The Little Known (But Crucial) Difference Between Folate and Folic Acid | Chris Kresser

The Little Known (But Crucial) Difference Between Folate and Folic Acid

by Chris Kresser

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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.

626 Comments

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  1. Hello All,
    Thorne has L 5-methyltetrahydrafolic Acid in their B complexes. Per Chris, anything with folic acid is to be avoided, correct?

  2. I know I’m late coming to the party here, but I just wanted to ask about folate. I take separate B vitamins (rather than a B Complex pill) because I’m more comfortable with the amounts in the separate pills on a daily basis. Some of the B Complex vitamins are so low in doses it practically makes no sense to buy them or take them.

    My folate is from Solgar (800 mcg) but the front of my bottle calls it “as Metafolin”, whereas Chris refers to it as Metfolin. Is there a difference between them?

  3. Chris, I would like to add that excess serum folic acid can also reduce homocysteine below the minimum healthy level of 4 umol/l, leading to insufficiency of glutathione and insufficient free radical scavenging causing cognitive impairment.
    IN reply to Sam, yes, if you have the C677T MTHFR variant you are likely to be low in Vit B12 at the cellular level even if your serum level is OK. Supplement only with methylcobalamin for B12 and methylfolate for folate. Avoid folic acid.

  4. Chris,

    What about people who have MTHFR mutation, would the food consumption be sufficient, or you’re forced to supplement?

    Also, are there any plant/meat sources of the active form of folate?

  5. Hi I have been suffering with my stomach/bal for years now a nutritionist has confirmed I have many food tolerances but funnily enough most of the foods have folic acid in them.. I can’t eat any dairy, no fruit or cereals.. I now am anemic for folate & they have given me folic acid tablets 1 per day 5mg I am so ill with them I thought at one point my stomach or bal was going to burst.. I have stopped taking them but I am now getting pains in my feet & arms & I know it’s all connected the doctors will not listen to me that I can not take these folic acid I really need help Is there anything else I can take as these are doing me more harm than good.. I have even been tested on these tablets & it come back I was highly intolerant to them.. I really need some advise because the doctors don’t know what they are doing..

    • Im no expert but it sounds like you may have a B12 deficiency as well. B9 is also known as folate or folic acid. Folate is natural, folic acid is not. The terms are used interchangeably. But they are not really interchangeable. Do some quick research on the difference and you will understand. Anyway, taking folic acid(especially to much) can give false indications as to your B12 levels, which is serious. Just a thought.

    • Tammy, do not take folic acid. Use 5-MTHF folate. Also get your serum folic acid checked – it is likely to be off the charts high and that is bad. It would probably be a good idea also to get your MTHFR gene variants checked, because if you have the C677T allele you can be low on Vit b12 even if your serum B12 is OK. If so use methylcobalamin, not cyanocobalamin as a supplement.

  6. What’s the difference between the Metfolin brand (“5-methyltetrahydrofolate” or “5-MTHF) and the Quatrefolic brand ((6S)-5-methyltetrahydrofolic acid”)?

  7. what can you take against the high dose folic acid in the blood caused by the synthetic supplements ?
    is there something that can remove/metabolise it quickly out of the body ? can tinnitus be a reaction of very high folic acid levels in the blood ?

    • Gil, if you are developing neurological symptoms after large doses of b9, get your b12 checked. B12 and b9 are cofactors in some ways, and it is thought too much b9 may possibly worsen an underlying b12 deficiency.

      Even if you are taking oral b12, it may not be absorbing. Get all your other b vitamins checked too.

      As for the high b9, some people use niacin, but that seems dubious to me. I have no idea if it’s valid.

      • Hi Ann . When I eat folic acid foods i feel having low blood pressure and when I tried to have b12 tablets or sublingual I couldn’t absorb it. So should I rather try taking metfolin . Please let me know

        • Hi Nitish! I used to take a simple B-12 supplement, but I recently switched to a “Superior form” of B-12 called Methylcobalmin (Methyl 12) and I can really feel the difference in my energy levels and work performance. I follow it with 800 mcg of Methylfolate (5-MTHF) not folic acid. I purchased mine at a Whole Foods type of Store called “Sprouts”

            • Hi Nitish,

              FYI, I am a different Ann.

              I take Methylcobalamin sublingual, but I take at least 30,000 mcg a day. If you have trouble absorbing, maybe you are not taking enough, or maybe you are not holding it under your tongue long enough.

              Also, how do you know you are not absorbing?

              Chris has a B12 page.

    • You have to quit your favorite multiple and tell your company why and look for supplements that has folate and avoid folic acid like the plague. This is a hard thing to do. I switched to nutritional yeast for my b complex, plus still having to buy some of those B’s separately, but I can’t get a good B 100 with all natural forms. So far it doesn’t exist.
      The only way to clear out folic acid is avoidance.

  8. Hi, it’s really nice to be in contact with you.

    I hope you can write me back!

    I really need to know if a woman in good health, 38 years old, with good nutrition and living her first month of pregnancy, should take Solgar – Folate 800 mcg (as Metafolin ) Tablets 100.

    I don’t understand if Folate is the same as Metafolin.

    Thanks yo so much!

    I’ll be waiting!

    Regards.

  9. Hi there, love your website Chris Kresser and team, and thank you for the informative article on the little known difference between folate and folic acid.
    I have a 5 year old daughter Elizabeth who was diagnosed with Hereditary Spherocytosis on Christmas Day 2014 and upon diagnosis was prescribed 2 x Folic Acid Tablets 0.5mg which she takes daily, for the rest of her life. Folic acid supplementation is indicated to prevent megaloblastic crisis. Is there a better way to supplement her Folate, rather than using the synthetic folic acid? She’s not a huge lover of greens at this point in time!… By the way, just downloaded your Better than Paleo Cookbook and it looks fabulous! Will definitely start cooking from this. Thanks in advance for your reply.
    Kind regards,
    Lara
    (Australia)

    • Lara, is your daughter treated adequately? Why are you searching for a better way? Don’t worry about the hype of folic acid vs. methylfolate. Know that for some people, methylfolate has incredibly severe adverse effects. Some of us switch back to folic acid after suffering from methylfolate. If it ain’t broke don’t fix it.

      • Yes, she is definitely treated adequately. I just had no idea that there were different forms of folate available and was interested to learn more. Thanks for your reply.

      • I’ve never tried methylfolate but have never noticed problems with folic acid. I’m compound heterozygous for the MTHFR variant and am currently taking a B complex with both folic acid and cyanocobalamin. It seems to be working well so far.

  10. I am taking methyl Cpg. The folate is called methyltetrahydrofolic acid glucosamine salt. Does that mean there is sodium in it?

    • No sodium in that. FYI A salt by chemical names just means a metal combined. Like, Magnesum Sulfate is a salt but it also has no sodium. Magnesium and sodium are metals in the periodic table!

      • Hi I am not able to absorb folate foods . I tried taking sublingual b12 , b12 tablets but couldn’t absorb it either . Can metfolin work for me .Please let me know

        • Nitish, you keep saying you “can’t absorb.” How do you know that? Are you certain of that statement?

  11. If folic acid has been linked with cancer or cognitive decline and folate is obviously the better choice why is the government continuing to make mandatory the addition of folic acid to all flours in the US since 1998. Could this be related to increase of alzheimers as well.

