. It can be purchased at Pure Have you considered nutritional testing (alternative practitioner) and natural supplements from Thorne or Standard Process?
          Thyroid issues (hypothyroidism) may be resolved with prolamine iodine (Standard Process) Your doctor is paid to perform procedures and prescribe medicine. Supplements are expensive and the cost adds up but what is your health worth to you?

      • ccarr says

        Mr. Mooney

        I have double mutation of the MTHFR C677T. This came to light when I was taking some Male Fertility pills that my wife was recommended. That had a lot of Folic acid. I had a neurological attack. I had all my blood work done and neurological test but with no explanation for the symptoms I was having. Short time later, I learned about MTHFR and had then learned about my mutations. I started taking Methylated form of B9 & B12 and initially over methylated making me kind of strung out. But I stuck with it and cut my dosage in half. I have not felt better in my entire life. My mood, energy, and just since of well being. From my understanding the doctors that prescribe Methyl folate start them at extreme dosage level. I take 400mcg and that has made a world of difference for me.

        for what its worth

        • Cathy says

          Hello ccarr; Thank you so much for sharing that. It is some hopeful, positive news for those of us who aren’t feeling well. Very happy that that worked out for you. Really shows how different we all are and that we kind of have to experiment (maybe boldly?) to see what finally works!

        • says

          Good post, ccarr.

          David Getoff told me that he will sometimes take someone that has MTHFR problems and give them a very low dose of methylfolate and gradually increase it over time. I have to ask him why he does that with some patients and not others.

          But your post reminded me of him saying that.

          Good post!

          • Kelly says

            In general it’s because their methylation hasn’t been working for decades, because of their genetic polymorphisms (not mutations), and because folic acid has built up in their tissues, blocking the active forms of folate.

            If anyone wants to prove that folic acid builds up in those with MTHFR or other polymorphisms, they can get a blood test called the Methylation Pathways Panel.

            My results showed high levels of the synthetic folic acid, with very low levels of folinic and methylfolate, despite years, even decades of eating a high-vegetable diet.

            This test also shows that excess folic acid isn’t just excreted in the urine as they believed 20+ years ago. Just like B12 and other B vitamins, just because they’re water soluble, doesn’t mean they don’t build up.

      • Analucia says

        Thank you so much for this informative post Mr. Mooney. It makes me feel validated. I’m one of those that got a horrendous bad reaction to methylfolate-with a low dose BTW.

        I believe that there are ppl that benefit from it, but it seems that there are many like myself that get terrible side effects from it. Thanks!!!!!

    • Cathy says

      lidcmd; I have a problem when I take methyfolate and am finding it more and more difficult to find what I want without methylfolate in it. I am happy that Michael Mooney’s company doesn’t cave just because of comments with no real basis. If you have studies to cite please do it so we can see the evidence. I would appreciate that so that I have needed information. Just because someone, ANYONE, comments on here it doesn’t mean they have an agenda.

      • Kelly says


        I too appreciate Mooney’s transparency, but that doesn’t make him right.

        Note that Chris Kresser, who’s site he’s allowing all of us to discuss these differences, recommends other companies brands in his article. He’s not trying to sell anyone anything.

        Now of course I can’t say that Michael is trying to sell us his products, but it is interesting that he keeps posting. Perhaps it’s just a defensive thing since he’s selling the inactive, synthetic form of folate?

        Again, if you’re having trouble tolerating the methylfolate, that may suggest that your methylation has been dysfunctional for a long time, and you need to start with very low doses.

        Dr. Ben Lynch knows a lot more about this than any of us. His information (on Youtube) or at the site (that Michael Mooney and others linked to above) is the most up to date online.

        And all of his information is backed up by clinical research, literally thousands of studies.

  30. Leigh says

    I’m homozygous for c677t and have been doing extensive reading about the best supplementation protocols. For the most part, people with this mutation seem to be extremely anti-folic acid with little scientific evidence to back up their beliefs. What I typically hear is that you shouldn’t take folic acid because it “blocks folate receptors”. In researching this, it seems to be true, at least theoretically.

    According to the American Journal of Clinical Nutrition (March 2008 vol. 87 no. 3 517-533), “Folic acid has a substantially higher bioavailability than do natural folates, being rapidly absorbed across the intestine. Even in countries without mandatory fortification, some members of the population, including infants, have detectable unmetabolized folic acid in their blood, probably because of the voluntary fortification of foods or intake of supplements containing folic acid….
    Theoretically, folic acid could interfere with the metabolism, cellular transport, and regulatory functions of the natural folates that occur in the body by competing with the reduced forms for binding with enzymes, carrier proteins, and binding proteins. For example, the folate receptor has a higher affinity for folic acid than for methyl-THF—the main form of folate that occurs in the blood. The transport of folates into the brain is carried out by the folate receptor in the choroid plexus, and so folic acid in the blood might inhibit the transport of methyl-THF into the brain.”

    Any thoughts on this? Is excess folic acid floating around in our blood something we actually need to worry about in terms of our bodies getting enough of the active form of folate? Or do we excrete it fast enough that this isn’t really a concern?

    • says

      I asked world nutrition authority, David Getoff, a Board Member of the Price-Pottinger Nutrition Foundation, and a long-term practicing traditional naturopath (TN’s don’t treat people with drugs, while some “naturopaths” do.) what happens to the unmetabolized folic acid and he said, “It just gets excreted, like any other B-vitamin.” He sees no danger for those of us that have the genetic mutations using folic acid. However, he warned me that he has had numerous patients who tested positive for the genetic defect, whose doctor put them on 5-methyl-folate and they had tremendous side-effects, including extreme fatigue, acne-like skin breakouts, and more. All of these things have been documented at Getoff told me that he believes these problems are caused by a cleansing reaction and that when he takes these people off methyl-folate the problems disappear. He said that he will very gradually introduce them to very low doses of folate and over a long period of time, bring them through gradually acclimating their bodies to being able to use supplemental folate, but it takes time. He, like other orthomolecular healthcare practitioners, said that since those of us with the genetic defect DO convert folic acid in our bodies, just less than people without the genetic defect. (One study, which I cited in an earlier post showed that we convert at between 30 and 60% as well as “normies.” This is why practitioners, like Getoff have their patients taking 1,000 mcg of folic acid, a higher, but safe, dose. We will convert that to the equivalent of 300 – 600 mcg of folate AND this is just a supplement to what we should be getting eating a healthy diet, where the majority of our folate intake SHOULD come from. So this, controversy about whether folic acid is ok for us is, frankly bordering on illogical hysteria. I saw this based on reading the published data AND asking very intelligent long-term alternative healthcare practitioners, like Getoff. I recommend checking out his site at as well as looking up his YOUTUBE videos. He is a tremendous voice of solidly backed science for a health life. Vegans should hear his YOUTUBE video of why veganism is not sustainable and a recipe for poor health at
      Many blessings!

      • says

        If someone has some solid, published data that conclusively shows that the unmetabolized folic acid does us harm, please post it, so that we can all learn more, based on real science, rather than hysterical fear, that so far, I have not found supported. In doing literature searches, I came up with numerous rebuttals to folic acid causing harm, such as cancer, by highly credible sources, including a study published by Walter Willet, Harvard’s Chair of Nutrition, that specifically stated, “We did not observe an adverse effect of total folate or synthetic folic acid on risk of colorectal cancer or adenoma even during the folic acid fortification era.”
        Please see:
        Then, here are some more –

        So, again, I ask that if anyone knows of a quality published study that shows that unmetabolized folic acid causes problems, please cite it.
        Many blessings!

        • Cathy says

          I too would like to see the data on unmetabolized folic acid. I believe Metametrix has an “Unmetabolized Folic Acid” test but want to know: just because it can be measured, does that make it harmful? Does this number ever change? Unless someone is a guinea pig and has done a number of these tests how would you know if it was high one week or month, that it would be high the next? And, if it is high, how long does it have to stay high to cause some deleterious effect? Seems that there are many unanswered questions but I concede, maybe I am the only one who doesn’t know the answers. Can anyone help out with this?

        • Jennifer Jackson says

          I don’t have a medical background, not that that helps much as most are not educated about nutrition and the bioavailability of what we ingest. Having said that it is apparent to me that the one size fits all studies fail when they don’t take into account individual differences. Even with in the group with the defective MTHFR there are so many different combinations of defects and prior damage to each individual. This is why not every child gets Autism from vaccinations, but they also are not safe for many others. At this point knowledge from as many sources as we can get and personal experiences from others as well as trial and error as to what helps us. This information is a blessing to those of us who have not healed through methods that have helped others– a true missing key for many.

      • Inger-Lisa says

        Thank you, Michael Mooney! Thank you! I have thought this complete nonsense for so long and You have confirmed it. THANK YOU!