    • Usually the government has some type of political reason, obviously. For example, the “science” behind putting fluoride in drinking water. That is simply a lie. Fluoride is VERY DAMAGING to humans in any quantity. Do some research. An industry had a need to get rid of its fluoride and “convinced” the government to dump it in drinking water. Don’t be so naive please.

    • Hey Chris! I have MTHFR and if you get your greens and veggies in, you should be good, but knowing which foods have folate is essential.

      MyKind has vitamins for men and women from real food sources and I’d recommend them. There are countless vitamin makers that use L5-Methylfolate and a lot of people to well with those. They are pretty inexpensive too!

  12. Hi, thanks for the article! I have a question about your ur suggested folate intake for women planning on gettiNg pregnant. Is that the same for a woman who is homozygous MTHFR t677t?

  13. I am compound heterozygous for MTHFR. I stopped synthetic folic acid 3 months ago and switched to methylfolate (400mcg/day). My MMA and homocysteine levels are good but my serum folate levels are still way above normal. Why haven’t they gone down at this point?

    • Agreed, you probably have a ton of unmetabolized folic acid causing the high reading. The medical fields are not yet caught up between the difference of folic acid and folate.

      I do believe that niacin helps (don’t use the non flushing kind because it is hard on the body. Take regular niacin on a full stomach to avoid the flushing).

    • Again, you haven’t defined what you mean by “causes of both.” How can anyone reply to an incomplete question?

  14. My question is how long does it take for the unmetabolized synthetic folic acid to leave the body? I was taking folic acid for a long time before I knew the dangers. I have recently eliminated fortified foods and switched to methyl folate in my prenatal vitamin. How long is a reasonable time to wait to conceive?

  15. This statement was made: “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.”

    The research referenced in the article does not speak to this specifically. Please provide the research that supports this claim so we can have confidence in what you are sharing.

    • Its called God’s creation and man can never mimic successfully the perfection of God’s design. Science will never fully capture what is natural.

    • Its called God’s creation and man can never mimic successfully the perfection of God’s design. Science will never be able to capture the essence of a natural substance.
      2nd time posting this my freedom of speech was censored the first go round.

      • First of all, your comment appears twice, so no censorship. Plus, freedom of speech is the right to articulate one’s opinions and ideas without fear of government retaliation or censorship. THE GOVERNMENT, not the administrator of a web site. Plus, to say that your freedom of speech was censored makes no sense. At all. What gets censored is the speech itself, not the freedom. Your freedom of speech may be suppressed but it doesn’t get censored.
        Oh, and BTW, god is a fairy tale and has no place in this discussion.

        • That God is a fairy tale if YOUR OPINION only. Can you prove your statement? Nor can he prove his. He can say what he likes. If you don’t like it, take yourself someplace else. Your criticism is crass and this is not the place for such things. So there.

        • Well guess what? You don’t determine what is and is not appropriate in a discussion. If you don’t believe in God well that’s your problem. If you don’t like it, that’s your problem. God can be brought into any discussion and is relevant to any discussion.

      • Agree with God’s design, but because of the American Dust Bowl phenomenon, we have lost much of our nutrient rich topsoil and with pesticides (like glyphosate) having further depleted plants and soil of their minerals. Thus, we do not obtain enough of these ‘nutrients’ from our food. So we must supplement. The trick is to find the right one…”folate” (a complex of B9 vitamins) cannot be written as an ingredient per FDA regulation but instead “folic acid” is allowd; thus most manufacturers are confused and use the cheaper folic acid as part of their Multivitamin or other formulation. Hope that helps.

        • And, folic acid is made by guess who? Big Pharma. They are making money from it, and the FDA directed the USDA to mandate the inclusion of folic acid in all wheat products, plus rice and a few other things. You cannot even buy a loaf of bread or any flour that doesn’t have folic acid in it!! So, we can, overall, thank the government for this. But, then, isn’t cancer a big money maker for Big Pharma and the medical industry? Think about that.

        • Yes. I ate all the fortified junk growing up because there were 8 and mom had to feed us. Had thee hardest time in school. Beet juice, spinach, orange juice no fortified food. Brought me out of that fog, PRENATAL vitamins made me hurl. With my son orange juice cravings to the hilt. Quite possible Spina Bifida and they thought he would have it but he closed up . I feed my children well try to avoid processed food but there are still signs and as nobody is perfect it sure helps to know we do not have that conversion for folic acid and maybe it won’t wreck us, not going to hyper kill it but boy you sure know the difference between walking dead and being awake. No matter, my children are geniuses, where they couldn’t cope, they found a way and excel against the odds. I only tested minimum for it and had low homocysteine levels because my thyroid was raised correctly. THen we lowered it and shit storm, I am sure homocysteine is high now. So we start the diet process all over again. I use gentle iron with the vit with mthf and I felt like wonder woman. The thyroid helped but it was ultimately that I could absorb the nutrients needed and the much needed iron . I should not say diet I should say eating right but eating wrong is so good to the taste bud but remember they add that to the food so we want it more. Naughty scientist. Naughty fast food. But it sure don’t taste good in the gut afterwards. OK I will shut up. My daughter lost two babies and I am sure it was a factor , while one of the Greatest Medical Universities said it was not. She now knows the difference. My body craved natural food that saved my son’s life. Listen close to those cravings, they are not wrong. The body tries to adapt, you just have to pay attention.

  16. 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.

  17. I have had extremely high blood levels of B12 and raised B6 since last December although I don’t supplement these.

    I’m in extreme, hardly bearable, pain with severe cognitive restrictions. Could it be I’m not absorbing B12 and so have the signs of deficiency?

    Should I supplement folate?

      • No. Not right off the bat. Kathryn should see a doctor for further testing.

        Too much B6 causes nerve damage.

        In some cases, too much B12 in the absence of supplementation can be a sign of certain cancers, liver, or kidney diseases.

        It is possible to have b12 deficiency symptoms with high serum levels, but I personally have not heard of this happening without supplementation.

        She should speak to a doctor to discuss these possibilities.

        • It all depends on the doctor. They all “interpret” the numbers differently. I believe current FDA guidelines state that if a patient shows symptoms of low B12, then the patient should be supplemented..

          The whole thing was this person was showing signs of B12 deficiency, but wanting to supplement with folate. Why? When I cut my finger, I don’t put a bandaid on my nose. That person did not tell us what the numbers were either. You’re assuming that they are super high, while I am assuming, not that high. I’m no professional, but I’ve been researching this for about 4 years now, and all I’ve heard and seen is that there is no harm at all in taking B12.

          • I’m not assuming anything.

            She said, “I have had extremely high blood levels of B12 and raised B6 since last December although I don’t supplement these.”

            It doesn’t matter what either of us imagines “extremely high” means. We don’t know. The bottom line is she should see a doctor.

            Is b12 deficiency a possibility, despite the imperfect blood tests? Maybe. Maybe it’s folate deficiency. Maybe it’s a disease process that causes b12 to become elevated (they do exist).

            My point is, see a doctor first before throwing yourself on the mercy of the internet.

            • I really don’t want to belabor the point, but unless she knows what the number was, we are assuming. Some doctors call numbers that are below the range high.

              As I said, I am no professional, but my doctor did not think much of b12 supplementation, even though I had absolutely classic signs and I was in so much pain I could barely walk. I supplemented and never went back to that doctor.