        • says

          You’re quite welcome. While I had regarded Chris as authoritative at first, I have seen him make too many mistakes and make absolute statements that are more scary than grounded. Scary statements, like Dr. Mercola makes, are just ways to keep people HAVING to follow someone so that they get the REAL deal on scary health issues. See this video and see what a brilliant guy thinks of Mercola, at al… — note, I am not a vegan and wonder if the guy in the video will do well long term, but he is brilliant. His knowledge of his blood tests and various nutritional biochemistry details is amazing! Blessings!

            • says

              Do you know you blood chemistry as well as he does? Do you understand the biochemical pathways that he is fluent in, such as triglyercised, hemoglobin A1c, insulin, IGF!, the fructorse pathway?
              Linus Pauling could use F words and he still would have won the Nobel Prize, twice.
              I rarely hear medical doctors that know what he fluidly elucidates. Give him credit for an advanced understand of metabolism and judging by other than the standards of science..

          • Cathy says

            I stopped reading Mercola a long time ago because I got sick of the “scare tactics”. How in the world does it help anyone’s health to scare them into submission? He does employ a backhanded effect to corral “believers”. Oh, PLEASE!

      • Kelly says

        With all due respect to “world nutrition authority, David Getoff”, the notion that excess folic acid “just gets excreted, like any other B-vitamin” is a very risky and shockingly ignorant statement, like something out of a 1980’s junior high school textbook.

        “Like any other B-Vitamin”.

        Speaking of the ’80s:

        In that small study, a dose of “only” 200mgs of B6 produced neuropathy, as the excess is not just excreted, but builds up.

        And if Dr. Getoff wants to hear from more patients with B6 toxicity — some who were taking small doses and still haven’t recovered after years of avoiding the vitamin, then here’s a link to pass on to him:

    • Christopher says

      what is >>>>>> Folic Acid (as folacin)
      this is listed on my Vitacost multi-vitamins for men.
      is (folacin) the same thing as folate?
      the centrum silver that i have
      been taken in the past, list: folic acid 400 mcg—100%
      the vitacost bottle: Folic Acid (as folacin)800mcg-200%
      Which one should I take?

    • pamela detering says

      I am an 87 y.o. female status post breast ca. I have been prescribed 1 mg folic acid q.d. of which I take 800 mcg. My latest blood test showed folate level of 40 that seems rather high – what do you think?

  31. Rebecca says

    I have the c677t homozygous mutation and do not tolerate methylfolate well- even in small amounts. For about 3 days after taking it I have depression and mood swings and can’t sleep well- and that’s on less than 100 mcg. So for now, I’m just eating a lot of folate rich foods, but I would like to supplement. Most topics cover how you shouldn’t take folic acid and should take methylfolate- but what about folate supplements and folacin- could that be an ok alternative? I understand that I still have to break those down to a usable form of folate, but I think my issue is the methyl groups as I can’t tolerate methyl cobalamin either but do ok on hydoxocobalamin. I have a healthy 4 year old and used prenatals with folic acid while TTC and while pregnant with him and had no issues. We want to try for another in a few months so I feel like I should do something. I eat no fortified foods and am waiting on my homocysteine labs to come back (next week). My functional medicine doc looked at my genetic info and suggested that I try the simply one prenatal which is mentioned on here but reading all this info makes me scared to even touch folic acid…

    • says

      Hello Rebecca. Please find my fully-referenced comments about folic acid being superior, in general, for those of us that have the genetic defect(s), by hitting “Control F” (find) on this page and putting in “Michael Mooney.”

      Unfortunately, there is a lot of misunderstand being promoted about folic acid and folate.

      Many blessings,

      • Kelly says


        Please get in touch with Dr. Ben Lynch, for his fully referenced information on the dangers of synthetic folic acid. I understand your defensiveness, but he’ll be able to help you learn why folic acid is not a good thing, to say the least.

      • AD says

        Please shout this from the rooftops! I am homozygous A1298C and methylfolate and methylcobalamin made my life HELL. HELL. Psychosis, paranoia, cognitive decline, neurological damage, fatigue, destroyed my skin with cystic acne, worsened gastrointestinal problems, tremors, palpitations, Hypokalemia, spasms, mood changes, on and on. My doctor, a follower of Lynch and yasko, called it detox. It was so bad I nearly killed myself. I suffer horribly from scarring and psychiatric and neuro problems over a year later.

        This stuff is not the end all be all. Lynch wants it to be, because he has multiple companies promoting it. I do not call him a doctor. He has no publications, no residency, no clinical experience, no educational background in genetics or nutrition. He is a naturopath who founded a supplement company, whose supplements destroyed my life.

        Now the blogosphere has become an echo chamber, full of frightened people thinking they need methylfolate and everything else is poison, and the side effects are their fault.

        We need a balanced approach to this.

    • Rock says

      My wife and I also suffered from sleep disturbances, headaches, feeling irritable, and dizzy when were tried multivitamins containing 5-MTHF. Even our Doctor got the same results after we told her of our experience.

      We tried Thorne Research, Ortho Molecular Products and Vital Nutrients. They are all Doctor brands and all contain 5-MTHF.

      We switched back to Vital Force form Eclectic Institute and our problems went away.

      Check them out at or use this link

    • Rebecca says

      Thanks for all the responses. I followed my doctor’s suggestion and tired the simply one prenatal. I like it so far. I feel more energetic on it and my mood is even better. I’m surprised by that. The only negatives are constipation and I have been having muscle twitching and kind of like a charlie horse feeling in my legs. I had this same issue while pregnant and thought it was restless legs. I’ll have to talk to my dr about that. Also my homocysteine is normal- so even with MTHFR it looks like the cycle is working somewhat. I’ll have my dr check again in a few months after supplementing with this. I stick with a paleo diet mostly and make sure to have greens everyday.

      • says

        Simply one’s are great because they give you 1000 mcg of folic acid, which is plenty to compensate for poor conversion of folic acid, even with the MTHFR gene problem. The muscle cramps and constipation are generally helped by taking extra magnesium, especially before bedtime. Doctors’ Best 100% chelated magnesium – works best to help. For me 200 – 400 mg of magnesium
        works best.

          • Rock says

            Do 200 mg in morning and 200 mg at night.
            The morning dose will increase your energy for the day and the nighttime dose will help you sleep

            We use:
            Doctors Best High Absorption 100% Chelated Magnesium 120 Tablets

        • Cathy says

          Hello Michael;
          I am reading your comments here and am quite interested in the info you present. Can you clear something up please? Are you saying that if we have MTHFR mutations we can avoid the methylfolate (or methylcobalamin) side-effects completely just by taking larger amounts of folic acid and converting it ourselves? I am interested in this because I am quite sick and kind of scared actually of the methylfolate/methylcobalamin IVs and shots my doc is trying to get me to do. I am compound heterozygous and before I knew this I used to get well just taking the multis with folic acid in them. Now I don’t know what to do……..ugh! Common sense says just do what I used to do.
          Thanks, Cathy

          • says

            Hello Cathy,
            Naturopath David Getoff told me what you read I said (above) – about a significant number of people with MTHFR mutations having severe side-effects when we take methylfolate. I didn’t have any problem with it, but it also didn’t change my mid-normal homocysteine level, compared to me just getting 1,000 mcg of folic acid in my multi. So, I figured why bother buying and taking the extra capsules, when I find no perceptible change in anything.

            Getoff also said that supplements are just that – supplements to food. We should be getting a lot of our folate by eating vegetables. Supplements just add to that. And the folate in foods doesn’t cause the odd problems that happen to some of us when we take methylfolate supplements.

            So, you said it. “Common sense says just do what I used to do.”

    • Jennifer Jackson says

      Rebecca, while you are preparing for another child please look into iodine supplementation. Regular diets don’t provide this essential nutrient and it is essential for your health and the health and IQ of your child. I would look into Lynn Farrow, Dr. Brownstein, and the support groups on line. Lots of ground breaking success is occurring in these groups.

  32. DaRinda says

    Hey Chris…I was just recently diagnosed with the MTHFR A1298C homozygous mutation, and have very high RBC folate levels (>1509)…it seems folate or folic acid is in everything…how best can I avoid this…my dr stated to NOT eat anything with folate in it….

    Thank you

  33. says

    Dear Chris, very interesting article! It made me think about my labs. I have been taking the last six months, 2 weeks every month, right before my menstrual cycle, a B-complex supplement (MEGASORB VITAMIN B-COMPLEX by SOLGAR) with 400μg Folic Acid. A week ago I got my lab results and my blood red cells are lower than normal (RBC= 4,13 with normal being 4,2-5,4). So, do you think that Folic Acid is the reason?