              I never said this person should not see any number of doctors. I was questioning why she would ask us, here on the internet, if she should suplement folate when she believes she might have symptoms of low b12, despite the bloodwork.

              • I think most informed people realize that doctors are NOT gods and the majority are completely ignorant concerning B12 deficiency. Search for the right doctor. Don’t just randomly go to any old doctor with this. And, personally, I believe we are pretty much left on our own and should educate ourselves and do what we think best individually.

    • check for an MTHFR gene mutation, impairing movement of b12 into the central nervous system, giving rises to falsely “reassuring” high levels of B12 (because brain levels are LOW). The MTHFR test is offered by spectracell labs at an excellent self pay price of forty dollars, or by numerous commercial labs that can attempt collection from your insurance company (but not all companies pay for genetic testing and the cost of the MTHFR test can run in the hundreds of dollars if denied). IF YOU test positive for the MTHFR mutation, you not only need to take folate in the methyl form, but also METHYL B12 (Jarrow, Solgar, etc)
      in order for B12 to be neurologically effective.

      • My last serum B12 test showed my level was >2000!!! My doctor (endo) said that neither high or low B12 are harmful. But, he had me tested because I was on Metformin (known to block B12 absorption) and was having tingling/burning in my feet. He said the Metformin couldn’t cause that but low B12 could. Go figure that!!!

  18. Hi Chris, I’m wondering what dose of folate I should be taking as we recently had a baby @ 21 weeks with a serious case of Spina bifida & brain damage. She was our fourth unsuccessful pregnancy (3 previous miscarriages)… it’s been a heartbreaking road and I’m only in the stages of trying to get my body and mind back into a heathy state before even considering to try again – I’m actually terrified of trying again. I’ve recently found out that I have the MTHFR mutation C677T but my homocysteine levels are normal. My naturopath has put me on a low mcg dose of folate 5MTHR but is it enough? Shouldn’t I be taking like a 5 millergram dose? Can you please help, I’m so confused.
    Thank you

  19. I recently became pregnant and was told by 2 midwives to make sure my prenatal vitamin contains FOLATE and not FOLIC ACID. Yours is one of the articles I found while researching the subject. When I went for my pregnancy confirmation appointment at my regular OBGYN she prescribed me prenatal vitamins. I requested that they contain FOLATE and not FOLIC ACID. I was told by her that I need to stay off the internet and listen to her and not Google. I’m shocked by the utter lack of education in the medical field, and my own doctors refusal to say anything other than that there is no difference between the two. Neeedless to say I forwarded her this article and have since found another OBGYN. Thank you for sharing your knowledge and keeping my little bean safe.

  20. Hi Chris – do you recommend that a woman (age 58) with a +/+ MTHFR Gene take a Multi-vitamin supplement with extra Folate and B12? If so, what types of Folate and B12? and if not, why?

    Thank you.

  21. Thank you for a straight forward explanation of folate versus folic acid. Does consuming folic acid in fortified foods block the body’s ability to process folate for people with the MTHFR mutation?

  22. Hi Chris, I am a 30 year old female looking to get pregnant in the next year in a half. My nutritionist has me on a diet and vitamin plan and I am supposed to avoid folate foods and supplements (I am an undermethylator with high levels of histamine and copper in my blood). What are alternative (if any)food/vitamin options to ensure my body is adequately prepared for pregnancy? Thanks!

  23. I’m taking methotrexate injections 17.5 mg 1/ week and doctor prescribed folic acid supplement, 1 mg 5 times per week. I would like to take 5-mthf 1 mg instead. Is this dose equivalent to the folic acid required? My doctor said it was my choice which one I chose.

    • I’ve read (don’t know the source, but try to find it), that 5-mthf is more, than folic acid, in other words, 1 mg of 5-mthf is like 5mg of folic acid.
      So, I think 400mcg of 5-mthf is enough for most people, pregnant woman can take 600-800 mcg, and maximum should be 1mg of 5-mthf daily.
      There is a risk of overmethylation, particulary, when you are taking also methyl-B12.
      I’ve heard, that 50mg of time-released niacin, can lower the risk of overmethylation, for people, that have problems with methyl-folate.
      Then, other option is to use natural folate, it is exctrated from food. It needs to be converted in body too, so people with gene mutation, will have problem also with this.

  24. Because my third child had spina bifida (in addition to multiple other birth defects which led to her death), doctors have told me to take 4,000 mcg of folic acid daily to prevent this from happening in my next pregnancy. It seems excessive, but her loss was devastating and we want to do whatever we can to try to help our next child be healthy (not pregnant yet). Now I don’t know what to do!! Any advice???

    • What about taking a comparable dose of methylfolate and/or folinic acid? I would also get genetic testing done.

    • My doctor recommended 4mg of l-methylfolate – currently 8 weeks pregnant. He mentioned that prenatal themselves do not have enough. I found 1mg on Amazon.

  25. Testing for folate- should we get our levels tested? Is it a blood serum or rbc test? Do we test for folate or folic acid?

    • I agree that one shouldn’t worry about it, but I would like to know if there really is any way to rid the body of excess folic acid floating in our bloodstreams or residing elsewhere in the body. I think that is very important. Thanks for the information if anyone here knows the answer.

  26. I was wondering why people with type 1 diabetes are told to take 5mg of Folic Acid per day in the run up to pregnancy? I understand Folate is the one to take not Folic Acid, however why the high dosage and is this amount safe?

  27. I wanted to add that Bill Walsh says, for reasons too complicated to explain in this space, that undermethylators who are also high in histamine, supplementation with a methylated folate can have some serious backlash symptoms, including depression. I know I experience the effects every time I try to take methylated folate supplements. See his youtube channel for more info.

  28. Hi,

    I saw a naturopath who recomended I take l-5-MTHF. I’m not sure if she had any genetic tests done on me. The stuff I take cost $27 a bottle which is a bit outside my price range. Would it be possible to get the same benefits from whole foods like leafy greens and whatnot and save the money I spend on the medicine?

    • Hello. Yes, you should be able to get adequate amounts from naturally occurring folate in foods, but you can also get methylfolate much cheaper than that. See, for example, Swanson, where you can get two bottles for $4.99

    • Sorry Sam, but you cannot eat good nutrition (no matter how hard you try) based on: 1. Top soil erosion. 2. Industrial farming. In order to perform at your net potential, you must SUPPLEMENT a diet with natural minerals and vitamins. Plants and animals provide vitamins. However, minerals come from the soil.

      “Dead Doctors Don’t Lie” by Dr. Wallach is worth the investment of time. Listen for free: https://www.youtube.com/watch?v=oAw17H9wlnA

        • The “critical look at Wallach” is so full of mistakes it’s embarrassing…

          One of many glaring examples discredits Dr. Wallach for his idea that certain nutrient deficiencies cause Cystic Fibrosis, and the “proof” is that a gene for cystic fibrosis was subsequently found. Of course there is a gene for CF…. there’s a gene for numerous diseases, but science has clearly proven that genes do not act alone and are expressed based on the environment (nutrient insufficiencies, toxins, stress, hidden food sensitivities, unbalanced microbiome, and so on).

          Scientists have known since the Human Genome Project that humans, for all our complexities, don’t have that many more genes than an earthworm. Why did it take years for this remarkable discovery to reach the public? Because the scientific community and mainstream media kept it under wraps to protect the massive profits generated by people believing we are victims of our genes, with only lip service to prevention and natural treatments.