    • brian says

      A low carb diet as carbs help produce red blood cells(RBC), and if you just started taking the multi, (even if it is not in whole food form) it could take time as B-complex is necessary for RBC formation. Iron deficiency could also very well be the issue. Ultimately low red blood cell count means less oxygen for the bodies fluids and tissues. Low oxygen means pH will be more acidic and even a slight decrease in blood pH like .1 means 10x less oxygen and increased risk for cancer and other chronic diseases. The tissue acidity is in addition and a much longer discussion.

  34. Rachel says

    Just wondering what your advise would be for women in their 40s who have been taking prenatal vitamins for years whilst they are trying to conceive? Personally, I’ve been taking prenatals everyday for the last 6 years (I’ve just turned 40) but i know of many other women who have been taking them for a lot longer than me.

    • Rachel says

      Just to clarify, I’m speaking of prenatals with folic acid of course. If persons shouldn’t be taking folic acid for extensive periods, what would your advice be for women having difficulty conceiving and therefore being on them for years?

  35. 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.

  36. 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.

  37. 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!!!


    • Lynn_M says

      Your supplement ingredient labeled Folate (Folic Acid) is folic acid. Folic acid is considered to be a form of folate.

    • Rebecca says

      I would avoid anything with folate qualified as folic acid. Folic acid is synthetic. Methylfolate is the natural form of folate. There are several brands that have methylfolate, including Solgar and Seeking Health.

  38. 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…

  39. 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. 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.

    • Sing Sing says

      Hi Michael, that’s some interesting info there, thank you. I get your point that MTHFR ‘mutants’ DO convert folic acid – just at a lesser rate (30% to 60%), so let’s just take heaps of the (much) less expensive folic acid so we can ultimately get enough. But what of the leftover, unconverted folic acid? The 40 – 70%? What happens to it? As I understand it, it’s the unmetabolized folic acid that’s the cancer risk.

      • Michael Mooney says

        There are lots of data to go through to give a complete analysis of this notion, Sing Sing.

        However, I found three studies that looked at folic acid and cancer risk most interesting, in particular the second study because Walter Willett, Chair of Harvard Nutrition, was involved. If his name is on a study, it is highly credible. From what I gathered this study was one he produced in a campaign to begin to clear up this misunderstanding about folic acid safety, as he is known as a very conservative long-term champion of nutritional science.

        Also, the third study was compelling because it was recent, it was rather comprehensive, and it was of high quality.

        It was published in 2013 and was a meta-analysis, published in Lancet, which specifically looked at folic acid and cancer with 49,621 subjects, with a weighted mean duration of 5.2 years and daily doses of folic acid ranging from 500 mcg mg to 5 mg (5,000 mcg), with one trial using a dose of 40 mg (!).

        The Lancet study found that even high-dose folic acid supplementation produced no risk of cancer.

        1. Wu K et al. A randomized trial on folic acid supplementation and risk of recurrent colorectal adenoma. Am J Clin Nutr. 2009 Dec;90(6):1623-31.

        2. Lee JE et al. Folate intake and risk of colorectal cancer and adenoma: modification by time. Am J Clin Nutr. 2011 Apr;93(4):817-25.

        3. Vollset SE et al. Effects of folic acid supplementation on overall and site-specific cancer incidence during the randomised trials: meta-analyses of data on 50,000 individuals. Lancet. 2013 Mar 23;381(19871):1029-36.

        So far, over the last 25+ years, whenever I dig into these anti-vitamin studies, they fall apart. I have found basically none of them to be anything but scary stuff that the media loves to riddle us with because it sells papers OR misunderstandings generated by poor quality studies, that even confuse people who are generally good sources of information.

        Vitamins are proven to be among the safest things that we can put in our mouths, and folic acid, while synthetic, appears to be superior to folate, because over and over it has been shown to cause no problems, while being good for many aspects of health, where supplemental folate can cause serious side-effects for a few of those of us that have MTHFR defects.

        I was warned about this by one of the world authority nutritionist ND’s, David Getoff (, who is on the Board at Price Pottenger Nutrition Foundation.

        He told me that he has had a number of patients come in whose MD found that they had a MTFHR defective genes and put them on 5-methyl folate and they experienced fatigue, acne-like skin problems and a host of other side-effects until he took them off 5-methyl folate and put them back on folic acid. He said it was likely a detox reaction.

        I found no change in my homocysteine when I switched to high-dose 5-methyl-folate from high-dose folic acid and many people would experience the same thing if they do the blood tests because we shouldn’t forget that taking folic acid is supposed to be a supplement to what we get from food.

        Eat plenty of healthy fresh natural foods and you have the foundation to address folate needs and then the supplements are just added protection. Nothing scary about that!

        I switched back to just taking a high-potency multi that gives me 1,000 mcg of folic acid a day, while I continue to eat well. Also, my homocycsteine blood tests continue to look good.

        I do 2-3 comprehensive blood tests a year and have been for about 25 years, as I have been doing research on anti-aging techniques for 47 of my 61 years under the mentorship of my biochemist father.

        Many blessings!

        • RockSmith says

          My wife and I experienced side effects of “methylfolate”

          It was in several multi vitamins we tried from Thorne Research, Vital Nutrients and Ortho Molecular.

          Side effects we felt:
          sore muscles
          achy joints
          severe anxiety

          We went back to a GOOD multi with “Folic Acid” and all side effects went bye bye.

      • Sandra says

        hi Michale,
        I have the 677 gene defect but was given a bio active form of folic acid 800mcg. Reading this article and cancer risks associated with folic acid I’m concerned as I was told to take it for the rest of my life. You seem knowledge on this topic wondering if you can provide some guidance?

        Thanks :)

      • says

        When I asked David Getoff about the unconverted folic acid, he said, it just gets excreted, like all the other B-vitamins. If you know David, he’s one of the brightest long-term traditional (no drug therapies) naturopaths in the world. When he says something it is because he has tested for it in his patients.
        His website –

  40. 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?!

      • Sarah says

        I agree with you completely. Why the big push on supplements. Supplement companies will be the next pharma conglomerates.

    • Lea Cronin says

      Garden of Life Raw prenatal is perfect. Many times it’s cheaper on Amazon than at a store. Have taken it for 3 years, after many other brands during my first 5 pregnancies and nursing. You will not regret forking out the $$ for this one!☺☺

      • Michael Mooney says

        I’m sorry, but GOL is a horrid company, with a huge profit margin. I won’t buy anything they produced because the company is founded on lies about J Rubin having terrible health problems as a child. An old-time health store worker that lives in the town he grew up in told me that he was never had those health problems and it was a crock of great marketing.The have a gigantic profit margin created by fooling the public into believing the nonsensical story of a guy that completely fabricated the basis for the entire company.

        • RockSmith says

          My two cents about GOL.

          J Rubin sold company several years ago to Atrium Innovations Inc. A Canadian company that also owns several “Doctors Only” supplements. Way way overpriced Walmart vitamins.

          Rubin is just a paid spokesman for GOL

          • Michael Mooney says

            Yes, and Atrium Innovations Inc. bought GOL because they have a huge profit margin – meaning they give the consumer little as far as raw material cost for the dollar spent.

            So it just continues Rubin’s profiteering at the expense of the public that is fooled into believing that ANY GOL product is worth its money.

    • Marissa says

      I’ve tried the premama prenatal vitamin drink and really liked it –

      I’ve had three pregnancies on regular folic acid and flinstone vitamins but over the past years all the information I’ve been reading has made me really anxious. I’m trying to read less of the information and trust my body more. I seem to do fine with folic acid.

      I agree with a lot of what Michael has said, and I also wonder if, despite MTHFR mutation, our bodies have other adaptations and genetic mutations we don’t know about that let us get the nutrients we need. When I started messing around with my diets and supplements, my anxiety went through the roof and I developed orthorexia.

      Now I’m trying to return to a more balanced approach. Anyway, I highly recommend premama – I mix mine with purple grape juice which masks the iron taste.

  41. 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?

  42. 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!!!

  43. 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.

  44. 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:

    sore muscles
    achy joints
    severe anxiety

  45. 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. :-(

    • Lynn_M says

      B12 is not a folate. Folate is B9. Folate is an umbrella term which can be used to label many forms of B9, including folic acid, MTHF, and folinic acid, among others.

      The conventional blood test called Serum Folate actually measures folic acid levels. If a person is taking folic acid and they can’t metabolize it, the serum folate levels can be very high, because the folic acid is not getting into the cells but instead pooling in the blood.

      An excellent test for measuring folate levels in the blood is The Methylation Pathways test from HRDI-USA or European Nutrients if overseas. See This test measures Glutathione (oxidized), Glutathione (reduced), S-adenosyl-methionine (RBC), S-adenosyl-homocysteine (RBC), Tetrahydrofolate (THE), 5-methyl-THF, 10-forrnyl-THF, 5-formyl-THF, Folic Acid, Folinic Acid, Folic Acid (RBC), Adenosine. Dr. Rich Konynenburg, highly respected in the CFS/ME patient community before his passing 2 or so years ago, recommended this test.