          • Susan’s comments were helpful to me. It’s not conspirary theory to note that the medical industry is now blaming everything on genes. Before that, they were fixated on viruses, and before that, on bacteria, and before that, for all I know, on evil spirits and “humors”.

            A gene for every ill! Everybody, send your $100 to 23andme or ancestry.com and find out your fate!

            • It’s just not as simple as saying the medical community is blaming everything on genes. That sort of suspicious assumption is not productive. It gives room for quacks like Wallach to take advantage of sick and desperate people.

              • Other than selling vitamins – which a desperate person can get anywhere – I don’t see how Wallach is quackier than anybody else. Anyway, once you’ve been diagnosed as incurable, as far as I am concerned, anything goes. Try anything.

      • It is true that Wallach seems to be a slimy character. However, that does not undo his work on minerals. I have his book and I am glad that I read it. I just don’t buy his supps, that’s all!

      • Samuel,

        Though I still believe in eating right, I have no faith that the nutrients that are claimed to be in certain foods actually is. I have also noticed that when people say such and such food is an excellent source of a certain vitamin, it is still pretty low.

        • 20 years ago I read an article in a health magazine, “Solstice”, where a scientist decided to test various meats for their Vitamin B12 content. She found that her samples contained exactly none. As I understand it, Vitamin B12 is synthesized in the animal’s body in the presence of cobalt. No cobalt would = no B12.

          • I think that the cow needs to eat grasses — possibly because of the chlorphyll — to make B12. Instead they feed them corn — which is no longer so natural as it is — and who knows what else.

    • “folic acid is considerably more bioavailable than naturally occurring food folates at equivalent intake levels.”

  29. Hi Chris, Just reviewing the folate information for my pregnant daughter. You mentioned Solgar has folate vs folic acid, but when I reviewed their ingredients it lists folic acid as the source. Just thought I would mention it. Love. love your information and wisdom. Much gratitude!

    • Note that Solgar carries both folic acid AND folate. Separate bottles, separate products. Make sure you are getting the right one!

  30. Does anyone have any input as to whether or not this Folic Acid fortification of foods circumstance might be contributing to escalating Cancer rates in our Pets? After reading this article last week I went on the hunt for a Folic acid free Dog Kibble….and there are NONE out there. So, our Pets are being fed this in high amounts also. I was researching originally for myself, but my Pets are as important as me..LOL- maybe more so!

    • Try Nature’s Logic brand. It’s mostly made with whole foods and I’m pretty sure there’s no added folic acid. I order from chewy.com, its not cheap but I think it’s more affordable from that site.

      • Pure synergy whole food multivitamins have naturally occurring folate from organic wildcrafter ingredients, as well as vitamin c, d, e etc in a real absorbable form your body is used to getting!

      • If you spend the money on quality dog food vs purina, etc you will notice fewer/smaller poops and less or possibly no shedding.

    • Check out Acana pet foods, also. In the two versions I have, I only see zinc proteinate added as a supplement. Nice to see some pet foods moving this direction.

  31. My entire family has various combinations of the MTHFR. L- Methelfolate (deplin 15 or the generic) is what we take every 4 days and Eyefolate once a week. Depending on the combination of mutations you have the protocol could vary. We have seen drastic improvements. IF you have been tested and have this gene mutation throw your folic acid in the trash. Do NOT listen to the foilic acid is good and will cure you stories. Additionally if you are taking B-12 infections to NOT take Cyanocobalamin as it stores in our systems and is toxic for us. This is the most common cheapest b-12 shot. You should.be taking the b-12 shot made with Methylcobalamin once a month, a compounding pharmacy makes these for us. We are in a study being overseen by 11 physicians that have the mutation themselves. Changing our protocol changed our lives. You MUST get to a doc that will listen first. Any physician, patient, or chemist on this thread is welcome to contact Dr. Brian Buel 479-521-7774. He has the same combination I have and is treating our entire family in the study. Folic acid makes us sicker…been there, done that. I KNOW the protocol will change in another 5-10 years. Folate will emerge the victor!

  32. Does this mean the standard 400mcg of folic acid in most/all multivitamens even if from a whole food source is going to increase our risk for cancer???? I’m soo confused!!!! …

    What about consuming superfood sources HIGH in folate? Is this the same risk??

    thank you.

    • Hi! Great question. I believe he’s saying that folic acid (synthetic) is dangerous while folate (natural and found in greens) is safe and healthy. Hope this helps! 🙂

    • Elle, there is actually no such thing as folic acid from whole food sources. Some vitamins say they are whole food sourced but if it says it contains folic acid it is the synthetic version being added to it.

  33. what I would like to know: is [6S]-5-methyltetrahydrofolic acid another name for [6S]-5-methyltetrahydrofolate or is it folic acid misnamed? The front of my supplement bottle states “”methylfolate” but the back does not quite agree. I am a retired environmental analytical chemist but my schooling did not prepare me for this.

  34. Just wondering if you had any thoughts on quatrefolic? It seems to be the glucosamine salt of 6S-MTHF. The company claim that it is more bioavailable than 5-MTHF, but I’m not altogether sure how much research has been done into it. Might there be any issues with people with digestive problems taking the glucosamine off, or if you have a leaky gut do you tend to absorb the whole quatrefolic, glucosamine still attached? Or is the glucosamine bond really weak and will just unattach itself, no matter whether you are on PPIs, have no stomach acid and poor digestive enzymes? Just wondering. Anyone know?

  35. Jessica is WRONG. Adding a proton to folinic acid does not make folic acid! I am also a chemist who is compound heterozygous MTHFR, and a member of several Facebook groups concerning these mutations. I think she is looking at the situation with a classical chemistry thought process, which does not fit here. JMO.

    Folic acid should be avoided, as much as possible. The end product for the enzyme pathway is L-5MTHF, however, those with homozygous COMT snps may have to supplement with folinic acid due to methyl group sensitivity.

    HERE is the difference between folic acid/5-MTHF/folinic acid:

    http://lpi.oregonstate.edu/mic/vitamins/folate
    Thank you,
    Carol w

    • Carol, thanks for the link, it is very helpful. However, I think you misquoted Jessica. She didn’t refer to folinic acid in her post. She referred to the difference between folic acid and folate. Like her, I think the only difference between FOLIC acid and folate is the protonation state depending on pH. I welcome correction if I am misunderstanding something.

    • Hi Carol,

      I was wondering if you could help answer a question I posted up there. I saw a naturopath who recomended I take l-5-MTHF but I’m not sure if she had any genetic tests done on me. The stuff I take cost $27 a bottle which is a bit outside my price range. Would it be possible to get the same benefits from whole foods like leafy greens and whatnot and save the money I spend on the medicine?

    • Hi there Carol,
      Thanks for the link. I read through it but not being a chemist I couldnt glean the difference between Folic Acid/ Folinic Acid / Methyl folate. Would you be able to give me some info?

      I am MTHR c167 heterogenous. I also have several COMT homogenous polymorphisms. I recently started taking Methyfolate but it doesnt seem to agree with me – I have had palpitations and mild insomnia – though its very difficult to be sure its the methylfolate or its a reverse placebo effect, as I was aware of the potential side effects.