    • 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!

      • Lynn_M says tests for about 51 MTHFR snps, as well as almost a million other genetic snps, all for $99. Probably a lot easier and cheaper than trying to talk a doctor into ordering a stand-alone MTHFR test.

    • Kathryn says

      This reference disagrees…
      “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.

      • Lynn_M says


        You need to look at a depiction of the entire folate cycle. The only active form of folate in the body is MTHF (methylenetetrahydrofolate). That is the form that is used for metabolic processes. Folic acid needs to go through a number of conversion steps before it becomes MTHF, and each step requires a different enzyme. MTHFR polymorphisms may be the most well-known conditions in which the conversion process is impaired, but there are snps associated with each of the steps that can impair conversion of folic acid to MTHF.

        A number of different forms of folates are found in foods, including MTHF itself. The other forms are further along the stepwise conversion path than folic acid is. Folic acid is less bioavailable than forms found in food.

        Folic acid is cheaper and more stable than MTHF. However, it poses two dangers. First, people with MTHFR mutations metabolize it poorly and therefore it accumulates in the blood as unmetabolized folic acid. A person with homozygous MTHFR metabolizes only 30% of folic acid. Heterozygotes metabolize around 60%. But around 40% of the population is either homozygous of heterozygous MTHFR, so this impacts a lot of people.

        The second danger is that folic acid competitively inhibits the more active form of MTHF from being taken up by the receptors on the cell membrane. Folic acid blocks MTHF from entering the cell.

        • says

          “Folic acid is less bioavailable than forms found in food.” Howso, Chris?

          Supplemental USP-type folic acid has been shown to absorb about 40% better than folic acid found in food. (Neuhouser ML, et al. Absorption of dietary and supplemental folate in women with prior pregnancies with neural tube defects. J Am Coll Nutr 1998 Dec;17(6):625-630.)

          Further, in a randomized, controlled trial, 437 mcg of supplemental folic acid reduced homocysteine by 20%, while folate from a plant-food source reduced it by only 9%. (Riddell LJ, et al. Dietary strategies for lowering homocysteine concentrations. Am J Clin Nutr 2000;71:1448-1454.)

          This is because food folate is bound to proteins that have to be broken down by digestion before the folate is gleaned for absorption.

          Folate in some food materials is even more poorly absorbed.

          For instance, folate in yeast (Sacchromyces cerevisiae) is bound to gamma glutamyl peptide, which cannot be broken down by human stomachs, so it has to be broken down, inefficiently in the jejunum in the small intestine, where it absorbs about 30%, where folic acid absorbs about 90%. (Swenseid ME, et al. Metabolic function of pteroylglutamic acid and its hexaglutamyl conjugate. II. Urinary excretion studies on normal persons. Effect of a conjugase inhibitor. J Lab Clin Med 32:23-27, 1947)

          This notion that folic acid is poorly absorbed is contrary to published science.

  46. 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.

      • Lynn_M says

        Folinic acid is sometimes used as a chemotherapy agent, in very large doses. But folinic acid is merely one of the intermediary steps in the conversion of precursor folate forms to MTHF. It is perfectly safe to take as a supplement.

  47. Allie Williams says

    Hi Chris,

    Dr. Lynch ( 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. :)

    • Lynn_M says

      People get lazy when they talk about folate and are guilty of not using precise terms. I think folate is often incorrectly used to mean some form of B9 other than folic acid, and that is probably what Chris did when he referred to folinic acid and methyl folate as folates.

      Folinic acid is one of the intermediary steps in the conversion pathway to 5-methyltetrahydrofolate, the ultimate end product of the folate pathway, which is probably what Chris was referring to when he said methylfolate. Folinic acid is 5-formyl tetrahydrofolate, a natural substance and not synthesized.

  48. 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%

    • Lynn_M says


      The product you cite is equivalent to 5-methyltetrahydrofolate. It is a newer product and perhaps superior because it is considered to be more stable.

  49. 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.

  50. 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.

  51. 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.

  52. Connie says

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

  53. 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!

  54. 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?

  55. 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 so that you can educate yourself.

  56. 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???

  57. 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.

  58. 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.

  59. 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 is a great resource for understanding this.

    • Lynn_M says


      Since this is a discussion of folate and folic acid, perhaps instead of saying you take methylcobalamin, which is the active form, you really meant to say you take methylfolate, which is the active form of Vitamin B9. Methylcobalamin is the active form of Vitamin B12.