      It seems strange though as I have previously tolerated other methyl groups quite well. For example I was taking methylcolabim for a time before I could source hydroxycolabim, without any incident.

      Why could it be that only mehylfolate gives me problems?

      Would you then recommend Folinic Acid instead?
      What is the difference between the two?
      With regards to Folic Acid, I appreciate that I can’t metabolise it so well, but why is it actively bad for me?

      Thanks so much for your help.

      • You can get detox symptoms from adding in methylfolate. Start very, very slow, like a fraction of a pill or sprinkle of a capsule and work up very slowly. Otherwise you can easily over tax your systems. Detox is good but it’s not good for you if it’s making you ill.

  36. Chris,
    I want to thank you for this blog. I am a chemist. I have been pondering this issue for quite some time as the difference between folic acid and folate is only one proton. Folic acid is NOT the oxidized version of folate as you state; it is the protonated version. So it made no sense to me AT ALL that people were pushing folate over folic acid…. because when it hits your stomach at pH 1 or 2, all of it will be folic acid, and when it hits the small intestine at much higher pH, it will be mostly folate.

    After reading what you wrote, I realize finally that the important part is not whether you buy folate or folic acid…. but it is whether or not you get TETRAHYDRO-folate or TETRAHYDRO-folic acid. Both forms exist. The tetrahydro is the adding of four hydrogens to the structure – it is the reduced form. It is the reduced form whether or not the carboxylic acid is protonated (folic acid) or not (folate).

    I really wish all of the bloggers and people that write about this would emphasize the tetrahydro more. That’s what matters. Folate/folic acid ARE the same (it just depends on the pH of the solution they are immersed in). Folate and tetrahydrofolate are not and are not easily converted.

    • Jessica,

      You really confused me towards the end of your post. I thought I was tracking with you, but at the end it seemed like when you said that “Folate and tetrahydrofolate are not and are not easily converted,” well I took that to mean that those forms are not easily converted in the body – ie. they are not bio-available, they are not useful. Is that what you meant? Is 5-MTHF in fact that best to supplement with? Where the supplements suggested in the article are best bet as far as supplements are concerned?

    • Hi Jessica

      I would like to converse with you as you are a chemist. I am a student with the International Foundation of Nutrition and Health. It is the position of many of the researchers from the early days (late 1800s to mid 1900s) that synthetic vitamins ARE NOT COMPARABLE to vitamins found in whole foods, because the whole food is comprised of a complex of factors that support the “vitamin effect”. When this became evident from many researchers at the time, it became evident that in processing food in order to make it commercially viable, the consequence would be malnutrition of the population, leading to degenerative diseases occurring at younger and younger ages and the onset of genetic predispositions. In response, the industrialist said that they would fortify food. When the scientist said NO, nature doesn’t work that way, they scientist were silenced. Find out about Dr. Wiley, the first head of the FDA and what happened to him for starters. What we are seeing now, in my understanding, is finally, at long last, the truth is having a hard time being covered up because it keeps rising to the surface, like cream. If you want to read more about that, I highly recommend a book by Judith DeCava called The Truth about Vitamins and Antioxidants.

    • I agree with Jessica in that folate/folic acid is comparable and that the body will not note a difference with them. The key in this material is two-fold. First, it is a Methyl-Folate. The number 5 postion on the pteridine ring is methylated. That is a major factor that increases solubility/availability and eliminates one step the body MUST take in the liver to create the vitamin required for the methyl-transferase cycle. Second is more minor in the tetrahydro aspect. Full protenation of the molecule will is important, but not necessarily for ease of incorporation into the enzymatic pathways.

      Biochemist – 35 years in enzymology.

      • I did not do good on a huge dose from compounded MTHYL. However, MD Essentials 5 in 1, two a day was perfect. Also There is a Two a Day vitamin online through walmart with perfect D3 and MTHF. $19.99. My Dr. carries this line as well in office. Both of these in fact. So maybe to have small amount is ok. Large amount and I could not add. So you have to start small. Not everyone is def in the same amount. Maybe it’s just the blood test picking up whats circulating and not DNA, I DK. Maybe the University stands to lose money if people actually get well but they said the studies showed no improvement. Idk im not a scientist. Just a mom. True as I have Alpha One and my liver does not convert a whole hell of a lot of things. You give me a bowl of cereal and milk and I’m out like a light from the sugar and milk in grade school. No paying attention whatsoever. Still to this day. I now science wants to fortify the world, they will have to, look at the land and animals and all of the injections to mass produce animals that make the animal fat and sick and so it trickles down to us. IT is wrong. Cant everyone just fast and stay home on sundays. hmmmm….seems to me God knew what he was talking about.

    • Hi, Jessica. You obviously know much more about this than I do, but I’ve been researching and trying to understand all the different forms of folate and came across this article written by Emily Deans: http://evolutionarypsychiatry.blogspot.com/2011/08/folate-beginning.html

      Towards the beginning she says: “Let’s just start with a diagram, and an explanation for those of us who were taught some basic organic chemistry. Folate does not equal folic acid. I know. It’s weird. For all the other acids, -ate equals -ic acid (such as phytate and phytic acid), but for whatever reason, folate = dihydrofolate, and folic acid equals synthetic folate that is used to fortify foods in the US and in multivitamins.” I don’t know basic organic chemistry, but it seems she is speaking to your logical assumption that folate and folic acid are the same and saying this isn’t true. Now as far as why this isn’t true or in what ways they are different, I don’t know. I apologize if I’m just misunderstanding this and making it even more confusing. It is all quite over my head at this point.

  37. I’ve been reading about Folic Acid and Folate all day and still nto sure I know the right answer.

    My fiance’ had a child previously that has spina bifida but I do not know if he has any of the genes or the mother. We then had a perfectly healthy child (was much younger then and did not research anything, just listened to the doctors) we are wanting to try for another one now and am not sure what I should be taking. Any help?

  38. 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!

  39. 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.

  40. 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?

  41. 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.

    • 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.

      • Hello, I was searching about this defect and found your comment. I dont know if I have the defect or not, but I’ve been having serious difficulty getting pregnant, and when I do, I suffer miscarriages. I have stiff fingers and joint pain in my hands when I wake up in the mornings. Your comment about having your pain disappear, caught my eye. Could you share more about the pain and how you got rid of it, and other symptoms you had, and how it affected you? This connection could be huge for me.

        Thank you profusely.

        • Hi – Please know that I am not a health professional and I understand very little about the chemical process involved in all this. Although it took me ten years to get pregnant ( then had four children rapidly), I did not have any confirmed miscarriages. I started taking natural folate because I have had chronic major depression since childhood (as well as allergy-induced asthma). Once I saw I had this gene defect, I thought maybe I should try the natural folate to see if it helped. I don’t believe it affected my depression or allergies, but it took away the joint pain in my right hand knuckles almost immediately (like within a week or two)! And the joint pain has not returned. This was unexpected. I am taking “Source Naturals” MegaFolinic, 800 Mcg 120 Tablets. This cost about $9 on Amazon. The whole gene thing is really complex, though, and you may need the help of a specialist if you have serious conditions.

        • I should add that I had all my genetic profile done for $99 on the 23&me website several years ago. I highly recommend it as something really fun to do in addition to the possibility of finding out useful information like this! 🙂

          • I would LOVE to do the 23&me test that showed all that for $99 but did you know our government outlawed it here in the US supposedly because it would cause paranoia and a DR should be present to better interpret your results. Now we have to pay hundreds to find out the same info plus the Dr visit. My insurance doesn’t cover it. You are lucky you got this info before the law changed.

                • 23andME offers your raw data. It may be on a tab on the home screen. Find it and download it with Promethease Report online. I think it cost me five or ten dollars. Promethease with then send you a zip file that you download and unzip. Amazing stuff will be discovered.

                • Or, if you just want to know specific genetic results (such as MTHFR status), you can get that by looking directly at the raw data on 23andme.

            • CJ

              23andme is not outlawed. They are not allowed to interpret the raw data. you get all your genetic raw data and you have 3rd party interpret it for a small fee or donation. Genetic Genie, Livewello, are a few that can do this right online. Takes minutes.

              • Chuck is so right that the 23andMe test has not been outlawed. The FDA didn’t like the health reports that 23andMe issued, so people from the U.S ordering tests on or after 11/22/13 can’t see their health results. 23andMe is still issuing the reports for people outside the U.S. and for those that ordered before that cutoff date.

                In addition to the sites Chuck mentioned, there are a couple other worthwhile interpretation sites: 1) MTHFR Support Variant Report and 2) Promethease . Furthermore, for information on any SNP, you can find out what your alleles are by looking them up on the Browse Raw Data feature of your 23andMe test, which can be accessed at https://www.23andme.com/you/explorer/

                • Correct. Even for those of us who joined a long time ago and who got the health reports, we still had to go through the work of uploading the raw data into a third party site to really know whether we had the folate problem. It takes a little searching and work (and I might have paid $30 or something to a third party site to upload my genome. Hard to remember for sure).

            • They still run all of your info here in the U.S. Just had mine done. Then I went on genetic genie and got all my MTFHR info for a donation and promethease for 5.00 broke down all my genetic health info for me.

          • I will check the 23andme site. Here in Canada, the healthcare system in my Province of Alberta is not functioning well. Earlier this year, the media reported that the gov’t Alberta Health Services executives misspent $800,000 of taxpayers’ money on roaming charges! Also, many physicians seem ‘out to lunch’. I am middle-aged and have spent the last 10 years seeking treatment for chronic pain (my entire body hurts). Now I am waiting for a referral to a Neurologist. I want to get comprehensive testing, but it is not available here even if someone wants to pay for it! I am interested in whether I have a genetic problem. It seems that there is more opportunity in the US for people wanting comprehensive health testing.

            • I hope you have read kressers work and given up grains…try reading “healing back pain, the mind body connection ” by John E. Sarno.

            • I am a biologist from Poland that worked in Cnada for over 10 years. I contracted “fibromyalgia” noone could cure which is excruciating pain. I ame back to Poland out of fear of dying. Tan wen to UK for work and cure . So far no one can help me and I a feel sorry for anyone who suffers pain. I am a “supplement ” junkie and made mistake for taking foilic acid without consultation. It i understand is necessary to get genetic profile before applying any therapy. I am interested with anything that combats p a i n (from hell ) that I can bearly stand. Could folate defficiency be the cause ???. Please, help if you know something. I would appreciate any feedback. Respectfully, Sylvia

              • Hi Sylvia,

                First, have you had your diagnosis checked and double checked? Second, have they checked for poisons, such as arsenic?

                Last, my first go to supplement is B12. I had many things starting to go wrong with me from the top of my head to the tips of my toes until I started taking B12. My feet and legs hurt so much that I could barely walk. Two weeks after I started with B12, I could walk with no problem! So, I would start with 20,000 micrograms of sublingual methylcobalamin. After that, I would EAT folate, meaning any food I could that is known to naturally have folate in it. This whole thread is confusing to me, but the one thing that I think I got from it is that people do not seem to have a problem with folate in (organic) foods.

                I take a number of vitamins and herbs. I am not 100% yet, but I am getting close. My biggest problem now is VERY HIGH blood pressure.

                The vitamins and herbs, besides B12, that have helped me feel better the most are Magnesium, D3, Iron, B2, and Turmeric.

                Some people like bee product therapy. Some people like supervised, medical fasting. Personally, I would check it out thoroughly if I were told to go on a low fat diet, because I think fats are very important, especially where nerves are concerned.

                Unfortunately, fibromyalgia is another disease that the medical community knows very little about, so you will have to educate yourself. Good luck.

              • Hey Sylvia:
                Just read your post on fibromyalgia. True fibromyalgia according to Dr William Wong who started World Nutrition long ago is essentially excess fibrin in the body essentially choking off the nerve endings. Much more common in Female then male since it is estrogen dependent if I recall correctly. I have seen men and women with true fibro eliminate their condition with a round of systmeic enzymes called Vitalzyme XE (the professional grade). They are nothing more then systemic enzymes which levels we produce fall as we age. Yours in health,
                David

                • David S.,

                  You know, I saw some female (I think doctor) on a religious show well over 10 years ago now. At the time, I only half paid attention to her because she seemed a little flaky, but now I wish I had gotten her name and the title of the book she wrote because she was right about quite a few things, one of them being that, for various reasons, we all have too much estrogen in our systems, and it is starting to cause problems. Considering what you just said, and a few other observances over the years, she might be onto something. If so, have you heard of any way to lower, or at least not increase our estrogen?

                • Chris K: To be honest, other than staying far from any and all soy products which is added to so many packaged foods to increase the protein content. We do not even feed any soy to our farm animals, nor do we feed any gmo seed/foods. We grow most of what we consume. It is difficult at best to avoid the hormone disrupters everywhere around us. From plastics to grocery receipts and beyond, they are everywhere. So I guess the long answer, is not that I am aware of…. Sorry, but it seems like Chinese herbal remedies might be a place to begin looking, perhaps something that binds with estrogen ?
                  Sorry, I could not be of more help.
                  Yours in health,
                  David
                  PS I should be getting my labs back soon for hypercoagulation disorder and will be requesting your opinon very soon. I will do some looking in the mean time and see if I can come up with some better possible suggestions.

        • Meme
          Check out a facebook group called “Lovenox Ladies++Clotting Disorders++TTC” you will find a wealth of information and awesome support here. I have also had miscarriages and belong to that facebook group.

    • 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.

  42. 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.

  43. 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.

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

  44. INTERESTING, I just read some of the comments.
    Whether one needs Folate or Multi-vitamin,.. or not – some of the main issues are:
    *** NO ONE NEED TO TAKE ANY SUPPLEMENT IF THEIR DIET IS BALNCED AND CONSTANTLY CORRECTED.
    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.

    • I’m afraid you are misunderstanding. If a person has the MTHFR 1298C &/or 677T genes…you can not absorb what you need from a balanced diet…..no matter how balanced your diet is. This is my case. So a blanket statement like yours can be dangerous to the lives of many persons. I agree a balanced proper diet is what everyone needs but that alone will not help people like me.

  45. 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?

    • 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.

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

    Kristy

  47. 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).

    • 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.

      • 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.

        • 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.

          • 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.

            • 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.”

              • 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.

                • Ruthie

                  I would say do not take it if it comes in the form of Folic Acid. Go on Mthfr.net
                  Lots of good info here.
                  Check out this link http://mthfr.net/mthfr-c677t-mutation-basic-protocol/2012/02/24/
                  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 Mthfr.net website there are others like mthfrsupport.weebly.com
                  Regards
                  Chuck

              • 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.