  60. 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.

  61. 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.

  62. 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.


    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.

  63. 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.

  64. 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.

  65. 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.

  66. 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.

  67. 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.

  68. 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

  69. 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.

    • 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

  70. 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.

  71. 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?

  72. 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

      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????

    • says

      Potassium supplements are a joke. As is the “eat bananas or potatoes” common wisdom. IF you truly need potassium, you need to start using potassium salt, and start eating beet *greens*.

      • says

        Potassium supplements have lowered my blood pressure and improved my overall digestion. I take 400 mg several times per day, as well as try to eat potassium-rich organic foods.

        They are inexpensive and for those that experience chronic low kalemia, like I do, they do miracles for little cost.

        • says

          And I have only used have “LO SALT” potassium choride in in my house for several years. However, it is too little potassium to budge the blood tests. For that I must take potassium supplements.

  73. 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. is a great resource to explain this better.

  74. 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?


  75. 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!

  76. 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.

  77. 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.

  78. 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?

  79. 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.

  80. 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: 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!

  81. 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.

  82. Jen says

    Hi Simonas,
    I’m so sorry about your first baby having spina bifida. Please spend time on, 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.

  83. Simonas says


    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.

  84. 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…

  85. Jen says

    Hi Joy,
    Try the Optimal kids multivitamin from 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.

  86. 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.

  87. 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?


  88. 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.

  89. 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, 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.

  90. Jen says

    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.

    • 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 ([email protected])

  91. Jen says

    Merle- have you looked at There is also’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….

  92. 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…..

  93. 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?

  94. 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?

  95. 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.

  96. 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.

  97. 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.

  98. 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.

  99. 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.

  100. 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.

  101. 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):

      Or if you’re really wanting a “whole food” multi, check out Innate Response Formulas’ “Kid’s Multi,” which has natural folate from broccoli:

      • 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.

  102. 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.

  103. 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.

  104. 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 ?

  105. 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.

  106. 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.


    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.

  107. 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.

  108. 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?

  109. 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!

  110. Dan says

    Folic acid supplementation assists cell division. In cancer and healthy cells. Same thing for methylfolate supplements?

  111. 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?

  112. 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?

  113. 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

  114. 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.

  115. 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.

  116. 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”.

  117. 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?

  118. 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.

  119. 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?

  120. 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!

  121. 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

  122. 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!

  123. 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?

  124. 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?

  125. 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…

  126. 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.

  127. 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.


    • 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….


  128. 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?

  129. 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)

    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 ??



  130. 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)

  131. 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.


    • 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.

  132. 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


  133. 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

  134. 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 – – 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 :

    Amy Yasko is a pioneer in this field:

    • 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 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. 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.

  135. Dan says


    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: And, here’s another one: 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):

    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


      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%.”

          • says


            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

  136. 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.

  137. Amy Shouse says


    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.

  138. tim says

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

    Also, Solgar does not sell 5-MTHF.

  139. 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.

  140. 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!

    • 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,


        • Kelly says

          Not exactly true Wendy.

          The calcium salt form of folinic is “synethetic”, but folinic acid is the form found in leafy greens and other vegetables.

  141. 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!

  142. 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?

  143. 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?

  144. 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 Look at the ingredients in B6, 12 and Folate.

  145. Ann says

    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.

  146. Deborah says

    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!

  147. 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).

  148. 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.


          • Monica says

            Mega Foods has a statement on their webpage that says they ‘add vitamins’ to their pure, natural foods. It’s a vague statement that made me suspicious. I suggest asking them to clarify.

      • 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.

      • Misty says

        How about The Honest Company 1 A Day Prenatal for pregnant or nursing Mothers?
        I love Pure Encapsulations, but can’t handle 6 pills a day when pregnant. 1-3 max. Is there a good option for me? Not sure if it matters, but I am 5′, 90#

    • 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!

      • 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, 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.

      • says

        Folic acid is NOT the demon that some slightly hysterical people make it out to be.
        When some statements about folic acid and folate make folate supplementation superior to folic acid, reports are clear.
        For some people with the MTHFR genetic defect, we don’t convert folic acid as well into active folate in our bodies. However, as one that has the genetic defect, folic acid works just as well as folate to lower my homocysteine. Probably, in part, because folate doesn’t absorb as well as folic acid, in general. I take high dose folic acid and find that it works quite well without producing the “side-effects” that folate causes.

    • 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