                • 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. http://dx.doi.org/10.1016/j.gene.2013.09.063

                  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.

                • David,
                  I so enjoyed reading the Chuck/David exchanged…For many reasons, but namely that (presumed) strangers were able to have a conversation that was not overly abbreviated and, despite disagreement and misunderstanding, did not result in personal attacks.

                  May I inquire as to your thoughts on genetic testing becoming a standard part of preventive care? Specific to MTHFR and the ethical and legal implications for the standardization of more comprehensive genetic testing as well.

                  I recently came to the realization that I am Heterozygous for MTHFR 677. My mother continually sends me links to nutritional research and questions how it may be effecting our family, much of which I disregard out of necessity, but I happened to follow up on MTHFR and look into my old 23 and Me raw data (thank you FDA for not completely shutting them down). It took a bit of searching to decode the data, but Sure enough (despite my mothers suspicion that I have a 1298 mutation, which I don’t) I do have 677 AG. Good to know, this definitely has immediate health implications for me…And now I can nag my father (whom my mother is no longer able to nag, as they were divorced years ago) to STOP taking the large amounts of Folic Acid he is currently on, switch to 5-MethylTetraHydraFolate or better yet, re-evaluate the need for supplemental Folate with genetic and possibly Spectracell testing.

                  ANYWHO…You see that I have little ability to abbreviate myself, hence my appreciation of your complete information.

                  RE MTHFR. As stated, I am pleased to have this personal info, but given the large number of us who have some degree of issue with methylation, I am extremely curious about whether it is becoming standard practice to advise Pregnant patients against taking Folic Acid supplements unless they are known to NOT have this issue.

                  Certainly, the concern over Neural tube defects is warranted, but I have a loved one who had stage 3 breast cancer diagnosed at 18 weeks pregnancy. Who knows how long the cells were present, but the growth was very sudden and profound. Previously I would have thought that it may be pregnancy related growth hormones that increased the incidence of, or at least growth of the cancer. However, I now question the possibility of whether un-metabolized Folic Acid (and the supposed decreased ability of those of us with 677 to rid ourselves of environmental toxins) that may increase the incidence of certain cancers. (FYI she has responded well to chemo, was able to carry to close to term, has a healthy baby boy and we are hopeful about the future)

                  Of course, looking into my genetic code also got me thinking about whether there are other genetic links with nutritional triggers to things like PROM or amino acid chains…….. The darned noggin NEVER stops, there is a domino effect.

                  I woke up at 4 am thinking about MTHFR and the implications for pregnant patients.

                  Another thought has to do with the process by which these tests become more widely available to the general public. Must we only come to discover individual traits and nutritional needs after suffering the consequences?

                  Your point regarding sound nutrition being the best option is well taken. However, for many of us, it is knowing the WHY of the magic pills not being a good option that gives us incentive to make better choices.

                  I just wonder if there is any way to expedite what has been the painfully slow process of moving from sound research, to making the information from said research available to patients and practitioners.

                  Thank you for your patience with my sleepy eyed brainstorming.

                  Peace,
                  Stephanie

                • This is a reply to Stephanie’s comments, which are below as I am seeing the board. I don’t see an option to reply directly to her comment, so I’m replying here. Regarding your question, yes, I see genetic testing as eventually being a standard part of preventative medicine. That is the general logic of personalized medicine. However, as I see it, there are currently at least two obvious problems with the practice. One is that we know too little about how various SNPs interact. When you do genetic testing you typically get results based on individual SNPS, and many times you will see opposite facts (e.g., you have a higher and lower risk for the same problem). Thus, we often don’t really know what to do based on those individual and sometimes conflicting results. Second, the effect sizes for various SNPS are often very small, and much smaller than for environmental factors. People then make a big deal out of the findings associated with the SNPs but don’t pay enough attention to environmental factors. Those are my thoughts, at least.
                  Kind regards
                  David

                • Hi David,

                  I know this is a year old post, but I was hoping you could help me understand something about MTHFR. Why is being homozygous for 677t a problem at all then? If we remove synthetic folic acid from our diet and eat adequate amounts of natural folate, shouldn’t we be able to methylate as well as everyone else? I believe your description of the issue is spot on btw. I just would like to know if this is a manufactured issue on many levels. However, I would be the first to admit that I have been helped methylated B’s. Please include any links to articles and studies that illuminate the issue further. Here is a good one I found. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3708334/
                  Thanks!

  48. 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.

    • 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?

      • James,
        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.

  49. 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.

      • 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.

  50. 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

    • 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.

  51. 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!

    • 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!

    • 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 – http://www.emed.com.au/anxiety-and-the-mthfr-gene/ also http://www.emed.com.au/folic-acid-or-folinic-acid-which-is-best/. Hope this helps you. This is all related so found this article really helpful for me.

    • 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 🙁

  52. 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.

    • 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.

      ————————

      http://articles.mercola.com/sites/articles/archive/2008/01/02/truth-about-eating-grains.aspx

      http://www.rodalenews.com/nutrient-deficiency

      http://www.ctds.info/fiberfoods.html

  53. 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?

  54. 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?

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

  55. 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

    http://1.usa.gov/1wlovWv

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

  56. 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.

  57. 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.

    • 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.

  58. 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.

    • 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.

    • 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.

      • 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!

      • 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.

  59. 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.

  60. 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.
    http://www.iherb.com/New-Chapter-Perfect-Prenatal-Multivitamin-270-Tablets/23615

  61. 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?

    • 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!

  62. 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.

    • 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.

      • 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!

    • I have MTHFR and you can take wright supplements , you have website MTHFR.net 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.

      • 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.

          • 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.

  63. 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#

    • 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 iherb.com. They have a link to Eclectics website. Copy and paste the below link

      http://www.iherb.com/Eclectic-Institute-Vita-Natal-Multi-Vitamin-Mineral-Formula-180-Tablets/15335

      • Rocksmith, I checked the vitamin you suggested and it contains Folic Acid.
        It also has a lot of Vitamin A as palmitate which I read can cause birth defects in high doses.
        I am trying to avoid Palmitate for pregnancy and Folic Acid for a MTHFR condition.
        I also have Hashimoto and it is not clear if I can take iodine.
        Also trying to avoid iron as much as possible as it can accumulate and I think that 18mg every day is already too much if one eats meats.
        Starting to be difficult to find prenatals that meet all the criteria, I haven’t found a single one yet!
        If anyone has any suggestion, I will appreciate it!

    • 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!

    • Of course I think it stands to reason that if your body is smaller than average it makes sense to take less of any supplement than what is recommended for the average consumer.

  64. 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.

    • 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 mthfr.net It really helps break down how and why there can be issues and what to work in at each point.

  65. 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.

  66. 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?

    • 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.

      • 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!

    • 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. http://mthfr.net/methylfolate-side-effects/2012/03/01/

      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 MTHFR.net 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.

      • 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.

        • 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 – http://jarrow.com/product/75/Methyl_B-12.

          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.
          http://www.sourcenaturals.com/products/GP1327/
          http://www.sourcenaturals.com/library/download/101456/

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

          • 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.

          • Michael,

            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.

            • 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.

              • 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.

        • 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 Formulas.com 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?

      • 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

        • 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!

        • 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!

          • 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.

      • 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!!!!!

    • 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.

      • Cathy,

        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 mthfr.net 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.

  67. 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?

    • 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 http://mthfr.net/methylfolate-side-effects/2012/03/01/. 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 http://www.naturopath4you.com/ 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 https://www.youtube.com/watch?v=1_E3iMrq-UA
      Many blessings!

      • 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: http://michaelmooney.net/FolateReducesCancerWillet.html
        Then, here are some more –
        http://www.medscape.com/viewarticle/778149?nlid=27526_1049&src=nldne
        http://michaelmooney.net/FolicAcidDoesNotCauseCancer.pdf
        http://michaelmooney.net/FolicAcidCancer.html

        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!

        • 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?

        • 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.

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

        • 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…https://www.youtube.com/watch?v=DCr614a6zPg — 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!

            • 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..

          • 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!

      • 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:

        http://www.neurology.org/content/35/10/1466.short

        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:

        http://www.medhelp.org/posts/Nutrition/B6-Toxicity/show/2642?page=1

    • 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?
      Anyone?
      Thanks!

    • 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?

  68. 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…

    • 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,
      Michael

      • Michael,

        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.

      • 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.

        • 1,000 times this!!!

          I stopped taking medicine that helped me to breastfeed because I thought it was giving me HORRIBLE anxiety and mood swings – never second guessed the methylated B vitamins that my endo “prescribed”

          I don’t subscribe to taking synthetic vitamins either – but you need to know that just because you have MTHFR does NOT mean that you are an undermethylator!!

        • Yes! I wish there was more out there to rebut the misinformation Lynch and others like him put out there about folic acid and perhaps other things as well. It’s hard to find anything countering it unless you’re specifically searching for it. When I realized I had a folate deficiency, I was afraid to try a folic acid supplement because I have the compound heterozygous MTHFR SNPs and had read all about how bad folic acid was. Funny thing is, I’d used products with folic acid in them for years with no issues. I’ve had trouble figuring out how much to supplement and if I actually need all the B vitamins, but to this day I feel I’ve suffered ZERO issues from folic acid itself. Also, I’ve had no issues with cyanocobalamin. I know there are some that do better on methylated forms, but this is definitely not true for everyone. I’ve personally never tried them, but since folic acid works, is more readily available, and is less expensive, I think I’ll stick to it unless my circumstances change.

    • 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 iherb.com or use this link http://tinyurl.com/loymozo

    • 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.

      • 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.

          • 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

        • 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

          • 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.”

    • 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.

  69. 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

  70. 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?

    • 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.

  71. 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.

    • 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?

  72. 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.

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

  74. Good morning Chris!!

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

    Jennie

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

    • 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.

  75. 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…

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

    • 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.

      • 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 (http://www.naturopath4you.com/), 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!

        • 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:
          rritability
          insomnia
          sore muscles
          achy joints
          severe anxiety
          palpitations
          nausea
          headaches
          migraines

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

      • 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 🙂

      • 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 – http://www.naturopath4you.com/

  77. 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?!

    • 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!☺☺

      • 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.

        • 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

          • 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.

    • I’ve tried the premama prenatal vitamin drink and really liked it – http://www.drinkpremama.com/

      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.

  78. 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?

  79. 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!!!

  80. 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.

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

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

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

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

    No more L-5-MTHF for us.

    Methylfolate Side Effects:

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

  82. 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. 🙁

    • Honora,
      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 http://www.hdri-usa.com/tests/methylation/. 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.

    • 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!

      • 23andMe.com 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.

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

      • Kathyrn,

        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.

        • “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.)
          http://www.ncbi.nlm.nih.gov/pubmed/9853543

          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.)
          http://ajcn.nutrition.org/content/71/6/1448.long

          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.

  83. 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!!

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

      • 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.

  84. Hi Chris,

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

    Thank you. 🙂

    • 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.

  85. 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%

    • Michwag,

      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.

  86. 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.

  87. 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.

      • 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?

    • 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.

  88. 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.

  89. 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!

  90. 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?

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

  92. 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???

  93. 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.

    • 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.

  94. 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.

    • 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.

      • 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.

    • 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.

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

    • Jen,

      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.

  96. 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?

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

  97. 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

    • 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.

      • 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.

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

    Anyway.

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

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

    • 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)

      • 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.

  99. 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.

  100. 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.

  101. 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.

    • 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.

  102. 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.

  103. 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.

  104. 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.

    • 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

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

    • Michael,

      I might have missed it, but I don’t think that it shows the numbers for the placebo group. It just basically said under findings that the folic acid group was better than the placebo group. If they did not provide placebo numbers, I am suspicious.

    • Hi there Chris great article.

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

      All the best
      Jennifer

  106. 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.

    • 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.

  107. 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?

  108. 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?

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

    • 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????

    • 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*.

      • 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.

        • 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.

    • Girlfromeurope,

      Have you had your endocrine glands tested? If one of them is off, the potassium may be doing you harm, or one of them could be responsible for its ups and downs in your system.

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

  110. H Chris,

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

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

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

    Is this okay for her?

    Thanks!

  111. 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!

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

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

  113. 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.

  114. 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?

  115. 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.

  116. 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

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

    • @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!

  117. 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.

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

  119. Hello,

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

  120. 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…

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

  122. 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.

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

    Thanks,
    Fiona

  124. 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

      • 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.

  125. 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!!

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

    • 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.

      • 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.

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

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

    • 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….

  128. 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…..

  129. 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?

  130. 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?

  131. 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.

  132. 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.

  133. 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.

  134. 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?

    • 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.

  135. 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

    • 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.

      • 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.

  136. 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.

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

    Folate (as folic acid)….. 200mcg

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

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

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

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

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

        • 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.

  138. 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.

  139. 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.

  140. 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 ?

  141. 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.

  142. Hi Veronica,

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

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

    Kelly

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

  143. 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.

  144. 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?

  145. 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’

    • 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!

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

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

  148. 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?

  149. 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

  150. 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!

    • 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.

  151. 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.

  152. 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”.

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

  154. 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.

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

  156. 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!

  157. 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

  158. 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!

  159. 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?

  160. 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?

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

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

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

  162. 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.

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

    Thanks!

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

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

      • Hi Chris,

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

        Thanks.

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

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

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

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

  165. Hi Everyone,

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

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

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

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

    Thanks

    Mark

  166. 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)

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

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

    Ned

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

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

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

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

        Who’s right ?

    • 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.

      • 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.

  168. 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.

    • 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.

      • 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

        ??

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

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

  170. Hi Chris,

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

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

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

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

    Good sites for more information:

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

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

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

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

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

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

  171. Chris,

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

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

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

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

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

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

    • Dan,

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

      • 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.

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

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

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

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

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

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

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

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

      • 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

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

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

  173. Chris,

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

  174. 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.

      • 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.

      • 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.

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

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

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

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

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

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

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

      • Hi Kim,

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

        Thanks in advance,

        Dan

        • 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.

  175. 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!

  176. 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?

  177. 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?

  178. 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!

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

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

      • I 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.

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

  181. 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).

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

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

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

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

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

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

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

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

                • 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.

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

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

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

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

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

          Mark

          • 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.

      • 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.

      • 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.

        • 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.

      • 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#

      • 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

        • 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.

      • 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.

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

      • 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?

    • 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?

      • 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.

      • 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.

    • 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

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